On Jan. 15, 2009, the Department of Health and Human Services (HHS) announced its final rule the International Classification of Diseases (ICD), version 10, with mandates for compliant adoption effective Oct. 1, 2013. ICD-9, which had increasingly limited flexibility for expanded and more detailed coding, has become obsolete in most of the world, and its replacement offers opportunities and challenges.
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To avoid succumbing to the tyranny of the majority in making business decisions, Dan Simile Jr and Greg Thomson of Medical Management Professionals, Inc (MMP), Atlanta, Georgia, recommend that radiology groups establish annual wildly important goals (WIGs) and make meeting those goals a practice-wide priority. Equally important, however, are the communication and information sharing that not only enable leaders and staff to track the execution of these goals, but also help them achieve the goals in the most efficient and informed manner possible.
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In spite of downturns in volumes and concerns about further reimbursement cuts, radiology physician recruiting remains a seller’s market, at least for the time being: more groups are looking for radiologists than there are qualified candidates, putting pressure on practices to optimize their recruiting techniques. While the recent changes in the health care industry may eventually lead to a reversal of this situation, for the time being, economic uncertainty is actually heightening the importance of effective physician recruiting.
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The decision to outsource billing is one faced with increasing regularity by radiology groups seeking to trim costs while maximizing reimbursement. Within this larger decision also lies another conundrum: how to select the outsourced-billing approach that best suits the practice. Kevin Shepherd is chief development officer for Medical Management Professionals (MMP), Atlanta, Georgia. He says, “Outsourcing is generally going to be less expensive. You’re going to save money, but the decision can become more complex, depending on whether you outsource off-site.”
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Executing strategic goals represents a challenge for any organization, in terms of both maintaining momentum and creating a sense of accountability among staff. For radiology groups, add another obstacle to that list: balancing the achievement of overarching goals against increasingly hectic day-to-day routines in which maximizing efficiency is critical to survival.
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Medical Management Professionals, Inc. (MMP) recently conducted its ninth annual physician survey to obtain beneficial industry data regarding practice payor mix percentages, procedure statistics, work RVUs and retirement/benefits plans from hospital-based physician practices. Since 2001, MMP has been extracting relevant client data from its internal database in an effort to survey its clients and provide them with a state-of-the-industry snapshot. This year, the company reviewed data from both shareholder and non-shareholder physicians in 43 radiology practices. Below is a listing of averaged MMP client data by category that was compiled from 2009.
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Groups must take a serious look at whether they need to upgrade their services and technology in a changing marketplace.

Hybrid teleradiology companies have taken over hospital contracts, raising red flags for many radiology groups. These groups are re-evaluating their use of these services, as well as other technologies within the hospital that impact scheduling and workflow. It is too late to put the genie back in the bottle, so what should a group do to compete with evolving teleradiology companies and remain relevant in a changing marketplace?
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In today’s payer policy environment, physician practices need an extensive focus on core business and practice management strategies in an effort to drive revenue.

While these fundamentals, philosophically, may not have changed in relation to yesterday’s practices, the threat of declining revenue has certainly brought them back in the spotlight. Utilizing fundamental practice management and business strategies including a broad spectrum of key performance indicators are crucial to long-term success and sustained revenue for any medical group.
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Atlanta, Ga. – August 16, 2010 – MMP, a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive full practice management contract with Reno Radiological Associates in Reno, Nev.

Reno Radiological Associates has been serving the Reno/Sparks area, Northern Nevada and the Eastern Sierra region since 1947. The radiology group consists of 16 board certified radiologists, most having completed fellowship training in one of several subspecialty areas of radiology.
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Most radiology practices readily admit that charge reconciliation is an important process to perform in order to prevent lost charges for services provided. Even small percentages of charge miss rates can result in large amounts of lost revenue.
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CMS released the 2011 Medicare Physician Fee Schedule (MPFS) in July, proposing myriad changes that CMS notes would result in a 6% payment cut for radiology services. That reduction doesn’t include the impact of the 23% cut that will take place on December 1, when this year’s temporary 2.2% payment update expires—or the additional 6.1% cut resulting from the 2011 sustainable growth rate (SGR) calculations, according to CMS. The 2011 proposal also begins implementing provisions of the Patient Protection and Affordable Care Act.
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MMP, a national firm providing billing and practice management services to radiologists
and imaging centers, has been awarded an exclusive billing contract with Gulf Imaging
Associates in Pasadena, Texas.

