CASE STUDY

Quality Care Family Practice
Location: Corona, CA
Founded: April 15, 2012
Provider: Dr. Anuradha Sathya, MD, Family Medicine Specialist
Practice Administrator: MK Sathya

HIGHLIGHTS

Days in A/R reduced by 84%
Average reimbursement per encounter increased by 12%
Annual encounters: 7,026
Average patients a day: 30–40 patients


The passion to serve

On April 15, 2012, Quality Care Family Practice opened its doors to Corona, California, and surrounding communities. “The origin of Quality Care Family Practice is a function of Dr. Sathya’s passion to control who she serves and how she serves, and was predicated on providing the best service possible,” said MK Sathya, practice administrator. “It was less about financials or the glory of having your own practice.”

On a typical day, Dr. Sathya sees 30–40 patients, with a staff of four to help her optimize the time spent with each patient. In such a high-traffic medical office, Dr. Sathya and her team do their best to accommodate as many patients as they can each day and effectively as possible—tuning systems for efficiency purposes without compromising care.
Dr. Sathya enables patients to have direct access to her. They can send her a direct message through the patient portal, or they can call her after hours. “She’s done that throughout her practice. And patients have always felt comfort in being able to reach her directly. So, in that context, it’s slightly unconventional,” said MK.

EHR from the start

Right out of the gate, Quality Care Family Practice implemented an electronic health record system for two reasons: government incentives and the size of their office. “In a 1,500 sq. ft. office with three exam rooms and a break room, there isn’t space for either servers or unnecessary reams of paper records or file cabinets,” MK explained. When
it came time to decide on an EHR, Dr. Sathya and MK were interested in three themes: security, ease of access, and flexibility—the ability to receive data, transmit data, transmit prescriptions, etc. They also wanted to make sure a dedicated support team would enable them to capitalize on the system. NextGen® Office was their final choice.

Billing becomes problematic

For the first six years, Quality Care Family Practice outsourced their billing responsibilities to a consultant who helped physicians get their practices up and running. MK subscribes to the following school of thought, “If it is not your ‘expertise,’ hire someone to do it for you because it will always be their expertise.” He continued,
“Billing is one of those things. You can have a biller on staff who might be very efficient, but cannot keep up with the changing requirements of the insurances—the changing requirements of the federal and state guidelines.” Their relationship with the billing consultant was solid for the first six years. However, in the final year their liaison began experiencing personal problems unrelated to work that got in the way of Dr. Sathya’s practice maximizing financial health—as seen by a significant accounts receivable (A/R) backlog. That’s when Dr. Sathya and MK decided it was time to find another solution.

An integrated approach to billing

The practice wanted to integrate their EHR with a professional billing service, which they found in NextGen® Office RCM Services. “We were able to tap into an integrated approach, and—much like my other business experiences—observe a single point of accountability. That’s what grew our relationship with the RCM services,” said MK.
NextGen Office RCM Services introduced Quality Care Family Practice to a team-based approach to billing. They had an account manager, an A/R manager, a charge release team, a payment posting team, and an A/R follow-up team. This eliminated the single point of failure that they were experiencing with their previous biller. And even though they were not a big business, the billing team ensured they were treated the same way a 20-doctor practice is—with dedicated professionals at every touchpoint of the revenue cycle.

Quality Care Family Practice observed an 84% reduction in A/R days and an average reimbursement per encounter increase of 12%.

MK and Dr. Sathya saw the immediate value of relying on the experts to do their billing for them. Relying on people whose sole business is to develop expertise in their areas, such as billing IT services, alleviated much of the administrative hassle of running their own practice.