Practice Analysis – Diversified Medical Revenue Services

Practice Information

Practice Name *

Date

Practice Website *

Email Address *

Practice Representative *

Practice Owner *

Number of Providers

Full Time *

Part-Time (less than 100 claims per mo.) *

Practice Specialty: *

Anticipate any growth of providers, locations or services offered within the next year *

Patient Registration

What Practice Mgmt. / Scheduling System does your office use? *

Do your patients have the ability to request appointments online?YesNo

Is it integrated with your scheduling system?YesNo

How do your patients currently schedule appointments?

Do your patients have the ability to fill out patient registration PRIOR to visit?YesNo

How exactly?

Do you have a patient portal?YesNo

Appointment Confirmation

What is your current process for confirming patient appointments?

How many staff hours are spent daily on confirming patient appointments?

Do you have a problem with patient No-shows?YesNo

Patient Eligibility

What is your current process for verifying insurance eligibility prior to NEW patient visits *

What is your current process for RE-verifying insurance eligibility prior to established patient visits?

How many staff hours are spent daily on verifying eligibility?

Check-In Process

Do you accept credit cards?YesNo

Is your credit card machine integrated with your Practice Management system? *YesNo

Are you happy with the amount of credit card fees you are currently paying?YesNo

Can you please provide a copy of your last 2 merchant statements?

Can your patients make payments online? *YesNo

Is it integrated with your Practice Management system?YesNo

Back Office

Does your practice currently use an EHR?YesNo

What EHR do you currently use?

What is your monthly subscription / update fees?

What is your per user fee?

Is it integrated with a billing system?

How often do you contact their support department?

Do they charge support fees?

How long does it typically take to complete one patient chart encounter/visit? Do you chart on a laptop or tablet?

Is it web-based or server based?

Can you access it from your phone?

Does your EHR have an integrated fax utility?YesNo - (They use a virtual fax company)

Are there any aspects of the system you are unhappy with?YesNo

What exactly?

Have you looked at any other EHR systems?YesNo

If yes, which ones?

If no, why not?

Are you interested in updating to an EHR system?YesNo

What specific features are you interested in (if any)?

What is your current method for charting patient encounters and storing patient healthcare records?

How much time is spent on pulling and re-filing patient charts daily?

How long does it typically take to complete documentation on patient visits?

What is your current process for providing patients medical records?

How many staff hours are spent daily on providing patients medical records?

Do your patients have the ability to obtain their medical records online?

Check Out

Do you send orders to labs?YesNo

How much time is spent daily on communicating lab results?in hours

Do you have an automated way to send lab orders electronically?YesNo

Do the lab results come back automatically attached to the Patient's chart?YesNo

Do your patients have the ability to check lab results online?YesNo

Do you currently send prescriptions electronically?YesNo

Can you send controlled substances electronically?YesNo

Do your patients have the ability to request prescription refills online?YesNo

What is the current process for refilling prescriptions?

Billing

Who is responsible for coding your claims before you submit them?

When was the last time your claims were reviewed by a certified coder?

How do you currently process claims in your office? *OutsourceIn House

What company do you use?

Do you have access to their system?

How do you get your claims info / EOB's to them?

How much do they charge?

What services do they provide?

How many hours each week are spent by your staff members on billing and collection related activities?

How many insurance claims are you filing per month?

Any surgeries?YesNo

How many a month?

On average, practices suffer a 30% claim rejection, denial, or non-payment rate. Would you say you are about average?

How much on average is collected per month (total revenue)?

USD

How much is in insurance A/R (total due from insurance companies)?

USD

What is your approximate patient payor base distribution? (all should add up to 100%)

Commercial%

Medicare%

Medicaid%

Self Pay%

Worker's Comp/PI (if any)%

If Medicare is over 25%: How prepared are you to submit your MIPS/MACRA data?

Who does your credentialing?OutsourceIn House

If in house, how many hours on spent on this task weekly?

Any insurance or government carriers you would like to enroll with?

Do you have any issues with denied/ rejected claims regarding network contracts?

If Outsource: How much do they charge?

USD

How much is in patient accounts receivable (total due from patients)?

USD

Do you currently utilize a Collection Agency?YesNo

If yes, which One?

How much do they charge?

Does it integrate with your billing system?YesNo

What is the process?

How successful are they?

If no, why not?

What are your internal collections methods?

How successful are you?

How much time is spent daily on this?

Who is responsible for sending out patient statements?

How much time is spent daily on this?

Who handles patient's calls with bill issues?

How much time is spent daily on this?

Are there any areas of your practice that you would like to enhance performance / efficiency?

Save as Draft

Practice Analysis Questionnaire.

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