Frequently Asked Questions

There is no one-size-fits-all approach to medical practice management. Each practice has its own environment, leadership style, workflow challenges, etc. Our practice management program is designed to let providers decide what areas they want to participate in, what areas they would like or need assistance with, and how much assistance.  Evolution’s Consulting team can collaborate with practices on start-up or project management, compliance, training, software selection and implementation, credentialing/contracting, practice finances, and essentially any aspect that doesn't involve direct clinical care of the patient.  As much or as little assistance as the practice needs. We bill hourly and can work into just about any budget. We have no long-term agreements and there is no usage requirement. Practice management consulting in the hand of the practice. 

Yes. Evolution is located in the beautiful Texas Hill Country in New Braunfels, Texas. We have been in New Braunfels since 2006 and service all over the United States, depending on needs. Evolution is a boutique-style consulting firm that believes when you work with the right clients, for the right goals, in the right way, we can achieve great things together. We pride ourselves on our performance, attention to detail, and going above and beyond for our clients. It is this performance that has yielded client relationships of 15+ years and counting. We have a proven infrastructure and knowledge base that can grow with any size practice.

One hundred percent of Evolution's staff resides in the United States. We have had experience with services being outsourced to practices and have found that the US healthcare system is unlike any other, and with that uniqueness, it is hard for other countries to understand and embrace. We have had a better experience with our boutique-style approach to our clients. Having the talent reside in the US may cost more in overhead, but it pays off in the higher recovery rates and attention to detail that can not be duplicated. There is a cost to the low rates offered by billing companies that have offshore staff. The question is if you are willing to pay it for your practice.

Yes. Coding is the selection of CPT codes that are billed out to the insurance payer.  Billing is the art of navigating the revenue cycle in the form of getting the charges to the payer timely, posting, working accounts receivable, and appeals to bring in the revenue.  It does not matter how great your coding is if you can not bring in the money from the payers.  The two must thrive together for the best performance.

Your gross (cash) collection percentage is as unique as a fingerprint.  It is based on your set billed charge as a percent of your payer contracts, your payer mix, CPT utilization, and specialty.  Benchmarks are helpful only to provide a ballpark estimate, but can not be used for accurate predictions, as with most benchmarks, they do not tell you all the needed information to make a direct comparison.

Evolution always estimates 120 Business days as the payers don’t work on the weekends. The timeline with commercial payers has grown over the years. Some payers credential first and then contract, while others contract first and then credential. The longest delay we currently see is getting the payers to load the providers into their systems and assign effective dates. We have also seen that retro effective dates are not as common as they once were. The payers now state that it can take 90-120 days to credential and up to 90 days to load the provider. With years of experience and building on established relationships with payers, we have been successful in navigating those timelines. 

Every mistake and open window of revenue loss is found in the revenue cycle or the accounts receivable of a practice. A revenue team is so much more than the billing of the past. A great revenue team searches payer policies and educates the provider and the practice on new or changing guidelines. They work with the practice management team to see what problems are observed in demographic data entry or securing of money. This is what makes the Evolution Revenue Cycle team so unique from the competition. For others, it is the quantity of billing, and for Evolution, it is about the quality of our work. We pay attention to the information that the revenue cycle shares and then work with the practice to close every window of revenue loss.