California Pathology Practice Increases Reimbursement by 40%

ATLANTA, June 27, 2012 /PRNewswire/ --Today's pathology practices face increasing billing complexities. Coding regulations are complicated, and penalties can be stiff if errors are made. Some physician groups miss valuable reimbursement revenue for certain services because they don't have the capacity or resources to bill for them electronically.

South Valley Pathology Associates in Bakersfield, CA, was one such group. With three full-time physicians, a small technical team and a three-person business office staff, South Valley was performing at an acceptable level while its billing was managed by an internal business manager. But when it made the switch to Orion HealthCorp, a leading medical billing and practice management company, it began to realize what it had been missing.

"Orion made us aware of revenue opportunities we didn't know existed," said Dr. Bruce Swinyer, medical director of the practice. "We never collected for clinical services (blood draws and testing), because the lab operates independent of us. Orion showed us how we could begin collecting for those services as well as for the anatomical (tissue) pathology services we perform. That has made a huge difference for us. We have streamlined our billing processes and optimized reimbursement."

40% reimbursement increase in 2011Typically, smaller pathology practices don't have the ability to bill for clinical services because the charges are sent electronically and the individual collections are small, so handling them manually usually costs more than the actual reimbursement. Orion has the software capabilities and the expertise to do the job correctly. With the addition of clinical collections and increased collections for anatomical services with Orion, the practice's reimbursement from Medicare and private insurers grew by 40% in 2011, a record year for the practice.

Also, since partnering with Orion in 2010, Dr. Swinyer says he has greater insight into how the business side of the practice is performing. That is extremely important in today's economy. "Orion's e-mail month-end statement of collections and weekly updates on collected revenue are a great asset," he said. "Also, being able to see revenue broken out by anatomical and clinical pathology services is very helpful."

Transparency into vital signs"They established credibility from the outset," he said. "And when they showed me their reporting capabilities and the visibility provided into our practice, I knew it was going to be a good match."

Osmium(SM), Orion's Business Intelligence (BI) tool that provides transparency into the practice's vital signs, makes much of that visibility possible. It puts data in relevant form so Dr. Swinyer can see precisely, in real time, how the practice is performing and how Orion is performing while identifying opportunities for improvement and future growth.

"We know Osmium is a valuable tool, but it is always good to see it validated in the marketplace this way, and to see the value it is providing Dr. Swinyer's practice," said Dale Brinkman, president of Orion Rand and Orion Western Skies Billing. "We work hard at Orion to see that our clients are satisfied, and this is proof positive that we are doing the job right."

Today, the practice's billing is handled much more professionally and objectively, giving Dr. Swinyer a new-found confidence. He is also lab director at a smaller hospital in Kern Valley. With his busy schedule, he appreciates knowing that the business side of the practice is in good hands with Orion.

According to Dr. Swinyer, Orion delivers benefits to the practice at every level. "Not only does their billing yield strong results, but they are also exceptionally responsive to our requests," he said. "Their team is extremely approachable, and I feel very comfortable dealing with them. It's a great partnership, and I have peace of mind knowing that our practice is running smoothly."

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California Pathology Practice Increases Reimbursement by 40%

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