PRACTICING PROFITABILITY

Lirov offers physicians and those involved in the field of medical billing reliable advice for improving their businesses and growing revenue.

When the author looks at the landscape of the medical profession, he sees a playing field tipped to benefit the payers and hurt the providers. Large insurance companies, still reaping the benefits from years of record profitability, continue to erect and maintain huge, costly infrastructures designed to chip away at one of the last sources of new revenue–provider claims. By increasing billing costs, underpaying claims and conducting a growing number of post-claim audits, insurance companies strive to keep profits high by depressing those of individual providers. To counteract these methods, Lirov contends that healthcare providers need to streamline their business practices. He envisions the relationship between payers and providers as adversarial, and his book is a set of strategies that will allow providers to get back into–and hopefully even win–the game. The author seeks to show providers how to enhance their billing practices with a set of strategies designed to take advantage of the “network effect,” a characteristic of systems that allows a large number of disparate providers to capitalize upon their strength in numbers. Lirov also presents a comprehensive model for improving many elements of the provider-patient experience. He offers helpful advice on building communication with patients, improving clinical documentation (notes physicians take when dealing with patients) and facilitating the scheduling of patient visits. Lirov helpfully notes that his book is not for the billing novice, and he directs beginners to a number of other helpful primers. But for those who already have a strong handle on billing–and have a need to improve their practices to increase revenue–the book is an invaluable resource. Lirov’s writing, though sometimes weighed down by jargon, is precise and evocative, and his methods are sound and clearly explained.

A superior addition to the field of medical billing.