Knowledge Expansion

Better Data, Better Decisions: Using Business Intelligence for the Medical Practice

Book

Financial Management

Overview

ISBN#: 978-1568294322

Medical practices are swimming in data. Data flows into medical practices daily from practice management (PM) systems, electronic medical record (EMR) systems, accounting systems and many other sources. Too many practices extract only the bare minimum of data required to file claims and meet reporting obligations, without recognizing the value in the flood of data that passes through the practice.

The book Better Data, Better Decisions: Using Business Intelligence in the Medical Practice demonstrates creative uses of data and reveals inexpensive data extrapolation tools, more efficient uses of data and inexpensive tools that will reduce operating costs.

Medical practice managers at all levels can benefit from a greater understanding of the data management tools available. In fact, many of these tools are already present in your computer systems. Give your practice a competitive advantage by learning what data to use, how to mine it and how to organize and report it in order to make better business decisions.

See what's inside the book:

PART I — MOVING PAST CANNED REPORTS

Chapter 1 – Getting Started 
  • Clarifying Your Data
  • Indicators
  • Improving Data Gathering
  • Administration and Staff Training
  • Your First Project
  • Out with the Old
  • Conclusion

Chapter 2 – Accumulating and Analyzing Your Data 
  • Excel PivotTable
  • Excel PivotChart
  • Excel Tables
  • PowerPivot
  • Connecting Excel to SQL Server
  • SQL Server’s Business Intelligence Tools
  • Send Me an Alert
  • Combining SQL Server and Excel
  • Report Servers
  • Data Warehouses
  • Conclusion

Chapter 3 – Presenting Your Data
  • Seeing Your Data
  • Dashboards
  • Operational Dashboards
  • Tactical Dashboards
  • Strategic Dashboards
  • Simplicity
  • Consistency
  • Focus on What is Important
  • Avoid Pie Charts
  • Evaluating Your Dashboard
  • Displaying Dashboard Data
  • Too Much Information
  • Conclusion

PART II — SEEING YOUR DATA

Chapter 4 – Accounts Receivable
  • Aging Pivot Table
  • Accounts Receivable Detailed Analysis
  • Forecast Collections Based on Accounts Receivable Balance
  • Days in Accounts Receivable
  • Days to Resolve Claims
  • Percentage of Resolved Claims
  • Patient Accounts Receivable
  • Balance Due from Cash-Paying Patients
  • Adjusted Fee-for-Service Collection Percentage

Chapter 5 – Payer Contracting
  • Percent of Charges Allowed by Primary Insurance
  • Comparing Top Procedure Code Reimbursement by Payer
  • Claims Paid at Less Than Contracted Amount
  • Payer Mix
  • Percentage of Medicare Reimbursement Charted against RVU Volume

Chapter 6 – Scheduling 
  • Who’s Where
  • No-Shows Based on Appointment Time
  • No-Shows Based on Date the Appointment Was Scheduled
  • No-Shows by Patient
  • Days to Third Next Available Appointment
  • Today’s and Tomorrow’s Registration Status for Scheduled Appointments
  • Open Appointment Slots

Chapter 7 – Prior Authorizations 
  • Expired Authorizations for Appointments Scheduled in the Next Two Weeks
  • Pending Authorizations

Chapter 8 – Collection at Time of Service
  • Copayments Collected
Chapter 9 – Workflow and Overall Duration of Appointments
  • Overall Appointment Duration
  • Patient Wait Times
  • Registration Time Compared to Number of New Patients

Chapter 10 – Lag Days 
  • Days from Last Date of Service to First Bill
  • Days from Last Date of Service to Claim Entered in PM System

Chapter 11 – Billed Charges
  • Productivity Based on Billed Charges
  • Productivity Based on RVUs
  • Evaluation and Management Coding Chart
  • Procedure Code Frequency
  • Volumes
  • Quality Measures

Chapter 12 – Payments and Adjustments
  • Collection Trends Pivot Table for Analysis
  • Collections by Location and Payer
  • Collections by Provider and Referring Physician
  • Charges, Payments, and Adjustments
  • Adjustments by Category

Chapter 13 – Claims Management
  • EDI Claims Detail
  • EDI Claims Pivot Table
  • Claims Denials
  • Denials Pivot Table

Chapter 14 – Acquiring, Valuing, and Retaining Patients
  • Track New Patients with a Pivot Table
  • Calculating the Value of a Patient
  • Date of Last Referral
  • New vs. Established and Sick vs. Well Patients
  • Trends in Referring Physicians
  • Clinical Marketing
  • Untreated Patients
  • Potential Lost Patients

Chapter 15 – Putting It All Together 
  • Billing Dashboard
  • Scheduling Dashboard
  • Revenue Cycle Director Dashboard
  • Strategic Dashboard
  • Dashboard Wrap-Up
Nate Moore

Nate Moore, CPA, MBA, FACMPE

President, Moore Solutions Inc.

Nate Moore, CPA, MBA, FACMPE, speaks, consults, records and writes about business intelligence in medical practices throughout the country. Nate’s book, Even Better Data, Better Decisions: Advanced Business Intelligence for Medical Practices, is an MGMA best seller. Nate’s consulting focuses on using SQL Server to mine and leverage medical practice data into actionable knowledge.

Nate creates a series of powerful Excel Videos at mooresolutionsinc.com demonstrating how to use Microsoft Excel in a medical practice. Excel Videos have been viewed thousands of times by practice managers across America. Nate also moderates the Excel Users MGMA Community, the online resource for practice administrators to collaborate about Microsoft Excel.



Mona Reimers

Mona Reimers, FACMPE, CPC

Mona Reimers is the Director of Revenue Services for Ortho NorthEast, in Fort Wayne, Indiana, She has a B.S. in Management from Indiana Wesleyan University, is a Fellow of the American College of Medical Practice Executives and a Certified Professional Coder. She is the co-author of “Better Data, Better Decisions: Using Business Intelligence in the Medical Practice,” published by MGMA in 2013. Mona has worked as a manager and consultant in medical practices in a variety of specialties for over 25 years. Mona is a Board member for the American Association of Orthopedic Executives and is a Board Member for the Fort Wayne Women’s Bureau, which provides counseling to rape victims and transitional housing for recovering addicts with children. She is currently serving on the publications advisory committee for the Medical Group Management Association. Mona is a past Board member for the national and Indiana Association of Orthopedic Executives and former Board member and President of Indiana MGMA. She has also served on the Midwest Section Committee and is former chair of the Government Affairs Committee for the Medical Group Management Association. Mona is a frequent speaker and advisor to physician practice managers and related organizations. She has testified to the Small Business Committee of the U.S. House of Representatives in Washington D.C. on behalf of MGMA members on Medicare physician payment rates and Medicare Advantage plan issues. Mona testified twice to the CMS National Committee on Vital and Health Statistics regarding ICD-10 implementation and administrative simplification.

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Lucien W. Roberts, III, MHA, FACMPE, Administrator, Gastrointestinal Specialists, Inc.

Nate and Mona have written a timeless classic with Better Data, Better Decisions. It's that rare book that will benefit everyone, from a new manager to a seasoned vet. Within days of my first read of it in October 2013, we had implemented changes that made a positive difference. I learned ways to do things I was already doing better and ways to get beyond the frustrating constraints of canned reports from our PM and EHR. Better Data, Better Decisions remains a top shelf 'go to' book, and its ROI is the largest of any book I have ever purchased. Thank you, Nate and Mona, for an amazing effort to inspire your peers to find new ways to access and use data. 

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