We Help You Achieve Your Ideal Practice
Empowering Primary Care Physicians
At Physicians Independent Network, we leverage our collective strength to secure advantageous capitated agreements with Medicare Advantage plans. Our enterprise, built by doctors for doctors, aims to help physicians maintain an effective and efficient practice that benefits all parties involved.
You maintain complete control over patient care while we optimize your Medicare Advantage participation. Our comprehensive support system enhances your practice’s performance without getting in the way of existing operations. We handle the complexities of plan management, allowing you to focus on what matters most – your patients.
Comprehensive Support Services
As a physician, you have full control over the care you provide to your patients. We are only there to offer a helping hand by simplifying your participation in Medicare Advantage Plans and optimizing the efficiency of your office operations.
1. Documentation Assistance: Our team helps handle the documentation required for proactive care, so you can dedicate your energy to patient care without getting tied up with administrative tasks.
2. Coding & Billing Solutions: We manage claims filing for Medicare Advantage patients, easing the workload on your billing staff. This allows them to concentrate on billing for your fee-for-service patients without additional burden. Additionally, we revise claims to see if there is any missing information that we need to fill in, which helps increase revenue for PCPs.
3. Strategic Marketing: Throughout the year, and specifically during the annual enrollment period (October 15–December 7), we coordinate with Medicare Advantage plans to arrange for representatives to visit your office. They answer your patients’ questions and help them understand the benefits of the specific plans you’re affiliated with.
Navigating Change: Turning Challenges into Opportunities
As a primary care physician in Florida, you’re facing unprecedented industry pressures. The landscape is shifting but change presents opportunities for those who know how to leverage it.
Key Challenges Facing PCP Practices:
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Balancing increased revenue needs with quality patient care
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Managing staff burnout from insurance claim battles
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Maintaining practice autonomy in a consolidating market
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Revenue plateau despite longer working hours
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Uncertainty about transitioning to value-based care
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Growing pressures to sell or merge
However, there’s a better path forward. Through the strategic use of Medicare Advantage, you’ll be able to:
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Participate with zero upfront investment
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Maintain complete control over patient care decisions
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Choose your preferred level of flexible risk-reward (including risk-free participation)
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Benefit from the compensation of performance bonuses (HEDIS & MLR)
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Keep ALL of your patients even if you decide to cancel our agreement
Breaking Free from Fee-for-Service Limitations (What You Need To Know About MLR & MRA)
What is MLR?
- The Medical Loss Ratio (MLR) is a measurement showing what percentage of premium dollars an insurance company spends on medical care and quality improvements compared to administrative costs and profit.
- The average MLR percentage for large groups is 85% and for individuals/small groups is 80%.
What increases MLR?
- Sick patients who are frequent flyers
- Non-generic medications
- Out of control patients
How MLR affects you under PIN:
- A lower MLR percentage will increase your earning potential for bonuses, capitation, & distribution.
What is MRA?
- Medicare Risk Adjustment (MRA) is a way to calculate how much money insurance companies should get based on how sick or healthy their patients are. The sicker the patients, the more money the plan receives to care for them.
How is MRA related to me under PIN?
- Our team will help you with the documentation requirements and data collection that contribute to MRA, making it easier for Medicare to properly adjust the diagnostics for each patient.
- This means we will help with ICD-10 coding, chronic conditions, provider authentication of diagnoses, encounter data, claims information, & Risk Adjustment Processing System data.
Flexibility & Freedom: How You Benefit
Our partnership allows you to:
- Access higher negotiated rates through collective bargaining power
- Have complete control over patient care decisions
- Experience risk-free participation options with potential for bonuses
- Receive direct payments from Medicare Advantage plans
Additional Financial Benefits:
- Zero upfront costs – we assume the risk
- You choose your comfort level: from no-risk to shared-reward options
- Monthly capitated payments sent directly to your practice
- Freedom to exit the clause with 60 days written notice for any reason (Again, you keep all of your patients should you decide to cancel our agreement)
Why This Works:
Primary care physicians often lack the leverage to negotiate favorable rates with Medicare Advantage plans. We combine the strengths of our affiliated providers to secure better terms while letting each practice maintain its independence. Whether you’re looking to establish long-term stability or build value for a future sale, our model provides the support you need without the usual constraints.
Take Control of Your Future
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Every week, more physicians find themselves forced to choose between early retirement or surrendering their autonomy to larger healthcare organizations. This is why our approach to value-based care represents healthcare’s future. Our primary focus is aligning quality patient care with financial sustainability.
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Whether you’re planning to practice for another twenty years or considering a transition in the near future, this approach positions you for success. Your practice becomes more valuable, more efficient, and more attractive to potential buyers, all while operating on your terms.
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The healthcare system wasn’t designed for physicians to succeed alone – but that doesn’t mean you have to fail or sell out. We’ve created a framework that turns market pressures into opportunities, allowing you to adapt and thrive in this evolving landscape. Regardless of what you choose to do with your practice, you’ll do so from a position of strength, not necessity.
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So, if you’re ready to take control of your practice’s future, let’s discuss how we can help you build a more sustainable, profitable, and satisfying future in medicine. Don’t let the current system prevent you from building a thriving practice – one which benefits you AND your patients.
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