Medical Office Start-up Checklist
The process of starting a Medical Office can be a difficult task but with the proper planning, you can have your Medical Office up and running effectively and efficiently. The decisions you make now are crucial as you set your goals regarding every aspect of your Medical Office.
In any medical office there are factors that can influence the success of the organization. The key is identifying those factors whether they are within your control or not, and developing a plan that will lead to the achievement of the organization's future goals.
This process of identifying the medical office goals and developing the plans to achieve those goals, is referred to as strategic planning. Every medical office need to develop a strategic plan whether for a new start-up or when re-evaluating an existing one.
Include:
Partnering with insurance carriers is a necessary process for any medical office. Physicians and other professionals must provide a list of verifications to insurance carriers, including Medicare and Medicaid, in order to be eligible for reimbursable expenses.
The results of not obtaining proper Credentialing can result in lost revenues. Insurance carriers will not reimburse any medical office that bills for professionals or for services provided by professionals that have not been properly credentialed.More »
Provider enrollment procedures may vary according to the insurance payer.Find out how to become a participating provider for the following:
More »
Negotiating managed care contracts requires comprehensive knowledge of the contracting process. This generally includes reimbursement rates, effective and termination dates, claim filing guidelines, payment terms and other contract provisions.
Carefully read any and all attachments, amendments or clauses to the contract to identify any wording that may limit the services the medical office is allowed to offer or reimbursement for services provided.
Terms should be specific and clearly defined with a start date and a termination date. Avoid wording that uses renewal dates, or annual and yearly. Also, the contract should require an agreed upon notice of termination if either party chooses to end the agreement or decide not to renew the terms of the contract.More »
Getting your medical claims out of the door and paid as soon as possible is every health care provider's primary goal as far as finance is concerned. The faster the claim goes out, the faster the money comes in. Make sure your office is equipped with the necessary software to save time and money.
Although your billing software is primarily used for billing your health care insurance claims, it is not the only feature of a good billing system. Your medical office billing software system should enable you staff access to multiple features necessary to performing their job effectively and efficiently.More »
Recruiting a successful medical office staff is an important responsibility. Customers of a medical office are not typical customers. They are patients that expect the highest quality of care and some may be in the midst of a medical crisis which requires delicate handling. Not only is it important for the staff to have certain professional skills and strengths, it is imperative that they understand that patient lives are reliant on the quality of their work. Effective planning is essential for recruiting success.
Being competitive in securing and maintaining quality employees is an essential piece to the success of your medical office. When developing your benefits package, here are ten employee benefits to consider.More »
Develop a Strategic Plan
In any medical office there are factors that can influence the success of the organization. The key is identifying those factors whether they are within your control or not, and developing a plan that will lead to the achievement of the organization's future goals.
This process of identifying the medical office goals and developing the plans to achieve those goals, is referred to as strategic planning. Every medical office need to develop a strategic plan whether for a new start-up or when re-evaluating an existing one.
Include:
- Market analysis
- Mission, vision, and values
- Start-up and operating budget
- Marketing
- Implementation
Obtain Proper Credentialing
Partnering with insurance carriers is a necessary process for any medical office. Physicians and other professionals must provide a list of verifications to insurance carriers, including Medicare and Medicaid, in order to be eligible for reimbursable expenses.
The results of not obtaining proper Credentialing can result in lost revenues. Insurance carriers will not reimburse any medical office that bills for professionals or for services provided by professionals that have not been properly credentialed.More »
Apply for a National Provider Identification (NPI)Number
The NPI was established by HIPAA in an effort to help reduce health care fraud. Providers that do not have an NPI will not be able to bill insurance companies or get paid. When completing the UB-04 or CMS-1500, you must enter your NPI in the correct field location in order for your claim to be considered for payment. Most electronic billing software have edits in place to prevent your claim from even billing if you have entered the NPI information in the proper location.More »Provider Enrollment
Provider enrollment procedures may vary according to the insurance payer.Find out how to become a participating provider for the following:
More »
Obtain an NPI
More »Negotiating Managed Care Contracts
Negotiating managed care contracts requires comprehensive knowledge of the contracting process. This generally includes reimbursement rates, effective and termination dates, claim filing guidelines, payment terms and other contract provisions.
Carefully read any and all attachments, amendments or clauses to the contract to identify any wording that may limit the services the medical office is allowed to offer or reimbursement for services provided.
Terms should be specific and clearly defined with a start date and a termination date. Avoid wording that uses renewal dates, or annual and yearly. Also, the contract should require an agreed upon notice of termination if either party chooses to end the agreement or decide not to renew the terms of the contract.More »
Select Billing Software
Getting your medical claims out of the door and paid as soon as possible is every health care provider's primary goal as far as finance is concerned. The faster the claim goes out, the faster the money comes in. Make sure your office is equipped with the necessary software to save time and money.
Although your billing software is primarily used for billing your health care insurance claims, it is not the only feature of a good billing system. Your medical office billing software system should enable you staff access to multiple features necessary to performing their job effectively and efficiently.More »
Staff Recruitment
Recruiting a successful medical office staff is an important responsibility. Customers of a medical office are not typical customers. They are patients that expect the highest quality of care and some may be in the midst of a medical crisis which requires delicate handling. Not only is it important for the staff to have certain professional skills and strengths, it is imperative that they understand that patient lives are reliant on the quality of their work. Effective planning is essential for recruiting success.
Being competitive in securing and maintaining quality employees is an essential piece to the success of your medical office. When developing your benefits package, here are ten employee benefits to consider.More »