Gulf Imaging Associates has six physicians on staff and offers a complete spectrum of diagnostic tests. Its physicians are fellowship trained and have special expertise in interventional radiology, neuroradiology, musculoskeletal radiology and body imaging.
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MMP, a national firm providing billing and practice management services to radiologists and
imaging centers, has been awarded an exclusive billing contract with Premier Radiology in
Kalamazoo, Mich.

Premier Radiology has 16 physicians on staff and is Southwest Michigan's leading provider of
diagnostic interpretation and treatment through innovative imaging technologies in addition to
state-of-the-art procedures in interventional radiology and vein treatments.
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A growing number of radiology groups are hiring radiology assistants (RAs) to provide
key support to physicians and enhance patient care. RAs possess advanced training that
allows them to perform technical imaging services and other functions across a practice.
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Plenty remains unknowable about the incipient impact of the Patient Protection and
Affordable Care Act of 2010 (PPACA), but the act does stand to affect imaging providers,
specifically through its compliance, fraud, and payment provisions, many of which have already taken effect or will take effect in the near future.
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Radiology Today: Maintaining a Hospital Contract When Administration Turns Over, by David Myrice – 07/05/2010

Think about the scenario where a radiology practice has a great relationship with its hospital
administration but then the leader or key players in that administration suddenly turn over,
leaving the practice back at square one. The situation is not new or unique to today’s
changing environment.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to physician based practices, recently completed its annual client satisfaction survey for 2010. The survey asked approximately 1,200 physicians to provide written input and rate their satisfaction for various MMP service-related questions on a scale of 1 to 10.
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In general, radiologists would prefer to devote their time to focusing on patients’ health rather than collecting payments. Yet, to ensure their ability to maintain a practice, some resources must be devoted to this complex process, whether they are employee time, payment to third-party firms, and/or the purchase of software. The most successful methods often combine the three elements to maximize the return on investment, both economically and efficiency-wise.
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Medical-necessity reviews by recovery audit contractors (RACs) are expected to pick up steam this summer, CMS’s top RAC official tells RMC.

