Christopher H. Loo, MD-PhD
Physician Spotlight: Dr. Heather Signorelli, DO
Updated: Oct 27, 2022
Dr. Heather Signorelli, DO (National Revenue Consulting)
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Christopher H. Loo, MD-PhD: So welcome, everybody to this week's podcast episode for the Financial Freedom for Physicians Podcast. And I'm your host, Dr. Christopher Loo. And as you know, I talk about four types of freedom: financial, time, location, and emotional freedom. And my mission is to bring you up to date information, and education from people from all over the world doing cutting edge things, and offering creative solutions to today's problems, particularly in the financial space.
So today, we have a physician, Dr. Heather Signorelli. And she is the founder and CEO of National Revenue Consulting, and she's going to talk to us all about medical billing, coding and all of the business solutions that she offers. So I'll let her introduce herself and go from there. So Heather, welcome.
Heather Signorelli, DO: Thank you so much, I appreciate the opportunity to come and chat with you guys. So like you said, I'm a physician, I'm actually a pathologist at my day job and work for a big health care company and do the administration side of things. And so I do that in my day job. And then on the other side of the world, we're also running this medical billing company, which my husband runs the day to day operations. And it's been a lot of fun really getting in there, and helping practices and helping physicians increase their revenue and get the revenue that they deserve.
Christopher H. Loo, MD-PhD: Yeah. I know, when we talk about medical billing and consulting, a lot of physicians, their eyes glaze over. But the problem is, they don't understand this space. And that's why insurance companies take advantage of them, and they essentially rip them off. So I'm really fascinated to bring you on and to talk to you. So tell us, I mean, just give us a general overview and lay of the land.
Heather Signorelli, DO: Yeah. And it's pretty interesting. Like you said, there's a lot of physicians who either don't have the time or the interest to get into the details. And it's certainly not necessary for a practice or a physician to know everything that they need to know, in regards to billing or coding. But having the general knowledge, and then having a team of people who can help support that, is critical. You know, $125 billion, is lost every year in revenue, because of insurance denials, and the complexities around the insurance process. And again, that's revenue that is due to the physician, but again, just lost due to the process.
And so our company, we are just a year old. And our big premise is working with physicians to help guide them in the development of their metrics, so that they can understand how they're doing, create benchmarks, so that they constantly know a pulse on the revenue in their company. And I think, having met with the clients we've worked with so far, the number one thing where I've seen physicians or practices lose, is not having a pulse on that, and hoping and praying that it's all going well. And then six months later, looking back going, “shoot, this doesn't look like how I expected, I'm not getting the revenue I expected, what do I do now?” And then they start looking for a new medical billing company, or they start looking for a new solution.
So our solution, our team that we have built, really goes and works with the practice to make sure that they have the data analytics from day one. And we're constantly meeting with them on a monthly or even sometimes weekly, depending on if we're onboarding somebody, so that they know, okay, how are we doing? Are there processes we need to improve on? Are there things that we can do in the registration process, or when the patient comes into the office for the first time to help simplify and streamline the billing process, right?
So if you know that you're getting accurate demographics, you know that you're getting your insurance verification, getting a prior authorization if it's necessary; all of those little steps, all equal, better billing, right? So if you're doing each of those things appropriately, or if you're tweaking those processes to make it more efficient, then the higher likelihood is that you're going to have a claim submitted and a claim paid, and faster.
Christopher H. Loo, MD-PhD: Yeah, that's so fascinating because in today's information economy data is the new gold or data is the oil, and that's what's powering everything. So if you can offer data and solutions and services to solve extremely complex problems such as insurance and billing. You know, that's really... You. So you do the data. Do you offer any staffing solutions, or help with staffing? Like if, for example, a physician’s office or practice needed your services. Do you provide staffing solutions, like a billing office or department, or if the hospital needs that?
Heather Signorelli, DO: Yeah, we have a full service, medical billing. So we can handle billing, coding, credentialing. We can do audits for practices, we can help with compliance. And one of the other things that we really work with is to identify trends that allow them to change their coding, appropriately, of course, to help increase revenue. Whether that's implementing the chronic care management services, or that's just using modifiers appropriately, or really diving in if they are having issues with denials, or if they previously had issues with denials, tracking and trending, why they've had denials, and then correcting for those.
And so it really just depends on the practice. We also partner with a couple different software companies. So if say a practice is looking for an EMR or a whole suite of e-Prescribing and telemedicine, we can help suggest partners. Again, we personally do not offer that. But we're happy to pass on the savings that we get at cost for the companies that we have partnerships with.
Christopher H. Loo, MD-PhD: Yeah, very interesting. And so you have data, you have staffing. How about in the consulting realm. If the office or practice needs advice on how to increase revenue, do you offer that as well?
Heather Signorelli, DO: Absolutely. And that can be as simple as trying to get a big picture view of what the expenses are, what revenue is coming in, and how can we tweak that? We can also spend some time looking at, if you have revenue generated by providers that are, say, seeing the same patient base, but the coding is very different between the two providers. We can take a look and say, Okay, why is this provider who's presumably seeing the same type of patients, coding more level fours than another patient who's coding more level threes?And so that really enables us to help practices to hone in on what may be more efficient and appropriate. Again, it's always about making sure that it's clinically appropriate. But we oftentimes when we start diving into the details on those trends, can really help a practice identify missed opportunities.
