CBaySystems Releases Practice Management Solution for Physicians' ARM

Most physicians had an idealized image of what it would be like to work in a solo or small group practice. They expected the opportunity to do meaningful work they enjoyed, and practice medicine in an environment where they could focus more time on patients – and make a comfortable living.

But as interviews recently conducted by CBaySystems have revealed, today’s reality is much different. Faced with an increased workload, building pressures on claims reimbursement and the enormous amount of medical data they need to collect and manage, physicians are frustrated, dissatisfied, and making less money than they had expected.

"I became a physician to treat patients, not to handle paperwork," says Diego Escobosa, M.D., from Bayside Pediatrics. "Every day, I’m seeing more and more patient and making less and less money. I’ve seen it happen in my practice, and with all of the other physicians I know who work in small practices."

According to Frost and Sullivan, the workload in physician’s offices keeps growing, in some cases exceeding 150 patient visits per week. Additionally, every patient visit generates about 10 pages of documentation and paper work, on average, from insurance claims to prescriptions. As a result, it becomes very difficult for a physicians office to complete the work and also maintain patient data. Some studies have reported that physicians are spending 25% to as much as 55% of their revenues on administrative overhead.

• Managed care and government agencies both are putting an incredible burden on physicians. Stretching their administrative staff, requiring them to see more and more patients than ever before, and causing delays in their ability to collect money (and causing them to collect less than they’re entitled to)

• Rejected claims from managed care and government agencies create an administrative burden and cash flow problems. Physicians end up leaving too much money on the table because of things like inadequate documentation, incorrect codes, and their administrative teams have to spend hours and hours on the phone trying to fix problems and collect what the physician is due.

"The deck is heavily stacked against small practices," says Dr. Escobosa, "I have to hire and dedicate a large number of staff just to properly complete paperwork – and then fight to get paid. We need to find a way to break this cycle."

CBaySystems has been studying these problems for years, and is presently in Beta with CBayPraxis, an integrated practice management solution designed to help physicians take back their time and money, at a fraction of their current costs.

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Challenges Facing Physician Practices

According to the interviews conducted by CBaySystems, the following are the biggest challenges facing physician practices today. Each of these is being targeted as a solution focus in the new CBayPraxis offering:

1. Understaffing and job turnover – Physicians can’t afford to pay administrators enough to keep them on board because their practices are being stretched too thin. Administrators are overworked and stressed dealing with all of the hassles related to insurance, billing and collections to the point that they are unable to focus on their core practice management and patient service responsibilities.

2. Inadequate Financial Reporting – The administrative staff doesn’t have the time or training to follow-up on every insurance claim or gain a clear idea of the practice’s true financial status. Most practices fall outside of MGMA financial benchmarks for accounts receivable management and aren’t even aware of it.

3. Expensive, complex technology – Software systems are expensive, hard to implement and hard to use, requiring a huge investment in money and training. Even once implemented, they require a lot of time and attention, forcing physicians to perform IT maintenance. In all, a Practice Management System typically costs physicians 20-40% of their Adjusted Gross Income.

4. Lost revenue due to submission errors or bad insurance claim follow-ups – According to the ACGroup, 45% of payments are delayed due to improper documentation, incorrect date and missing deadlines.

5. Unsatisfactory patient service – The administrative team is spending time chasing the insurance company rather than taking care of patients. Meaning that patients feel neglected and dissatisfied.

6. Patient data is disorganized – Frost and Sullivan reports that the number of visits is increasing everyday; there are some physician offices in the US which get more than 150 patient visits every week; every patient generates about 10 pages of documentation and paper work on average, from insurance claims to prescriptions.