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Clinical Practice Management & You. Have You Been Asking Yourself … Do I know my collection results month to month? Have we been reimbursed properly?

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Presentation on theme: "Clinical Practice Management & You. Have You Been Asking Yourself … Do I know my collection results month to month? Have we been reimbursed properly?"— Presentation transcript:

1 Clinical Practice Management & You

2 Have You Been Asking Yourself … Do I know my collection results month to month? Have we been reimbursed properly? Is our office current on coding changes, rules, laws, mandates, trends? Our office is getting bombarded with denials, why? Should we upgrade our software and what about administration? I find Im unable to focus on patient care trying to keep up with all of the above!

3 Allow us to Introduce Ourselves… If You Have Been Asking Yourself Those Questions… C P M

4 Reimbursement & Recovery Specialists in Revenue Cycle Management Revenue Cycle Management Specialists Medical Billing | Collections | Compliance | Training | Added Value Services | Reports | Newsletter Clinical Practice Management (CPM) offers a comprehensive suite of services to the health care industry including electronic and paper medical billing, collections, compliance, reporting, information, and training. CPMs story begins in 1998 when a group of Physical Therapists had the vision to provide what they, themselves, were looking for in a Revenue Cycle Management company...billing accuracy, optimum reimbursements, maximized collections, training and compliance in their field. CPM has realized that vision and today is a successful Revenue Cycle Management Company dedicated to providing well informed, exceptional services, to which our satisfied clients will attest. Clinical Practice Management will team with your practice in managing all aspects of your Revenue Cycleas well as keeping your practice compliant and informed. We also offer Added Value Services, the most popular being CPMs Medicare Provider Enrollment support which, to date, boasts a 100% success rate. Our customary and added value services both ultimately work toward the success of your practice which allows you to provide higher quality healthcare services.

5 CPM – Your Solution to Healthcare in the 21 st Century We understand how the many new electronic and other requirements and mandates may have you feeling overwhelmed. Let us tell you why CPM should be your outsource Revenue Cycle Management solution. Audit and Review Clinic Charges Submit All eClaims and Paper Billing Electronic and Manual Payment Posting and Audit Set Up ERA and EFT Patient Statements & Collections Comprehensive Collection Process Economies of Scale Staffing Contingencies

6 Who are We? John O'Connor, PT, CSCS - Owner John graduated from The University of Pennsylvania's Physical Therapy program in 1980 after completing his undergraduate degree at Villanova University. He started Palos Verdes Physical Therapy in 1985 and has been a successful owner treating orthopedic clients for over 27 years. As a Certified Strength and Conditioning Specialist and a member of the NSCA, he has a strong interest in sports and performance enhancement for youth, high school, college, and weekend athletes. He is a member of the American Physical Therapy Association (Orthopedic, Sports, & Private Practice Sections). In order to keep up on the latest advances in Physical Therapy he continually attends lectures and stays current with the latest journals and research. Joseph Donohue, PT - Owner Joe is the owner/managing partner of Clinical Practice Management, Inc. (CPM), which performs management, consulting and billing services for private practices throughout California and Texas. He also founded ProSport Physical Therapy in Newport Beach, CA and opened a second office in Rancho Santa Margarita. Joe also has strong ties in the athletic community. He provides athletic training and physical therapy services for local high schools and also serves as the team Physical Therapist for two professional teams: the Anaheim Storm Indoor Lacrosse team and the NHL's Anaheim Ducks. In the fall of 2003, and summer of 2004, Joe served as the Medical Director/Coordinator of the World Gymnastics Championships and USA Olympic Gymnastics Trials held at the Arrowhead Pond of Anaheim. Kimberly Gordon, Operations Manager Kimberly graduated from California UniversityLong Beach in She joined CPM in 2005 as an Accounting Manager. Kimberly became the CPM Operations Manager in Kimberly came to CPM with a strong Accounting background having worked in this field for 17+ years. Kimberly enjoys playing soccer in her spare time and is part of a successful womens league that has gone on to earn statewide recognition.

7 "I have been a client of CPM for 7 years and have never regretted that decision. Throughout the years CPM has been a reliable partner that always went the extra mile to ensure the best possible results. CPM continues to work with me as my business grows and offers services that keep my business up to date with changes in the healthcare environment. I would highly recommend CPM to any physical therapist either starting a new business or considering changing their business needs so that they are better prepared for the future. -Matt, P.T. Practice Owner, CA "I have been a client of CPM for 7 years and have never regretted that decision. Throughout the years CPM has been a reliable partner that always went the extra mile to ensure the best possible results. CPM continues to work with me as my business grows and offers services that keep my business up to date with changes in the healthcare environment. I would highly recommend CPM to any physical therapist either starting a new business or considering changing their business needs so that they are better prepared for the future. -Matt, P.T. Practice Owner, CA What Our Clients Say…

8 Clinical Practice Management has been an invaluable resource for my business since the day I opened my doors 4 years ago. CPM has assisted me not only in my billing, but in everything from obtaining Medicare provider numbers for my therapists to keeping up with daily changes in insurance reimbursement and government healthcare issues. The have been my "go to" resource that allows me to see a full patient load while still feeling in control of what was happening with billing and reimbursement. A lot of billing companies promise to fight for maximum reimbursement and to be easy to contact with any questions, but CPM has proven it to me allowing me to grow my business. -Nino PT, DPTPractice Owner, TX Clinical Practice Management has been an invaluable resource for my business since the day I opened my doors 4 years ago. CPM has assisted me not only in my billing, but in everything from obtaining Medicare provider numbers for my therapists to keeping up with daily changes in insurance reimbursement and government healthcare issues. The have been my "go to" resource that allows me to see a full patient load while still feeling in control of what was happening with billing and reimbursement. A lot of billing companies promise to fight for maximum reimbursement and to be easy to contact with any questions, but CPM has proven it to me allowing me to grow my business. -Nino PT, DPTPractice Owner, TX What Our Clients Say…

