The New Business of Independent Medical Practice

Managing a medical practice is becoming more challenging every year. Not only must you have good business sense and leadership skills but also have the time to see patients. Doctors are increasingly bogged down with administration and lower reimbursements so it’s even more important to keep an eye on new technology, billing, marketing and practice management.

Keeping your financials in good order is essential to a healthy business. Knowing how many appointments you need every week to keep things running smoothly and having the discipline to keep accurate records can help you determine what is needed to sustain profitability. The technical challenges in the years to come are immense with Electronic Medical Records, ANSI 5010, and ICD10. These are quickly becoming a major priority.

The first part of this series will discuss Technology and Medical Billing in the ambulatory setting.


The transformation of a medical practice has rapidly evolved because of system design knowledge as well as innovations in information technology (IT). These efforts are advancing health care quality with electronic integration, connectivity, and advancements in devices that help physicians deliver high standards.

This transformation requires an e-connectivity infrastructure that integrates seamlessly with an adequate Practice Management system and an EMR (Electronic Medical Record). These systems allow for adequate follow-up and methods to track patients so that they are not lost in the shuffle. The large amount of data in these systems necessitates an IT infrastructure that provides quick access to patient-specific information. The products are hosted on a network that includes an operating system, high speed Internet access, voice recognition software, secure remote access and backup systems. They will normally include anti-spam/antiviral software, word processing, spreadsheet, and accounting software. Complete systems normally contain the following components:

•Practice Management System

•Customized encounter forms

•Disease registries

•Secure messaging (encrypted email) and connectivity

•Secure Internet portal

•Practice decision support

•Diagnostic technology


Network faxing

•Interfaces with laboratories, hospital systems and radiology

Medical Billing

To deliver quality medical billing services, a practice or billing service should be equipped with state-of-the-art technology, modern devices and experienced staff. This includes software that is easy to learn and operate.

For smooth and profitable functioning, a medical practice must keep their revenue cycle steady. Timely submission of medical bills and claims is important but having a motivated and competent staff is the key. Medical billing services offer practices many advantages and are fast becoming a trusted resource for providers.

The advantages include:

•Reduction of administrative workload

•Savings in employee salaries and benefits

•Infrastructure costs are less

It is even more important to get paid for your claims now that there are Medicare payment cuts. The government has called for a decrease in reimbursements that are sure to affect a great many practices. When reimbursement is reduced and expenses increased, many physicians try to see more patients to make up for the shortfall. To accomplish that, some target based marketing will help increase traffic in the office. Using techniques like optimizing your website for better visibility is a great way to start.

The Medical Group Management Association released a Cost survey for Multispecialty Practices in 2011. Here are some interesting numbers that reflect medical office employee turnover:

Receptionist and medical records staff: 25%

Nursing and clinical support staff: 20.22%

Billing/Collections and data entry: 11.77%

E/M documentation will hit a new level of frustration in the coming years so it is eminent to prepare for this new wave of guidelines. This means that more training might be needed for all billers and coders.

Decreased revenues are putting pressure on all physicians to capture lost charges that previously would have been under-coded. To have a firm grasp on the fundamentals of E/M coding it is essential to compare your coding patterns to national benchmarks. This would keep you out of the audit category and insure that the coding accurately.