2011 – What Your Practice Should Consider as Year End Approaches
Meaningful Use – What's New and What You Need to Remember
Medicaid Eligibility Requirement for EHR Incentive Clarified by CMS
2011 – What Your Practice Should Consider as Year End Approaches
Year-End Tax Planning:
Consider the following when projecting and planning for year end taxable income:
- Year-end bonuses for physicians and staff.
Acceleration of payments on expenses/outstanding tax-deductible obligations (not loan or line of credit repayments).- Purchase of fixed assets that will be required in the first part of 2012, prior to year-end, which can then be fully expensed up to $500,000 to reduce your taxable income. Such purchases will only be fully expensable up to $125,000 starting in 2012.
Keep an eye on Medicare rate reductions. If Congress does not act in a timely manner, physicians could face a 29.5% cut in their rates starting January 1, 2012. Depending on the volume of Medicare patients in your practice, this could present some serious cash flow problems for many practices. Make sure you know the potential impact this could have on your practice financially and tax-wise, and consider ways to make up for the lost revenue (in both the short and long term) should these cuts go through. Having a line of credit in place will be helpful in the event of a cash shortfall on a short term basis. That process should start now if your current line of credit is inadequate or non-exist. Include these topics now in your year-end discussions with your advisors.
Year-End Financial Review:
Look at revenue trends by payor, by provider, and by office to see if revenue is flat or has decreased. Determine why, as this may require a change in strategy moving forward (i.e., engage in payor rate negotiations, review of provider incentives, add/close an office, etc.).
Review your expense items line by line to determine which ones increased in 2011 compared to 2010. For larger increases, find out why the increase occurred. Focus especially on your bigger dollar categories.
Practice Management/Billing:
Review and develop a game plan to clean up your A/R balances. Focus on larger carriers and larger $$ amounts first.
Resubmit or appeal all outstanding Medicare claims by 12/31/11. The Patient Protection and Affordable Care Act requires that providers must file claims for services furnished on or after 1/1/10 within one calendar year after the date of service. Don’t miss the timely filing deadline.
Institute a big push for collection of past due patient balances (possibly consider an evening phone-a-thon).
Check on line of credit availability to cover any possible cash shortfall at year-end.
Conduct employee evaluations (and self-evaluations) to make sure that you have the right staff in the right positions and that they are paid correctly and competitively, especially your star employees. Check the Snyder Cohn Salary Survey (due out in November 2011) for all medical office position salary norms and competitive benefits packages.
ANSI 5010 conversion – all transaction connections must be tested and converted prior to 12/31/11. Make sure you have allocated proper time and resources to this project.
Schedule OSHA/HIPAA/Compliance/Coding training for your office staff and providers.
Review the websites of your top carriers to check for updates or changes to the following:
- Medical Policies
- Operational Policies
- Pre-Certification Requirements
- Formularies
Review the practice’s top CPT codes for revisions, additions, or deletions in the CPT 2012 edition.
Update any necessary fee schedule changes in your practice management system based on changes to the Medicare fee schedule, costs of vaccines and other services, or your normal annual COLA increase.
