Wendy Bruno Thomson, President
Physicians are the first and primary point of contact in the healthcare ecosystem. Carrying out fiduciary duty to patients, physicians intrinsically have a high level of responsibility in the patient’s healthcare journey. Also, they have a business to run. However, in today’s world of shared accountability for the total healthcare experience, physician revenues are declining. Physicians struggle to traverse the intricate labyrinth of healthcare payment ecosystem that encompasses financial and insurance policies, compliance requirements, coding standards, and others.
The amount of time physicians and healthcare facilities spend fighting for payment has increased by more than 40 percent in the last ten years, according to Wendy Bruno Thomson. “This means more staff, and more expense, for healthcare businesses trying to get paid for services that were rendered to patients.”
TTG Advisors was founded after Wendy Bruno Thomson, a Licensed Healthcare Auditor and healthcare industry expert, helped a physician practice which experienced revenue constrains. “Unfortunately, we discovered over $400,000 of theft by the Office Manager. Whether it’s theft or revenue cycle management challenges, it’s easy for healthcare businesses to lose track of money,” says Wendy.
"By combining our expertise and strategic skills with the vision of our clients, we empower them to become more productive and profitable"
Wendy laid the cornerstone of TTG Advisors to help healthcare providers and medical facilities identify payment loss and opportunity. Wendy and her team bring a fresh perspective to healthcare by providing medical practices and facilities quality and scalable consulting services and practice management. “We ensure our clients are ‘collecting’ the revenue that they are producing and capitalizing on all opportunities to increase revenue,” remarked Wendy, President, TTG.
TTG develops a unique strategy that focuses on auditing and analyzing the revenue, negotiating contracts with insurance carriers, streamlining operations, compliance management and credentialing. All of these efforts are aimed at ensuring TTG’s client experience a consistent influx of revenue. “TTG enables our clients to increase profit. Our clients typically see a minimum of 30 percent increase in their profitability. We want our services to have a high return on investment,” said Wendy.
Making Independence Profitable
While many Physicians worry about their future in our volatile healthcare system, Wendy explained that there is also a large shift of Physicians leaving hospital or large employment groups to set up practice as their own independent group. TTG creates, and implements, strategies that make Physician ownership profitable. Across the country, each region and specialty has different needs and goals. TTG collaborates to remove roadblocks and advocate for their clients.
The Lifestyle of Physicians
Healthcare providers have hectic schedules with great demands on their time, physical and mental capacity. Wendy paints a picture of Physicians and Facility leaders who are trying to show up at their kid’s soccer game and participate in their marriage, while balancing their medical practice. If Physicians don’t have the right infrastructure in place, they literally have their entire business on their shoulders. “Specialty Physicians may want to take their family on vacation for a week but, they know they will not generate income while they are traveling. Five days of vacation can cost a medical practice $50,000 of income. That’s a lot of pressure.” She explains the cost and risk of a medical business is extraordinary and that, in many medical practices, Physicians are only earning 10 percent-40 percent of their income. This is a drastic comparison to the typical perception of the healthcare industry.
“I am concerned about the future of healthcare in a way that is different than many people. I am worried that the healthcare environment won’t attract the highest and best talent because the risk and investment may not be worth the reward for future Physicians.”
TTG Changes the Lives of its Clients
Wendy proudly boasts that her client’s quality of life has changed with TTG’s involvement, “not only because they are more profitable but, because we share the burden of many strategic, financial, and operational challenges.”
TTG enables our clients to increase profit. Our clients typically see a minimum of 30 percent increase in their profitability
Wendy enjoys the satisfaction of collaborating to create a long term plan and strategy for her clients. She shares case studies of community hospitals, surgery centers, and medical practices who have designed a strategic and implemented strategic plans, increasing the client’s value and profitability.
The Struggle to Collect
Meanwhile, facility and physician services are fighting to receive payment for services rendered. Dashing from pillar to post, physicians might have to settle for whatever revenue comes their way.
TTG audits billing/revenue cycle management (RCM) services. With a history of growing and guiding healthcare businesses, TTG believes the RCM responsibilities are one of the most critical in the healthcare ecosystem. “Physician leaders are often focused on what percentage they are paying for their RCM services however, often, that difference in service fee is minimal compared to financial loss due to poor performance.”
TTG evaluates RCM companies and services with a methodical and fair approach. “First and foremost, we want to earn the trust of our clients—we become their safety net.”
Reliable credentialing is the foundation to establishing any practice or facility. TTG began tackling the arduous process of credentialing over five years ago after finding significant financial loss due to credentialing errors or lapses. Wendy explained, “We’ve seen physicians and facilities provide services for years, unpaid by particular insurance carriers, without even knowing it.”
A Multi-Specialty Medical Group, in Northern California, was on the verge of dissolving their very large practice due to poor revenue, in spite of the massive patient growth. They engaged TTG to identify the source of their decreased revenue and recommend potential solutions to avoid dissolution. TTG implemented controls and processes to identify the issues. TTG negotiated insurance contracts and also introduced reporting, business controls, audit processes, right-sized compensation packages, and outlined communication protocols. With these capabilities, the client increased profitability by a wide margin and credited TTG for their sustainability.
Mastering Contract Negotiation and Compliance
Wendy, based on her observations and experience in the healthcare payments landscape, opines that care providers often falter when it comes negotiating the right contract with insurance carriers. “Physicians are given almost no time to negotiate the contract, and they are often pressured to accept whatever rate is initially offered just to get the contract executed.” TTG’s team is knowledgeable about market rates and stays abreast of policy changes in order to achieve the best rates.
“We have been fortunate enough to develop great relationships various Provider Representatives and Executives with insurance carriers across the country. We stay educated on upcoming policy changes and work to implement these changes within the practice or facility,” explained Wendy.
The TTG Team
Wendy is proud of having a work culture that is passionate and committed. She describes her team as the best in healthcare consulting, “because they are driven, bright, and tenacious.” Wendy explained, “We make mistakes. We just have redundancies in place to minimize those mistakes and quickly rebound.” Though Wendy is the founder at TTG, she contributes her team for her company’s success.
Jesse Straub, Vice President of TTG, oversees compliance programs, among many other responsibilities. “Jesse’s work has resulted in our clients avoiding hundreds of thousands of dollars of government penalties. She is the reason we started our expansion and she’s led our organization through significant growth.” TTG also added an attorney to its bench. Monika Ceglowska, Director of Contracts and Credentialing, oversees valuable client accounts while leading the growth and development of the Contracts and Credentialing team. “Monika brought a new energy and skill set to our team. She’s discovered hidden clauses in agreements most of us would not have noticed.” Monika and Jesse both collaborate to create business plans and proformas for TTG’s clients, while overseeing some of TTG’s largest accounts.
The TTG team also includes experts in financial analytics, operational processes, credentialing and healthcare strategy. Their varied background includes employment with Medicare, United Healthcare, Cigna, and other facilities and practices. Wendy’s plan is that the TTG team members grow as the company grows. She describes their environment as committed, collaborative and intense. “I have always said that TTG would grow as we found the talent. I couldn’t be more proud of our team,” Wendy remarked.
“By combining our expertise and strategic skills with the vision of our clients, we empower them to increase profitability. We want to make a positive difference in our client’s business and, to some degree, we’d like to make a difference in healthcare delivery,” concludes Wendy.