Work With Practices
Practice Projects And Case Studies
Most of what goes wrong in a practice is a handful of recurring problems: a provider added without the payer work finishing, a contract that quietly stopped working, records that no longer agree after a business change, staff working around a system nobody owns. Here are four of those, and what it took to fix each one.
Practice Growth Consulting
Five Months Of Denials Cleared Before This Practice Added Its Next Provider
Five payer applications for one October start, an office added to the existing contracts, and a payer that confirmed the new location then never loaded the group contract. Also two problems that looked like billing and weren’t.
Practice Operations And Workflows
Rebuilding A Practice’s Digital Systems, Workflows, And Automation
Anyone who opens a shared file can change it, and nobody does it on purpose. Ninety-seven approved masters that staff can use but can’t overwrite, with access matched to each role across two SharePoint sites.
Payer And Billing Transition Support
Transferring A Solo Practitioner Into Their Own Corporation
Four insurers wanted the same change five different ways: two portals, two emails, and a fax. One payment enrollment came back denied purely because the insurer hadn’t loaded the new Tax ID yet.
Spravato Operations
A Scheduling Tool Built Around The Staff Workflow
Scheduling an esketamine patient means knowing the authorization dates, the room time left, and the follow up status at the same moment, and no single screen showed all three. So we watched the work first, then built the view.
Finding Record Conflicts Before Four Payer Changes
Before any payer work starts, the practice’s own records have to agree with each other. On another provider engagement we checked the W-9, the organization NPI, the state business record, and the DataSpring provider profile (formerly CAQH) against one another, and they didn’t match. Sorting that out first is cheaper than having four payers reject the same application for four different reasons. We verified the organization NPI update, documented what still needed correcting, built a payer specific start sheet, and prepared the PacificSource change packet. The four payer scope covered Moda, Aetna, PacificSource, and Regence.
- Match the legal business name, Tax ID, organization NPI, and DataSpring practice record.
- Keep the Moda, Aetna, PacificSource, and Regence requirements in separate payer rows.
- Record the owner action, submission route, latest status, and next follow up for each payer.
A public summary of the project map. Provider identifiers and private account information are omitted.
What Does Your Practice Need Next?
Credentialing packages and Ongoing Billing have published prices. An Automation Program is $5,000 for one workflow, and anything bigger gets a written scope first.
Next Step
See What It Would Cost Your Practice
Every service has a published price and a written scope. Not sure which one fits? Ask, and we’ll point you to the right one.