Helping a Busy Emergency Services Practice Streamline Accounting Processes


Learn how Change Healthcare physician management services helped a group of physicians that was in financial distress and disorganization. With auditing and improved processes, the team helped ensure the company’s financial health and allowed physicians more time and confidence to do their jobs.


Winchester Emergency Physicians


As a result of a poor engagement with an outsourced professional accounting firm, a group of emergency physicians faced the challenge of extensive financial and coverage errors. The inconsistencies were leading to missing paychecks and even insurance lapses. 


Physician Group Management Services 


Physicians had 10 extra hours per week to focus on patients, hiring, and improved processes in the practice.

The risk of a mismanaged accounting system

While it might seem like physicians are the heart of any practice, the hands and feet helping daily operations and financials run smoothly is the accounting department. When this department isn’t meticulously handling ledgers, relationships with insurers and claims departments, and more, the physicians aren’t able to do their job. Instead, they find themselves sorting through messy accounting books, untangling spreadsheets with missing numbers, and wasting valuable time that could be better spent caring for their patients.

Winchester Emergency Physicians found themselves in this exact position after a long-time accountant at their outsourced CPA firm retired— working through six to nine replacements before realizing they were behind on payments, including physician paychecks. Change Healthcare worked hand in hand through each aspect of Physician Group Management Services to give doctors back their time, peace of mind, and the organization they deserve.

“The Change Healthcare team delivers on its promises. I would let others know that they will work with you to help you prosper in the business of healthcare.”  

-  David Watts, M.D., emergency medicine physician at Winchester Emergency Physicians

Determining accounting mismanagement

In a practice with over 50 employees—including high earners such as physicians, medium earners such as physician assistants, and additional staff members—there can be complex and robust accounting needs. The three core problems Change Healthcare found upon their initial exploration through Winchester’s files included:

  • Lapses in insurance coverage, such as payments that were noted as paid but money had never been sent.
  • Delayed paychecks for physicians due to poor accounting.
  • Confusion from leaders trying to step in and solve accounting problems without a comprehensive view of the whole picture, or specialized medical accounting knowledge, resulting in hours of wasted time.

Putting in the legwork to start anew

In my initial interview with Change Healthcare leaders, I was pleasantly surprised by their initiative, forethought, and expertise. They were already two steps ahead, saying, “They’re going to need this. This is going to be an issue.”

Change Healthcare specialists implemented an immediate audit of 16,000 ledger lines, working cooperatively alongside current staff members, and finally created a comprehensive plan:

  • Audit each ledger line for accuracy in numbers, dates, and other information, reviewing years of data.
  • Determine missed deadlines including health and disability insurance, which were close to being canceled due to missed payments.
  • Reinstate canceled MetLife policies for providers.
  • Clean up all reports and create a data story to teach staff members how pay is generated from these numbers.
  • Educate providers on financial aspects for increased understanding in the process.
  • Rebuild a more forward-thinking ledger system for improved accounting processes and automation.
  • Improve invoicing processes, including with the practice’s hospital system, to ensure timely provider payments.
  • Switch from an out-of-date, handwritten time-keeping system to an automated system.

Creating a new and sustainable financial system for the practice was a significant undertaking. What made it sustainable, however, was the corresponding education to ensure all relevant employees could keep up with it for years to come, with the timely help and support of Change Healthcare.

Less rush, more accuracy

Not only do employees appreciate being paid on time again, but stakeholders such as the hospital’s billing department appreciate the built-in time and flexibility the practice now has to solve problems alongside them. Instead of rushing through flawed processes, new systems have padded buffer time and mechanisms for issue management, allowing for meaningful conversations and resolutions with extra time to spare, while still ensuring all parties are paid on time, and correctly.

A key support system for success is continued weekly calls with Change Healthcare’s Physician Services team, problem-solving and troubleshooting to ensure long-term success with the new systems. My confidence has improved significantly, as I can now trust the systems in place when an employee or collaborating group has a question about payment. Instead of questioning my own team’s accuracy, I’m now confident their numbers are correct.

Rediscovering time, organization, and peace of mind

Forty hours each month, that’s how much additional time I’ve gained back to run my practice, tend to my patients, hire and train new staff members, and more, thanks to these new systems. With my new gift of time, I’ve worked on legal documents; reorganized the corporate structure; and hired multiple doctors, physician assistants, and nurse practitioners for the benefit of patients. I’m accomplishing a long-time goal I haven’t had time for, reorganizing and restructuring employee contracts to better reflect their positions.

More importantly, I have the confidence and peace of mind to oversee and negotiate every aspect of the business. I know the company’s health at any given time and have confidence in the accuracy of each number representing it.

The practice is making headway in rebuilding lost trust with stakeholders who suffered from late payments and broken contracts. But through reparations and consistency, those relationships are flourishing again, providing mutually beneficial results for both parties.

Finally, ongoing collaboration with Change Healthcare has given me and my team the confidence to pursue our vision for the type of tomorrow we hope for with our practice. With burnout and errors and complications swept aside, we are moving assuredly toward this future with Change Healthcare’s ongoing support.

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