AMPS

What Color is Your Bottom Line?

The average medical practice may generate between 14% and 23% of net revenue (or between $35,000 and $48,000 per physician) LESS than they could.

Let PYA's Advanced Medical Practice Solutions ("AMPS") help your practice identify opportunities to change the color of your bottom line.

AMPS is a comprehensive technology-based solution to diagnose certain complex and time-intensive medical practice issues. For example, the AMPS analysis includes:

A comprehensive review of evaluation and management (E/M) codes to assess possible compliance risks and revenue opportunities. Using three degrees of analysis, AMPS assists the practice in understanding not only how its E/M coding compares to Medicare benchmarks by specialty, but also how different sets of E/M codes compare to one another (e.g. new office visits to office consults) and to all E/M codes (Client Example I). Ultimately, these three analyses allow for the identification of potential coding issues and provide a quantifiable, patient acuity adjusted opportunity for improvement.

In-depth cost accounting and physician compensation and productivity surveys. AMPS reveals what it costs in real dollars to perform a procedure or deliver a service, which allows for a calculation of profit and loss by procedure, provider, and/or location (Client Example II). Additionally, AMPS can determine break even fees for managed care contract negotiations as well as providing a defensible foundation for physician compensation and bonus calculations (Client Example III) based upon the Practice's own data, not just external benchmarks.

Evaluation of the validity, appropriateness, and compliance of procedure codes and modifiers. AMPS reviews all procedure codes and modifiers to identify which codes have been deleted, are invalid, or have been replaced by a new code (Client Example IV). AMPS also pinpoints high risk and inappropriate code/modifier relationships which may trigger a profiled audit.

Analysis of the practice fee schedule in relationship to the practice payor mix, allowing for the establishment of a unique and optimal fee schedule for your practice. Using a practice's fee schedule and explanation of benefits, AMPS optimizes commercial revenue by estimating an unknown maximum allowable payment (Client Example V). AMPS also provides a defensible mechanism for adjusting fees (e.g. based upon reasonable practice expenses) and analyzes every single CPT code, not just the top 20%.

If you would like to discuss the ways AMPS may benefit your practice, please contact PYA's Physician Services team today at (800) 270-9629 or email AMPS@pyapc.com.

The information provided via PYA Alert, Tax Planning Alert, or Audit and Accounting Alert should not be construed as accounting, auditing, consulting, or legal advice on any specific facts or circumstances. The contents are intended for general information purposes only.  Please contact us at (800) 270-9629 to discuss your specific situation or to discuss any specific questions you may have.