After 15 years as part of an independent hospitalist group in Milwaukee, WI, Dr. Alok Goyal and Dr. Pandey Krishna were in transition. They ended their contract with St. Joseph’s Regional Medical Center and formed Milwaukee Internal Medicine Associates (MIMA) to serve patients in both clinical and hospital settings.
Doctors Goyal and Krishna brought in ebix to assist them through this transition, minimizing denied claims from insurance companies, maximizing revenue and ensuring consistent cash flow.
Assessing what the Market will Bear
The first step in increasing MIMA’s revenue was to ensure that their services were priced appropriately.
ebix analyzed MIMA’s fee structure by comparing it to both competition and Medicare guidelines to gauge market sensitivity and appropriate reimbursement levels. During this process, ebix also provided MIMA with industry averages and recommendations; allowing them to make their own informed decisions about pricing.
Accurate Diagnostic Coding Prevents Denied Claims
ebix’s experienced certified professional coders (CPC) performed a comprehensive review of the CPTs (Current Procedural Terminology codes) using CCI (Correct Coding Initiative) edits, to ensure codes were not bundled and that no modifiers were missing. This enabled ebix to prevent MIMA from realizing too many denied claims due to inaccurate coding.
Future Growth Ensured
ebix supported MIMA as they grew during their first year, utilizing their expertise to drive revenue and create results.
- Over a three year period, MIMA increased their annual charges by 55%.
- Over that same period MIMA’s receipts increased by 60%.
- The doctors identified other hospitals that would benefit from their services and contracted with them.
At ebix, the coders are trained to look at the physician’s coding and check to ensure the physician is documenting properly. ebix’s physician education, with auditing, provides the on-going feedback to combine sound documentation principles and implement the use of well-documented comprehensive coding policies. ebix provides consultative services to assist with every aspect of a business operation.
Milwaukee Internal Medicine Associates