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Origins of Medical Practice Patient Flow
[By Dr. Charles F. Fenton III; Esq]
In the current medical environment a physician’s practice does not consist of a collection of individual patients, or even of the “charts.”
Rather, a physician’s practice consists of a number of managed care contracts that allows the physician to be a member of a panel and listed in the individual subscriber’s insurance book-of-business.
Practice Cash Flow
Today, patients merely flow from managed care contracts. Without managed care contracts, there are few patients and little cash flow.
Therefore, the physician may face the risk of being de-selected from an individual, or several, managed care panels as contractual issues change, morph or are otherwise altered during each enrollment period.
Assessment
Each de-selection will have an adverse effect on the physician’s practice. In actuality, the revenue lost from de-selection will come disproportionally from the net revenue of the practice.
Often one de-selection will snowball into several de-selections, until the physician barely has a practice remaining.
Conclusion
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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: Risk Management | Tagged: Managed Care |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
How to Avoid Medical Provider Exclusion
By David R. Dearden, Esq.
In order to receive payments from an insurer, a provider must be credentialed. Insurers routinely de-credential providers who are excluded from the Medicare/Medicaid Program.
This link explores the power of the government to exclude providers from the Medicare/Medicaid Program, the reasons used to exclude providers and a new technique being used to avoid provider exclusion
Read more: http://physiciansnews.com/law/308dearden.html
-Ann
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