BACKGROUND

Located in Portland, Oregon, the Portland Hypertension and Nephrology Clinic (PHNC) is a 30-year-old medical practice with five clinical providers. PHNC diagnoses and treats kidney disease with the primary objective to preserve remaining kidney function. Since 1979, PHNC has been recognized by its peers and patients as one of Portland’s elite nephrology-based practices.

CHALLENGE

Like most medical practices, PHNC was operating without a full support staff and the billing process was therefore compromised. Revenue was dwindling and with an onslaught of regulatory changes, policy updates and evolving healthcare industry, PHNC was struggling to stay ahead. Physician fee schedules were outdated and improper and inconsistent coding had resulted in claim denials, claim re-submittals and a portion of potential profits and charges became obsolete. Lastly, contracts with several dialysis companies and hospitals presented relationship challenges.

OPPORTUNITY

It was evident that PHNC would benefit from DoctorsXL’s suit of services including PracticeXL, TechnologyXL and RevenueXL. Equipped with these tools, the medical group could transform itself into a profitable, stable practice positioned for growth.

Through the PracticeXL practice management solutions, PHNC was able to re-examine and update benefits, payroll, retirement and staff development. In addition, DoctorsXL helped PHNC verify coding techniques and assumed responsibility for payer credentialing. DoctorsXL also assumed all of PHNC’s billing services and streamlined the accounts receivable process. PHNC also benefitted from TechnologyXL solutions that included a transition to EHR and the use of MobileXL, DoctorsXL’s mobile charge capturing service that allows physicians to capture charges in real-time when providing patient care outside of the office (such as during hospital rotations).

RESULTS

As a result of DoctorsXL revenue cycle solutions, PHNC physicians increased their annual income in the first year. Contributing to this increase was a risk assessment that was conducted to identify specific cash flow problems and to resolve them as quickly as possible. Additionally, medical record templates were introduced to organize data, which assisted with standardizing information and ultimately reduced claim resubmissions and denials.

Management and adherence to the contractual relationships with multiple dialysis companies were simplified by creating points of contact to facilitate requests and filter inquiries. Strategic relationships with hospitals were also improved to augment patient care hospital follow-through.

Technical advancement created communication synergy among PHNC physicians and staff, as wells as with supporting healthcare organizations and facilities. The ability to code charges through MobileXL allowed providers to become more efficient and disengaged them from administrative tasks so that focus was directed to providing better patient care and management.