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Austin Cardiac Clinic

At a Glance

 

Austin Cardio Clinic's single provider, Dr. Tiblier, is intent on remaining independent while delivering the same level of service as a large practice and also staying profitable–a nearly impossible feat. With athenaCollector, 94% of claims submitted get resolved the first time, and they have seen a 55% decrease in DAR-enabling financial stability despite charging less for services than larger systems to increase patient loyalty.

 

 



Organization
  • Located in Austin, TX
  • One provider
  • Four full-time employees and four contract technicians
  • Two locations
  • More than 5,500 patient visits per year
Issues
  • Declining Medicare reimbursements for cardiology
  • Desire to remain an independent solo practice
  • State regulations add complexity to filing claims and collecting revenue
  • Claims stuck in Days in Accounts Receivable (DAR)
Solutions Results
  • Practice runs lean and efficient to allow financial flexibility and independence
  • Claims paid on first submission resulting in more revenue, faster
  • Collections increased 2.82%*
  • DAR decreased 22.88%*
Texas Cardiologist’s Quest to Stay Independent
 

Austin Cardiac Clinic’s Dr. Eric Tiblier, an interventional cardiologist, has seen revenues decrease, while documentation, administrative, and charting requirements have all increased. Moreover, many of his cardiology colleagues have sold their practices to hospitals, making the challenge to remain independent more difficult.

Remaining independent, however, is the path of choice for Dr. Tiblier, who prefers to care for his patients in a small, intimate environment. Over the years, he has developed a strong relationship with his patients, the kind you typically see with primary care physicians. That care and devotion have been rewarded with loyal patients who don’t want to be seen by anyone other than Dr. T, as he’s known to many. “We are blessed with many loyal patients and referring practices who value the kind of attention to detail and personalized service that we are able to provide,” says Austin Cardiac’s office manager Susanne Tetzlaff, who is also Dr. Tiblier’s wife.

Patient loyalty, however, only goes so far in supporting an independent cardiologist. “If we’re going to survive, we need a bigger company behind us,” says Dr. Tiblier. “I can’t imagine being a solo practitioner without an army of people like athena behind us. I wouldn’t be able to sleep at night.”

Knowing an army of “athenistas,” as they refer to themselves, are helping his practice thrive allows Dr. Tiblier to focus on providing the kind of personal care and attention chronic heart disease patients require.
Running Lean and Efficient to Counter Declining Reimbursements

In recent years, Medicare has slashed reimbursement rates for various cardiology procedures, such as pacemaker insertions, echocardiograms (sonogram of the heart), nuclear stress testing, heart imaging, cath labs, and others. The reimbursement cuts would be a pain point for any provider, but when the majority of your patient population is older and relies on Medicare, it makes running a practice difficult.

“In addition to fairly significant cuts to reimbursement, insurance companies provide other hurdles to compensation by requiring pre-authorization and notification of many services,” says Tetzlaff. “But athena does help us identify these issues and provides solutions to help us address them.”

Despite those declining reimbursements, Austin Cardiac Clinic still has to deliver the same level of service as hospitals or larger cardiology practices. “You are at a disadvantage if you can’t offer your patients one-stop shopping when it comes to cardiovascular testing and care; otherwise they’ll just go elsewhere,” says Tetzlaff.

One way to build loyalty is charging less than a hospital would charge for the same procedure or test. “Because the tests that we provide in office are not subjected to facility fees, as hospitals and hospital-owned imaging centers/practices usually are, we are able to provide the same high quality services at a lower cost to patients and insurance companies alike,” says Tetzlaff. The practice can do this because they get paid on the majority of their claims. In fact, the practice has even received referrals straight from insurance companies, some of whom recognize the cost savings and efficiency.

The practice generates more revenue faster through the use of athenaCollector, which uses its patented rules engine to ensure that 94% of claims submitted get resolved the first time. It has also reduced the practice’s days in accounts receivable by nearly 55%. The documentation required to be paid on claims continues to get more complex in the state of Texas, which requires a pre-authorization form attached to the majority of claims.

“Clean claims in Texas are required by law to be paid within 30-45 days. athena allows us to build custom rules tailored to our practice’s needs. That ability, plus athena’s built in rules, have been helpful to prevent us from filing claims that would likely be denied,” says Tetzlaff.

Adds Dr. Tiblier: “Billing services are incentivized to work on the easy money, but I have every incentive to get paid on all claims. I am confident that if I didn’t have athena to push things back to us when a claim gets denied, we wouldn’t get paid for it otherwise.”

Cloud-based services take patient care securely on the road

athenahealth’s cloud-based service also allows Dr. Tiblier the flexibility to practice medicine wherever and whenever from just an Internet browser or his mobile device. When practicing at the clinic’s second location, which is equipped with computers, Dr. Tiblier prefers to use the athenahealth app on his mobile phone in the exam room, along with Epocrates for select drug monograph information.

“I can do most of the encounter with the data in the app and I can show the patient lab results. Then I use Entrada to dictate my encounters straight into my phone,” he notes, of the speech recognition app that integrates seamlessly with athenahealth’s services thanks to its More Disruption Please initiative.

During a family vacation to Germany in 2012, using only an iPad, Dr. Tiblier was able to wake up every morning before his family fun started and log in to his EHR, athenaClinicals, from across the Atlantic Ocean to check in on patients, send prescription refills, examine test results, and answer lingering questions from the night before so his staff had answers ready for them first thing in the morning.

Having a partner like athenahealth behind him means Dr. Tiblier is able to devote more of his time to his patients while remaining independent in a competitive market.

*Our clients see an average 6% increase in collections and 32% decrease in days in accounts receivable. These metrics are based on a weighted average for athenahealth clients with valid pre-athenahealth benchmark data that had their 15-month anniversary with athenahealth between January 1, 2010, and October 31, 2013.
Eric Tiblier participates in athenahealth’s Physician Maven Program. For more information on this program, please visit www.athenahealth.com/maven.

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