We started PhysicianXpress by investing years learning to operate a profitable Pediatric Office prior to developing software, systems and processes that can be used in Medical Practices. We truly understand how to own, operate and manage a Medical practice because we did this prior to starting PhysicianXpress. We learned that a priority for Medical Practices is for providers to provide Healthcare to patients and be paid appropriately and timely for their services. The revenue cycle is complicated in Healthcare due to the payer and patient both paying a portion of the bill as well as ranges in insurance contracts, payment rates and claims payment rules. This complication has caused many providers to either sell their practices or operate in a manner that is either not-cost effective or is a burden to them requiring constant learning, management and monitoring of the revenue cycle and staff performance.
Managing the complex revenue cycle consistently and appropriately is a different skill set than other operations of a medical practice. The skill required to optimize the revenue cycle is much different today than years ago. Understanding this, we researched and developed an optimal solution to operate Medical practices. PhysicianXpress was built from the ground up around an independent medical practice (two office-two provider group). The team mapped out the entire revenue cycle and leveraged developers to build the Revenue Cycle Management System of PhysicianXpress.
While seeking a better solution to manage the revenue cycle, we evaluated the billing process of hundreds of practices and noticed that there were many issues in common, including:
• Inadequate training
• Lack of management controls
• No benchmarks for performance compared to national averages
• Non-optimal staffing
• Inconsistency in managing the overall revenue cycle
We also noticed that most practices have significant gaps in specialty-specific billing rules as well as collecting their reimbursable claim dollar (total contract amount collected from patient and payer). Some practices have gaps that are more significant than others since most are collecting payments from Insurance and Patients at the national average and below the Medical Group Management Association Benchmarks. We understand that managing the revenue cycle requires high focus, monitoring and management and that this work load is in addition to the management of other components of a medical practice. Since 2007, the payer and payer edits have become more complex which require a billing team that consistently learns and improves. PhysicianXpress not only collects above the national average but also significantly above the MGMA benchmarks of success.
We have been in Business since 2007 and consistently achieve results for our clients. We learned that most clients want a solution for their practice that supports optimal Healthcare delivery, reduces administrative work while optimizing their total revenue/income for the providers. Additionally, practice owners should expect consistent performance, inclusive pricing and a customer service model that is customer-friendly. We provide all this at PhysicianXpress and strive to improve every year. We are aware of our clients needs to reduce complexity so we develop processes and systems to simplify the work required by the office that leads to collection of >99% of the total reimbursable amount. The usual requirement of our clients is to check patients in, see patients and close their charts in the system. We designed, developed and implemented a system that allows providers and staff to manage their business effectively and in a logical matter.
The physicianXpress Electronic Health Record and Medical Billing system was built on a flexible platform so the system could be configured to the needs of independent pediatric offices. It keeps pace with providers without slowing them down so they can see 30+ patients per day. The system also develops automated rules related to billing for well visits, sick visits, and vaccines (including admin codes).
After a number of years of continued success at averaging a collection rate >99% for our pediatric practices, we transferred our Revenue Cycle Management knowledge and processes to service a large distributor of a Specialty Medical Device (DME Industry). Specifically, we leveraged our knowledge in medical practices and buy-and-bill products to develop processes for a durable medical equipment device and DME items to service a large distributor. We continue to develop our product, processes and people at PhysicianXpress. We appreciate our clients and are dedicated to supporting them and their patients.