Core Services - Office Based Practice Management and Centralized Operations
ADM Core Services
Patient Management: Scheduling, Billing and Collection
Coding and Documentation Compliance Services
Risk Management and Compliance
Contract and Credentialing
Group Practice Coordination
General Accounting and Accounts Payable
HR/Payroll
Group Purchasing
Business Development and Overall Practice Coordination
IT Infrastructure
Patient Management: Scheduling, Billing and Collection
ADM’s billing and collection services are the heart of what makes us an essential business partner. Our efficient and experienced office staff registers patients, posts all charge entries, processes electronic and manual claims and posts all payments ensuring that an office’s daily receipts are credited with the bank and are a first check to prevent fraud/theft in the office and billing process. Additionally, we provide complete team management for all exceptions and claims rejection for Medicare and insurance companies as well as Medicare and commercial insurance audit support. Our well trained, supervised staff uses advanced practice management software to deliver the following operational services:
- ADM staff registration of patients
- Charge entry
- Claim production
- Electronic and manual claims processing
- Patient Statements printed and mailed
- Toll free number for patients to call
- Payment posting
- Claims exception management and follow up
- Management of exceptions/claims rejection
- Medicare and ommercial insurance audit support
Coding and Documentation Compliance Services
Under the direction of Mark S. Nestor, M.D, Ph.D., ADM employs Certified Dermatology Coders who perform two important functions. We select ten charts from each physician twice each year and proactively review them and use the results of that review to provide continuous feedback and education to help physicians maintain compliance with coding and documentation standards. All requests for medical record documentation from insurance companies are coordinated by ADM. All documentation for release is sent to ADM, where our coding staff reviews each piece of physician prepared documentation correlates it to billing and assures it is correct and complete before it is released to third parties.
- Internal Proactive Documentation and Coding Education
- All record requests coordinated by ADM
- All records reviewed by coding specialists before release
Risk Management and Compliance
Under the direction of Dr. Nestor, ADM directs licensed risk managers to help assure that the physicians of SCA meet all regulatory requirements, including regular and ongoing compliance and safety training, OSHA and CLIA compliance with office manuals and forms provided for each location. Dr. Nestor also works closely with all SCA physicians and mid-level providers in order to decrease potential malpractice risk by helping to assure proper documentation and consents as well as assisting in resolving patient concerns.
- Risk management staffing
- Risk manager visits twice yearly to each physician
- Risk manager onsite for all inspections
- Risk management telephone support 24 hours a day, 7 days a week
- Compliance and safety training
Contract and Credentialing
ADM has specialized personnel that, on behalf of each physician, maintain all contracts and credentials with managed care companies and Medicare. ADM also handles hospital re-credentialing. Because of our unique group structure and size we have been able to negotiate favorable managed care contracts with some of the largest and most popular insurance carriers. We continue to update and renegotiate these contracts as needed.
- Managed care contracting
- Managed care credentialing
- Hospital credentialing
Group Practice Coordination
SCA functions as a true group practice. Because of this, ADM has the ability to assist physicians in obtaining physician coverage in cases of illness, injury or other temporary need and/or staff coverage to be able to allow physicians to continue to optimize practice revenue in an emergency situation. Often times ADM is able to arrange practice opportunities in existing locations whereby physicians who, as they are building their own practice, have the desire to supplement their income by working in other existing SCA offices.
- Emergency physician coverage
- Emergency staff coverage
- Inter-office physician opportunities
General Accounting and Accounts Payable
ADM provides the services of a Chief Financial Officer, a Controller, a cashier, and a full time staff for general accounting and accounts payable. Monthly financial statements and supporting general ledgers are given to each physician/location. By ADM staff reviewing and balancing all cash receipts and reviewing and processing all disbursements creates an internal control environment that markedly reduces the chances of employee theft going undetected. This complete accounting of practice and office related income and expenses as well as detailed analytical reporting helps physicians better understand and better manage their income, their fixed and variable costs, their staff, and ultimately their bottom line.
- Cashiering – lockbox and Point of Service payments
- Balance cash checks/credit card payments, by location
- Accounts Payable (bill paying)
- Vendor negotiations
- Lease administration
- Monitor office leases and CAM reconciliations
- Monitor equipment leases and buy-outs
- Vendor account reconciliations
- Patient refund processing
- General ledger maintenance
- Financial statement production
- Detailed reporting and analytical support
- Customized reporting as requested
HR/Payroll
ADM provides complete Human Resource management, from assistance in recruiting administrative and professional personnel to complete payroll, benefits and pension administration and a group level employment practices liability policy.Payroll/customized reporting
- Recruiting
- Benefits administration
- Insurances
- Workers comp claims administration
- FMLA
- Cobra administration
- Pension plan administration
- Employment practices liability insurance
- PA supervision data forms and licensing
Group Purchasing
SCA and ADM leverage their tremendous group wide buying power as well as the personal connection our doctors have with vendors and industry to negotiate dramatic price reductions for services and products. These include reductions in the cost for professional liability insurance, medical supplies, office supplies, overnight mail, medical waste management, and special aesthetic pricing of devices and injectables with companies such as:
- McKesson
- Ethicon
- Allergen
- Medicis
- Office Depot
- Stericycle
- FedEx
- Others
Business Development and Overall Practice Coordination
ADM is committed to aiding physicians in the development of their individual practices. Business development occurs on many different levels. The entire ADM team is available to assist physicians in growing their business by leveraging our experience and proven methods to increase patient awareness of services provided by that physician, increasing access to new patients, and developing new services to offer all patients. ADM also facilitates expansion to additional locations, including physician recruitment, facilities planning, and lease or purchase negotiations.
- Practice expansion-same store and new locations
- Physician recruitment
- Facilities planning
- Lease and purchase negotiation
- Assistance in developing marketing plans
- Public Relations
IT Infrastructure
ADM offers an enterprise level, sophisticated, interconnected high speed wide area data network to connect all physician office locations and our ADM office facility. Redundant servers, robust anti-virus malware and intrusion protection as well as full back-up and disaster recovery facilities, all housed at a CAT-5 resistant bunker assures continuous delivery of IT services. The infrastructure is supported by fully staffed in-house IT department.
- The network is maintained and supported by five full-time IT staff personnel
- High speed wide area data network connecting all locations
- Full back up and disaster recovery facilities
- Co-location of key systems at CAT-5 resistant data bunker
- Installation of onsite computer hardware and practice management software
- Anti-virus malware and intrusion protection
- High speed wide area data network connecting all locations
- Sophisticated e-mail system
- Internet and Intranet sites
- Maintenance and support