Consulting Services for Medical Practices

We provide comprehensive physician practice consulting services tailored to meet your specific needs. Our team of experienced consultants offers a wide range of expertise to help optimize your practice’s operations and maximize efficiency. From streamlining administrative processes to implementing effective revenue cycle management strategies, we are dedicated to supporting the success of your practice. Our services include practice assessment and analysis, where we evaluate your current workflows and identify areas for improvement. We also offer assistance with compliance, ensuring that your practice remains HIPAA compliant and OIG cleared. Additionally, our consultants can provide guidance on strategic planning, financial management, and technology integration to enhance the overall performance of your practice. With our extensive knowledge and commitment to excellence, we are confident in our ability to deliver tangible results for your physician practice. Contact us today to learn more about how our consulting services can help elevate your practice to new heights.

Service Area	Description
Consulting Services
Revenue Cycle Management	Streamline financial processes from patient registration to reimbursement, ensuring optimal revenue capture and flow.
Reimbursement Strategies	Develop tailored approaches to maximize reimbursement rates and minimize denials, optimizing revenue generation.
Physician Practice Management	Provide comprehensive support for practice operations, including scheduling, staffing, and financial management.
Post-Acute Care Services	Enhance care coordination and efficiency in post-acute settings, improving patient outcomes and reducing costs.
IT Risk Management	Identify and mitigate cybersecurity risks, safeguarding sensitive patient data and ensuring compliance with regulations.
HIPAA Compliance	Ensure adherence to HIPAA regulations through robust policies, training, and security measures, protecting patient privacy.
Business Valuation	Conduct thorough evaluations of healthcare entities to determine their fair market value for transactions or planning.
Benchmarking	Compare performance metrics against industry standards to identify areas for improvement and drive operational excellence.
Mergers and Acquisitions	Guide organizations through mergers, acquisitions, or partnerships, facilitating smooth transitions and maximizing value.
Outpatient Therapy Optimization	Optimize outpatient therapy services to improve patient care quality, efficiency, and financial performance.
Fee Schedule Reviews	Analyze fee schedules to ensure alignment with market rates and optimize reimbursement while maintaining competitiveness.
Contract Negotiations	Negotiate favorable terms in contracts with payers, vendors, and partners to enhance profitability and mitigate risks.
340B Compliance	Assist with compliance requirements for the federal 340B Drug Pricing Program, ensuring eligible entities maximize benefits.
Buy/Sell Agreements	Provide guidance and support in the negotiation and execution of buy/sell agreements for healthcare assets or practices.
Loan Procurement	Facilitate access to financing options and assist in securing loans to support healthcare facility expansions or operations.
Feasibility Studies	Conduct comprehensive feasibility studies to assess the viability of healthcare projects or initiatives before implementation.
Operating Agreements	Draft clear and effective operating agreements to govern the relationships and responsibilities of healthcare stakeholders.
Cost-Per-Case Analysis	Analyze the costs associated with each patient case to identify opportunities for cost savings and process improvements.
Community Health Needs Assessment (CHNA)	Conduct assessments to identify priority health needs in the community and develop strategies to address them effectively.
Emergency Department Throughput Services	Improve efficiency and patient flow in emergency departments to enhance quality of care and reduce wait times.
Managed Care Underpayment Recovery	Identify and recover underpayments from managed care payers, maximizing revenue and improving financial performance.
Medicare/Medicaid Rate Analysis	Evaluate Medicare and Medicaid reimbursement rates to ensure accuracy and optimize revenue for healthcare providers.
Hospital Accounts Receivable Assessment and Action Plan	Assess and address accounts receivable challenges, implementing strategies to accelerate collections and reduce outstanding balances.

Our comprehensive suite of services redefines medical billing, streamlining revenue cycles and optimizing reimbursement for healthcare practices. With a focus on tangible benefits and value, here’s how we stand out:

Consulting Services:

 

Revenue cycle optimization: We analyze and enhance every stage of your revenue cycle to maximize efficiency and profitability.

• Physician practice management: Our expert guidance ensures seamless operations and increased practice revenue.
• Post-acute care services: We provide tailored solutions to improve post-acute care reimbursement and compliance.
• IT risk management and cybersecurity: Protect your practice from data breaches and ensure HIPAA compliance with our robust IT solutions.
• Business valuation and benchmarking: Gain insights into your practice’s financial health and industry standing for informed decision-making.
• Mergers/acquisitions and community health needs assessment: Navigate complex transitions and fulfill community health requirements with confidence.

Outpatient Therapy Services:

• Fee schedule reviews and contract negotiations: Optimize reimbursement rates and secure favorable contracts for your therapy services.
• 340B compliance: Ensure compliance with 340B program regulations to maximize savings on outpatient drug costs.
• Buy/sell agreements and loan procurement: Facilitate smooth transactions and secure financing for your therapy practice’s growth.
• Feasibility studies and operating agreements: Make informed decisions and establish solid operational frameworks for your therapy practice.

Hospital Services:

• Cost-per-case analysis and emergency department throughput services: Identify cost-saving opportunities and streamline emergency department processes for improved patient care.
• Managed care underpayment recovery and Medicare/Medicaid rate analysis: Maximize reimbursements and ensure fair compensation for services rendered.
• Hospital accounts receivable assessment and action plan: Streamline accounts receivable processes and accelerate cash flow for your hospital.

Medical Coding/Billing Services:

• Revenue optimization and claim denial management: Maximize revenue and minimize claim denials through expert coding and billing practices.
• Compliance and technology: Stay compliant with ever-changing regulations and leverage cutting-edge technology for efficient billing processes.
• Outsourced certified professional coding and contract management: Access top-tier coding expertise and manage contracts effectively to optimize revenue.
• Fee analysis and accounts receivable resolution management: Identify opportunities for revenue enhancement and resolve outstanding accounts receivable efficiently.

By partnering with CMBC, healthcare practices gain not only comprehensive support in medical billing but also strategic insights and solutions that drive sustainable growth and success.

Yes, we are HIPAA Compliant and OIG cleared.

• Evaluate and review the current state of your billing structure
• Remote access to current practice management software or recommend according to practice needs
• Credential for Medicare, Medicaid, commercial payers, and hospital privileges
• Compliance requirements per specialty
• HIPAA document
• Optimize fee schedule
• Medicare enrollment (PECOS)
• CAQH registration and completions
• Scheduling of appointments
• Eligibility and benefits secured prior to patient’s visit
• Coding (ICD-10)
• Charge (CPT)
• Primary and secondary insurance billing
• Clearinghouse submission
• Payment posting/adjustment posting
• Patient balance statements
• Collections
• Accounts receivables audits
• Outstanding claims follow-up
• Customized monthly reports