Healthcare Credentialing | symplr Blog

Mergers & Acquisitions - A Tragedy in Two Acts

Written by Patrick Birmingham | Nov 8, 2012 4:40:00 PM

The owners of most successful medical practices will eventually be faced with the choice of whether to merge with another company or acquire one outright. Usually, this situation is the result of years of hard work and superior patient care which has resulted in more than a modicum of financial success.

While the merger or acquisition can produce a financial windfall, they still have many potential pitfalls that can ruin a successful practice. While the physician and his administrative staff can likely deal with the medical aspects of process, there still remains the problem of dealing with the government, the medical regulatory bodies and the healthcare industry payors.

Act I - Administrative Problems

There is an appalling amount of day-to-day paperwork involved in any medical practice. Next, compound this relatively routine paperwork process with the task of completing a whole new set of documents for every healthcare professional in your newly acquired or merged company. Without expert help or guidance, the results will be predictably catastrophic for your business.

Just to be clear, when any medical practice acquires new physicians, nurses or other healthcare staff, a new set of documents must be submitted to the proper authorities and to each and every payor. It is simply a monumental task to perform without the proper expertise and resources.

Act II - The Unforeseen Consequences

A newly enlarged company has, by design, taken on more overhead in the form of larger facilities and staff. Naturally, it expects that its revenue will increase to account for this fact and even offer a greater net income. Unfortunately, their lack of familiarity with the paperwork processes involved leads them to underestimate the time necessary to complete their enrollment process.

This lack of preparation in turn leads to a healthcare staff without the proper credentials and privileges to bill the services that they are providing. In turn, the medical practice must await delayed payment or not receive it at all while their administrative staff sorts out the mess. In addition, the added workload and stress related to the paperwork results in lowered morale and less productivity. In short, less money for more work and that situation makes nobody happy.

All’s Well that Ends Well

Fortunately, there is an efficient and affordable solution to this problem. Payor Enrollment Service companies are experts at the accumulation and dissemination of information. They have systems in place to reliably and efficiently provide multiple payors, regulatory bodies and government agencies with the redundant information that they require. In addition, their staffs understand the vagaries of the various entities and how best to accommodate their needs.

With all mergers and acquisitions, the healthcare providers should be free to concentrate on the medical needs of their patients, it is far more cost-effective to let them do their jobs and let a proven expert like a PES handle the time-consuming, paperwork tasks.