CAVETT ACCOUNTING
Certified Public Accountants

Experience that drives your healthcare system to success.
Gary Cavett has been involved in the healthcare industry since 1969. It’s this expertise that allows Gary to provide a unique perspective when offering front-end and long-term supportive consulting services to clinics, medical practices, and physicians to the Fargo-Moorhead area and beyond.

 

Medical consulting that is specific to YOUR needs.

The ever-changing medical arena can be a tricky atmosphere to navigate. Gary's ability to view the healthcare industry from different angles allows our clients to make stable, well-informed decisions. This pragmatic approach ensures confidential and concrete consulting advice in making your practice perfect.

 

When making recommendations, OUR guidance begins with YOU. We place special emphasis on client needs instead of umbrella consulting. The client's vision is the cornerstone of our recommendations.
 

Why choose Cavett Accounting?

• Collaboration with Affiliated Healthcare Advisors (AHA) to provide technical support and multi-location service abilities. AHA is a prestigious association of approximately 50 Certified Public Accounting firms offering the same wide range of expertise as national and regional CPA firms

• National recognition for participation in state and national healthcare associations and frequently speaking at seminars, conferences and workshops

• Extensive accounting, tax, and consulting services experience in physician practices and clinics

• National contacts with healthcare consulting firms and Information Technology professionals

• Multi-state knowledge of healthcare regulations

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Evaluation and Management (E&M) Analysis

We offer a method to the madness that occurs before, during, and after a patient encounter. We can implement and coordinate proper documentation guidelines throughout the practice to help alleviate complex encounter issues. E&M Analysis has three key components to manage this stress: history of the patient, type of examination, and the medical decision making which leads to a diagnosis. Physicians will be better equipped to evaluate, plan, treat and monitor patients over time by following the three components in documenting patient encounters. Proper documentation also leads to accurate and timely claims reviews/payments, appropriate utilization review, and proof billed services were actually performed. To ensure proper checks and balances, we will educate physicians and staff to make sure everyone is on the same page with this critical component to a successful and profitable practice.
 

Establishing a New Practice

Do you know what steps to take one, four or twelve months before establishing your new practice? We can help you navigate the unknowns by setting-up leases, calculating cash flow projections, arranging for working capitals loans, hiring attorneys, and making sure the practice has the correct state and federal licenses. We will also assist in figuring out whether the practice should be an HMO, a clinic, an established group, a start-up group, a multi-specialty, a single specialty, a partnership, or a solo practice. This will support contacting a third party to determine the reimbursement requirements. Using the correct method to establish a practice is the difference between success and failure. We can effectively help launch new practices and offers guidance to bring organizations back from the red into the black.
 

Strategic Planning

What does the future hold for your practice? Successful practices have expectations of group success over individual success. Profitability is essential in this equation. In order to meet the profitability expectations it is crucial to develop a consensus on the future direction of the group and to identify both the needs of the patients being served and the needs of the physicians. Establishing a predominant market position, meeting payer screening requirements, guaranteeing patient satisfaction, ensuring effective governance, and controlling costs are strategic imperatives crucial to a flourishing health provider. The ability to get the ship moving in the right direction depends on an understanding of the strengths and weaknesses of the practice in comparison to regional and national standards related to procedure codes, use of modifiers, patient mix, E&M utilization, and costs of producing procedures. We have helped struggling practices comprehend the complex layers of the healthcare industry. It continually proves to be the difference between success and failure.
 

Compliance Planning

The healthcare industry is littered with rules and regulations that vary from state to state. We offer services to guard against fraud, and that are helpful with audits. We can make sure you are coding and documenting properly, have the correct fee schedule/encounter forms, and adhere to tax guidelines. This occurs by designing the right compliance plan according to the size of a practice, complexity of operations and regulatory responsibilities, and a general tolerance for regulatory risks. We will review current policies, contracts, and help educate and train present employees. As a critical element in running a practice it should be considered that detection and punishment of healthcare fraud and abuse is second only to the prosecution of violent crimes on the federal government's list of priorities. Is your practice in compliance with state and federal regulations?

