• Accounting and Finance
• Managed Care Negotiations and Contract Administration
• Operations
  • Billing
  • Collections
  • Practice Administration Support Services
  • Payment Posting
  • Training
• Human Resources and Personnel Management
• Risk Management for Professional Liability
• Information Technology and Computer Billing System Support

Managed Care Negotiations and Contract Administration:
This service offers the most important benefits to the practice and to your bottom line. In
today’s medical profession, physicians face pressure from managed care organizations
that impede the way they practice medicine. Most physician providers do not have the
resources needed to negotiate with managed care plans. Consequently, their
reimbursements fall below industry standard and may not cover their costs. At VitalMD,
we have been successful in partnering with managed care companies to obtain better
contract terms and higher reimbursements.

Negotiating Power
Under the group concept we are able to speak with one powerful voice to managed care
organizations. With our excellent reputation we are able to form respectful
business relationships with payors and work with them to negotiate optimal rates. These
renegotiated rates represent a significant increase in reimbursement in comparison to
industry standards. Under this partnership philosophy, we have found that managed
care plans are willing to negotiate a contract under mutually beneficial terms. We build
on what matters most to our physicians, which is the ability to provide quality care to
their patients. In turn, managed care plans enjoy the added value top-quality physicians
bring to their organization and hope that it will attract prospective members to join their
plan.

Management of Contracts
In addition to rate negotiation, VitalMD has established open lines of communication with
managed care plans that allow us to proactively monitor claims payment to ensure
reimbursement is made in accordance with contracted rates. We facilitate claims
projects that resolve underpayments and erroneous denials. We also maintain current
fee schedules to guarantee the allowables on EOB’s are consistent with billing system
information as well as being the primary source of reference for all managed care
updates and concerns.

VitalMD has successfully negotiated with the following managed care companies in
South Florida:

Accounting and Finance:
Accounting & Taxes
We provide all corporate accounting and tax services to the practice, including:

• Monthly Accounting (bank reconciliation and write-up);
• Preparation of the company’s quarterly financial statements (consolidated),
  including an annual CPA review;
• Preparation of the annual tax return and related tax documents;
• Preparation of quarterly payroll returns, including coordination of tax deposits
  and preparation of annual W-2’s and tax form 940;
• Preparation of annual tangible tax returns, and
• Preparation of annual 1099 forms.

In addition, we are available to meet with your financial and tax advisor to discuss the
practice’s financials, and how these matters may affect your personal “bottom line.”

We utilize an independent CPA firm to review and issue all quarterly financial statements
and to prepare the annual tax returns.

In addition, we are available to meet with your financial and tax advisor to discuss the
practice’s financials, and how these matters may affect your personal “bottom line.”

We utilize an independent CPA firm to review and issue all quarterly financial statements
and to prepare the annual tax returns.

Accounts Payable
All practices retain control over their accounts payable. At the same time, we have
secured a number of group purchasing contracts with vendors to assist you in
keeping the practice’s costs down, thereby improving your take-home pay.

• Office supplies – up to 20-40% off corporate rates.
• Medical supplies at hospital rates.
• Laboratory services at a negotiated reduced rate, including a special online
  interface for our clients only.
• Outside collections at a specially negotiated
  reduced rate.
• Record storage.

Banking
We open a bank account for each new practice. This account is solely operational, to be
used by the practice only for practice receipts and related expenses.

In addition, we arrange for banking materials (checks, deposit books, endorsement
stamps) as well as deposit delivery services for the practice.

Distributions
About 85% of your medical service receipts flow through the central office. We post
these payments to your patients’ accounts, along with the appropriate contractual
adjustments.

We distribute collected receipts to the practices on a bi-weekly basis. The funds are
internally wire-transferred into the practices’ operating accounts for immediate
availability and use by the practice.

Reports are provided to the practice reconciling the bi-weekly distribution of funds.

Refunds
We also take extra work away from the practice by preparing all insurance refunds for
the practices.

Once the practice administrator has approved a refund, a signed authorization is faxed
to the central office. The accounting department will research the refund, write the
check, post the refund to the patient’s account, mail the check, and follow up with the
insurance company.

Operations:
Billing
Although billing is conducted through our highly-secured and central computer billing
system, we offer the following additional billing services for a nominal fee at the
practice’s discretion.
* Electronic billing of claims with verification of receipt;
* Error-checking claims for miscoding; and
* Printing and mailing of paper claims and re-bills.

Because of our highly specialized billing personnel, we ensure accurate and prompt
claim payment. In addition, we maintain all insurance plan files in the computer billing
system and add new plans/payors as requested.

In addition, we offer at reduced rates electronic patient statements and recall notices.
Training for billing through our computer system is provided to all practices that wish to
bill individually.

