Efficiency in Practice

Practical and Achievable Approaches to Compliance - Tips for Preventing Coding/Billing Audits, and What to Do If You Get Audited

2012-02-21T12:35:00.000-05:00

Join us for this Informative Tele-class

Thursday, March 15, 2012

12:00 pm (EST)

There are easy steps any medical practice can take to reduce their exposure to coding audits by Medicare, Medicaid and other payers. You don’t necessarily have to implement a costly and time-consuming, full-blown compliance program to start audit proofing your medical practice.

Clearly it is best to avoid audits in the first place. But sometimes – despite your best efforts – they happen and you have to prepare an effective audit response. We’ll cover those responses, as well.

Topics will include:

* Common Types of Audits Impacting Medical Practices.

* Audit Horror Stories . . . . . and . . . . . Audit Success Stories.

*Which Audits Are Really Dangerous

*Update on RAC Audits.

*Medicare Carrier/MAC’s New Partner – ZPICs.

*Common Audit Targets.

*Responding to an Audit.

*Practical/Achievable Approaches to Compliance and Audit Prevention.

*Self Audits to Reduce Compliance Risks.

*Voluntary Refunds. Whistle-Blowers. And Much More.

REGISTER NOW

presented by

InHealth Consulting & Educational Services

and

Guest Expert Hoyt Torras,

Senior Consultant, InGauge Healthcare Solutions

Mr. Torras' nearly 40 years experience provides expertise in General Practice/Group Practice Management and Administration, Reimbursement, Coding, Regulatory Compliance, Financial Analysis & Projections, and Managed Care Contracting.

He presents seminars and educational programs, as well as develops medical publications and training manuals.

Register for this tele-class HERE

The Efficiency in Practice Manager Association Membership includes monthly tele-classes like this, recordings of past tele-classes, a members-only forum, and discounts on products and services. Click HERE for more information and to JOIN

Five Tips for Helping Patients Pay off a Balance

2012-02-21T12:26:00.001-05:00

by Michelle Dunn

Medical bills aren’t always like other bills, many times they are not planned for and the bill is an unexpected surprise that some people cannot afford. If a patient doesn’t have insurance, this can be a real problem, especially in this economy where as more and more people lose their jobs they also lose their medical insurance.

As a doctor billing patients when they cannot pay in full at the time of service, you must have policies and procedures in place for your office staff to follow in order to successfully get paid for your services. You should look at it as part of your job to help your patients be able to pay your office.

With that in mind here are my top five tips for helping your patients pay off a balance due.

1. Be realistic when talking with patients about payments. If you aren’t realistic, you won’t get paid. Ask them about their income and monthly bills and set a monthly payment they can realistically make, otherwise they won’t make any payment.

2. Get payments twice a month rather than once a month. Even if the installment payment is less, if someone is paying twice a month it could be more than one monthly payment, resulting in the bill getting paid quicker.

3. Put it in writing. Whatever you decide with your patient in regards to their bill, put it in writing and send them a copy.

4. Follow up. Any collection efforts you put in go down the drain if you don’t follow up.

5. Offer your patients a couple of solutions. Many people are embarrassed to have a past due balance with you, and want to pay it off as quickly as possible. Offer them a couple of options so they can be part of the decision making process on how they will pay you.

Michelle Dunn, author of The Guide to Getting Paid, is an expert on the topics of credit and collections. For more information on Michelle, visit http://www.credit-and-collections.com/. To read more articles like this, visit http://www.efficiencyinpractice.com/ and sign up for a complimentary subscription to our Efficiency in Practice enewsletter.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2012-02-07T11:05:00.000-05:00

Dear Readers –
Managing a medical practice can often be a daunting job. There are so many areas to take care of all at once – managing personnel, overseeing billing and financial reports, ensuring quality patient care and legal compliance for the practice, and a half dozen other things. To get it all done, it can sometimes be tempting for you or your staff to take short-cuts or rush through a task. Don’t do it.

“It takes less time to do a thing right, than it does to explain why you did it wrong.” – Henry Wadsworth Longfellow

We’ve all experienced the consequences of rushing though something and making mistakes. Take your time and do things right the first time. It’s always worth it.

Today’s article is from guest author Hoyt Torras, Senior Consultant with InGauge Healthcare Solutions. In “How to Respond to an Initial Request for Records, Medicare & Medicaid Audits”, Hoyt gives guidelines on how to properly respond to a request for records. It may take a little time at first, but once you have the procedures in place it will run smoothly and efficiently.

For more information on audits, join us on March 15, 2012 for “Practical and Achievable Approaches to Compliance – Tips for Preventing Coding/Billing Audits, and What to Do if You get Audited”. For more information and to register, Click Here.

How to Respond to an Initial Request for Records, Medicare & Medicaid Audits

2012-02-07T11:03:00.000-05:00

by Hoyt Torras, MPA, MHA

One of the biggest mistakes a medical practice can make when they receive a request for medical records from a payer, such as Medicare or Medicaid, is to quickly copy some records and throw them into an envelope. Most audits start with the payer, or their audit contractor, providing a list of names and dates of service for which they are requesting copies of medical records.

Here are a Baker’s Dozen worth of tips for those type audits:

1. Before submitting records to the payer or their audit contractor, make sure records are legible and that there are records for each date of service. Further, make sure the documents are well-organized so that auditors can easily find the pertinent records.

2. Designate one person to be responsible for responding to the audit and follow-up.

3. Allow plenty of time to respond. Pay close attention to the deadline for responding in the audit notice. Sometimes you may be granted an extension. Request an extension early, and request it in writing.

4. Read the audit request letter carefully. It usually lists the types of information the auditor expects. Don’t worry if the generic list you’re provided includes information that is not applicable to your patient or the services provided. Just make sure you send a copy of documentation in your records that supports each service billed.

5. Send only copies of the record, not the original, and number the pages.

6. Make at least one copy of the records you submit, exactly as submitted. It is more difficult to appeal an audit when you and your advisors are not sure what was sent to the auditors and used to render their initial decision.

7. Make sure to submit documentation for each date of service requested, but do not fabricate documentation if you do not have it.

8. If your office note for an Evaluation and Management (E/M) code refers to a prior history, you should include documentation related to those aspects. This is especially important for new patient visits where all three elements, History, Exam and Complexity of Medical Decision Making, will be reviewed.

9. If lab tests, x-rays or other diagnostic tests were ordered and billed by your medical practice for the date of service, make sure the report is in the record submission even if the report was not available for several days, after the encounter. Even if the tests were performed or billed by another physician or entity, include them because they may help justify higher levels of E & M services.

10. If you performed a consult, even if it is a payer such as Medicare that no longer recognizes consult codes, include a copy of the report to the referring physician. Again, that helps indicate the extent of work performed on the date of service.

11. If your handwriting is not legible, it may be best to have the records transcribed. Some auditors may deny a service if the records are not easy to read. At other times, auditors may miss important aspects and down code or deny the service. If you transcribe old records, make sure it is clear that the transcription is recent, with the current date prominently displayed. When you submit the record, place the handwritten copy behind the transcription. Usually, you should include a comment about the recently transcribed records in the cover letter you send with the audit submission.

12. Write a cover letter outlining the contents of the package. Provide the name of a contact person at your medical practice along with phone and email address in case the auditor needs additional information.

13. Use FedEx, UPS or mail with return receipt requested so that you have a record of delivery. Some payers allow electronic transfer of records.

Finally, the steps you take to comply with the request will make a difference in how the audit proceeds and how much time and effort it takes to appeal any adverse findings.

Hoyt Torras, MPA, MHA is a Senior Consultant Senior with InGauge Healthcare Solutions and a contributing author to Efficiency in Practice. For more information on Efficiency in Practice and to register for Hoyt’s tele-class, “Practical and Achievable Approaches to Compliance - Tips for Preventing Coding/Billing Audits, and What to Do If You Get Audited” click Here. First time attendees register at no charge.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2012-01-24T11:52:00.000-05:00

January is a great time to review and plan for the New Year. Your office policies and procedures is a good place to start.

For instance, have you updated your procedures to ensure you are compliant with HIPAA, HITECH and other regulations? Today’s guest author Brian Tuttle, Senior IT Specialist for InGauge Healthcare Solutions, Inc., an InHealth company, shares several steps you should take to make sure your are compliant when it comes to FAXing patients’ private health information.

Another area to review is how patients are handled in person, on the telephone and through electronic communication. Your employees should have specific guidelines to ensure effective communication as well as legal compliance. Our next Third Thursday tele-class is “Maximizing Patient Communication” with Donna Weinstock, President of Office Management Solution. Join us on February 16th to learn more. Click Here to Register.

Here at Efficiency in Practice, we have been busy planning our new year to include some exciting new programs for our readers. Over the next several weeks we’ll be sending you additional information on:

• Tele-classes for 2012

• New resources available through InGauge Healthcare Solutions, InHealth’s newest division

• Information on our expanded Efficiency in Practice Managers Association

Until next time, keep striving for efficiency in your practice!

Warning! HIPAA is now larger, with teeth and ready to strike!

2012-01-24T11:50:00.000-05:00

by Brian Tuttle

After the ARRA (American Recovery and Reinvestment Act) or “The Obama Stimulus Bill” was signed into law in February of 2009 there are many new provisions for HIPAA to be aware of. The section of the bill known as HITECH (Health Information Technology for Economic and Clinical Health Act) is of concern.

What’s different? To begin with, HITECH adds the following requirements to what is already in place for “covered entities”.

• Mandatory annual audits by Health and Human Services to ensure compliance.

• Fines up to $1.5 million for violations.

• Business Associates Agreements are now required for vendors and partners who have access to your patients’ private health information (PHI).

• If there are unauthorized disclosures of PHI it is now mandatory to notify those whose PHI was accessed (patient) , to Health and Human Services and (if large enough breach) the media!

Have you reviewed your organizations IT to ensure your systems are in compliance? What about faxing or e-faxing, are you taking measures to ensure these are in compliance? Is your website HIPAA compliant? Are emails encrypted if they contain PHI? Does your organization have a disaster recovery plan in place? Has your site ever been audited by a third party for HIPAA compliance?

Traditional Faxing and HIPAA

We are often asked questions by physicians and practice managers regarding faxing and HIPAA compliance. One would assume following the logic that email containing PHI cannot be sent unsecure that FAXing is also a no-no. That’s not entirely true.

HIPAA states in the “Safeguards Principle”: Individually identifiable health information should be protected with reasonable administrative, technical, and physical safeguards to ensure its confidentiality, integrity, and availability and to prevent unauthorized or inappropriate access, use or disclosure.

As you can see from the above, HIPAA lays out rules and guidelines but doesn’t offer any solutions to get this implemented (especially in the case of FAXing). With email it’s quite simple to meet the above by using end to end encryption. However FAXing isn’t quite so “cut and dry”

What sensible steps can you take for HIPAA compliant FAXing?

1. Use a cover letter. This will help to avoid any casual or accidental reading of PHI.

2. Send only the necessary PHI, no more.

3. Use saved speed dial numbers for entities that your practice faxes often. This will help prevent dialing wrong numbers.

4. Verify any new fax numbers with a test fax.

5. Document in your “Policies and Procedures Manual” what to do if PHI is accidentally faxed to the wrong location.

6. Make sure your fax machine DOES NOT save copies of received faxes. This is a simple configuration on the machine.

7. Never leave PHI sitting on fax machine once received or sent.

8. Do not fax if there are other “more secure” ways to deliver PHI (i.e. encrypted email, by hand, etc.)

Website Design, Content and Legal Considerations in the Medical Practice

2012-01-10T10:35:00.001-05:00

by Rebecca Umberger

Look who’s searching…

In today’s medicine, the web and social media are important and beneficial tools that should not be ignored. According to an article from amednews Feb. 21, 2011, “New vital sign: degree of patient’s online access” by Pamela Lewis Dolan, searching for health information is the third most common online activity behind checking e-mail and using a search engine, with women more likely than men doing healthcare research.

A Harris survey conducted in January 2011 on behalf of Insider Pages, an online directory that has a “physician finder”; found that most people look for physicians based solely on their location. Patients starting with a physician finder normally do a query on physicians in a particular geographic area, and once that is generated, the patients will click on the profiles of the physicians they are interested in. This is then normally followed by the searching the profile page and then the physician’s personal web page if they wanted more information. The survey also noted that even though not all adults go online, the percentage of online health information seekers is at 59% of the total U.S. population.

Designed for Success…

In considering web design/medical website development, you should carefully consider what type of audience you want to attract. You may want to attract a certain type of patient, specific to your specialty, which will dictate how your design and website should be promoted. A plastic surgeon would certainly want to promote beautiful photos of before and after surgical procedure pictures, whereas a pediatrician may want to promote an “ask-a-nurse” component or brightly colored home page. Another consideration is the actual design. If you aren’t sure what type of design you would like to promote the practice, do some research and find other practices online in your same specialty.

“Googling” the simple phrase “Family Practice” for instance, will provide hundreds of practices with an online presence. Review them, making helpful notes to assist you in design. What was the first thing that caught your eye on their site? Did it seem professional? Were there any “special” effects such as flash animation, special links or other features you would like to incorporate in your website? Did the website allow patient interaction with the providers? How were the physicians highlighted in the website? Is it easy for the patients to navigate? Did they have a pleasing home page, highlighting the practice with easy to read information? Keeping a list of website links that contained special designs, features or undesirable attributes will help down the road when designing your home page or speaking to the web designers if you decide to use a professional service.

