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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 work with practices on start-up or project management, hiring, compliance, training, software selection and implementation, credentialing/contracting, finances of the practice, and pretty much any area that does not cross into the 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.
At Evolution, we spend most of our time in a good kind of chaos. We work with transitioning, start-up, or clean-up practices mostly, other than consulting projects. Transitions can be the most emotional and trying times for these practices. Either way, money is very tight, budget is the matter of making it or not, and the uncertainty is maddening. These privately-owned, independent practices, want the autonomy to stay independent and service the community on their terms. Evolution is here to help. With over 16 years of start-up/clean-up experience, we know how to transition practices surgical and get the practice revenue moving. We are here to help providers to remain calm and navigate the road to, or back to, practice health and growth. Evolution likes to work with 1-6 provider practices in any specialty.
Evolution has great long tenureships with our internal staff and this is a benefit to the clients who enjoy long relationships with their billing team. The billing team learns provider and staff behavior as well as builds solid working relationships and workflows. Evolution is designed to be an integrated part of the client’s medical practice, down to how we answer the phone. We have situations in which clients have had the same point of contact thought out in their relationship with Evolution. Our billing teams are backed by certified coders and many years of experience across multiple software and specialties.
We recommend the one that the provider likes using. There is no perfect software; each EMR comes with nuances that must be worked around. These workarounds are facilitated by an understanding of the reporting capabilities and changes in office processes or workflows during implementation. Most EMR issues can be overcome relatively easily. The provider must like the software or it will not be successful. A practice utilizing the software of their choice maximizes their potential for success. At Evolution, we work with a wide range of software that is selected by our clients. We can assist in demos and implementation of any software. We always recommend that the provider owns the license and not a 3rd party billing or management company. In all of our years of working with practices undergoing a clean-up. We have seen the medical records held hostage, thus placing the provider in liability with the Texas Medical Board. Always think about what happens when you want to change companies or pull the billing in-house. You need to own and control the data and access it.
Evolution can assist with contract negotiations, but traditionally reserve these activities for existing clients who have a full credentialing file in our office. Rate negotiations are not the same as they were even ten years ago. It is getting harder and harder to achieve improved rates, but it is not impossible. Data is power. Many times we are approached to negotiate contracts for practices that do not have copies of their contracts and do not know what their fee schedules are. It is hard to know what to ask for if you do not know your current allowable. In these instances, contract negotiations are more costly because Evolution must first acquire the needed information in which to start the process. We have found that conducting this activity for established clients is more fruitful for the client investment.
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.