Five Ways to Optimize your FHO Group Billing and Management

Being a part of a Family Health Organization (FHO) group offers a lot of great benefits such as guaranteed income, more patient access, and work life balance. But managing a FHO group is not easy. There are many components to consider when managing a FHO group that takes a lot of time and effort.

Over the years, we’ve worked with over 100 FHO groups, helping them improve their access bonus, patient satisfaction, staff knowledge, and strengthen the overall financial performance of the group and its members. In this post, we’ll share five strategies to help you optimize your FHO group’s performance.

1. Keep your FHO Group’s Access Bonus Positive

Managing your FHO group’s outside use is important to achieve the bi-annual access bonus potential. Doctors must regularly monitor their outside use to ensure that their total access bonus is positive while taking the necessary steps when it is negative.

Here are some best practices you can implement in your practice to ensure your FHO group’s access bonus stays positive:

  • Analyze your outside use data to determine which patients to move from the roster to the FFS bucket.
  • De-roster patients back to earliest date of outside use within the last six months.
  • Ensure same day urgent appointments are available for patients.
  • Ensure front office staff understand the FHO program – we have a poster that you can put in your office explaining outside use. You can download it here.
  • Educate patients on what it means to be in a FHO group.
  • Be aware of “Red Flag” codes – patients who use services that contribute to outside use due to ongoing relationships with other GPs.

2. Automate your FHO Group’s Administrative Tasks

Automation is a great way for FHO group doctors to shorten the process of tedious administrative tasks. For example, you can automate some payment processes by setting up direct deposits for physicians to receive their locum payments, OMD funding, access bonus payments, etc.

3. Implement Regular Reporting for your FHO Group

Regular reporting allows you to monitor and have visibility on the performance of your FHO group. We recommended keeping track of the following on a regular basis:

  • FFS hard-cap summary reports
  • Access bonus group performance reports
  • Banking reconciliation and distribution reports
  • Governance reviews
  • IntraFHO adjustment reports (if applicable to your FHO group)

4. Train your Staff

Highly trained staff can lead to a more efficient practice. We recommend that you train your FHO group staff on best practices for MOH billing, MOH reports, workflow opportunities, EMR capabilities, and error reconciliation.

5. Optimize your FHO Group’s Practice Management Workflow

We have five best practices you can implement into your FHO group’s practice to help manage your workflows and optimize your revenue opportunities more efficiently.

  • Identify patients to recall: Make sure that patient recalls are all up to date. For example, organize a monthly list of the diabetic and cardiac heart failure (CHF) patients in your FHO group that are due for their next visit.
  • Generate accurate high risk patient lists: High risk patients include those diagnosed with diabetes, CHF, schizophrenia, bipolar, smokers, etc. Identify those patients in you FHO group to provide insight on how to optimize your group’s out of basket potential.
  • Create alerts in your EMR: You can keep track of your FHO group’s billing and enhance your EMR experience by creating alerts to identify the patient’s condition. For example, on your patient’s profiles, indicate whether your patient is diabetic, as smoker or CHF to remind you to bill the corresponding codes on their next visit.
  • Send smart alerts: You can also create reminders of when to bill high yield incentive codes to ensure that you don’t miss out on potential revenue. These include reminders for preventative, diabetes, smokers, well baby check, and CHF.

Still unsure of how to manage your FHO Group? We can help!

We provide FHO group management services to support our five best practice strategies including:  

  • Clear and transparent reports: Our Practice Care reports give all the doctors in your FHO group visibility into their billings and outside use to help identify high offenders and de-roster.
  • Administrative tasks: We take the administrative burden off your plate by providing additional practice support and advisory services. We also liaise with the MOHLTC on your FHO group’s behalf.
  • Staff training: Our Primary Care Staff Training Program ensures your staff is using the best possible tactics for all administrative and operational processes for your office. Our 20 modules cover FHO best practices to ensure they have the resources they need when they need them.
  • Access to Practice Care: All doctors in your group has access to Practice Care, our flagship product for practice care management. Practice Care delivers deep insights and takes the complexity out of capitation, FFS models, and bonuses to ensure FHO group doctors are maximizing revenue potential every month. Unlike most traditional billing agents and services, our billing experts and advisors proactively book quarterly review meetings with your FHO group to review Practice Care insights including missed or potential revenue opportunities, strategies to improve workflows, and alignment with the MOH priorities to focus on patient care.
  • Support for lead doctors: We support your doctors every step of the way, taking care of most of the work to ensure that you are on the best track with your FHO group management. All physicians have access to our billing hotline and there is always someone on the other end of the phone to answer any questions you may have.

Interested in managing your FHO group with DoctorCare? Contact us today for a complimentary group consultation.

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