In respect to website content, this is obviously going to be specific to your practice and specialty. Some items to keep in mind globally would be using your practice name, address, phone number and any other means of contacting the office on each page. If you can, include a map for patients to find your location and a link to such as “Mapquest” or “Googlemaps” that will allow the patient to print out directions to your practice.

Keeping the content fresh and updated is also a good idea for visitors to return. Information about sunburns isn’t really relative in the Midwest during a February snowstorm. If you are using a professional web design company, they will question you for interest in SEO or “search engine optimization” which is normally an additional fee to site design. By using the design company, they will “promote” your website by SEO optimization, which is done by paying special attention to descriptions and keywords making sure that your scores rate higher in ranking in search results.

There are many free analysis tools to track your site’s SEO performance, such as Yahoo! Site Explorer, Google Webmaster Tools, Google Analytics, SEO Book and SEO Chat that will give you a wide range of options to follow your SEO campaigns.

Legally Speaking…

Using a website for your practice is treated as advertising under the law, so any legal and ethical rules of advertising for physicians should be applied. One should also take into consideration any patient-physician-practice contact and the legal ramifications under HIPAA (Health Insurance and Portability and Accountability Act) and ARRA (American Recovery and Reinvestment Act) standards.

The AMA has guidelines available to help you develop your web presence and social media rules for the practice as well. Your malpractice carrier should be aware that you are developing a practice website for risk management purposes. Some malpractice carriers will have specific suggestions/guidelines for their clients to use with legal resources and documents. A good resource for HIPAA, ARRA and social networking/media updates can be found at the AMA Practice Management Center at www.ama-assn.org/go/pmc.

In considering truth-of-advertising, if you list or mention your staff on websites, make sure that the written content matches their titles and credentials. For example, if your office only employs medical assistants in the practice, you wouldn’t want to have a statement or content stating that “our nurses” or “the nurses” provide XYZ services to the patients. This would be misleading to patients on the website and possibly make them believe they are speaking to a “nurse” in your practice when they are really speaking to a medical assistant. Patients deserve to know who is providing their care. The AMA also clarifies in H-405.968 code ethics “Clarification of the Term “Provider” in Advertising, Contracts and Other Communications”.

As mentioned previously, a website in a physicians’ practice is considered advertising under the law, so you would treat it no differently than an advertisement in the newspaper or telephone book, with the exception that the physician must also be aware of truth-in-advertising and testimonials.

Many attorneys will advise clients to stay away from testimonials and deal with straight facts and information about the office. Your site may describe to patients why they should choose your practice, as long as they aren’t legally false, deceptive or misleading, as judged by the state medical board. The AMA has a code of ethics that states “Generalized statements of satisfaction with a physician’s services may be made if they are representative of the experience of that physician’s patients”.

Additionally, while social networking (Facebook, Twitter, MySpace, etc.) continues to be an undeniable presence with 35% of American adults using them in the online community, they are viewed in the medical community as a “minefield” of legal and professional hazards for the medical professionals who “friend” patients to communicate.

In Summary…

Healthcare providers and physicians see the potential in online interactions with patients for improving access and quality of care. Healthcare searches compose the third highest volume of online activity. Patients search initially for physicians demographically then by profiles if interested in further information.

Website design is specific to your audience and specialty. A professional appearance with easy to navigate pages and current relevant site content will keep the patients returning to your site. Women are more likely to be viewing and researching your online presence. Website SEO optimization increases the likelihood of your site to be “noticed” online and moved higher on the search engines with key words and descriptions based on your site content.

There are valid concerns to consider in regards to patient privacy, liability, risk management and the compromised situations the practice can be exposed to. Social networking sites carry an additional legal & ethical concern for the employer-physician and should not be ignored when considering online communication with patients.

Healthcare and the internet “society” will certainly increase and is destined to be a continuum. The healthcare community can continue to use these tools to improve the quality of health care and patient outcomes, as well as practice enhancement and patient satisfaction, but should seriously consider how best to use electronic media to everyone’s advantage, by protecting the patients’ rights as well as using best practice techniques and effective risk management.

© 2012 Efficiency in Practice

Rebecca Umberger, CMA(AAMA), CPM is currently Vice President of Development at Family Care Centers of Ohio, and over the past 9 years served as part-time Adjunct Instructor in the Health Division/Medical Assisting Department at Stark State College North Canton, Ohio. She has worked various positions both as a CMA and Practice Manager in an outpatient setting for over 26 years. During this time, she has focused in clinic operations management, practice design, planning and development, marketing, recruiting, process improvement and workflow efficiency, supervisory training and leadership development with a special interest in medical law/ethics. She can be contacted at Rsumberger@famcareohio.com or you can check out her company’s website at http://www.famcareohio.com/

From Sue . . .

2011-12-20T12:30:00.000-05:00

Well, it’s that time of year again - the holiday rush. Everyone is busy and excited planning, shopping and spending time with friends and family. The holidays bring so much enjoyment, but what they don’t bring is extra time.

Time management and making the most of your time are year-round endeavors, both in your personal life and in business. I am always looking for ways to improve my time management whether it is a new type of electronic or paper-based planner or just a simple tip to make my day run smoother. Here are a few of my favorite time management tips:

• Take the first 30 minutes of every day to plan your day – prioritize your tasks and DELEGATE what you can.

• Limit distractions when you are working on a project– turn off your phone and email, and log out of Facebook and other social media.

• Put up a "Do not disturb" sign when you absolutely have to get work done.

• And remember to take care of yourself – get plenty of sleep, exercise and eat well. It will improve your focus and concentration.

Effective use of time is necessary not only for you and your staff, but also for your patients. Today’s article, Measuring Office Visit Cycle Time, is from guest author Tom Ludwig, President and CEO of Forward Healthcare Solutions, LLC. Tom explains how to measure the office time cycle to ensure your patients don’t have unnecessary wait times, and therefore, can effectively manage their time as well.

Measuring Office Visit Cycle Time

2011-12-20T12:28:00.000-05:00

By Tom Ludwig, RN, MBA, FACMPE

Does your practice receive patient complaints about long waits during the visit? Do you have a physician who is constantly behind schedule? Prolonged waiting times affect your practice in several ways. Patients can become dissatisfied to the point of leaving your practice. Physicians and staff become frustrated with delays that can result in long hours and patient complaints.

There are a variety of reasons for prolonged waiting times. Patients who arrive late, staff who take too much time with patients, providers who try to do too many things at once, and poor communication within the office are just a few of the many possible causes. Are you not sure where the problem lies in your practice? It might be time to measure your office visit cycle time.

According to the Institute for Healthcare Improvement (IHI), office visit cycle time "... is the amount of time in minutes that a patient spends at an office visit. The cycle begins at the time of arrival and ends when the patient leaves the office." Measuring the office visit cycle time can help you identify where the bottlenecks exist in your practice.

When measuring cycle time, you can measure as few or as many steps in the patient visit process as you wish. The fewer steps you measure, the easier it is - but you get less information. The more steps you measure, the more helpful your information will be - but it will also be more resource-intensive. The steps you will want to consider are:

• Patient appointment time

• Time patient checks in at desk

• Time patient is taken to exam room by staff

• Time staff leaves the room

• Time provider enters the room

• Time provider leaves the room

• Time patient leaves the room

• Time patient checks out at desk

IHI recommends that you measure a total of 15 patients in order to get a good average cycle time. The patients should also be measured on the same day of the week and at the same time of the day. Depending on your specialty - or where you think your bottlenecks are - you might also want to include lab, x-ray, or certain procedures in your cycle time measurement.

Cycle time can be measured manually or, depending on the sophistication of your electronic health record (EHR), automatically. The manual method can be done by staff or by patients. A sample form can be found at IHI's web site, www.ihi.org. Patient Cycle Tool If you prefer to try to automate it, many EHRs are able to time-stamp several important steps in the cycle: patient check-in, staff logging in and out of the record, providers logging in and out of the record, and the end of the visit (closing the encounter).

Once you've identified where the bottleneck exists, focus on that step in the cycle and use basic process improvement tools (process mapping, plan-do-study-act cycle) to make changes that will improve your cycle time.
When measuring cycle time for the first time in your practice, you should consider doing several (if not all) of your providers. This will not only enable you to get an overall average for your practice, but you can also identify best performers within your practice and use them as a model for the others. As for a standard benchmark, IHI suggests that you take the amount of time that a patient spends with the provider and multiply that by 1.5. For example, if a patient spends 20 minutes with the provider, the ideal cycle time would be 30 minutes (20 x 1.5 = 30).
Improving patient cycle time can help reduce waiting times in your practice. It can become a valuable aspect of your practice's quality program. It not only makes the practice more efficient, it is also a great satisfier to patients, staff and providers.

© 2011 Efficiency in Practice

Tom Ludwig is President and CEO of Forward Healthcare Solutions, LLC, a consulting firm that specializes in working with physician practices. Tom has worked in the physician practice setting for a variety of organizations for 35 years. He has extensive experience in clinic operations management with expertise in strategic and business planning, process improvement and workflow efficiency, advanced access, supervisory training and leadership development. Tom can be reached at tludwig@forwardhealthcaresolutions.com or www.forwardhealthcaresolutions.com

And for more medical practice management resources and information, visit http://www.efficiencyinpractice.com/
This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2011-12-01T10:36:00.000-05:00

Dear Readers,

I hope you had an enjoyable Thanksgiving and were able to spend time with family and friends, not to mention eat some turkey!

One of my favorite parts of Thanksgiving Day is sitting around the table after the meal is finished talking with everyone. The conversation is always interesting and animated, and no one seems to be in a hurry to get up. It is a great opportunity for real communication.

Good personal communication is often lacking in this overly-technological age of texting, tweeting and emailing. In your medical practice, effective personal communication is not only critical for conveying proper medical information; it is an important customer service tool. When you or your staff are with a patient, that patient needs to know they are being listened to AND heard.

In today’s article, “Communication: Improving the Patient Experience” guest author Donna Weinstock, President Office Management Solution, offers tips and suggestions for improving the relationship between patient and practice through good communication.

Donna will also be presenting a tele-class on Maximizing Patient Communication in February 16th. For more information and to register, click here.

And, if you haven’t already registered for this month’s tele-class, Marketing Your Medical Practice, there is still time. Click here for more information and to register.

Until next time, keep striving for Efficiency in your Practice!

Sue Kay.
Editor

Communication: Improving the Patient Experience

2011-12-01T10:33:00.000-05:00

By Donna Weinstock

Healthcare practices often spend time looking at ways to improve patient satisfaction, but how often do they address communication as it relates to improved patient service? I would have to say, not often enough.

Every aspect of patient care involves communication. Whether it is in person, on the telephone or using technology, what you say is as important as how you say it. It is so easy for a patient to misinterpret what is being conveyed. For this reason, practices should look at their communication as a way of improving “the patient experience.”

When a patient is face to face with the front receptionist, does that receptionist look the patient in the eye? Does she address the patient by name and offer her the same respect and consideration that she herself would want? For that matter, every person in the office, from the clinical staff to billing person should treat patients with respect and dignity. Starting with the patient, there is a definite link between a patient’s understanding and patient satisfaction. In improving the relationship between the practice and the patient, it is important to:

• Include the pleasantries. Whether it’s greeting a person by name, offering them a seat or shaking hands, pleasantries and greetings are important.

• Create a rapport with the patient. This includes an understanding of the patient’s concerns, issues and needs.

• Understand the patient’s perspective and what he/she wants out of the visit to the office. This can include areas of scheduling, billing and education as well as the physician visits with the patient.

• Be empathetic and sympathetic to the patient’s concerns. They need to know that you care about them as a person. RESPECT and SUPPORT are essential.

• Do not appear rushed even if you are. Let the patient feel that they are important and you are giving them the time they need.

• Keep the conversation on track.

• Listen without interrupting. Look at the patient so they know you are listening. Hear what your patients are saying. If needed, repeat what they said; “if I understand you, you are saying….”

• Involve the patient in his/her care. Whether it’s educating the patient of his diagnosis, explaining a bill, or discussing insurance, the patient needs to be aware and understand what is happening. Build on the relationship and make the patient and family members PARTNERS in their care.

• Manage patient expectations. Try coaching your patients as to what reasonable expectations are.

Telephone encounters with the patient need to be equally respectful and considerate. Reaching a live person should be easy and telephone hold time should be kept to a minimum. Staff should try and establish why a patient is calling prior to transferring the call and should share the reason with the person they are transferring the call to. There is nothing more aggravating than having to explain the purpose of your call several times during the encounter.

Communication is more than just the spoken word. It is the little things that we do that remind the patient of their importance to the practice.

Some things a practice may want to consider doing are to:

• Send all patients a welcome letter

• Make special efforts to meet the patient’s needs

• Educate your staff on working with patients

• Listen

• Follow up

• Do the unexpected

• Exceed their expectations.

It is the body language we use to make a point and the gestures we make. It is going above and beyond the expectation of the patient to insure that the patient understands what he is being told and recognizes his value to the practice.

Every encounter we share with a patient, whether on the telephone, in person, on the internet or using advanced technology is a means of communicating. Practices should value all forms of communication and look for ways to improve them. Effective communication is customer service at its best.

