Joel Chodos, MD

What accounting system are you using?  The statement above uses a hybrid system that combines features of cash and accrual.  They do not match allowables with collections, so they never have a month to month measure of collection efficiency.

Since you are so heavy on Medicare have you and your colleagues planned for the MACRA reimbursement adjustments?  There are large organizations who assure a “Don’t worry be happy” approach and tell their staff that they will take care of it.  Except the MIPS value is tracked to the individual physician and all that data will soon be public on M…[Read more]

First, cash accounting is only allowed by the IRS in healthcare and legal small business.  Many small businesses have a delay between earning and payment of the revenue.  Think of your practice’s payables, those are AR on someone else’s books.   You are correct, the AR is the accounting tool that keeps it all straight.  Those same businesses nee…[Read more]

I hear what you are saying.  Speaking of radiation oncology, I was at the 2016 national meeting in Boston and all of the major keynote speakers talked about costs, and the importance of calculating costs in your organization.  A director from UCLA described how their calculations had changed the way they deliver care, and that everyone should d…[Read more]

Hey Andrew

Also the terms adjustments and collectible are not defined and should be.

Although days in AR is a good indicator, it is nevertheless an indirect metric of your revenue cycle efficiency.  The reason they are using this is because it is likely an easy value to computer for them.  Above is where the money is and those values are all I w…[Read more]

One of the problems with yearly review is if you find an irregularity you are a year behind in correcting it.  Also blips in collection efficiency can be masked with yearly reviews.  One last thing, think about the purpose of financial statements.  They should supply actionable information.  If the review is a year after the fact, how act…[Read more]

Hey Louis.

The first question is what am I trying to collect?  If your goal is charges, you are trying to collect a fictitious amount.  What account should be the goal of your collections efforts?

What does the large write off in your practice represent?  In part 1 of the next section of the course you will find some of these answers.  Let’s rev…[Read more]

Hey Louis.

The first question is what am I trying to collect?  If your goal is charges, you are trying to collect a fictitious amount.  What account should be the goal of you collections efforts?

What does the large write off in your practice represent?  In part 1 of the next section of the course you will find some of these answers.  Let’s rev…[Read more]

This is a little of the cart coming before the horse.  Understanding some accounting gives you a big head start in figuring out how the numbers on this statement are generated.  Certain accounting methods, although commonly used in healthcare are almost worthless when it comes time to evaluating financial performance.  You will get this in Part 1…[Read more]

If anyone of you can give me an idea of this practice’s collection efficiency, I have a special prize for you.  Take a shot at the answer and I will let you know what I think.

Nothing worse than working hard and then letting the revenue slip away because of a combination of bad accounting, poor communication, and lack of oversight.  Remember, r…[Read more]

Great example Rubeen.  There has been a lot of comparison in between pilots and physicians.  Each have responsibilities that have very immediate results.  We both also live in a zero mistake environment.  Theory X leadership seems easier, but the implementation is a lot of work and oversight.  Theory Y, involves setting a framework and then stan…[Read more]

I agree it does sound like the military except when dealing with small units like the squad level of Marines and Navy SEALS, Quality Leadership is in full view.  The members of those teams are given a general framework to accomplish a task and then they are left with the ability to plan and then alter the plan as they see fit.  It is a, giving b…[Read more]

Hi Louis, thanks  for the reply.  You know that theory X is like 60 years old leadership theory, maybe older.  Yet it has been the most common description our students characterization of the leadership style they have experienced.  Why is healthcare so slow to adapt more a modern and clearly more productive leadership style?  I have my own idea…[Read more]

Wow Velma, you sound like you are channelling Deming.  He ran into the same type of thinking when he attempted to bring his data driven improvement ideas to the American auto industry in the 1950s.  The rebuttal he received ended up almost bringing down that same industry when he went to Japan and found a country with a dismal industrial e…[Read more]