Christopher H. Loo, MD-PhD: Yeah. And what sort of clients do you work with? Do you work with small practices or do you work with outpatient centers or large hospitals? Tell us more.
Heather Signorelli, DO: Yeah, so primarily, we're working with outpatient practices, and some physician groups that do inpatient services, but we're billing for their professional components. So we, at this time, are not billing for hospitals, it's mainly for private practices. And physicians who say are, again, independent, but going in and seeing patients in the hospital and so they're just needing to build their professional piece.
We have also worked with some audits for some surgery centers. And so that has been a good experience for us to kind of see on the facility side, but in general, it's private practices that we're primarily supporting.
Christopher H. Loo, MD-PhD: And so if I were a private practice owner, my revenue, I see it's declining. What's the number one mistake that you're seeing in these practices? Wrong billing or just not adequate staff? Tell us more.
Heather Signorelli, DO: So the number one thing seems to kind of stem back to that data, right? They're not tracking and trending the data. And so it's kind of like they don't know where things are going wrong. That denial rate could be high, but they don't know that the denials are all coming because there's a lack of insurance verification. So patients come in and their insurance has changed, and they aren't aware of it, because they don't have that checks and balances in, and then they're getting denials because of it. We also see practices that the staff just really isn't staying on top of the denials. Right. So obviously timely filing comes into play there. So the denial will happen, and then instead of getting right on it and managing that denial immediately, they're waiting 30+ days to manage those denials.
And every step of the way, if you have a delay, whether that's in a rejection or a denial, or anything that goes on through the claim process, then you bump up against timely filing, and the likelihood of not capturing that revenue increases. And so for us, one of the main things I tell practices who, maybe they have an in-house biller or aren't quite ready to switch to a billing service, like ourselves, is to look at your accounts receivable. Look at your data around accounts receivable. What is your average AR in days, what is the percent of AR over 90 or 120 days? And that can give you just a real glimpse of how things are doing. Obviously, it's important, then, to track and trend that to see why you're seeing that, right. If you have a long if you have a lot of money in your AR, and you're not quite sure why. And then you realize, well, I have all these denials. And that's why. Then, you can kind of dive into that.
Another thing we've seen is about the patient payment process. And so, if you're not capturing and collecting deductibles, and co pays ahead of time, and trying to capture that on the back end, even though they may be small amounts, it just increases the likelihood that you're going to have again, a longer AR, a lot of money held up where you're not getting paid. And so, we work with practices to really improve that process. So we can collect payment, collect credit card, save them in a HIPAA compliant manner, create a patient payment policy for the practice where the patients are coming in, and they're signing that ahead of time, so that they recognize the differences between co pays and deductibles, and why they're having to pay those and what the policy is for the practice, if they haven't received payment, when they're sending either an email or mail or out to the patient's home.
And all of that, it just comes down to process, right? You kind of have to know each step of the process. From the time the patient comes into the practice, to the time after the patient leaves and their bills are created. And the insurance companies have paid or not paid, depending on the claim itself. So, we really dive into the details on each one of those and make sure that the practices are doing it as efficiently as possible, and in a way that helps them capture that revenue as fast as possible.
Christopher H. Loo, MD-PhD: Yeah. So it sounds like you have a very unique company. And what's really interesting is you talk about quality and efficiency and customization and innovation. So I think this has been a really fascinating conversation. I'm sure a lot of physicians are listening to this and thinking, oh, I want to increase my revenue. So how can they contact you, visit your website, and maybe possibly work with you?
Heather Signorelli, DO: Of course. So our website is NationalRevenueConsulting.com. And there's a Contact Us button on there. And then you can also email us at info[at]NationalRevenueConsulting.com. And we look forward to having a discovery call, we're also able to help sit down. If and if you're not ready for practices and ready to change billers, we're happy to sit down and take a look at the metrics that they have in their practice and help give some guiding tips to say hey, you may want to look at this or drill down on that or think about this differently. And again, that's a no cost service that we're happy to do and sit down with practices. Should they be questioning, gosh, I don't even know where to start. I feel overwhelmed. How do I go about this? It just helps us give some ideas and tips to the practice who may be struggling.
Christopher H. Loo, MD-PhD: Yeah, yeah, that's been. So for all the listeners out there. Heather's links and resources will be included in the show notes in the hitter. Is there anything you'd like to add before we conclude?
Heather Signorelli, DO: No, I appreciate the time today and I hope you guys have a great afternoon.
Christopher H. Loo, MD-PhD: You've given us a really good overview and how National Revenue Consulting fits in, and I'm sure every lot of people will have a lot of interest.
Heather Signorelli, DO: Thank you.
Christopher H. Loo, MD-PhD: Many thanks again for being here. If you’re new, you can find me online at Christopher H. Loo, MD-PhD, where I have links to other episodes or links to online resources that will support you on your financial literacy journey. I’ll see you there in on next week’s show. While I bring you thoroughly vetted information on this show regarding a variety of financial topics, I cannot promise you a one size fits all solution. This is why I caution you to continue to learn. Educate yourself and seek professional advice unique to your situation. If you want to talk to me, I welcome it. Please reach out via my website or email at Chris@drchrisloomdphd.com. I read and personally respond to all of my emails. Talk soon!
Editor's note: This transcript has been edited for brevity and clarity.