Realizing the importance of the healthcare industry here, many Birmingham area accounting firms have identified ways to provide their clients with highly specialized services. In some firms, a few individuals dedicate most of their time to medical clients. Other firms have established separate divisions dedicated to the field. As in any professional arrangement, being able to communicate comfortably with a chosen accounting firm can be as important as the services provided. The firms listed below reflect some of the range of dedicated healthcare accounting services available locally. BKR Borland Benefield claims that about a third of its business is healthcare related, consisting mostly of physician groups. Founded in 1922, the Birmingham-based firm also has an office in Florence. "We are the Alabama affiliate of BKR International," says executive vice president John Wilson. "We have representation in every state and 130 countries around the world." Besides the best-practice knowledge that the firm gains from this affiliation, it also means instant access to information in any locale. "We talk a lot with our Canadian counterparts about pharmaceutical issues." Wilson describes his company as a high-touch personalized service firm. "We start with the individual doctors and work our way out instead of starting at the entity level." "We offer the same services as any accounting firm. What's different is our approach, our personalized service," says Wilson. "We make sure each doctor has at least two partners he or she can contact in case one is not here. We're selective with our clients, but we treat them like they deserve to be treated." Hardman Frost & Cummings provides accounting services to a broad spectrum of healthcare-related companies, but emphasize services to physicians. "We treat them like the small business they are," says Tommie G. Cummings. "We look at their practice and the individual doctors in a practice and help them with their total financial planning in an effort to minimize their taxes and maximize their wealth." Most of the firm's hospital work is in physician education. Cummings says they teach residents and others business skills, from goal setting and budgets to the requirements for setting up a practice. "We do a lot of business planning, making sure practices and businesses are running efficiently. If they're small, we make sure they have a good internal control," says Cummings. "If they're large, we make sure the systems and people talk to one another." The firm functions as a stand-in controller or chief financial officer that clients can speak with on a very confidential basis and on a very high level, explains Cummings. "We like to be the Physician Desk Reference for financial matters." L. Paul Kassouf & Co, P.C. has 25 individuals working in healthcare including two non-accounting healthcare consultants, both former practice administrators. "They perform specific healthcare consulting in areas of new practice startup, operational consulting, business office assessment, accounts receivable review, strategic development, and compensation plans," says managing partner Gerry Kassouf. About half of the firm's services are related to the healthcare profession. Established in 1931, the firm primarily works with physicians, their practices, and ancillary businesses, but does some special projects for hospitals. Because it is always in transition, Kassouf says healthcare continues to present challenges and opportunities. "The various HIPAA regulations and requirements have been an operational challenge for physicians over the last several years. But we also see many opportunities to generate ancillary income." Through its nationwide healthcare consulting group, the firm utilizes individuals in the CPA field who deal with relevant issues, adding a broad national perspective or a specialty-focused one. Warren Averett Kimbrough & Marino, LLC has two healthcare divisions employing 50 people in its offices in Birmingham, Anniston and Cullman. One division serves about 40 hospitals and nursing homes statewide, the other serves 150 medical practices. The hospital division provides comprehensive services. "The basics are financial audits, tax returns and planning and cost reports and planning," says J. C. Rouse. "We also assist clients with bond issues." When an entity is being bought or sold, the firm also reviews the financial records to make sure they are appropriate. "In the cost report area, we assist if they are audited by Medicare or Blue Cross," says Rouse, explaining that Warren Averett negotiates with the intermediaries and helps settle those cost reports. If a hospital is being bought or sold, the firm reviews financial resousrces to ensure they look appropriate. "We also assist clients in the implementation of new accounting standards," says Rouse. "Clients look to us when accounting standards boards issue new releases and implement those." In the physician practice division, Jim Stroud, CPA, feels that clients benefit from his familiarity with ever-changing regulatory and human resources issues. "You just can't do a good job if you're dividing your energies among several industries." The firm strives to improve profitability for clients. "Anybody can sum up the numbers and put them on a tax return," says Stroud. "The challenging thing is to look forward - for profit that could have been there but wasn't." "We have a certified procedure coder on staff," says Mary Elliott, a CPA at the firm. "I don't think you'll find that at other firms. She helps determine whether practices are using the right codes and documenting correctly." Other physicians consulting services include strategic planning for issues such as malpractice insurance, customized compensation formulas, profit potential of equipment, retreats, conflict resolution and personal financial planning.