Comprehensive Medical Practice Analysis

A Comprehensive Medical Practice Analysis (CMPA) is performed for a medical practice using both a computer program interface and interactive consulting services. It provides the administration information necessary to make the right decisions to solve complex problems. The primary focus of the analysis is the revenue and reimbursement of the practice. Recommendations will include the possibility of adding additional procedure codes in the fee schedule as well as revising the manner in which certain codes are used. It will also include recommendations to raise fees for specific procedures. This will allow the practice to optimize both revenue and patient volumes. We will also identify fees that appear to be too high for your market area. We can analyze your practice's revenues and expenses to find opportunities to enhance the bottom line.

More information on the CMPA can be found in the article "Increasing Revenue and Reimbursement."
 

Medical Practice Assessment

There are several ways to analyze a practice. A Medical Practice Assessment uses a questionnaire to start an objective interpretation. This process involves measuring procedures or applications within a medical practice, accumulating the data into a digestible format and comparing it to either internal or external information at an acceptable or higher level of performance. Areas, such as, billing and collection, coding issues, accounts receivable, appointment scheduling/telephone management and HIPPA compliance are interpreted and analyzed. Once these areas have been assessed a plan of action for improving them is implemented. The key to continued progress necessitates understanding the ebbs and flows of the volatile business atmosphere. A Medical Practice Assessment must be renegotiated on a continual basis. We launch practices from a solid base and provides continued support in the ever changing medical arena.
 

Acuity Analysis

Acuity is the relative value that measures complexity of services and procedures delivered to specific patient populations. It is calculated by using the RBRVS and selected RVU component values. It is specialty specific and is compared nationally to Medicare claims data. It works by measuring resources consumed for procedures and services (ration of RVUs to procedures); the higher the RVU value, the greater the resources and complexity. Based on this assumption, the greater the acuity factor the greater overall complexity of treating a specific patient population and since it is based on the RBRVS, only those procedures assigned RVU values are included. Non-RVU procedures and/or services do not have resources assigned to them (i.e. drugs, (j-codes), non-specified and lab procedures). You then multiply RVUs for each code by frequency and calculate the sum of the products (calculates grand total RVUs). Next, you equate the sum of the frequencies. Finally, you divide the total RVUs into total frequency (higher = more complex, lower = less complex). It is important to understand just how sick your patients are. We have the ability to tell you just how sick they are!
 

Physician Compensation

Compensation for current and future physicians can be a tricky issue to tackle. Administrations must consider methods of compensation, recruiting incentives, and how to allocate expenses. Methods of compensation can range from guaranteed salaries, profit sharing, bonuses, and production based compensation. Recruiting incentives can include salary guarantees, signing bonuses, moving expenses, loan forgiveness, malpractice insurance, and marketing assistance. Current and future physicians need to understand whether expenses are incurred equally, based on national statistics or if they are fixed, varied or semi-varied. It is vital these issues are set in stone and everyone from the current CEO to a recruit understand how the organization is run from a profit distribution/allocating expenses perspective. We have experience establishing objective resource allocations in existing practices and helps navigate the unknowns of future practices.
 

Provider Productivity

Productivity can be measured by comparing the relationship of revenue to consumption of resources or expense. Productivity, while still considering revenue, must also consider expenses. Productivity is not revenue alone, expenses alone or work effort alone. It is important to measure financial volume and expenses in three ways. Financial volume is the combination of gross charges, collections or receipts and profits. Gross charges put more burden on the fee schedule and measures fee schedule discrepancies. Collections take into account the efficiency of billing and collecting, considers A/R, can identify areas of non-compliance and/or coding problems, and hold physicians accountable for these processes. Profit looks at what's left after all expenses are considered. Expenses are tracked by contributions, time-motion studies and the RBRVS database. Tracked contributions require the ability to track expenses by physician. Time-motion studies are complex, expensive and variable in design. The RBRVS is a good research model. It has been standardized within the industry, simple and inexpensive to use, is a relational model and works well within closed system, and excellent for measuring moving dynamics within the practice.