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Austin Business Journal


Consultant helps doctors have healthy business

    Picture by ABJ / Walt Stoneham


Margaret Huff, left and Carole Kirtley, of Healthcare Solutions Consulting, at Alosco Medical Services, one of the company's clients.


Carole Kirtley is in the business of letting doctors be doctors.

More specifically, Kirtley negotiates contracts with insurance companies on behalf of doctors, thus relieving them of the burden of bartering for a fair deal. As the owner of Healthcare Solutions Consulting, she has taken her one-woman show from nearly total obscurity to a household name in Austin's medical community in little more than a year.

Kirtley's services aren't limited to insurance negotiations, however. With experience in the marketing and financial arena, her medical practice cost analyses inform doctors of how billing systems could be improved and whether an office is being run in a cost efficient manner. She also trains office personnel in handling heavy workloads with lessons that she draws from her former experience as an office administrator. Kirtley says she not only feels accountable to the doctors, she works to ensure the entire practice is an effective one.

"To me, you have to provide excellent customer services to maximize all contracts," she says.

Kirtley's first taste of the medical world came 17 years ago when her husband was pursuing a medical degree. Her knowledge of and interest in health care led her to pursue a MBA from Southwest Texas State University. In 1994 she was hired by Prudential Healthcare as a consultant and gained valuable experience in both the provider and managed care sides of health care.

In July 1995, Kirtley was recruited as a managed care coordinator by Health South Corporation, a multi-million dollar Alabama company. That new role thrust her even further into consulting, where she contracted on behalf of outpatient, skilled nursing facilities and surgical hospitals. She secured new contracts, recruited new business and taught medical administrators how to handle all of their contracts.

After a divorce in 1996, Kirtley began tossing around ideas of branching out on her own. Left with three children to support, she felt starting her own business might allow her more time with them as well as give her more freedom to develop different consulting strategies. After 18 months at Health South, she did just that, and Healthcare Solutions Consulting was born Jan. 1, 1997.

Since that time, she has contracted with 10 clients ranging in size from small to large medical practices that have come to her to fine tune the administrative sides of their business.

"I do anything from bringing billing systems in-house to contracting and retrieving new business," she says.

Kirtley's consulting services begin by meeting with doctors and administrators to determine what their needs are. After listening to what they have to say, she assesses the situation and offers her own possible solutions to alleviating any administrative or financial burdens. If the business is interested, a contract is signed during a second meeting.

Kirtley then tackles each issue one by one. She trains a staff on managed care terminology and operational issues, examines the business' financial records to determine what the collection ratio is and where spending is headed and plays the middle-man between doctors and insurance companies to reach a fair and effective agreement between both.

"I feel the financials are very important, but it's also important to have the hands on experience," Kirtley stresses. "That's what I bring to the table. I've been in the administration role when the phones are going nuts. I know first hand how that is."

In a recent job, Kirtley helped track contracts and fee schedules for the Orthopedic Group of Austin. Because of the magnitude of that task, the administration simply was unable to perform that function before Kirtley entered the picture.

"She's given us that organization, that ability to track our contracts and use our fee schedules for future planning. These are all things that we didn't have available to us before, " says Stacy Wilkins, an administrator with the group.

The Pain and Stress Management Center was in need of a reorganization when Kirtley was hired on to consult, says Dr. Ray Jimenez, one of two practicing physicians at the center.

"We were involved in a medical practice and it was apparent to us that something was not working correctly," Jimenez says. "What Carole did was analyze the situation and find a way to streamline everything.

"Through that whole process we ended up being much more efficient," he says.

One of Kirtley's toughest jobs is reassuring doctors that she will live up to her end of the contract. Because consultants have a reputation for charging a high fee and leaving clients wondering if issues are resolved, she guarantees her work and charges her client either by the hour or project.

Although Kirtley's target market is the four to ten doctor group, her clientele is not limited to that. Her largest client, DME Home Health IV Infusion and Sleep Diagnostics, has 70 Austin-based employees and more statewide. Her market is growing and she is currently in the process of being endorsed by the Texas Medical Association.

"Life is good," Kirtley says. "I feel very fortunate; I have a lot of people pulling for me in this market."

LEE SIMMONS is an Austin-based freelance writer.

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This article is reprinted from the Austin Business Journal, Volume 18, Number 6, pages 24 and 40