© 2011 Efficiency in Practice

Donna Weinstock is a Senior Consultant at InHealth, and the President of Office Management Solution. She consults with healthcare practices to perform workflow analysis, improve processes, and increase profits as well as select and implement electronic health records. She can be reached at donna.weinstock@inhealthconsulting.com

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Documenting a Preventive Visit

2011-11-17T10:41:00.000-05:00

By: Ellen Risotti, BS, CPC, CEMC, CFPC

Annual preventive exams have been a standard of care in the medical industry for many years. CPT describes these services as a periodic comprehensive preventive medicine evaluation (or reevaluation) and management of an individual. CPT codes 99381-99387 are the codes used to represent these services and their selection is based on whether the patient is new or established as well as the patient’s age. CPT goes on to describe the services to include an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures.

Unlike other evaluation and management services in the CPT book, annual preventive exams do not have specific documentation guidelines required to support the service that is being provided. A preventive medicine service is considered to be of a comprehensive nature however the “comprehensive” nature of these services is not synonymous with the comprehensive examination required in other evaluation and management codes. So the age old question, what constitutes a comprehensive history and exam in relation to a preventive medicine service?

Here at Indianapolis Medical Management (IMM) this topic has brought much debate. Some of the many services that we offer include chart reviews and provider education. When these functions are performed around preventive services, the question of how these services should be documented comes up. What types of information should we expect to see to constitute a comprehensive history? What equates to an age and gender appropriate examination? What types of counseling, anticipatory guidance and risk factor reductions should be addressed? What laboratory and diagnostic procedures would be relevant to a preventive service? What should we be educating physicians and non-physician practitioners (NPPs) to document in a patient’s medical record to support the billing of a preventive medicine evaluation and management service?

Again, there are no official, specific documentation guidelines, so in an effort to help streamline this process for both our team of billing and coding consultants and our clients, we have done extensive research and come up with best practice guidelines based on recommendations from the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the U.S. Preventive Services Task Force (USPSTF), the American College of Physicians (ACP) Internal Medicine and the American College of Obstetrics and Gynecology (ACOG). These guidelines will be used to evaluate these services. The following breaks down the information that we would expect to see documented in the review of a preventive medicine service based on the patient’s age and gender.

Well Baby Visits – Birth to 2 Years

History: Past illnesses, surgeries, medications, allergies, pregnancy/birth history, family history and social history

Exam: Hearing for newborns, weight, length, head circumference, head, chest, abdomen, genitalia, neck, extremities, eyes, ENT, cardiovascular, respiratory, skin, neurological

Counseling/Anticipatory Guidance: Safety, health, nutrition, development, immunizations

Risk Factors: Age appropriate developmental and behavioral assessments

Lab/Diagnostic Services: Hemoglobin or hematocrit once between 9-12 months, lead testing at 1year and 2 years if uncertain about lead exposure, PKU screening

Well Child Visits – 3 to 10 Years

History: Past illnesses, surgeries, medications, allergies, family history and social history

Exam: Blood pressure, vision screen, hearing screen, height, weight, BMI, w/percentiles for age, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological

Counseling/Anticipatory Guidance: safety, injury prevention, health, nutrition, development, immunization, screenings

Risk Factors: Age appropriate developmental and behavioral assessments

Lab/Diagnostic Services: Any warranted based on risk factors

Well Child Visits – 11 to 18 Years

History: Past illnesses, surgeries, medications, allergies, family history and social history, status of chronic conditions

Exam: Blood pressure, vision screen, hearing screen, height, weight, BMI, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological, hematological

Counseling/Anticipatory Guidance: Nutrition, physical activity, healthy weight, injury prevention, avoidance of tobacco, alcohol and drugs, sexual behavior and STDs, dental health, mental health, immunization, screenings

Risk Factors: hypertension, hyperlipidemia, coronary heart disease, depression, eating disorders, emotional, physical, or sexual abuse, problems with learning and school

Lab/Diagnostic Services: Chlamydia screening for sexually active females,

Adult Visits – 19 to 39 Years

History: Past illnesses, surgeries, medications, allergies, family history and social history, status of chronic conditions

Exam: Blood pressure, height, weight, BMI, breast exam for women, depression screen, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological, hematological

Counseling/Anticipatory Guidance: nutrition, family planning/contraception, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior and STDs, dental health, mental health, immunizations, screenings

For Women: Breast cancer and self breast exams

Lab/Diagnostic Services: Cholesterol every 5 years beginning at 20 years, Chlamydia for sexually active women under 25, cervical cancer

Adult Visits – 40 to 64 Years

History: Past illnesses, surgeries, medications, allergies, family history and social history, status of chronic conditions

Exam: Blood pressure, height, weight, BMI, depression screen, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological, hematological

Counseling/Anticipatory Guidance: Nutrition, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior and STDs, contraception, dental health, mental health, immunizations, screenings

Lab/Diagnostic Services: Cholesterol, diabetes, colorectal cancer beginning at 50 years

For Women: Breast cancer, cervical cancer

For Men: Prostate cancer beginning at 50 years

Adult Visits – 65 Years and Older

History: Past illnesses, surgeries, medications, allergies, family history and social history, status of chronic conditions

Exam: Blood pressure, height, weight, BMI, hearing screening, depression screen, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological, hematological

Counseling/Anticipatory Guidance: Nutrition, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior, dental health, mental health, immunizations, screenings

Lab/Diagnostic Services: Cholesterol, diabetes, colorectal cancer

For Women: Breast cancer, cervical cancer, osteoporosis beginning at 65

For Men: Abnormal Aortic Aneurysm one time for men 65-75 years with history of smoking, prostate cancer

It is important to note that checking the status of chronic conditions and refilling on-going prescriptions is expected during the course of an Annual Preventive Exam and thus would not warrant the billing of a separate Problem Oriented Evaluation and Management service. However, if a chronic condition is not being well controlled and decisions are being made as to how to treat the patient to improve control, changing the dosage of medications, changing to a new medication etc, this may substantiate a separate Problem Oriented Evaluation and Management service if more work is done (and documented) than what would normally be performed in the course of an Annual Preventive Exam.

In closing, please keep in mind, the above recommendations are just that, recommendations. The individual needs of the patient and their history and risk factors will determine the extent to which counseling, anticipatory guidance and screening services should be performed. For example, a female with a family history of breast cancer may need a screening at an earlier age than typically recommended. What is important to remember is the documentation should include what counseling and anticipatory guidance was provided to each patient as well as the screenings that were discussed and ordered or offered, should the patient decline. The documentation should very clearly show that the elements of the Annual Preventive service were met. At IMM, it is our hope to provide information and education that will help our clients improve on documentation and thus help ensure that the services performed are supported by that documentation. Hopefully this article will help you in your documentation of Preventive visits.

© 2011 Efficiency in Practice

Ellen Risotti, CPC, CEMC, CFPC is a billing and coding consultant for Indianapolis Medical Management and a contributing author to Efficiency in Practice. Efficiency in Practice is the free eNewsletter for medical practice managers who want to save time, money and reduce risk . To read more articles like this, visit www.efficiencyinpractice.com and subscribe free of charge. This article can be reprinted freely online, as long as the entire article and this resource box are included.

New Tele-class just added!

2011-11-10T11:11:00.001-05:00

"Maximizing Patient Communication"

Thursday, February 16, 201212:00 pm (EST)

Communication is not only about what the speaker is saying. In fact, it is not always what a person says, rather what the recipient hears and how those words are interpreted. Therefore it is important to relay what you want to say in a meaningful manner.

This tele-class will describe the various means of communication, including telephones and how to handle them, when a patient is in the office, emailing and how social networking affects your practice in both positive and negative ways. It will also include other ways that communication has been improved through technology.

Body language is often an expressive way of communication. What does your body language say when you are speaking? Find out, by tuning into this informative tele-class.

During this class, attendees will learn to:

•Describe different types of communication

•Analyze verbiage that offers calming effect

•Apply effective communication techniques with patients, staff and between employees

•Recognize the advantages and disadvantages of using social networking in your practice

presented by

InHealth Consulting and Educational Services

and

Guest Expert Donna Weinstock,
President, Office Management Solution

Donna consults with healthcare practices to perform workflow analysis, improve processes, and increase profits as well as select and implement electronic health records. She is a writer, speaker and trainer on practice management topics, and writes employee handbooks, job descriptions and procedure manuals.

Just $24.97
(First time attendees register at no charge)
Click HERE for more information and to Register

Starting a Physician Liaison Program to Market your Practice

2011-11-01T12:02:00.000-04:00

Many hospitals and health systems have Physician Liaison and/or Physician Relations Representatives that have the responsibility of visiting physician practices to promote the service lines of the hospital. Similarly many physician practices, in particular specialty practices, have initiated or have considered initiating such a program as a vehicle to carry their message(s) to the field and ultimately grow their referrals. Some consulting organizations provide the option of outsourcing this role to them (Practice-Reps) while others will provide a Physician Liaison training program for your new hire (Healthcare Success Strategies, Practice Builders).

If you decide that you want to start a Physician Liaison program on your own, where do you start? Let’s examine some of the areas you need to consider:

Job Description for a Physician Liaison

Many practices are at a loss regarding defining a job description because this is a new, unexplored role for them. The following is a general example of the role and responsibilities of a Physician Liaison:

The Physician Liaison will support the practice by representing and promoting our clinical services, physicians and programs in order to increase referrals from existing providers and secure new business from current low volume and non-referring physicians.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

• Functions as the primary sales and marketing contact for referring physician offices

• Interfaces with both physicians and their staffs to improve communication and understanding of the needs and wants of the referring practices

• Develops a sales plan for physician practices with measurable goals and objectives

• Conducts personal visits to referral sources on a daily basis

• Identify issues and concerns from referring offices and communicates them back to the practice

• Facilitates meetings for our physicians with referral sources and coordinates “lunch and learns” to discuss new clinical offerings

• Documents daily contact with referring physician offices

• Develops referral trend reports

• Facilitates community outreach, speaking and education opportunities for the practice

MINIMUM QUALIFICATIONS:

Education: BA in marketing or business.

Experience: Three to five years in healthcare sales, preferably in a physician services environment.

Finding the Right Candidate

Practices need to understand that if you are going to have a successful Physician Liaison it takes more than finding someone with an outgoing personality. That is certainly an important trait but there needs to be more. Your Physician Liaison needs to have the ability to listen and understand what the client is truly saying. They should have great attention to detail and excellent organization and follow up skills. They need to be problem-solvers and be able to facilitate solutions, calling upon resources within your practice. And they need to have “conceptual” selling skills so they can be your communication eyes and ears.

Can you get this from an entry-level hire? Perhaps, but it is going to take time, training and personal management, which in many cases practices cannot devote. Ideally you should be looking for someone that has been in a sales capacity in a physician services environment and has already been through a variety of sales training programs. To hire a “Marketing” versus a “Sales” person or move a clinical person into a Physician Liaison role is often a difficult transition for them due to their lack of experience making sales calls and “cold call fear”.

Potential sources to identify candidates can be online job posting websites along with recommendations from your vendors and hospital Physician Relations Department.

Finding the right, experienced person will put you further ahead on their road to productivity.

Setting Objectives for Your Physician Liaison

One of the challenges for a Physician Liaison role, particularly if it is new to a practice, is staying focused on the job responsibilities. Inevitably what happens is that if something even has the slightest orientation to a sales and/or marketing responsibility, most people in the practice will direct it to the Physician Liaison. As this continues over time, the Physician Liaison becomes engulfed in day-to-day “stuff” and is not able to get into the field, fulfilling what they were hired to do i.e. calling on referral sources. To avoid this all too common situation, it is important to set clear, measurable and quantifiable objectives for your Physician Liaison so that they know, and your practice knows, what is expected of them. The following are some of the many measurable goals that can be established for a Physician Liaison:

• # of visits per week to referring physician offices

• # of meetings facilitated for practice MDs with referring physicians

• # of lunch and learns coordinated with referring practices

• # of social events scheduled with your practice and referring practices

• # of referral coordinator lunches scheduled

• # of meetings with ER physicians and Hospitalists

• # of speaking engagements coordinated

• Development of quarterly sales plan and rotational call schedule

• Submission of weekly sales activity report

Mentoring Your Physician Liaison

A challenge for many practices is what do you do with this person? For practices that have no experience with a Physician Liaison, the short answer is that you need to mentor them, provide them with an opportunity to succeed, give them clear direction, and monitor their activities not only through their reports but also by spending time with them in the field making calls on your referral sources. Giving them a list of your referring physicians and telling them to make calls and deliver referral pads is potentially a recipe for disappointment.

On a weekly basis you should meet with your Physician Liaison and review the planned activities for the week. Questions that you and the Physician Liaison should discuss include: What are the objectives of your calls? Who are you going to call on in the practices? Who in the practices determine where referrals are sent? What do you want to accomplish with the calls? What have been their referral trends? Have there been any problems expressed by these practices? In other words, you need to strategize with the Physician Liaison on their calls. Leaving them on their own to do this will likely not yield the results that you are looking for.

Tracking Physician Liaison Sales Activities
On a weekly basis the Physician Liaison should submit an activity report to the Practice Administrator. The Physician Liaison should document what practices they visited, who they spoke to, what information they left with the practice, and any issues that were identified and follow up that may be required.

Targeting the Referral Influencer

While private practices are physician owned and controlled, the bottom line is that the physicians don’t necessarily always influence where the patient is sent for additional testing or consults. More often than not a referral coordinator, check out person or mid-level will play a key role in where the patient is referred. As part of the Physician Liaison’s role, they need to determine who coordinates referrals within these practices and then target them from a relationship building standpoint.

