In order to succeed in today’s changing health care environment, practice administrators must gain increased expertise in practice financial matters. This expertise does not require the skill and training of an accountant. However, many vital decisions that must be made by practice leadership require a certain level of financial understanding. This chapter provides a primer on financial statement terminology and an overview of accounting for transactions.

In today’s health care environment, practice administrators will, by necessity, have to be in a much better position to manipulate and manage the financial aspects of the medical practice. Lower levels of fee-for-service reimbursement, as well as increasing overhead costs, place a great deal of pressure on medical practitioners to manage their financial resources more efficiently.

Successful ophthalmic practices are committed to providing the highest quality of care to patients. In order to provide this level of care, excellence must be maintained in the clinic as well as in the business office and other practice areas. Maximizing the collection process is critical to practice success in that the practice must have adequate revenues to meet its financial responsibilities. Failure to have a specific data collection process will result in difficulties with collections, lost collections, and additional work for the billing office. Although each practice will operate in different ways, the basic elements of the business office function will be similar to those processes described in this chapter.

The collection process is certainly not a simple one. The larger the practice, the more complex the collection process becomes. However, with specific protocols in place, the practice can experience an effective process that allows maximization of collections while simultaneously reducing rework and lost charges.

While practice administrators may not perform specific duties on the billing team, many practice administrators are ultimately responsible for the accuracy and timeliness of a practice’s billing department. This chapter reviews the billing process, the management of accounts, cash management, and the reporting process. With specific protocols and processes in place, a practice administrator can enable the billing team to attain the goal of maximizing practice collections.

A benchmark can be defined as a standard to which practices compare their own results. This chapter is designed to help practice administrators understand the basics of benchmarking and, ultimately, be able to apply specific benchmarks to their practices. The first part of the chapter addresses general topics in financial reporting and benchmarking and provides several caveats on how benchmarks should be used. The chapter then addresses specific benchmarks and healthy ranges practice administrators can use to compare their practice with national averages. The chapter concludes with a discussion on how to gather the information needed to develop benchmark data.

Proper planning and budgeting are the cornerstones of practice success. To effectively operate and manage an ophthalmology practice in today’s highly competitive and complex environment, administrators must be able to accurately assess the impact of the threats and opportunities confronting their practice. These developments should be analyzed with good information, allowing the practice stakeholders to act in a decisive and timely manner.

The health of a practice’s revenue stream is largely defined by the terms found within its contracts with payers. Practices that carefully and regularly review contract terms tend be more profitable than those that do not review their contracts on a regular basis.