Collections
The practice is responsible for its own collections efforts. However, we are able to use
our leverage and outstanding relationship with managed care to assist and support the
practice personnel in resolving collection issues with insurance companies through our
on-staff insurance liaison. Due to our large group status, we enjoy having assigned
provider relations representatives for all large insurers to assist in resolving any claim
issues.

Our collections department provides continuous monitoring of practice accounts
receivable and collections training on our computer system to practice personnel. In
addition, our experienced collections personnel conduct random account/collections
assessments and give recommendations on effective collections procedures.

Practice Administration Support Services
We provide continuing support for all practice administrators on managing the
practice. Procedures,methods, and reports are provided to practice administrators on a
regular basis to work towards the improvement of the practice. In addition, monthly
informative meetings are held to discuss all issues affecting the practice.

Practice administrators are encouraged to contact the operations department for
guidance and support whenever needed with regards to:

• Billing and coding questions
• Collections and payor relations
• HIPAA guidelines
• Staff efficiency
• Workflow analysis

Payment Posting
We post approximately 85% of total practice revenues. We post directly to your patients’
accounts and post contractual adjustments as appropriate. Each practice can stipulate
how they want the payments posted and adjustments handled. EOBs are also available
electronically and/or in paper format.

Training
Our centralized training department has highly skilled and knowledgeable trainers in
both technical and practical aspects of our practice management software. We train
new-hire personnel, physicians, and provide
advanced system training for current staff.

We conduct yearly workshops including Medicare Compliance, Fraud and Abuse, and
Advanced System Modules. We deliver these workshops with the utmost
professionalism.

We assist physicians with chart review as it pertains to coding guidelines. Physicians
and administrators are welcomed into our training center to learn effective practice
management through our software system.

Human Resources and Personnel Management:
The function of the Human Resources department is to provide our members with the
knowledge and tools to hire/terminate, train, and pay the practice personnel. In addition,
we provide payroll and employment tax processing services, offer employee group
benefits which include a 401K-retirement plan, and help practices meet government
record-keeping requirements.

Staffing

• Job openings are posted internally to all practices to maximize employee
  retention.
• To ensure that all documents (W4, I-9, EEOC and ADA) are processed in
  accordance with state guidelines, new hire paperwork is handled through the
  central office.
• Employee orientation is held at the central office. The new staff member is
  provided an employee handbook where they are informed of the benefits and
  responsibilities of working for the practice, including a pre-employment drug
  test. Standard group policies and eligibility dates such as vacation, sick and
  holiday pay are also discussed.
• Employee documentation is essential in all aspects of personnel
  management. We offer guidance in effective record-keeping which includes
  any and all disciplinary actions, terminations, and changes in employee
  status. Properly documenting the time and reason of any termination will
  minimize the risk of costly litigation.
  

Training

• Management and supervisory training is scheduled on a monthly basis.
• OSHA compliance training is required and provided on an annual basis.

Wage and Salary Administration

• We monitor that all practices are in compliance with state laws to include
  minimum wage, overtime, child labor and exempt/non-exempt employees.
• We report and process payment of federal, state and local withholdings, as
  well as social security and medicare taxes for all practice employees.
• We prepare W2’s for all practice employees.

Group Benefits

• Medical, dental, vision, life Insurance, short-term and long-term disability,
  long-term care, and employee assistance programs are offered to eligible
  practice employees. We handle all aspects of administering group benefits
  and processing of all bi-weekly deductions.
• We also offer a 401K savings plan to all eligible practice employees.

Other Services

• Job descriptions for all entry-level and management positions are available
  upon request.
• We are available to meet with employees and supervisors to mediate any
  complaints to avoid arbitration or any other legal action.

Risk Management:
Practicing Defensive Medicine is an integral part of the practice of medicine in our highly
litigious environment. The risk management department is here to give you advice,
guidance and support on your risk management/liability questions. The risk management
team will guide you through the litigation process by:

• Answering any questions you may have about the litigation process;
• Assisting you in selecting counsel;
• Independently reviewing salient records;
• Communicating often with your defense counsel and obtaining frequent
  status updates;
• Assisting you in your preparation of answers to interrogatories;
• Preparing you for your deposition, mediation and/or trial; and
• Setting up a "round table" discussion with the risk management team prior to mediation and/or trial to assess the legal and medical issues posed by your
  case as well as the strengths and weaknesses of your defense.

Information Technology:
Computer Systems & Software
We maintain a secure and reliable computer system network for all the practices.
Communications to the central computer site is accomplished via private, high-speed
dedicated lines. The network is equipped with the industry proven WebMD system for
patient accounts and is fully HIPPA compliant.

In addition, we furnish on-going maintenance and service support for our system
including software upgrades as well as coordination of system-related equipment repair
as needed. A Help Desk is also available during normal business hours.

Finally, through group purchasing, the physicians and the practices can enjoy the most
up-to-date technology at substantial savings, that would not otherwise be
possible as a solo provider or in a small group practice.