Reed Tinsley, CPA has provided consulting services to physicians and physician related entities and their legal counsel for more than 20 years. A sampling of his services to physicians include all aspects of physician practice management and economics, managed care contract review / negotiation, profit growth strategies, strategic planning, practice merger facilitation, physician contract reviews, physician buy-ins/buy-outs, regulatory compliance, and litigation support. Mr. Tinsley's litigation support specific services have included billing and collection reviews, medical practice or healthcare entity business valuation, lost profits analysis, covenant not to compete valuation, wrongful termination damage analysis, physician compensation disputes, and overhead allocation reviews. He has also been engaged as a court appointed Special Master and Receiver.
Areas of Expertise:
- Practice and Healthcare Entity Valuation
- Economic, Financial and Statistical Analysis Expert Witness
- Physician Economic Disputes
- Billing, Collection, Accounts Receivable Reviews
- Managed Care Contract Reviews
- Office Sharing and Physician Compensation Overhead Allocations
- Physician Contract Disputes
- Physician Compensation
- Lost Profits and other Damage Analysis / Calculations
- Physician Regulatory Compliane
Reed Tinsley is a Houston-based CPA, Certified Valuation Analyst, and healthcare consultant. His entire practice is devoted to providing tax, accounting, and healthcare consulting services to physicians and their attorneys. Reed has published numerous articles in national and regional publications and is frequently asked to speak on a variety of health care topics, including capitation, revenue enhancement, and integration strategies. His articles have been published in the Journal of Medical Practice Management, MGMA Journal, Hospital Physician, Texas Medicine Family Practice Journal, and Group Practice Journal. Mr. Tinsley also serves on the Editorial Panel of Consultants for the publication Managed Care Contract Negotiator.
Former New York City Mayor Ed Koch gained many fans among the voting public when news cameras caught him shaking New Yorkers' hands and greeting them with, "I'm Ed Koch. How am I doin'?" That warm gesture and short phrase characterized him as a public servant who felt accountable to ordinary citizens - in spite of his powerful position.
Your office manager and billing staff periodically audit claims to assess whether your doctors code accurately. But how do you know that they know what they're doing? Spending several thousand dollars to bring in and outside consultant can be an expensive way to confirm that your practice is doing a good job coding. A far less expensive way to obtain some coding peace of mind:
In May 2012, the Department of Health and Human Services Office of Inspector General (OIG) issued a report entitled "Coding Trends of Medicare Evaluation and Management Services." This study was conducted because between 2001 and 2010, Medicare payments for Part B goods and services increased by 43 percent, from $77 billion to $110 billion.
While not intended as a legal document, did you know your personnel manual may have the force of an employment contract? If you haven't done so in a while, or not at all, review it to be sure it won't cause unintended problems. Like many other physician contracts, personnel manuals often do not get an annual review; they get stuck in a drawer never to be looked at again until an employee leaves the practice and a problem arises.
As a CPA and healthcare consultant, one of the things that continues to concerns me is employee theft within a medical practice (or any other healthcare entity for that matter). You trust your staff, right? You know them to be loyal and dedicated individuals who would never steal from the practice, right? Unfortunately physician practices are no less at risk of employee theft than any other business.
Many physicians were once content (and a few still are) to let their coders select their codes for billing purposes. At a time when enforcement authorities have some heavy-duty technological weapons for identifying improper billing, physicians can no longer avoid learning the billing rules applicable to their services.
So you've decided to enter into a merger. First of all, congratulations for taking control of your future and addressing a changing healthcare environment in a proactive manner. You've obviously completed tireless hours of feasibility analysis and chosen your partners with the utmost care.
Administrators produce pounds of paper as part of the month-end close process. Typically, buried deep within these reports lies the key to Accounts Receivable (AR) performance. These statistics are usually filed away with other documents, often without analysis. This is not to say that they are unimportant, but who has the time?
Ancillary services are becoming an increasingly important source of medical practice revenues.
