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David Joyce MD, MBA replied to the topic Welcome to the Discussion Forum in the forum Leading Improvement Discussion Forum 7 years, 7 months ago
Velma, this is an excellent practice improvement problem that would benefit from CPI methodology. The LQC or metrics to measure would likely be % patients with incorrect pillboxes. This will help you make sure the problem is frequent enough to merit attention. Sometimes small volume issues seem more frustrating and time consuming than they re…[Read more]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
Janet, your comments are not unlike many comments I have seen from non-military physicians. Even in the service, somewhere, somehow these financial decisions are being made based on financial information that is collected. Fact is, they organization you work for has a global budget and revenue in the form of work and expenses are calculated to f…[Read more]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
In looking back at my experience in an OB/GYN setting at Ft. Hood in Tx. I had the same dilemma. You would think that there is no financial consideration. Resources are allocated on some different basis that financial because there is no billing. Of course that is naive.
I would start by getting involved in the budgeting. There is likely a t…[Read more]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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.
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David Joyce MD, MBA and Joel Chodos, MD are now friends 7 years, 7 months ago
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 7 months ago
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]
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David Joyce MD, MBA and Nathan Merriman are now friends 7 years, 7 months ago
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 8 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 8 months ago
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]
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 8 months ago
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]
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David Joyce MD, MBA and Rubeen Israni are now friends 7 years, 8 months ago
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David Joyce MD, MBA replied to the topic in the forum Katelin Haley, DO 7 years, 8 months ago
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]
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David Joyce MD, MBA started the topic in the forum Financial Tools of Healthcare Discussion Board 7 years, 8 months ago
First, do you have access to departmental financial statements or personal profit/loss statements. If so, what effect have they had on you and if not, why have you not accessed them?
Second, this charges and collections statement, from one of the largest billing companies in the country, is a breakdown of the revenue portion of your income…[Read more] -
David Joyce MD, MBA and Rob Palandjian are now friends 7 years, 8 months ago
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David Joyce MD, MBA started the topic in the forum 7 years, 9 months ago
Thanks for joining the forum. If you would be so kind, share with others how you felt when you first discovered you had diabetes. Who or what helped you most to cope with this discovery. Your contribution here will be valuable to others struggling with their efforts to take control of their diabetes.
Thank You
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David Joyce MD, MBA replied to the topic Welcome to the Discussion Forum in the forum Quality Leadership Discussion Forum 7 years, 9 months ago
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]
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