CASE STUDY: Medical Group, Union NJ (2 Providers) An Internal Medicine/Primary Care office located in Union, NJ was quite overwhelmed with the overbearing costs, administrative hassles, staff issues and gross collection deficits. An administrative decision to sell the group was earnestly deliberated. With an average monthly collections between the 2 providers totaling less than $60,000 while estimated hospital based physician salary is nearly $220,000, a quick resolution was necessary. In 2011, in an attempt to save the group, ClinicSpectrum was hired by the administrative team. Immediately, imperative key issues were discovered, and a revenue maximization strategy for cost efficiency was implemented. Step 1: Operational Restructure through Hybrid Workflow Model ClinicSpectrum immediately identified all the office tasks including inventory management, cleaning of exam rooms, scanning of documents, appointment confirmation, eligibility services, preparing patient in exam room before physician walks in, and many others. We assigned those tasks/activities between LOCAL EMPLOYEES in the office and OFFSHORE employees in our back-office operation. Our back-office employees took over eligibility verification, indexing of scanned documents; follow up on outstanding claims, transcription services, appointment confirmation, missed appointments management and procedure recalls. The group’s local team members were then separated into an administrative team, billing team and clinical team combined with DAILY REPORTING to build self-accountability. RESULT: With the above planning in place the practice is running smoothly and seeing 55+ patients’ on a daily basis without depending on an “Individual Team” member to run the office. Step 1 took care of operational efficiency and cost reduction through our back office team members. Step 2: Medically Necessary Tests/Procedures for better Outcomes and Risk Management ClinicSpectrum introduced a concept of collaborative medicine by joining an IPA (Independent Physician Association) which has turned into an ACO now. By joining an IPA, we participated in several incentive programs for Risk Management and reducing cost of care for payers. We created a clinical team that went through each patient’s clinical notes. Based on medical necessity and evidence based medicine we recommended TESTS/Procedures that were urgently needed. This resulted into better care for patients. Utilization of clinical resources/teams and diagnostic equipment made a difference in patients’ lives and saved money for Insurance companies. RESULT: The implementation of Step 2 has resulted in significant revenue growth averaging an additional $30,000 per month over the last 4 years. At present the practice collects $1.1M per year. Step 3: Monthly Audit Nothing is taken for granted. Every task/office function gets audited randomly across the practice. A knowledgeable audit team focuses on the following areas: End of wee

1. PRACTICE REVENUE
GROWTH
New Jersey
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Phone : 908-834-1608
Fax : 877-600-9390
Sales
Ph: (908)-834-1608
Email: info@Clinicspectrum.com
Facebook.com/Clinicspectrum
@Clinicspectrum
YouTube.com/Clinicspectrum

2. PRIMARY PROBLEM
An Internal Medicine/Primary Care office located in Union, NJ was
quite overwhelmed with the overbearing costs, administrative
hassles, staff issues and gross collection deficits.
An administrative decision to sell the group was earnestly
deliberated.
With an average monthly collections between the 2 providers
totaling less than $60,000 while estimated hospital based physician
salary is nearly $220,000, a quick resolution was necessary.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 1

3. RESOLUTION
In 2011, in an attempt to save the group, Clinicspectrum was hired by the
administrative team.
Immediately, imperative key issues were discovered, and a revenue maximization
strategy for cost efficiency was implemented.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 2

4. SOLUTION STEPS
Following three steps were implemented :
Step 1: Operational Restructure through Hybrid Workflow Model
Step 2: Medically Necessary Tests/Procedures for better Outcomes and Risk
Management
Step 3: Monthly Audit
© Copyright 2014. Clinicspectrum, All Rights Reserved. 3

5. SOLUTION STEP 1
Operational Restructure through Hybrid Workflow Model
Clinicspectrum immediately identified all the office tasks including:
inventory management, cleaning of exam rooms, scanning of documents,
appointment confirmation, eligibility services, preparing patient in exam room before
physician walks in, and many others.
We assigned those tasks/activities between LOCAL EMPLOYEES in the office and
OFFSHORE employees in our back-office operation.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 4

6. SOLUTION STEP 1
Our back-office employees took over eligibility verification, indexing of scanned
documents; follow up on outstanding claims, transcription services, appointment
confirmation, missed appointments management and procedure recalls.
The group’s local team members were then separated into an administrative team,
billing team and clinical team combined with DAILY REPORTING to build self-accountability.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 5

7. RESULT STEP 1
With the above planning in place the practice is running smoothly and seeing 55+
patients’ on a daily basis without depending on an “Individual Team” member to run the
office. Step 1 took care of operational efficiency and cost reduction through our back
office team members.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 6

8. SOLUTION STEP 2
Medically Necessary Tests/Procedures for better Outcomes and
Risk Management
Clinicspectrum introduced a concept of collaborative medicine by joining an IPA
(Independent Physician Association) which has turned into an ACO now.
By joining an IPA, we participated in several incentive programs for Risk Management
and reducing cost of care for payers.
We created a clinical team that went through each patient’s clinical notes. Based on
medical necessity and evidence based medicine we recommended TESTS/Procedures
that were urgently needed.
This resulted into better care for patients.
Utilization of clinical resources/teams and diagnostic equipment made a difference in
patients’ lives and saved money for Insurance companies.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 7

9. RESULT STEP 2
The implementation of Step 2 has resulted in significant revenue growth averaging an
additional $30,000 per month over the last 4 years. At present the practice collects
$1.1M per year.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 8

10. SOLUTION STEP 3
Monthly Audit
Every task/office function gets audited randomly across the practice. A knowledgeable
audit team focuses on the following areas:
End of week supplies inventory check,
Daily closing report for co-pay/co-Insurance/deductibles,
Outstanding balances,
Patient clinical non-compliance,
Reminders for tests/procedures,
Follow up with insurance companies with outstanding claims,
Medical necessity compliances,
Proper documentation,
Complaint resolution and voice message tracking.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 9

11. RESULT STEP 3
Efficiently checks and balances mechanism in place lessened errors, and improved
efficiency.
© Copyright 2014. Clinicspectrum, All Rights Reserved. 10

12. CONTACT US
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Website
http://clinicspectrum.com/
Phone Number
908.834.1608
Email
info@Clinicspectrum.com
Clinicspectrum is a healthcare services company providing outsourcing and back office solutions for medical
billing companies, medical offices, hospital billing departments, and hospital medical records departments.
© Copyright 2014. Clinicspectrum, All Rights Reserved.