In this episode of the Edge Podcast, Terry and her guest, NSCHBC member and consultant Joe Lessard, discuss how to advise clients on critical business decisions for medical and dental practices. They cover topics such as:

• Insurance acceptance: What insurance plans should practices accept?
• Hiring strategies: When is the right time to hire new associates or partners?
• Location expansion: Should new locations be opened, and if so, where?
• Operational scaling: When should practices expand or contract outsourced operations?
• Equipment acquisition: Should practices lease or purchase new equipment?

Tune in for expert insights on practice management, financial planning for healthcare practices, and growth strategies for medical and dental clinics.

In the context of medical and/or dental insurance, ADR refers to Additional Documentation Request. This is a request from an insurance payer (like Medicare) for additional records to support a claim. It's not a sign of wrongdoing, but rather a way to ensure compliance with policies and verify the validity of claims.

Ignoring these requests, or failure to meet their deadlines, can result in a loss of revenue and trigger additional payers' audits and ADR’s.

Terry outlines the ADRs and best practices to make sure your staff is on top of these requests, which helps save your revenue.

In-house billing offers enhanced internal control and potential return on investment but entails higher costs and staffing challenges.

Conversely, outsourcing is cost-effective, transparent, and consistent but may result in skewed control of financial operations and introduce hidden costs.

Terry discusses this important topic with healthcare consultant Donna White, covering the best option for different-sized practices.