It is one thing to want to negotiate and another thing to know HOW to negotiate. However, the first step in this process is to understand the do's and don'ts of a negotiation - Here they are:
In order to compete in a market that is moving towards ACOs, value-based purchasing, cost efficiency, and cost containment, doctors must change old clinical habits.
After a managed care contract is signed, it is important to make sure the office handles these payors correctly, handles their patients correctly, and makes sure the office continues to operate efficiently.
Does your staff really knows what "revenue cycle management" means or is? I am constantly advocating the importance of training your entire staff to understand how their job functions affect cash flow. There are many points of entry into the revenue cycle at your practice. Be sure your staff knows all of the following:
As most readers will be well aware, every group practice should have agreements providing the terms of employment of the physicians as well as terms related to the consideration the physician is to receive when he or she leaves the practice, whether by death, disability, retirement or otherwise.
We all know we are in an era of declining physician reimbursement. What physicians get paid for their services is much less than it was 5-10 years ago. This is particularly true with respect to managed care payers.
The Medical Group Management Association (www.mgma.com) recently published results of its annual member survey and listed the top challenges facing physician practices today.
As I've noticed, stated and PREACHED, physician practice mergers are heating up. A practice merger in my opinion is an EXCELLENT strategic option to address the future of physician medical practice.
Any expectations you have for a new Associate only works if you follow through with frequent evaluations. However, I am often struck by how little attention senior doctors give to basic personnel management of newly employed physicians.
Due in large part to concerns over healthcare reform and declining reimbursement rates, physicians are increasingly looking for opportunities to sell their practices to hospitals and work as employees.
As you are well aware, physicians and their practices face new and complex challenges.
Similar to the mid to late 1990's, medical practice management today has begun to be dominated by mergers, affiliations, and other external strategic initiatives aimed, ideally, at enhancing economic potential and performance within a rapidly-changing industry landscape.
You and another or a group of physicians are considering a merger with each other.
Reed Tinsley, CPA
Complete guide to accounting, tax issues, managed care, and daily operations.
Reed Tinsley, CPA
This practical resource has the information and tools you need to obtain the most favorable legal and financial terms possible in today's competitive managed care market. It explains how to successfully negotiate both discounted fee-for-service and capitated managed care contracts and offers strategies designed to improve managed care contracting relationships.
James W. Karling, Reed Tinsley, CPA, Joe Havens
tHIS is the first comprehensive guide to setting up an IPA, detailing the many operational, legal, and logistical complexities of managing a physician-owned organization. Since controlling the financial and tax aspects of an IPA is critical to its survival, the Manual addresses an entire range of financial accounting concerns, including accounting concepts and methods for an IPA, internal control procedures, insurance issues, tax issues, policy guidance, and profit-making issues.
Reed Tinsley, CPA, Rhonda W. Sides, CPA, Gregory D. Anderson
Covering the specific issues that impact valuation, this book takes you through the entire process, highlighting pitfalls and mistakes that are commonly made and that should be avoided.
Reed Tinsley, CPA & Joe Havens
Written by one of the foremost experts in the field, this book—the first of its kind—provides expert guidance on how to perform an operational and strategic assessment of a medical practice. It includes proven suggestions and ideas on how to maximize the operational efficiency of a practice, enhance the medical office revenue stream, position the practice for future success, and maintain and increase income. Contains evaluation and assessment forms, as well as sample financial reports.
Dr. Michael R. Klein, Jr., M.D., specializes in Orthopedic Surgery and is a founding member and the first Medical Director of Northern California Orthopedic Centers. He was involved with the development of the orthopedic section of the Level II Trauma Center at Mercy San Juan Medical Center. He served as a clinical professor at the University of California, Davis, Medical Center for more than thirty years. He has been a member of the North American Spine Society since 2009 and was awarded the David O. Selby Award in 2020 for his contributions. He is a fellow of the American College of Surgeons and American Academy of Orthopedic Surgeons, and a member of the American Medical Association and the California Medical Association. He retired from the USAF in 1998 after being on active duty during the Vietnam War, and he was activated for Operation Desert Storm in 1991. 
