Q. I altered an Excel spreadsheet category. What should I do?
A. Don’t worry. TACT lets you alter the categories. Go ahead and change the name of the category to whatever you want.
Q. We don’t provide certain services listed in TACT, like hospital inpatient care. What do we do?
A. Just skip those services on the input tab. Any blanks you leave will not roll forward to the detail or summary tabs.
Q. What clinic data can I put into TACT?
A. Look at your billing and/or appointment systems. If you use a third-party billing service, they can probably give you a count of units of service—by category of service. Usually, encounters (visits) are coded using CPT codes, revenue codes, or some other coding system. Use the codes to create categories of services and then let TACT give you cost data on them.
Q. I need definitions for our services. Where do I go? For example, who defines a primary care visit versus a comprehensive primary care visit?
A. Don’t get bogged down. If nobody in your organization can explain the difference between a “primary care visit” and a “comprehensive primary care visit,” then the difference probably doesn’t matter. However, if the resources required for the two are substantially different, or you actually bill different amounts for the two, then you should distinguish them. Your coding people can help you define your service categories.
Q. What cost data can be put into TACT?
A. Ask your accounting office. They can provide detailed ledgers for certain time periods. You’d be surprised how much detail on costs they have. If the categories are not good enough (for example, if there is only one line item for “payroll”), you may have to ask them to do some calculations (like split “payroll” into “care provider payroll,” “administrative payroll” and “other payroll”).
Q. How do I factor in expenses such as rent, administrative costs, and the time of volunteer physicians into the cost of the services my organization provides?
A. Allocate these items (indirect costs) to the care service categories you have defined for your organization. You can allocate them proportionate to direct costs that can be directly assigned to services. You can also use some other rational basis like the percentage of total care provider time, portion of square footage used, or another basis that fairly represents the portion of indirect costs that should be charged to each service.
Q. How do I allocate non-patient care costs to various care services that we provide?
A. Most non-patient costs are best allocated proportionate to direct care costs. In other words, if “primary care” represents 23% of total direct costs, then “primary care” would be charged 23% of janitorial costs. Other bases are equally acceptable, and sometimes result in fairer allocations. For example, if “primary care” occupies 17% of the total building square footage, allocating 17% of the electricity bill might be fairer. Discuss the allocation with your accounting people.
Q. Will the information we put into TACT be used by others to evaluate the costs of our services?
A. Only if you want to share that information with others. For example, you may find that showing a potential payer detailed cost analyses is useful for negotiating a fair price for services that the payer is asking you to provide.
Q. How much reimbursement would I need from a managed care organization to cover my average monthly costs of care for patients who are living with HIV/AIDS?
A. On the input tab, be sure that you have entered a “1” in the “Included in Review” column for each of the services that the managed care organization (MCO) is asking you to provide. The “Total gross service cost PMPM” column of either the detail tab or rollup tab will have your answer. Remember: the answer is your best estimate of costs based on your past experience. The MCO’s population may have different needs than your estimate, in which case your actual costs with the MCO may differ from your past experience.
Q. We provide lab services to our patients and want to know what these services cost. Can TACT give me this information?
A. If lab services is a line item on the input tab, enter the units of service provided and your estimate of the fully-burdened (direct costs, plus allocations of rent, administrative, etc., costs). The detail tab will then give you the cost of that specific lab service. It will give you a unit cost. If you have estimated the number of persons that you serve, the detail tab will also give you an estimated cost per member per month.