In meeting with the referral influencer your Physician Liaison should try to integrate questions such as the following into their discussion to get valuable feedback for your practice:

• What's the most important factor in determining where to send your patients for ________________ care?

• How’s your experience been with scheduling and with reports at our practice?

• Have your referrals to our practice changed over the last year? (If they're down, why?)

• Have you been satisfied with our care of your patients and service to your office?

• What feedback do you receive from your patients regarding our practice?

• Can I answer any questions about the services we offer?

• How can we improve our service to your practice?

• Are there any issues or problems we should be aware of?

Involving Your Physicians in the “Sales” Process

One of the most effective marketing initiatives is getting your physicians face-to-face, developing relationships with your referring physicians. Your Physician Liaison should be a conduit to facilitate these encounters. Primary Care physicians are often overloaded with patients so it is difficult to bring your physicians into their office for a “lunch and learn” or breakfast or lunch meeting. What can be very effective however is to bring your physicians to the PCP office for a “check in” with the physicians and staff regarding how your practice is performing on behalf of their patients. It does not need to be a formal, sit-down meeting but the fact that you are showing them that you value your relationship will end up paying dividends.

Report Generation

As part of your Physician Liaison’s responsibilities, they should be the “go-to” person for collecting, analyzing and disseminating reports related to referral activity. Some examples of tracking reports include:

• Monthly referrals by referring physician

• Monthly new consults by referring physician

• Monthly referrals, new consults and total visits per office location

• Referring physician monthly ancillary services referrals

• Monthly ancillary services volumes by office location

• Source of self-referred patients by month (e.g. friend, television commercial, etc.)

• New patients generated as a result of community screening programs

• Referrals by your practice physicians to internal programs (e.g. exercise, nutrition, etc.)

Considerations

Implementing a Physicians Liaison program is a very viable initiative to enhance relationships, increase visibility and grow referrals for your practice. However, to have a successful Physician Liaison program and an overall effective marketing strategy, you first need to have a plan before you can “work the plan”.

Marketing is a process rather than an event. To position yourself to “market”, you need to develop a plan, looking both internally to evaluate the current state of your practice and externally to analyze your market and define specific goals, tactics and action plans.

To help you understand the elements of marketing planning, register for the December 15th Efficiency in Practice tele-conference, Marketing Your Medical Practice: You Need To Have A Plan Before You Can “Work The Plan”. Click HERE for more information and to Register.

This tele-conference will provide you with the building blocks to develop a systematic and comprehensive marketing plan to promote your practice.

Our discussion will review:

• How to evaluate your practice from a marketing perspective

• The key elements of a strategic marketing plan

• Potential PR and marketing tactics to consider

ARE YOU READY FOR ICD-10?

2011-10-18T10:56:00.002-04:00

by Pat Schmitter CPC, CPC-I

In approximately 24 months the most significant change to the diagnosis coding system will happen. The Department of Health and Human Services released the final regulation in 2009 to move from the current diagnosis ICD-9 coding system to the ICD-10 coding system beginning October 1, 2013. If your professional options do not include imminent retirement or a drastic career change, surviving the transition from ICD-9-CM to ICD-10-CM will require a strong foundation.

ICD-10 is not just a routine annual diagnosis update. This is a much bigger transition that requires attention devoted to physician and staff education, workflow alterations, clinical documentation, practice management operations and claims management processes and systems which must be reconfigured for ICD-10. Failure to transition to ICD-10 on October 1, 2013 will result in delayed or denied reimbursement. Reconfiguring your systems to be ready for implementation is required January 1, 2012 with the conversion to 5010. While 5010 is a technical conversion where vendors will do most of the heavy lifting, the same is not true for ICD-10. The ICD-10 code set will require action from you and your practice.

Studies conducted by The Advisory Board (www.advisory.com) estimate the incremental impact on net revenue for a 250 bed hospital one year following implementation to be $1.0-2.5M with a three year impact of $2.5-7.1M. The reasons for such significant loss include:

• lack of clean mapping to the new code set

• claim denials as a result of unfamiliarity with newly revised policies regarding medical necessity from payers

• under-coding due to documentation specificity that was insufficient for accurate coding

• over-coding driven by coder inexperience

• payment errors due to IT issues

Of serious concern is the loss in productivity as coders query physicians for more information. Successful use of ICD-10-CM begins with the physician or provider who is documenting the service. Staff cannot pick a code if they do not have enough detail in the documentation. It is critical that physicians engage now in education to improve current documentation habits in preparation for greater specificity requirements in ICD-10. If you don’t start by making changes in your documentation now, you will be overwhelmed when it is time to implement the new codes.

While ICD-10-CM is similar to ICD-9-CM in that some terminology, conventions, classifications, and other features are the same, there are also many differences in terminology, categories, chapters, guidelines and code structure. Advances in medicine and medical terminology and how we report quality data cannot be accommodated in the current ICD-9 system.

Some of the category changes will include additional chapters in ICD-10-CM and the moving of some diseases to a different category.

For example currently in ICD-9-CM, Chapter 3 Endocrine, Nutritional and Metabolic Diseases and Immunity (240-279) physicians would choose category 274 Gout and select one of 15 different codes to describe the encounter. In ICD-10-CM, this chapter has been renamed and moved to Chapter 4, Endocrine, Nutritional and Metabolic Diseases (E00-E89). Gout has been removed from this category and placed in Chapter 13 Diseases of Musculoskeletal System and Connective Tissue. In ICD-10-CM, physicians will choose from the category M10 Gout, and select a code from 162 choices. In order to select the appropriate choice, your documentation will need to describe all of the following elements that most accurately describe the encounter:

• anatomical area affected

• laterality

• idiopathic

• lead-induced (also identify the toxic effects of lead and its compounds)

• drug induced (also identify the drug)

• renal impairment (also code the associated renal disease)

• other secondary diagnoses (coding first the associated condition)

• an additional code to identify certain diseases and/or disorders classified elsewhere

ICD-10 is so much more than coding and IT. The transition to ICD-10 will have a significant impact on provider operations in almost every area. Are you ready for ICD-10? The time to begin preparation for transition to ICD-10 is now.

© 2011 Efficiency in Practice

Pat Schmitter, CPC, CPC-I is a Billing, Coding and Credentialing Consultant with Indianapolis Medical Management.

With almost 40 years of experience, Pat has a strong background in government payer regulations. She provides billing and coding consulting services and is responsible for various audits; education on billing, coding and government regulations; and solvinf payor-related problems.

To reach Pat, email her at pat.schmitter@inhealthconsulting.com

Are You Marketing Your Medical Practice?

2011-10-04T10:32:00.001-04:00

Marketing Your Medical Practice:

You Need to Have A Plan Before You Can "Market the Plan"

Join us for this Informative Tele-class

Thursday, December 15, 2011

12:00 pm (EST)

New to Third Thursdays Tele-classes? The first one is on Us. If this is your first tele-class with InHealth, we invite you to join us at no charge. Click here to Register.

In this competitive environment you know you need to market your practice, but where do you start?

This tele-class will provide you with the building blocks to develop a systematic and comprehensive marketing plan to promote your practice.

Our discussion will review:

How to evaluate your practice from a marketing perspective

The key elements of a strategic marketing plan, including:

Defining target markets and customers

Establish quantifiable goals

Action plans and a marketing calendar

Potential PR and marketing tactics to consider

Developing an annual marketing plan is a critical element of a practice's overall strategic process. It will provide the road map to guide your internal and external activities, as well as help you to stay focused and ultimately help you to grow your business.

presented by

InHealth Consulting & Educational Services

and

Guest Expert Bob Healy,
Managing Partner of MD Practice Marketing and author of the Physician Practice Marketing Tips blog.

Bob has over twenty-five years of healthcare experience helping physician practices implement programs to grow revenue, referrals and new patient consults.

Registration for this tele-class is just $24.97

REGISTER HERE

Member Price: $0

New to Third Thursdays Tele-classes? The first one is on Us. If this is your first tele-class with InHealth, we invite you to join us at no charge. Click here to Register.

Your call-in number and access code will be sent to you in a confirming email.
If you cannot attend the tele-class live, an audio recording will be sent to all Registered attendees after the tele-class.
"Marketing Your Medical Practice" meets the criteria of the Professional Association of Health Care Management and is approved for 1 CEU.

Interested in more medical practice management information? Subscribe free of charge to Efficiency in Practice, the enewsletter for medical practice managers who want to save time, money and reduce risk. Click here to subscribe and you will also receive important information on the Recovery Audit Contractors (RAC).

Preparing To” Market” Your Physician Practice

2011-09-15T09:48:00.012-04:00

by Bob Healy

Many physician practices often take a reactionary, shot-gun approach when it comes to marketing initiatives. For example, a competitor starts running ads in a local paper so the practice decides they need to do the same. This leads to careless spending and no integration of what you want to accomplish from a branding and messaging perspective.

While practices consistently plan and budget annually for operational expenditures and activities, the same thought process and attention needs to be devoted to marketing. To be successful, efficient and cost-conscious, developing a marketing plan is a necessary and critical element of a practice’s overall strategic process. The marketing plan will serve as a road map to guide your internal and external activities, define your budget and detail your planned strategies and tactics for a twelve month period.

Developing an effective marketing plan requires that you take both an “inside” and “outside” look at your practice. As a first step in the marketing planning process you need to conduct an internal marketing assessment. This assessment should evaluate the current state of your practice from a marketing perspective, the effectiveness of past marketing initiatives, referral trends that exist and how you are perceived by your patients and referral sources.

In beginning your internal evaluation, as a first step, it is beneficial to “interview” each of your physician providers, mid-levels and management team members to gain their perspective of your practice. The interviews will allow you to get their view on your unique differentiators, SWOT (Strengths, Weaknesses, Opportunities and Threats), key messages, the competitive environment, marketing opportunities, relationships with referring physicians and any barriers to referrals that might exist.

The information they provide will not only be useful to you but it will also give them a feeling of ownership in shaping the future message, positioning and plans for the practice. It is recommended that you send them in advance a questionnaire to consider and then conduct individual face-to-face meetings to gather their input.

Click HERE for a sample Internal Interview Questionnaire and SWOT Analysis

An important outcome of the internal marketing assessment is the development of a SWOT Analysis which will serve as a key component of the marketing plan. The SWOT Analysis is a subjective, yet useful, strategic look at your practice. The physician and management team interviews will provide the detail for this exercise. The information from the SWOT will help to drive your key messages and define your marketing tactics to help your practice achieve its objectives.

The SWOT Analysis identifies those internal and external factors affecting your practice:

• Strengths- internal practice aspects that provide a competitive advantage. Examples of strengths might include clinical outcomes in relation to national standards, same day consults, on-site prescription dispensing, bi-lingual staff…

• Weaknesses- the lack of strengths in certain areas may be considered an internal weakness. Weaknesses could include poor staff customer service skills, scheduling difficulties, not being a provider for a major insurance carrier, office location…

• Opportunities- external factors which provide growth and differentiation possibilities. Opportunities could include new clinical services not being offered in the community, new physicians and office locations, research initiatives and clinical trials…

• Threats- market and competitive activity which might negatively impact the practice. Threats could include declining outpatient reimbursement, growth and expansion of other providers, health system integration of our specialty…

In defining your goals which will be elaborated on in the marketing plan, the practice should attempt to capitalize on its strengths in relation to the identified opportunities and attempt to minimize weaknesses or threats or, conversely, develop strategies to transform these areas into strengths and opportunities.

Marketing should be approached as an ongoing process. To position yourself to “market”, you need to develop a plan, looking both internally to evaluate the current state of your practice and externally to analyze your market and define specific goals, tactics and action plans.

The following link (http://mdpracticemarketing.blogspot.com/2011/08/conducting-marketing-assessment-of-your.html) will provide a guide for conducting an internal marketing assessment of your practice. The assessment will serve as the foundation from which you will be able to develop a systematic and comprehensive marketing plan.

© 2011 Efficiency in Practice

Bob Healy, Managing Partner of MD Practice Marketing, and author of the Physician Practice Marketing Tips blog, has over twenty-five years of healthcare experience helping physician practices to implement programs to grow revenue, referrals and new patient consults.

For assistance in conducting an internal marketing assessment, developing a marketing plan or implementing the plan, contact Bob at mdstrategies@gmail.com or visit mdpracticemarketing.com http://mdpracticemarketing.com/

From Sue . . .

2011-08-25T10:45:00.000-04:00

Dear Readers,

As the editor of Efficiency in Practice, I myself subscribe to many healthcare-related electronic newsletters and blogs. Lately, I've noticed a trend. Many of the articles have something to do with the auditing of physician records – RAC audits, Medicaid audits, and internal practice audits.

As a matter of fact, out of curiosity, I typed the word audit in my email search function. I finally stopped the search after 10 minutes with hundreds of emails already listed. The message is clear – chart audits is a hot topic.

Today's newsletter article is "Five Steps for Auditing Physician Records," written by Carol Hoppe, a senior consultant with InHealth Consulting Services and the Director of Billing and Coding with Indianapolis Medical Management.

Until then, keep striving for Efficiency in Your Practice!

