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Excellent book describing the modern business practice of medicine
Health care spending continues to rise at the fastest rate in our history. On one hand, the insurance companies, bio-tech and pharmaceutical companies, as well as lawyers, have increased their profits in step with the rising costs of health care. On the other hand, the medical and chiropractic office owners - the actual health care providers - have not only failed to keep up with raising costs but have lost a significant part of their income.
How such a paradoxical situation is possible without a deliberate strategy against health care providers?
The best part of Lirov's book, for me, was understanding this paradox and becoming more conscious of how insurance companies manage to systematically reduce my income to improve their shareholders value. Lirov's book spells out the reasons for and the symptoms of the payer-provider adversity. The book outlines both the strategy and the tactics the insurance companies use to underpay or worse, take back the money already paid to the providers. This is not a theoretical work trying to lay out a strategy of underpayment. This is a road map for any insurance company interested in a simple and pragmatic system to increase its share value.
Next, Lirov's book outlines an Internet-based strategy for providers interested in leveling the playing field with the insurance companies. This is a toolkit, designed to give the reader a selection of tools for specific circumstances. The underlying theory is that multiple small practices can use the Internet to combine their insurance claim volumes to "transform the many into the mighty" and use Metcalf's law to guide them during such a transformation. Lirov's book tells you how to create a shared and continuously improving billing knowledge base and an integrated system for both front office and an outsourced, or even off-shored, billing service.
In spite of the title that mentions chiropractic, most of the information in this book is directly applicable to any health care provider running a private practice and dependent on insurance payments. The book is filled with valuable advice and simple examples about using modern technology to increase provider's revenue. The introduction of the billing network effect concept is simple and convincing. The audit part could use more examples but the parts on metrics and on outsourcing are both practical and easy to follow.
Overall, this outstanding book provokes thinking about best practices, scalability, and professional management of the physician's office. It should be required reading for practitioners at any level of business experience.
Prashant N. Pandya, MD
Billing Intelligence
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Interventional Radiology
Hoag Memorial Hospital
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Allianz Asset Management
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M.D., Heart Specialists of Central Jersey in Manalapan and Centrastate Medical Center
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Surgical Pathology Associates in Wrightstown
Centrastate Medical Center
Freehold, New Jersey
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Tatum CIO Partners
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Azima Health Services
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Care Management at St. Joseph's Hospital
America's Top Physician by Consumer's Research Council of America, 2003
Clifton, New Jersey
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Executive Director
Association of New Jersey Chiropractors
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ANJC Legal Counsel |
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