So far, RACs have sent 15 to 20 hospitals about 140 additional documentation requests (ADRs) involving medical-necessity issues, says Connie Leonard, director of the Division of Recovery Audit Operations. The documentation was requested for the RACs’ probe audits, which are mini-reviews conducted to flush out high-risk areas that merit a full-scale audit.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, in conjunction with ImagingBiz will deliver a complimentary webinar on hospital relationship strategies and ways that radiology practices can protect their hospital contracts.
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Goal setting and strategic planning are important processes for any business, and though radiology practices are no exception, many of the challenges they face are unique to the imaging industry, according to Greg Thomson and Dan Simile Jr of Medical Management Professionals, Inc. (MMP), Atlanta, Georgia.
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It looked bad for one physician after her first audit as a member of MedicalEdge Healthcare Group, a Dallas-based physician management organization. The audit turned up serious flaws with her evaluation and management (E/M) documentation.
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Change is inevitable. In the case of the Physician Quality Reporting Initiative (PQRI) for 2010, a few new changes accompany the program. For those who have reported in prior years since the inception of PQRI in 2007, these types of adjustments and alterations merely come with the territory.
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Radiology is among the most technical and advanced medical specialties—and so is its billing processes. A new suite of products recently launched by Medical Management Professionals, Inc. (MMP) is designed to make billing clearer and more successful for radiology departments and imaging centers.
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ImagingBiz: Tapping the Rural Market: A User’s Guide, featuring Gabe Graham – 04/12/2010
The emergence of PACS has given practices a chance to expand their business and boost revenue by tapping the rural hospital market. Before adding clients to their own networks, however, groups must pay attention to projected costs and potential profits, according to Gabe Graham, CPA, a financial consultant at Medical Management Professionals Inc (MMP), Atlanta, Georgia.
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As radiology practices nationwide look for new revenue streams to compensate for ever-declining reimbursement, the answer might be getting back to basics, according to Greg Thomson and Dan Simile Jr of Medical Management Professionals, Inc (MMP), Atlanta, Georgia. In the first installment of a four-part series on critical business principles, Thomson and Simile outline three ways in which practices can improve the effectiveness of their operations: goal setting and strategic planning, execution of goals, and communication and information sharing.
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The federal government is stepping up its audit activities in Medicare, and that could mean greater scrutiny of emergency department billing practices, including the use of observation codes. One development that physicians should keep a close eye on is the recent nationwide rollout of Medicare's Recovery Audit Contractor program, said Edward R. Gaines III, vice president and chief compliance officer at Medical Management Professionals Inc.
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As growing radiology practices build governing boards, group leaders need to govern the board so it can effectively oversee the group. Executive accountability and flexibility are also fundamental to board success and governance. Establishing the size of the board and selecting members is the first step. Setting up a functioning code of regulations, learning how to effectively run board meetings, and determining any necessary subcommittees help set up a board to successfully govern a group.
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Medical Management Professionals (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive billing and practice management contract with Radiologic Center, Inc. in Omaha, Nebraska.
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MMP Lands Nebraska-based Radiologic Center, Inc., Signs Full Practice Management Contract - 02/23/2010

Medical Management Professionals (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive billing and practice management contract with Radiologic Center, Inc. in Omaha, Nebraska.

Radiologic Center, Inc. is a full-service radiology practice with 13 physicians on staff. MMP will provide a full range of strategic practice management services.
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From May 2007 to January 2008, an Atlanta, Georgia-based radiologist signed and submitted thousands of reports in his name, with one major caveat—he didn’t review a single one. Instead, he delegated the work to his radiology practitioner assistants (RPAs), who interpreted the exams and prepared the reports. In November 2009, the US Department of Justice caught on and indicted him under federal charges of wire fraud, mail fraud, health-care fraud, and obstruction of justice.
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Broadly, HIPAA originally set out to simplify administrative procedures in the healthcare industry, and mandated the adoption of regulations for privacy, security, unique health identifiers, and electronic transaction and code sets. Yet the very nature of the process for reporting violations of HIPAA Transaction and Code Sets serves only to deter their adoption, therefore making complaints meaningless.
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Why is it that I can put a credit card in a machine halfway around the world and get cash, yet the health care industry remains in the electronic Ice Age?

In the late 1990s, HIPAA Transaction and Code Set (TCS) Standards were hailed as solutions that could make the health care industry more efficient while lowering health care costs. Now, almost 15 years later, major concerns still persist surrounding the adoption of HIPAA TCS Standards, which should be of concern to all stakeholders in practice management and health care billing.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, has joined ImagingBiz’s affiliate program for 2010.

The partnership is exclusive to the billing and practice management category, and will allow MMP to collaborate with the professionals of ImagingBiz and the Imaging Center Institute to develop informative editorial pieces, advertisements and educational initiatives based on research, trade data and business solutions.
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ImagingBiz: Strategies for Accommodating Self Pay Patients, featuring Randy Roat, CHBME, and Jana Landreth, CPA, MBA – 01/20/2010

As the ranks of the uninsured continue to grow, it is increasingly important for radiology practices to implement strategies for dealing with self-pay patients, according to Randal Roat, CHBME, and Jana Landreth, CPA, MBA, of Medical Management Professionals (MMP), a physician billing and practice-management company based in Atlanta, Georgia.
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In response to the increasing costs of the Medicare program, and specifically to recover improper payments to providers, the Centers for Medicare and Medicaid Services (CMS) has formally instituted its program of Recovery Audit Contractors (RAC).
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