Five Steps for Auditing Physician Charts

2011-08-25T10:43:00.000-04:00

by Carol Hoppe, CPC, CCS-P, CPC-I

With continuing decline in reimbursement, establishing an internal audit process is critical for physician practices to ensure charges are being billed appropriately and optimal revenue is being captured. Correct coding is essential to getting paid appropriately and avoiding audits by Medicare, Medicaid and other payers. Even the best practices can experience billing errors and the only way to minimize them is to have a system in place to monitor the work done by staff and physicians.

Step #1 – Establish and Follow a Documented Compliance Program

While voluntary for 12 years now, the Healthcare Reform law of 2010 mandates that all physicians participating in Medicare and Medicaid must adopt a compliance program in the near future. While most large healthcare organizations already have some type of compliance program in place, small physician practices may be unprepared for this requirement. Although details have not yet been defined, all healthcare providers will need to increase their compliance efforts. The new regulations will undoubtedly raise the stands but incorporating a model compliance plan now will reduce the risk of liability under the False Claims Act (FCA) requiring providers to prevent and identify improper payment of government funds.

The goal of a compliance plan is to ensure appropriate billing occurs and avoid fines that could result by submitting codes you know or should know are wrong. Under the civil FCA [31 U.S.C. § § 3729-3733], fines up to three times the reimbursement plus $11,000 per claim could be assessed. Criminal fines and imprisonment could also result from the criminal FCA [18 U.S.C. § 287]. A good compliance plan will not only protect against these violations, but will also minimize billing errors, optimize appropriate reimbursement and minimize refunds or take-backs if RACs, MICs or other auditing agencies come knocking on your door.

Step #2 – Conduct internal monitoring and auditing

Ongoing evaluation is necessary to ensure policies and procedures remain current, and also demonstrate that the compliance plan is working. Periodic chart audits should be conducted to ensure that documentation supports the levels of service billed. Consider the following when establishing a plan for your internal auditing program:

1) Number of Providers and Charts to be Audited – The Office of Inspector General (OIG) recommends auditing claims submitted during the prior three months on five to ten randomly selected claims per physician. The more providers you have, the more time it will take for the chart auditing process.

2) Frequency of Audits – Will you audit weekly, monthly, quarterly, semi-annually or annually?

3) Who Will Perform the Audits – Will you outsource this to a coding consultant or company? Train internal staff? Train physicians and have them audit each other’s records?

4) Schedule of Audits – A practice with four providers might audit five charts per provider, rotating providers on a weekly basis. A larger practice may audit ten charts per provider quarterly or annually, with more frequent education and monitoring for those with higher error rates.

5) Retrospective vs. Prospective Audits – A retrospective audit is done on charts where the claims have already been submitted to the payer. If coding errors are found, a corrected claim must be submitted and any overpayment refunded to the payer within 60 days of discovery. The benefit to this type of audit is that claims are not held up pending audit results. A prospective audit is done on charts where the claims have not yet been submitted. With this type of audit, any problems found can be corrected before claim submission eliminating payment corrections on the back end.

6) Presenting the Findings to the Provider – Findings should be documented in a written report and presented one-on-one or to a group. Education should be based on findings and documented.

Step #3 – Start by Reviewing Evaluation and Management Services

Evaluation and Management (E&M) codes are typically the best place to start because they are the most frequently used codes and have a variety of elements required.

The selection of E&M codes is based on:

• Patient status (new, established, initial or subsequent hospital visit, etc.)

• Place of service (office, hospital, emergency room, nursing facility, etc.)

• Type of service (office visit, consultation, counseling, admission, etc.)

• Extent of documentation

Documentation of three key components is essential in determining the appropriate level of E&M service. The three key components are: 1) History, 2) Examination, and 3) Medical Decision Making. There are elements within each key component that must be documented depending on the nature of the presenting problem and the level of service billed. Refer to the Evaluation and Management Services Guide from the Medicare Learning Network for more information on E&M documentation requirements.

Step #4 – Look for Other Missed Revenue Opportunities or Risk Factors

Some common errors to look for when conducting chart audits include:

• Copied or “cloned” EMR records where every visit looks the same resulting in higher level services being billed than what is medically necessary for the presenting

• Billing for a service marked on the billing sheet but not documented in the medical record

• Services documented in the medical record, but not billed resulting in lost revenue

• Billing separately for services included in another code or global fee, like 99211 billed for a nurse visit when the only service performed was a routine venipuncture billable with code 36415 or a post-op visit billed with an E&M code during a global surgical period

• Incorrect number of units billed for medications, vaccine administration codes, and certain skin procedures resulting in lost revenue

• Inappropriate or missing modifiers that could affect the payment or denial of a claim

• Records not signed legibly or electronically by the provider

Step #5 – Document Your Audit Findings

Reports, spreadsheet, graphs and wall charts are ways of tracking progress. Audit findings must be documented and maintained to:

• Prove that audits are being performed for compliance purposes

• Show the corrective action plan and when educational efforts occurred

• Identify date of discovery and when claims were refunded or corrected and rebilled

(NOTE: If a significant error is found, contact a healthcare attorney for advice on following the OIG’s Self-Disclosure Protocol)

• Demonstrate the program is working and improvement is occurring

Be Proactive and Start Auditing Now!

With Medicare RACs, Medicaid MICs and others out looking for overpayments, an internal review of physician charts is something every practice should do to prevent refunds, take-backs and fines due to incorrect coding. Remember the familiar saying “If it wasn’t documented, it wasn’t done.” A proactive approach is your best defense!

© 2011 Efficiency in Practice

Carol Hoppe, CPC, CCS-P, CPC-I is a Senior Consultant with InHealth, the Director of Billing and Coding with Indianapolis Medical Management, and an Instructor with ICDExpert.net. For more practice management information and to register for tele-classes and webinars, visit http://efficiencyinpractice.com/seminars.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Join us for this informative free tele-class

2011-07-27T13:26:00.000-04:00

Team Building and Goal Setting in Your Medical Practice

Join us for this Free tele-class

Tuesday, August 9, 2011 at 12:00 noon est.

Building a strong team in your medical practice is vital to running an efficient and effective office. As a practice administrator, you need to know the key ingredients for a successful team.

•Team Dynamics

•Mission/Vision Statements

•Strategic Planning

•"In Your Shoes" Challenge

•Expect the Unexpected

presented by InHealth and Efficiency in Practice with Guest Expert,

Gail Eminhizer, CMM

PAHCOM National Advisory Board

Practice Administrator, Digestive Health Associates of Northern Michigan, P.C

Register HERE - Your call-in number and access code will be sent to you in a confirming email.

If you cannot attend the tele-class live, an audio recording will be sent to all Registered attendees after the tele-class.

"Team Building and Goal Setting in Your Medical Practice" meets the criteria of the Professional Association of Health Care Office Management and is approved for I CEU.

From Sue . . .

2011-07-21T10:30:00.000-04:00

Dear Readers,

As managers of busy medical practices, it is sometimes easy to fall into the habit of managing projects and processes to the exclusion of managing the practice's most valuable resources – its employees. I know with everything I have on my plate here at InHealth and Efficiency in Practice, I tend to sometimes become task-oriented as opposed to people-oriented.

This week at Efficiency in Practice, we're challenging you to break that habit. And, we're providing tips, suggestions and resources to help you:

• Elizabeth Escalante, Business Services Manager for Atlanta Gastroenterology Associates and one of our favorite contributing writers, offers some great advice in today's article, "The Lost Art of Employee Orientation."

• Elizabeth was also kind enough to send along a sample job description and a sample new employee training schedule for you to review and use.

• There's still time to register for this week's Third Thursday Tele-Class. Guest Expert Andrea Santiago will offer advice on "How to Retain Your Talent – Preventing and Reducing Employee Turnover." Click here for additional information and to register. You can also follow Andrea as About.com's Guide to Health Careers (healthcareers.about.com).

Until next time, keep striving for efficiency in your practice!

The Lost Art of Employee Orientation

2011-07-21T10:27:00.001-04:00

by Elizabeth Escalante

In today’s medical practices, employee turn-over is a fact of life. Employees who remain with an employer for many years are becoming increasingly few and far between. While managers cannot always stop an employee from leaving the practice, we can make sure that their departure was not due to factors that could have been prevented. Cultivating an environment where employees are happy to come to work and are dedicated to their jobs starts from the first moments of that new hire’s employment. It all starts with their orientation.

Years ago, I worked for a behavioral health practice as the ‘Training Manager’. It was my job to go around to our various offices when a new employee was hired to train them on the specific procedures and functions of their role. I usually did this training 1-2 weeks after the employee was hired. Invariably, I would arrive and sit down with the new employee to find that he or she didn’t even know the basics of their new position yet, nor even the general information regarding how their office functioned. My training, which was supposed to be detail-oriented and role-specific, usually ended up incorporating the much broader aspects of the office, things that employee should have been educated on before I arrived.

In my current practice, things are quite different. Each new employee attends a two-day orientation class designed to educate the employee on everything from the history and organizational chart of the practice, to the basics of GI anatomy, to insurance, billing and coding basics. The class gives the new hire a solid foundation for understanding how their individual role fits into the whole. It also provides them with a strong basis for mastering their role-specific functions.

Whether your practice is able to utilize a formal classroom setting for training or relies on the office manager and co-workers to provide this orientation, there are several key components that should be included in your orientation plan.

 Basic orientation – Introduce the new employee to their co-workers and to the physicians. Show them where to park, where to put personal belongings, and where the break room is located. I have found it very beneficial to have the new hire spend a couple of hours sitting with each department in the office to obtain a general understanding of that department’s function and how it relates to their own.

 Employee Handbook – Review the handbook with the new hire and place a signed acknowledgement of this in the employee file. If you don’t currently have an employee handbook in your office, it is a tool that I highly recommend creating. An official handbook aids greatly in creating consistency in how office policies are understood across the practice.

 Job Description – A job specific outline of the employee’s role, what is expected of them, and on what specific factors their performance will be evaluated should be reviewed and then signed by both the new employee and his/her manager.
 Training schedule – Create an employee and role-specific schedule indicating what the employee will be learning during the first 2 – 3 weeks of his/her employment and who will be providing that orientation. The employee and manager/trainer should be able to check off specific items as they are completed, providing the employee with the confidence that his/her training has been thorough.
 Evaluation schedule – The employee should know at what intervals he/she will be evaluated as to his/her progress and performance. When will you, as the manager, be meeting with the new hire to discuss the progress made thus far and provide feedback?

Other items that I typically include are a listing of all the offices/locations in the practice, including the address and telephone number and who the manager is at that location; a name, role and telephone extension list for each co-worker in their specific department and copies of any department specific policies that may not be included in the employee handbook.

The more effectively your new hires are oriented to their individual roles and to the practice as a whole, the greater your chances of retaining that employee on a long term basis. Creating staff that are invested in their jobs is the single greatest challenge and success for which a manager can reach. If your staff members take ownership of their positions and pride in a job well-done then you will have a successful office. Achieving this is a continuous process for the manager - it does not end with the initial training and orientation. But it certainly starts there.

© 2011 Efficiency in Practice

Elizabeth Escalante, CPC, is the Business Services Manager for Atlanta Gastroenterology Associates, and a contributing writer to Efficiency in Practice. For more information and to sign up for your first tele-class free, visit http://efficiencyinpractice.com/seminars

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2011-07-07T10:53:00.000-04:00

Dear Readers,

I came across an interesting press release yesterday. The dateline was Lake Buena Vista, FLA, otherwise known as home to Disney World. The Disney Institute was announcing a professional development program designed specifically for hospitals and healthcare organizations.

According to the press release, "The new program, which is available in a variety of formats, incorporates the five most powerful Disney philosophies – leadership excellence, people management, quality service, brand loyalty and creativity/innovation – to help healthcare administrators, physicians, nurses and other manager-level personnel consistently exceed the expectations of patients."

If you've ever been to Disney and experienced these philosophies first-hand, you know how powerful they can be. The fact that this level of training is now being provided in the healthcare marketplace demonstrates how important great patient customer service is.

While I don't pretend to be as good at it as Disney, today's article includes my 5 Customer Service Tips I Learned from my Orthodontist. I'd love to hear your feedback as well as any other ideas or suggestions you have. Please email them to editor@efficiencyinpractice.com

It's tough to offer good customer service without the right staff in place. And if you find a good person, keeping them should be a priority. Please join me on Thursday, July 21, 2010 for our Third Thursday Tele-Class on "How to Retain Your Talent – Preventing and Reducing Employee Turnover." Click here for additional details and to register.

Until next time, keep striving for efficiency in your practice.

Sue

Five Customer Service Tips I Learned From the Orthodontist

2011-07-07T10:43:00.014-04:00

How ironic that the day I set aside to write an article on medical practice customer service, I find myself sitting in our orthodontist's office. With two children in braces, I'm here often. If you are looking to improve the customer service you provide your patients, consider modeling your office after my orthodontist's office.

They are the epitome of great customer service. Why? Because they have to be:

* Most insurance plans do not cover orthodontics. Therefore, most patients are self pay. A satisfied patient pays his bill; a dissatisfied patient does not.
* If you enter your zip code and Google "orthodontist," you'll get a long list of options in your area. You have many choices and your orthodontist knows this.
* The orthodontist relies on you for patient referrals. Other parents see that my children have braces and they immediately ask who my orthodontist is and if I like him.
* The orthodontist's best referral? A second (or third) child from the same family. As in my case, many parents choose an orthodontist more than once.

Here are five customer service tips compliments of my experience at the orthodontist. You should strongly consider implementing them as well.

