White Nelson Diehl Evans is dedicated to providing high quality, client focused tax, financial accounting and advisory services to assist our many customers in the medical and healthcare field:

  • Medical Practices
  • Dental Practices
  • Physicians Groups
  • Independent Physician Associations
  • Surgery Centers
  • Nursing and in Home Care
  • Aging Services and Senior Care
How Does the Affordable Care Act Affect Your Business?

For many companies that offer and provide health insurance to employees as a part of their standard benefits package, the Affordable Care Act (ACA) or “Obamacare” has little administrative impact, except for some additional payroll and tax reporting. For the providers of healthcare and medical services, ACA has expanded access of health insurance to an estimated 30 million people. While expansion of coverage or access has occurred, there has not been commensurate expansion of actual care.

The industry is now struggling to serve a vast influx of new patients. Increasing the supply of healthcare providers to meet the increased level of demand may take many years to achieve. Increased innovation can only do so much and the healthcare system is likely to be burdened as providers react to the market. The expected results are shortened time with providers, greater difficulty accessing providers, increased costs and new frustrations for patients and health-care providers alike. These issues are only the tip of the iceberg and implementing the ACA may aggravate an already stressed health-care provider workforce.

Despite the obvious challenges of the ACA, there are some provisions that will improve the financial viability of many family practices by providing coverage to patients who previously received services on a discounted or free basis. Preventative care covered by insurance has expanded and some patients with life-threatening illnesses now have coverage. Hospitals in particular, have seen a boost in revenue from more paying patients. To accomplish the expanded coverage, much of the education and training has fallen on service providers to enroll patients in the appropriate insurance plan.

Medical Billing and Realization of Receivables

Billings and accounts receivable are the lifeblood of most companies. In the healthcare industry, the complexity and importance of effective billing operations is even more critical than in most other industries. Insurance companies and other payers have a confusing and complex process for claim submissions that makes it harder and harder for physicians and other service providers to get paid for the work they perform. Patients hold off on paying until the insurance company reimbursement is received and documentation confirming the patient’s share of the billing is received, thereby delaying collection efforts. Furthermore, the new regulatory challenges from The Affordable Care Act and the Patient Protection Act, make it even more important for providers to collect the money they are owed.

Some figures that will alarm most doctors include only 70% of claims are paid the first time they are submitted. The remaining 20% are denied and 10% are ignored. Of the 30% not paid, 60% are never resubmitted to payers. With other factors contributing to collection efforts, statistics show that over $125 billion dollars are left on the table annually by American medical practices.

The key to increasing your receivables success is to establish performance metrics for your accounting team. You can only manage what you measure so knowing the success rate of collections efforts is the first step. Simplifying and automating the revenue cycle is a major step to reclaim unpaid funds. Electronic health records, online patient portals and practice management systems provide better opportunities for providers to cut costs and improve results.

There are several key best practices that should be employed to improve medical accounts receivable management and most start with automation. Strong software tools can identify denied claims before submitted, manager payer contracts, report on daily aging of receivables, create claim process workflows, business and analytics tools, electronic remittances and advanced tracking of denials, underpayments or unpaid claims.

Perspectives

Managing Partner Dave Doran Retires After 42 Years with White Nelson Diehl Evans

12/09/17

Dave Doran, Managing Partner of White Nelson Diehl Evans, is retiring after 42 years of service with the firm.  Dave began with the firm in 1975 and has spent his entire career with WNDE. 7th...

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Here We Grow Again: WNDE Staff Increases through Proactive Recruiting, M&A Activities

11/16/17

Through a combination of proactive recruiting and M&A activities, White Nelson Diehl Evans has enjoyed steady growth throughout 2017.  The firm staff size has grown to nearly 150 professionals,...

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Illustration of Basic Controls Over Wire Transfers

11/13/17

The following is the next installment in WNDE's series on fraud authored by Bill Morgan, principal at WNDE.  In October’s WNDE newsletter, we set forth the basic controls that should be in...

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Tax Planning Guide

At White Nelson Diehl Evans, we know how difficult it is to stay ahead of the complex and dynamic tax laws. From new standards changing revenue recognition rules to the impact of the Affordable Care Act, our goal is to help our clients stay in front of tax issues that impact your bottom line. To help in this effort, we have put together a comprehensive tax-planning guide and it’s available to download for free.

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Partner Testimonial

“At WNDE, we are proud of our long history serving medical organizations and healthcare professionals. We recognize that this sector faces ever increasing regulatory and cost related challenges, as it strives to provide patient care. We are focused on delivering expert tax and accounting services to improve financial results, and after-tax positions, for both the medical organizations that we serve, and the professionals behind them.”

Candy Huie Tax Partner