9 I have been a partner with CPM since before I ventured into private practice 5 years ago. They were integral in helping me get off on the right track. Lots of things have changed in that time but they have helped me through every step. As a practitioner and business man it is impossible to keep up with all the changes. CPM keeps me on track and up to date with requirements of billing, reimbursement, insurance and Medicare. Bryan PT, Practice owner CA I have been a partner with CPM since before I ventured into private practice 5 years ago. They were integral in helping me get off on the right track. Lots of things have changed in that time but they have helped me through every step. As a practitioner and business man it is impossible to keep up with all the changes. CPM keeps me on track and up to date with requirements of billing, reimbursement, insurance and Medicare. Bryan PT, Practice owner CA

10 What Sets CPM Apart… Provider Training Integrated Software Program CPM website Client Portal Online Client Handbook Research & Information - Newsletter - Flash Traffics

11 Teleconference or On-site Online Client Handbook Online Training Tools Ongoing Client Education Provider Training Comprehensive New Client Training Program

12 Which Includes Scheduling Module Electronic Medical Record (EMR) Detailed Patient Demographics & Ledgers Clinics have 24/7 access to their information CPM is responsible for Maintaining your database on our server Data Back-up All Electronic Submission Requirements and Clearing Houses All Software and Hardware requirements and updates And much, much more… CPM Utilizes an Integrated Software Program

13 Client Portal Access to your clinic specific CPM website Client portal - 24/7 access - Monthly Reports Access - Customized Clinic Charge Ticket forms - Monthly Newsletter - Client Handbook - Reference Library - Training Tools - Industry Links - Fee Schedules

14 Monthly Online Newsletter – CPM Provider Newsletter Digest © CPMs Research Team keeps abreast of legislation, mandates, rules, and other matters that affect health care. We usually give our clients a heads-up months in advance of implementation dates so they wont be caught unaware of significant changes. This information is compiled into our online Monthly Newsletter.

15 Flash Traffics! When a hot button issue comes to Clinical Practice Managements attention, we immediately inform our clients. Our Research Team monitors and subscribes to various government and payer websites so as to give our clients up-to-date information. We also gauge what impact, if any, the information will have on our clients clinic. ____________________ EXTRA! FLASH TRAFFIC! CPM PROVIDER NEWS DIGEST !

16 CPMs Points of Focus Goal Orientation Teamwork Ongoing Staff Training Total Quality Management Continuous Improvement Team Approach These points of focus and values serve as our road map to maximizing reimbursement for your healthcare business.

17 Goal Orientation – Benefits to your Practice We start by setting performance goals for your healthcare business. Next we break these goals down into specific individual team actions that will result in the achievement of these goals. Incorporating our services into your healthcare business allows you to immediately gain years of business administration experience and expertise. CPM will also provide your healthcare business with valuable operational procedures that result in strong improvements to your bottom line. Ultimately, your practice can see more patients and provide better care.

18 Teamwork! CPM works with your healthcare business to establish a successful working partnership Your healthcare business will have a CPM primary point of contact in keeping with our relationship based approach to reimbursement Working well together as a team will maximize reimbursement by reducing errors or repeating tasks CPM and Client responsibilities are delineated clearly in the Client Handbook to ensure efficiency and quality

19 Ongoing Staff Training CPM focuses on continual improvement through: Research Keeping abreast of current rules, laws & regulations Education through regular in-house training sessions Keeping current with technology by upgrading software applications CPM takes a Proactive Approach on Upcoming Industry Standards such as the ICD-10 and Implementation of Healthcare Reform

20 Total Quality Management Speed & Accuracy! CPMs focus is on first time accuracy in all areas of reimbursement to increase cost effectiveness CPM reviews outgoing claims for Medicare (CMS) Local Coverage Determination (LCD) compliance as well as correct usage of any current therapy cap modifiers Patient statements are sent out every 30 days Electronic billing and other advanced billing methods are used extensively to promote timely and complete payment

21 Speed and Accuracy! Maximize reimbursement through: Claims sent out several times each week Line item posting Contractual adjustment accuracy Policy and contract knowledge Timely filing of secondary insurance claims Timely open balance follow-up with insurance companies and patients

22 Continuous Improvement -- Education & Communication Tools CPM offers various communication and educational tools to keep CPM clients informed. Contact your CPM Training Representative for more information on…

23 Team Approach The CPM Teams Management Team Accounting Team Charge Entry Team Payment Team Collection Team Information & Research Team Information Systems Team

24 …Team Approach CPMs focus is on the Team Approach! All CPM team members are involved in making sure that your healthcare business gets optimum reimbursement This approach affects all aspects of reimbursement: Sending clean claims Posting of payments correctly according to client contracts Prioritized Collection Efforts Diligence in all areas of your healthcare business

25 Congratulations on making the smart choice of investigating the benefits and services that we, at the Clinical Practice Management family provide. Make an even smarter choice by choosing to join CPM in moving your healthcare business reimbursement and office needs into the 21 st century and beyond!


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