1. Office Hours and Appointment Scheduling

* The patient's schedule is acknowledged – Three mornings a week, my orthodontist's office opens at 7 am, and two afternoons per week, they are open until 6 pm. Why? To accommodate their patient's school schedules in the event the child is unable to miss school. As a working mother, I appreciate the schedule as well as it's more conducive to my work schedule.
* They are flexible – On numerous occasions, I've had to make a last-minute call to the office because the next day's appointment conflicted with a test, a presentation or an extra band rehearsal. Each time, I've been greeted by a friendly voice that tells me she understands and who works with me to get the appointment rescheduled as soon as possible.
* They are considerate – Even though I have two children at different stages in the orthodontic process, the office works with me to schedule their appointments at the same time whenever possible. This shows me that they value my time and my business.

2. The Waiting Room

What does your waiting room say to your patients? My orthodontist's waiting room sends the message loud and clear that this is an office that values me as a patient. How?

* It is large and includes many seating options including couches, chairs and benches.
* There is a large table and chairs in the corner designed for patients and siblings of patients to use for homework while they wait.
* There are two play areas (one for younger children and one for older children) designed specifically for siblings to use during appointment wait times.
* There are many magazines. They cover a multitude of interests, and they are all current.

3. Internet/Computer Access in the Waiting Area

My orthodontist's office has two computers set up in the waiting area with internet access. They also provide free wireless services for parents/patients with their own devices.

I'm always looking for ways to be more efficient and to get more done. I frequently use these services to check work email, research a practice efficiency topic or to send emails on behalf of the marching band. I very much appreciate this attention to detail and access to this service. Some orthodontic appointments are long, and I get a lot done. I bet your patients would appreciate the same consideration.

4. Appointment Reminder Services

We are all busy – at times, extremely so. And sometimes, things like scheduled doctor's appointments fall through the cracks. I truly appreciate it when an office calls to remind me of my appointment, and I'm sure your patients would appreciate it as well.

When should you call? Most consultants say the day before. My orthodontist calls two days before? Why? They figure if I've forgotten about the appointment that it might take me a little longer than one day to shuffle things around in order to keep it, especially when you factor in that I need to take my child's schedule into consideration as well. Now, that's being considerate and thinking of your patient first.

My orthodontist uses existing staff to make these calls but there are also automated services available as well.

5. The Patient Experience

Here are just a few of the things that my orthodontist does to make the patient experience special:

* They take and provide copies of before and after pictures.
* They have an entire hallway where they display all of the after pictures.
* They have a room with disposable toothbrushes and toothpaste so the patient can brush his teeth just before his appointment. This is particularly helpful for those middle-of-the-school-day appointments.
* They do all of the legwork when a referral to an oral surgeon is required. They make the call, they set up the appointment and they get pre-approval from the insurance company.
* The after-hours office message includes the orthodontist's cell phone number. I've had to call several times when a wire has come loose or when my daughter needed a prescription for ointment to heal terrible mouth sores. Each time, the doctor answered the phone himself. On one occasion, he met me back at the office that night because we were leaving for vacation the next morning. I've told that customer service story over and over again. I'm sure he has several new patients as a result.
* They celebrate when the braces are removed. Each child receives a huge goody bag filled with all of the things they couldn't eat while they had their braces (gum, popcorn, chewy candy, etc.) It's a nice way to celebrate an important milestone.

While I realize that not all of these ideas will work specifically for your practice, specialty or patient population, I do hope that you look beyond the specifics and consider the spirit with which they are offered up as suggestions. Take a few minutes and ask yourself what you and your practice could do to provide a similar experience for your patients.

Sue Kay, Senior Consultant at InHealth, is the Editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to register for a complimentary tele-class, visit http://efficiencyinpractice.com/seminars

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Maximizing Your Patient Communication with Technology

2011-06-28T12:35:00.000-04:00

Join us for this Important Tele-class -

Thursday, September 15, 2011 - 12:00 pm (EST)

Is your phone ringing off the hook with patient questions that could be answered on a website?

Do you have "holes" in your patient schedule that you don't know how to fill?

Are patients no showing for scheduled visits and leaving you with lost revenue?

This tele-class we will help you utilize and embrace technology in your practice to maximize revenue and enhance patient care and communication.

With the ever increasing volume of Americans using the internet for socializing, bill paying and other communication, why wouldn’t your patients want the same type of access to their physicians?

There are many types of low to moderate costs communication methods to accomplish greater access for patients including:

• Call reminder services

•Patient and Referring Provider Portals

•Facebook

•Twitter

•Constant Contact

presented by

InHealth Consulting & Educational Services

and

Guest Expert Felicia Gentry

Practice Management and EHR Sales Consultant with InHealth Systems and Services

Identifying and Reducing Employee Turnover

2011-06-14T16:29:00.000-04:00

by Andrea C. Santiago

Every employer experiences turnover. But how do you determine if your attrition is “normal” or average, or if there is something more serious going on with the staff or work environment?

Turnover can be very costly to a practice. With each employee who leaves, much time and money go out the door with that person. Being short-staffed can be particularly challenging in a medical practice environment, because patients don’t stop getting sick or stop scheduling appointments just because your key staff member(s) quit today.

Sometimes turnover can even have a “snowball” effect – once one or two people leave, others will follow, and then you’re left scrambling to put the staff back together.

Below are a few ways you can assess and engage your staff to help prevent or reduce high turnover in your practice.

Review your hiring/firing history for at least the past year, or few years, if possible. To calculate a more precise turnover rate, there are numerous turnover calculators to help you determine turnover rate, such as this one at ExpressPros.com.

If your rate is much higher than 12-15%, there may be an issue. You probably don’t need to be seriously concerned unless your turnover rate is significantly higher, in the 25%-plus range.

Then you need to determine which turnover was due to external factors beyond your control, and which turnover was prompted by internal factors that you could control, prevent, or reduce.

If you are not sure why your people leave their jobs at your office, that’s one place to start – by asking detailed questions when people resign – and then read between the lines! Often, departing employees will not tell you the real reason they are leaving. Professionals are usually (and rightfully) advised to prevent “burning bridges” with contacts at former places of employment, which is a diplomatic and professional way to exit. Therefore, you may need to have some other more formal measures in place to determine causes of turnover.

Review your hiring and on-boarding processes. Perhaps it’s not the workplace that is the issue – you could simply be hiring the wrong people. This could be true especially if you have high turnover due to external factors vs. internal factors. Review your interview questions and hiring decisions as well as the people who are making the hiring decisions. The hiring process should help find candidates who not only are capable and qualified for the job, but also those who will fit into the work environment and want to stay there long term.

Additionally, the first 90 days are a critical time period for any new hire. Review your training and orientation procedures, and look for ways to help make the new employee feel more confident and comfortable in his or her new role.

Administer employee satisfaction surveys. There are many online tools you can use to administer confidential surveys that will auto-score and are user-friendly.

Conduct exit interviews for every departure. These should be formal and standardized (the same questions for everyone) if possible.

Follow-up on the survey/interview findings. The key to utilizing these surveys are to follow up on the results – meet with the management of your office and develop strategies to address the issues that are expressed in the satisfaction surveys and exit interviews. You don’t need to be overly concerned with every single grievance that is expressed in these interviews and surveys. However, look for patterns in the results, such as several complaints about the same issue, then it’s probably time to make some changes.

Once you’ve assessed your turnover rate and the staff feedback, some of the ways you can improve the work environment include:

Employee Recognition – increased opportunity for recognition helps your employees feel more valued and important which may help them feel more loyalty for the employer.

Improve incentives and perks – add more ways to earn additional vacation, bonuses, etc.

Remove negative influences – if you have a “rotten apple” in the bunch, it can spoil the entire team. You may think that it’s “just one person” – but one negative team member can truly impact your entire team.

Reduce Stress in the Workplace – any way that you can improve efficiencies, or simplify the processes in the workplace may help reduce the stress on your employees. Also there are more direct ways to reduce stress, such as offering therapeutic support both for mental and physical health.

© 2011 Efficiency in Practice

Andrea Santiago is the Health Careers Guide at About.com and the Director of Communications at the Medicus Firm.

For more ways to reduce turnover and retain your employees, register for the "Retaining Your Talent - How to Reduce and Prevent Employee Turnover" tele-class with Andrea on July 21, 2011 at 12:00 noon est. Register Here - your first tele-class with us is on the house!

From Sue . . .

2011-06-06T09:34:00.000-04:00

Dear Readers,

Happy Anniversary to us! June marks our second anniversary publishing this newsletter. (We published a few test editions earlier but June 2009 was our official launch.) When we first started, our goal was to provide our valued InHealth customers, along with other medical practices across the country, with information on running an efficient and effective medical practice – to provide the building blocks to help take you and your practice to the next level.

Since then, we've published articles, presented tele-classes and sponsored seminars on a multitude of important healthcare topics including: RAC Audits, The Stimulus Package, Meaningful Use, ICD-10, Medicare Changes, Outsourcing, Conducting a Practice Financial Analysis, Collections, Revenue Cycle Management, Recruiting, and Embezzlement among others. Visit http://efficiencyinpractice.com/ to view many of these archived articles.

Last year, we also launched the Efficiency in Practice Manager's Association and continue to have new members join each month. Click here to learn more.

As we start our third year, we hope to continue our tradition of providing you with valuable content and trusted resources.

One of those resources is Michelle Trandel, CPC, Billing and Coding Consultant with Indianapolis Medical Management. She is our guest expert for our next Third Thursday Tele-Class, "PQRS Made Simple: A Roadmap to Successful Reporting."

First, read the article she wrote for today's newsletter," Say Yes to PQRS: 5 Things You Need to Know for Successful Reporting."

Then, mark your calendar for Thursday, June 16, 2011 at 12 noon EST and click here to register for our June tele-class.

Last month, we had a record-breaking number of tele-class participants – so be sure to reserve your spot early.

Thank you to each of you for being a valued subscriber of Efficiency in Practice. We look forward to being a resource for many more years to come.

Until next time, keep striving for efficiency in your practice.

Sue

Say Yes to PQRS: 5 Things You Need to Know for Successful Reporting

2011-06-06T09:25:00.002-04:00

By Michelle Trandel

Four years after its introduction, the PQRS program (Physician Quality Reporting System) continues to frustrate providers and office staffs. Complaints about a lack of timely feedback and confusion about how to sort through the endless maze of information on the CMS website are just some of the challenges facing practices. An understanding of the background and benefits of the program is the first step towards successful reporting. So let’s review some program basics.

1. PQRS is here to stay

The PQRS program, formerly PQRI (Physician Quality Reporting Initiative), was created in 2006 as part of the Tax Relief and Health Care Act. This act required the creation of a voluntary program where eligible providers could receive an incentive for reporting on quality health measures with the goal that clinical data would help drive improvement in health care and reduce costs. Currently, the PQRS program is focused on data collection. Success is defined as whether providers satisfactorily report the measures; however, it is anticipated that PQRS will transition from a pay-for-reporting system to a pay-for-performance system in the future.

2. Many are eligible to participate

The PQRS program is open to many different professionals including Doctors of Medicine, Osteopathy, Podiatry, Optometry, Oral Surgery, Chiropractic, and Dental Medicine. Practitioners including Physician Assistants, Nurse Practitioners, Clinical Nurse Specialists and Clinical Social Workers are also eligible as are Physical and Occupational Therapists. One in five eligible professionals currently participate in PQRS with participation increasing 50% each year since 2007. For a complete list of eligible professionals visit:

www.cms.gov/PQRS/Downloads/Eligible_Professionals03-08-2011.pdf

3. Measures and more measures

For 2011 there are 190 individual measures and 14 measures groups that you can report. Since 2007, participation has steadily increased as the program has expanded to include measures which appeal to a broader range of providers. You have the option to either report on individual measures or measures groups. A measures group is a collection of related individual measures such as diabetes, back pain, and heart failure. How many measures and patients you must report on to be considered a successful PQRS reporter depends upon the reporting mechanism and reporting period you select as well as whether you report as an individual provider or as part of a group. For a complete list of PQRS measures click on:

http://www.cms.gov/PQRS/15_MeasuresCodes.asp#TopOfPage

4. No excuse not to participate

Just as there are a variety of measures, there are several reporting mechanisms, reporting periods, and participation options you may select.

You can choose from three different reporting mechanisms:

• Claims

• Qualified registry

• Qualified electronic health record

and two different reporting periods:

• 12 month period from January 1, 2011 through December 31, 2011

• 6 month reporting period from July 1, 2011 through December 31, 2011

and finally, three participation options:

• Individual

• Group of 200 or more eligible professionals

• Group of 2 to 199 eligible professionals

Just as with measure selection, you must carefully consider which reporting mechanism and reporting period is the right solution for your practice. For detailed information about the reporting options available click on the following:

www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp#TopOfPage

www.cms.gov/PQRS/22_Group_Practice_Reporting_Option.asp#TopOfPage

www.cms.gov/PQRS/03_How_To_Get_Started.asp#TopOfPage

5. Successful reporting = Incentive!

An eligible provider who successfully reports PQRS measures will receive an incentive equal to a percentage of their total estimated Medicare Part B Physician Fee Schedule allowed charges for covered professional services furnished during the reporting period. Currently, the PQRS program is voluntary; however, beginning in 2015 failure to successfully report will result in a payment adjustment of your Part B Physician Fee Schedule amounts for covered professional services. The table below summarizes the incentive and adjustment schedule.

