“We have been extremely happy. Not only have the services been comprehensive and top-notch, but their people have been engaged and committed to our success from the start. They’ve exceeded our expectations in all respects, and we’re looking forward to a long and continuing relationship with them.”
- Fernando G. Mendoza, M.D.
Mission-critical tasks such as establishing a viable billing solution to optimize claims and collections, physician enrollment, and financial projections
Revenue Management Services
- Successful practice launch
- Long-term revenue cycle stability
- Ongoing process improvements
- Detailed reporting
PedEM, PLLC is a physician staffing group formed in 2012 to provide round-the-clock pediatric emergency care coverage for Baptist Children’s Hospital in Miami. The 16-physician group is responsible for about 30,000 emergency pediatric cases annually.
The Challenge: Establishing a Viable Billing Solution
PedEM was formed by longtime pediatric emergency medicine physician Fernando G. Mendoza, M.D., to bid for pediatric emergency coverage at Baptist Children’s Hospital. After winning the business from the incumbent physician practice, the startup needed to quickly execute a series of steps to become operational. Chief among these was setting up a revenue cycle process that would allow cash to begin flowing.
“It was essential that we get up and running so that we could get paid quickly,” says Dr. Mendoza, the group’s president. “It took us three or four months of planning before we could actually generate income. So we were running on fumes.”
Beyond billing, other necessary duties included physician enrollment and payer contracting. The group also needed to develop business models based on anticipated payer and patient mix.
The Solution: Turn-key Revenue Cycle Services
Dr. Mendoza began looking for a vendor who could help with the start-up-related tasks. A fellow Miami area emergency physician recommended Change Healthcare. Discussions with Change Healthcare representatives soon convinced Mendoza and other practice leaders that the company could meet the new organization’s needs.
“It was clear that they could help us quickly operationalize revenue cycle management, and also provide us with a variety of other services the group needed to get off the ground,” he states. “It was really a turn-key solution. That was very attractive for us, because it meant we would be dealing with just one company.”