Year Incentive Payment Payment Adjustment

2011 1% N/A

2012 0.5% N/A

2013 0.5% N/A

2014 0.5% N/A

2015 0% -1.5%

2016 and subsequent years 0% -2.0%

In this age of declining reimbursement your practice cannot afford to pass up on payer incentive programs such as PQRS. Start reporting today so you can claim your share of the incentive. Tune into the tele-class on June 16, 2011 for step-by-step instructions and tips on how to make your practice a PQRS success!

© 2011 Efficiency in Practice

Michelle Trandel, CPC is a Senior Consultant with InHealth and a Billing and Coding Consultant with Indianapolis Medical Management. For information on PQRS, register for “PQRS Made Simple: A Roadmap to Successful Reporting” or another of our tele-classes at http://efficiencyinpractice.com/seminars

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2011-05-18T10:30:00.000-04:00

Back in 2009, when the Department of Health and Human Services first announced plans for you to begin using ICD-10 coding, October 2013 seemed a long way off. We're now more than halfway there, and it's time to get serious about this deadline if you haven't done so already.

Here at Efficiency in Practice, we want to help with your preparation. We will be offering several opportunities over the next several months for you to learn more about ICD-10. The first opportunity is this coming Thursday, May 19, 2011 as part of our Third-Thursday Tele-class Series.

We'll be presenting "Preparing for ICD-10." We'll be discussing the basics of what you need to know about ICD-10. This tele-class is designed to make sure we are all on the same wavelength in terms of the requirements, the timelines, and the steps you should be taking now to prepare for ICD-10. Our guest expert is Donna Weinstock, President of Office Management Solution.

Click here for additional information and to register.

Donna also wrote today's article on ICD-10. It's a great introduction to some of the information she will be covering on the tele-class.

Later in the year, we will be presenting a webinar as part of our Third-Thursday series that will present a more indepth look at ICD-10 coding. Stay tuned for additional information.

If there is a particular topic you'd like to see covered during one of our monthly tele-classes, please email me at editor@efficiencyinpractice.com.

Until next time, keep striving for efficiency in your practice.

Preparing for ICD-10: The Basics

2011-05-18T10:28:00.000-04:00

by Donna Weinstock

If there is one thing we can be sure of in healthcare, it is that things are always changing. This time the change is really significant.
Effective October 1, 2013, ICD-10 codes must be used on all HIPAA transactions. Additionally, effective January 1, 2012, electronic health care transactions must be processed using Version 5010, a format that will accommodate the ICD-10 codes.

While there are always questions and uncertainty surrounding change, one thing is certain: payers and providers who are not prepared will suffer. Providers will face rejected claims and delayed reimbursement. Payers will experience a huge influx of support calls and customer service issues.

There are several steps that a practice can take to be ready for each of these deadlines. To implement the 5010 transactions by January 1, 2012, a practice should:
• Conduct an impact analysis

• Contact your software vendor to be certain their systems will be upgraded to meet the requirements

• Contact your trading partners including your billing service, clearinghouses and payers

• Undergo installation of vendor upgrades

• Conduct internal testing and staff training

• Conduct external testing with trading partners

• Make the switch to Version 5010

Unlike ICD-10 codes, the switch to Version 5010 can be made and utilized prior to the required date provided the practice's payers and billing partners are also set up and ready for this change. After January 1, 2012, all claims submitted using version 4010 will be rejected.

ICD-10 was developed by the World Health Organization (WHO) in 1989 and released in 1994. Although the U.S. implemented mortality reporting in 1999, we continued to use ICD-9 codes. In January 2009, the Department of Health and Human Services announced that the US would join with the rest of the world and switch from using ICD-9 to ICD-10.

With the use of ICD-10 codes, the total number of codes expands from about 14,000 to 68,000 codes. The codes will be alpha-numeric, expand in length to 3-7 characters and will offer much more specific descriptions.

The new ICD-10-CM codes will be more specific, more flexible and allow for improved measures of healthcare services. It uses current medical terminology whole acknowledges the advances in medicine and medical terminology.

The breakdown of the specific code characters are as follows:

• Characters 1-3 offer the category

• Characters 4-6 is the etiology, anatomic site, severity or other clinical details

• Character 7 describes the extension

What is the best approach to being ready to implement ICD-10 on the appropriate date? It is best to:

• Conduct an impact analysis to determine how it will affect your practice

• Contact your payers

• Contact your vendors to verify they will have their processes in place

• Contact your clearinghouse and/or billing service

• Undergo installation of vendor upgrades

• Conduct internal testing

• Update internal processes

• Conduct staff training

• Conduct external testing with trading partners

• Make the switch to ICD-10 on October 1, 2013

The best option for making a smooth transition is to plan ahead. Take the transition in phases. Review your systems, contact your partners, train your staff and be prepared!

© 2011 Efficiency in Practice

Donna Weinstock is a Senior Consultant at InHealth, and the President of Office Management Solution. She can be reached at donna.weinstock@inhealthconsulting.com

Efficiency in Practice is the free eNewsletter for medical practice managers who want to save time, money and reduce risk. Join us for our Third Thursday tele-classes by visiting www.efficiencyinpractice.com/seminars.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2011-05-05T09:31:00.000-04:00

Here at the InHealth offices, I have been known to make the statement, "I could get so much more done if I didn't have so many meetings." Of course, that's usually during a period of time when we are launching something new or working hard to get something implemented in a short period of time. In reality, meetings (properly run) are one of the most efficient ways to stay in close communication with key people in your organization.

Today's article, The Five Must-Have Meetings for Your Medical Office, provides insight on the types of meetings critical to the efficient and effective running of your medical office. Our guest author is Elizabeth Escalante. You may remember Elizabeth as the winner of our recent writing contest. She is the Business Services Manager for Atlanta Gastroenterology Associates, a large, multi-location practice here in Georgia.

When you are looking at your schedule for the coming weeks, there is another "meeting" that is a "must." That's our Third-Thursday Tele-Class Series. This month's topic is "Preparing for ICD-10." During this tele-class, you'll learn:

• How to Prepare your Staff for ICD-10

• The Benefits of ICD-10 Coding

• Why it is Important to Contact your Vendors, Billing Services and Clearing Houses

• Coding Basics including the New Longer Codes

Our guest expert is Donna Weinstock, President of Office Management Solution.

If you are a PAHCOM member, I'm pleased to announce that this seminar has been approved for CEUs.

Click here for additional information or to register.

Do you have a topic you'd like to see covered either here in the newsletter or as part of our tele-class series? I'd love to hear from you. Email me your suggestions at editor@efficiencyinpractice.com.
Until next time, keep striving for efficiency in your practice.

The Five Must-Have Meetings for Your Medical Office

2011-05-05T09:29:00.000-04:00

by Elizabeth Escalante

For any team to work well together, it is vital that each player know how their individual role fits into the big picture of what the organization is trying to achieve. It is why the football coach gathers the entire team together before the big game to discuss strategy. Equally important is that the players with similar functions or who are working on common projects stay connected and informed regarding their goals and objectives. It is why the quarterback calls for a huddle with the offense before a big play.

To keep your team cohesively moving together toward a common purpose, management must communicate in an organized and consistent manner. The most effective way to do this is by meeting regularly with your team. These are the 5 meetings that I recommend every manager incorporate into their medical office.

1. Office Staff Meetings

Whether you schedule them weekly or monthly, regular meetings with your entire office staff go a long way toward keeping everyone functioning as a single, efficient entity rather than as several disjointed departments. Staff meetings are also a very effective way to communicate policy and procedure changes, discuss company goals, disseminate information regarding compliance issues, etc. Discussing these things in an organized fashion with all staff present keeps everyone on the same page and prevents misinformation or lack of information from becoming a problem in your office.

2. Department Meetings

In most of our offices we have staff doing similar jobs that have challenges and concerns unique to that specific role they fill. Conducting periodic department meetings separate from your Office Staff meetings will enable you to focus some time on issues pertaining to that specific department, such as communicating information regarding new clinical policies or services to your Medical Assistants.

3. Team Lead Meetings

Do you have staff in your office that have, either officially or unofficially, taken on leadership roles in their department? Meeting weekly with those who are assisting you to lead your staff is an invaluable way to ensure that the messages you want communicated and the goals you want reached are being consistently and accurately relayed. Opening this forum for those taking the lead to communicate their observations and concerns to you will also result in a stronger relationship with that leadership staff, helping those individuals to further develop their leadership skills.

4. Physician Meetings

Are your goals for your office the same goals your physicians have? Do the doctors in your medical office understand the steps you are taking to reach those goals? If not, could it be a communication problem? Conducting periodic meetings with your physicians, taking the time to listen to and address their concerns and issues, but also communicating to them your well-thought out, specific plan for how to achieve your common goals, will add to the peace and overall functionality of your office. Meeting with them to ensure that they understand what you are doing creates an environment in which you are working with your physicians and not against them.

5. Manager Meetings

If you are fortunate enough to work in a practice with multiple offices and office managers, then take advantage of this opportunity. If not, seek out groups and organizations that are geared toward office or practice management and utilize the resources those provide. Your best and most valuable asset as a manager can be other managers who share your same challenges and goals. Whether these meetings are created formally by your administrators or are informal gatherings you coordinate yourself, use your fellow managers and benefit from their experience and their knowledge.

We all know that communication is the key to any successful venture. Ask any football coach or quarterback and they will tell you that it is not enough just to take the ball and run with it. The rest of your team needs to understand where you are going and how you plan to get there. Meetings are an effective and vital way to make sure your entire team understands what play you are running and what their part is in it.

© 2011 Efficiency in Practice

Elizabeth Escalante, CPC, is the Business Services Manager for Atlanta Gastroenterology Associates, and a contributing writer to Efficiency in Practice. For more information and to register for your first tele-class free of charge, visit www.efficiencyinpractice.com/seminars or www.eipmanagers.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Third Thursday Tele-class Series

2011-04-26T13:33:00.001-04:00

We've added several new tele-classes to our Third Thursday series including "Preparing for ICD-10" which has been approved for CEUs by the Professional Association of Health Care Office Management. Visit our website for more information and to register. While you're there, sign up for a complimentary subscription to our enewsletter, Efficiency in Practice.

http://www.efficiencyinpractice.com/
http://www.eipmanagers.com/

The Case for Certification

2011-04-21T10:30:00.000-04:00

As a Medical Office Manager, you are faced with many challenges as it relates to practice revenue:

• Patient visits are down;

• Reimbursements are down;

• Patient collections have increased as more and more patients have either high-deductible insurance plans or no insurance at all;

• You're faced with the continued threats of additional Medicare cuts; and

• Your odds of an insurance audit (especially Medicare) have increased as insurance companies look to recoup what they consider to be overpayments.

While you may be looking for ways to decrease practice costs, there is one area in which you should consider making an additional investment – in your billing and coding personnel. Either hire a professional, certified medical coder or consider paying to have one of your top coders become certified.

Why?

Insurance billing and coding has become an increasingly complicated process. You need someone in your office who is both responsible and accountable for getting the job done correctly and accurately. Certified coders typically are trained in medical terminology, anatomy and the intricacies of coding. They sit for a certification exam and are required to continue their education to maintain their certification.

Coding rules and regulations change frequently; minimally once per year. The continuing education your certified coder is required to maintain will ensure that your office stays up to date and aware of these changes.

Statistics show that many practices actually undercode because they are afraid of overcoding – even when clinical documentation supports a higher level of service. You may not even be aware that you are doing this but, you are leaving money on the table. Certified coders are trained to select the appropriate code based on the clinical documentation and can help your practice code with confidence.

If your practice is audited, you can be assured that the auditors use certified coders. As a matter of fact, RAC auditors are required to do so. Even the playing field by making sure you have the knowledge and expertise of a certified coder as well.

Do you have a valued coding or billing employee who isn't certified? Consider paying for them to become certified. You can do this in a number of ways.

• Have them pay to take a medical terminology and/or anatomy class at a local college and you pay for a Coding Boot Camp and for the actual certification exam.

• Have the associate pay for the entire process upfront. Once they are certified, you will reimburse them a certain amount for each month or quarter they remain employed by your practice.

• Offer to pay for the entire certification process up front. The employee makes monthly payments to the practice (ideally through a payroll deduction) for some, all or most of the upfront amount. You ask the employee to make a two-year post-certification commitment to the practice.

Or you could hire someone who is already an experienced certified medical coder. Whichever option you choose, make it a goal to have a certified medical coder in place in your practice within the next 12 months.

From Sue . . .

2011-03-29T11:29:00.000-04:00

It's hard to believe it's almost the end of March. A quarter of the year is almost over. I don't know about you, but 2011 seems to be speeding by.

I’m also still trying to recover from "Time Change" Sunday. The older I get, the longer it seems to take my body to adjust. While I don't like the idea of losing an hour of sleep each March, I do like the idea of "Springing Forward."

Spring is the perfect time for new things and growth. Here at Efficiency in Practice, we have a lot of "new" things happening:

* Third Thursday Tele-Class Series

We've gotten great response to our Third Thursday Tele-Class Series. Our first two tele-classes were on the topic of technology and meaningful use. If you missed either of those tele-classes and would like to receive an audio recording, please email me at editor@efficiencyinpractice.com.

Our next tele-class is Thursday, April 21, 2011 and is on the topic of "Protecting Against Embezzlement in Your Practice." Click here for additional details or to register.

* Donna Weinstock

I'm pleased to introduce Donna Weinstock. Donna is the President of Office Management Solution and will be contributing her expertise to Efficiency in Practice during 2011. Donna will be our guest expert for April's Third Thursday Tele-class on Embezzlement.

Donna consults with healthcare practices to perform workflow analysis, improve processes, and increase profits as well as select and implement electronic health records. She is a writer, speaker and trainer on practice management topics, and writes employee handbooks, job descriptions and procedure manuals. I'm very pleased to have her affiliated with Efficiency in Practice.

* 2011 Coding Certification Boot Camps

We are offering Coding Boot Camps designed to help you prepare for national coding certification exams. Our first one will be in Savannah, GA May 11 – 13, 2011. Our expert educator for these Boot Camps will be Mary Kustermann, RMC, RMM, CPC, CHC. Many of you will remember Mary from the Medicare tele-classes and seminars we offered during 2010.

Click here for a detailed agenda and registration information.

Additionally, I'm working on our tele-class topics for the second half of 2011. If you have any ideas, suggestions or topics you would find helpful, please email me at editor@efficiencyinpractice.com.

Until next time, keep striving for efficiency in YOUR practice!

Reduce the Risk of Embezzlement in Your Practice

2011-03-29T11:25:00.000-04:00

By Donna Weinstock

Do you have a policy in place to prevent embezzlement in your practice? How about a procedure for handling embezzlement should it occur? You might even ask yourself whether you really need a policy; after all, what are the chances that it could happen to you?

It is hard to imagine that a healthcare practice could be subject to embezzlement, but the truth is, it can happen anywhere and by anyone. No practice is immune from potential stealing or fraudulent behavior. Yes, it could very easily happen to you.

Medical practices, like other businesses need to be cognizant of employee behaviors and protect themselves against embezzlement. There are those who will embezzle right under your nose. The truth is anyone in a practice can find a way to steal.

Most people believe that embezzlement is the taking of money or company funds, but it is more than just stealing funds. In addition to money, it may also include taking of product or property that belongs to the office. Whether an employee takes home a box of staples or a ream of paper, he/she is stealing. When an employee uses your postage meter or stamps for his personal use, he is stealing. Any type of stealing is not acceptable.

Other forms of stealing are the copying of computer software programs, internet use on company time, personal and long distance telephone calls. Stealing of time is another form of cheating. When a staff member cheats on his/her timecard, he is being dishonest.

Despite all your reminders and monitoring, theft and embezzlement may still occur in your office. How can you prevent embezzlement, especially in the small office? Be proactive and take steps to prevent any form of illegal behavior.

As a practice, it is important to have a zero tolerance to theft. Practice embezzlement is a serious offence. Be proactive and take the following steps to prevent any form of illegal behavior:

1. Have a policy in place and adhere to that policy. This policy needs to be written in your employee handbook and given to every employee. Employees need to know that if they are caught, they will be terminated and prosecuted.

2. Learn what areas of your office are most at risk for theft and steps you can take to protect your practice. Knowledge is power. It can go a long way in protecting you. The person at your front desk has as much potential to steal as the billing person, collector or even the office manager.

3. Listen to your instincts. If you think something doesn’t feel right, investigate and dig to see if there is something wrong. Many of us use our “gut instinct” in life and business. Your instincts may be a great start to finding hard evidence of embezzlement.

4. A couple of the areas to audit for theft are co-pays, account receivables, expense reports, patient complaints and office supplies. Separate duties so one person does not have all the control of the money. By rotating employee positions, encouraging vacations and conducting surprise audits you may lower the potential for embezzlement in your office.

Unethical behavior is costly to a practice, both monetarily and in terms of trust. The employees and patients who see the results of the punishment will have a better understanding of the repercussions of the unethical behavior.

Having systems in place which safeguard the receipt of any money by the practice to ensure that it is correctly deposited into the practice’s account is the key to preventing embezzlement and unprofessional behavior. The financial well being of your office may depend on it.

© 2011 Efficiency in Practice

Donna Weinstock is a Senior Consultant at InHealth, and the President of Office Management Solution. She can be reached at donna.weinstock@inhealthconsulting.com

Efficiency in Practice is the free eNewsletter for medical practice managers who want to save time, money and reduce risk. Join us for our upcoming tele-class, “How to Protect Your Practice from Embezzlement” on April 21, 2011 by going to www.efficiencyinpractice.com/seminars.
This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2011-03-10T09:50:00.000-05:00

Dear Readers,

Wow! We had a great response to our February Tele-Class "HITECH and Meaningful Use: What You Need to Know Part One." This is obviously a topic in which you are interested as evidenced by the record number of people who both registered for and dialed in live for the tele-class.

A few important notes:

• We recorded Part One. If you missed it and would like us to email you a link to a downloadable audio file, please email us at editor@efficiencyinpractice.com.

• Part Two of this tele-class is scheduled for Thursday, March 17, 2011 at 12 pm EST.

To Register, Click Here

• Part Two will cover how to select the right EHR system and how to make sure your practice's network, security and infrastructure meet requirements. You don't want to miss this Tele-Class.

• Please forward this email to any friends and colleagues whom you feel might benefit from this topic. We'd love to have them register as well.

During 2011, we will be offering monthly tele-classes on healthcare-related topics on a monthly basis. We are calling them our Third-Thursday Tele-Class Series. You guessed it – they will be the third Thursday of each month. In April, our topic will be "How to Protect Your Practice from Embezzlement" and in may, our topic will be "ICD-10 basics." These monthly tele-classes will be free for our Efficiency in Practice Manager's Association members and any first-time listeners. Our other readers will have the opportunity to sign up for the tele-classes on a topic-by-topic basis and will pay a small fee. We'll have additional details in our next newsletter.

Before reading today's article, go ahead and stop and register for next week's tele-class. We are offering it at no charge for all readers/listeners. I look forward to "seeing" you on the call.

Until next time, keep striving for Efficiency in your Practice.

Stimulus Dollars: Medicare vs. Medicaid

2011-03-10T09:47:00.000-05:00

During Part One of our recent Tele-class series "HITECH and Meaningful Use: What You Need to Know," Sheryl Cherico, founder of MDTechPro, a national healthcare IT company, clarified a lot of information as it relates to stimulus dollars and meaningful use. Many questions were raised both in advance of the tele-class and afterward in regard to the differences between the Medicare Stimulus Program and the Medicaid Stimulus Program.

Please find below a synopsis of each of the programs:

1. Eligible Providers

Medicare

Doctors of Medicine or Osteopathy
Doctors of Dental Surgery or Dental Medicine
Doctors of Podiatric Medicine
Doctors of Optometry
Chiropractors

Medicaid

Physicians
Nurse Practitioners
Certified Nurse – Midwife
Dentists
Physician Assistants who practice in a FQHC (Federally Qualified Health Center) or RHC (Rural Health Center) that is lead by a physician assistant.

2. The Medicare EHR Incentive Program starts in 2011 and continues through 2016.

3. The Medicaid EHR Incentive Program can start as early as 2011 and continues through 2021. The last year to begin participation in the Medicaid Incentive Program is 2016.

4. To qualify for the Medicaid Incentive Program, 30 percent of the eligible provider's patient encounters must be Medicaid. The threshold is 20 percent for pediatricians.

5. Eligible Professionals who demonstrate meaningful use of a certified EHR technology can receive up to a maximum of $44,000 over 5 years under the Medicare EHR Incentive Program. To receive this maximum, however, Medicare eligible professionals must begin participation by 2012.

6. Medicare payments to Eligible Professionals are tied to 75 percent of the physician's annual allowed charges up to the maximum annual bonus.

7. For each year past 2012 that Medicare Eligible Professionals demonstrate meaningful use of a certified product, the maximum incentive bonus possible is reduced. If implemented in 2013, the maximum incentive payment is $39,000 over three years. If implemented in 2014, the maximum incentive payment is $24,000 over two years.

8. For 2015 and later, Medicare Eligible Professionals who do not successfully demonstrate meaningful use will have a payment adjustment to their Medicare reimbursement.

9. Medicaid Eligible Professionals can receive up to $63,750 over 6 years if they begin participation at any time between now and 2016. There is no reduction in maximum incentive payment potential no matter when a Medicaid Eligible Professional begins participation provided they do no later than 2016.

10. The incentive payments for Medicaid are based on the net cost of purchasing, implementing and maintaining an EHR and are considered to be a flat fee reimbursement. The Medicaid incentive calculation is not tied to reimbursement rates or claims in any way.

11. States do not have to offer the Medicaid EHR Incentive Program. They area able to make that decision on a voluntary basis. As of January 2011, registration was opened in the following states: Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. It is expected that other states will follow suite during the spring and summer of 2011. Click here for more information about expected Medicaid EHR Programs in your state. www.cms.gov/apps/files/medicaid-HIT-sites/

12. There are no penalties for not adopting associated with the Medicaid Program.

13. Professionals who are eligible for both the Medicare and the Medicaid EHR Incentive Program must choose one or the other. An Eligible Professional may switch between the Medicare and Medicaid programs one time.

14. An Eligible Professional in the Medicare program may also participate in the PQRI system but is not eligible to receive incentive payments through the ePrescribing incentive program.

15. Eligible Professionals in the Medicaid program are eligible to receive incentive payments from both the PQRI program and the ePrescribing incentive program provided they meet the eligibility requirements of each.

16. Eligible providers within the same practice may choose to participate with different EHR Incentive Program. For example: In a two-physician practice, one may opt in with the Medicare program and one with the Medicaid program.

Bottomline…

How do you decide between Medicare and Medicaid? Do the math.

• Do you meet the eligibility requirements for the Medicaid program?

• Do you have Nurse Practitioners in your practice (who qualify under the Medicaid and not the Medicare Incentive Program)?

• Will your state participate in the Medicaid Incentive program?

• Where are you in the evaluation, selection and installation of an EHR system? Will you meet the 2012 deadline to demonstrate meaningful use in order to receive the maximum Medicare incentive of $44,000 per eligible provider?

• Does each Eligible Professional have enough annual Medicare allowed charges so that 75 percent of those equal the maximum Medicare incentive payment each year?

• Are you currently receiving incentive payments through the ePrescribing incentive program? You are eligible to continue receiving them with participation in the Medicaid program but not the Medicare program.

Have you already made this decision? If so, we'd love to hear about your decision-making process and what made you decide to participate in one over the other. Email us at editor@efficiencyinpractice.com.

HITECH & Meaningful Use Free Tele-class

2011-02-28T09:40:00.001-05:00

"From HITECH to Meaningful Use:
What You NEED to Know" - Part II

Please join us for this free tele-class

March 17, 2011

12:00 pm EST

Building an Infrastructure
Choosing an EHR
Sharing Patient Information
Important Stimulus Dates you need to know

presented by

InHealth Consulting & Educational Services

and

Guest Expert Sheryl Cherico, co-founder of MD Tech Pro

From Sue . . .

2011-02-09T10:50:00.000-05:00

Dear Readers,

I think Punxsutawney Phil was a little confused. Perhaps he thought it was April Fool’s Day instead of Groundhog Day. Despite the fact that he saw his shadow, there are no signs of an early spring here in Atlanta. As a matter of fact, we are expecting snow again on Wednesday into Thursday. And I know that many of our readers throughout the Midwest have been hit even harder.

In the last newsletter, I asked for input from you for an upcoming article on the topic of closing your practice due to the weather. I appreciate those of you who responded but would appreciate some additional feedback especially as it relates to whether you or your staff has remote access to your practice’s computer system in these types of situations. Please email me at editor@efficiencyinpractice.com with details on how your practice handles it from a patient perspective and from an employee perspective with you are forced to close the office.

As the weather has permitted, I’ve been spending quite a bit of time out in the field visiting InHealth clients. The overwhelming majority are either in the process of installing an EHR (Electronic Health Record), in the process of evaluating EHRs or at least have it on their radar for 2011. While the selection of the right system for your practice is critical, making sure you have the right network and IT infrastructure in place is an equally important and often overlooked piece of the process.

Join Us For A

FREE TELE-CLASS

HITECH and Meaningful Use:

What You Need to Know

Part One

Thursday, February 24, 2011

12 pm (EST)

Topics Include:

• Overview of the HITECH Act

• Stimulus Dollars Available

• Medicare vs. Medicaid

• Meeting Meaningful Use

-Certified Product

-Meeting Core Measures

-Security

• Registering for Government Incentives

Our Guest Expert is Sheryl Cherico, co-founder of MD Tech Pro (http://www.mdtechpro.com/). Not only is MD Tech Pro InHealth’s outsourced IT company, we also partner with them to provide IT Support Solutions and EHR Services to healthcare practices. Sheryl serves as the company’s resident practice management specialist ensuring that all software, be it third party or proprietary, enhances provider productivity. Sheryl has mastered numerous medical practice software packages over the course of her career, and is an expert at everything from the front-end to the back-end. She has also worked directly for a leading national medical software group. She recently completed a certification in Meaningful Use.

You don’t want to miss this tele-class. In addition to presenting it live and giving you the opportunity to ask questions, you will also receive access to a recording of the tele-class in case your schedule does not permit you to listen live. Part Two of this seminar will be offered sometime in March with registration details available in an upcoming newsletter.

TO REGISTER FOR PART ONE, CLICK HERE

At the end of last year, we sponsored an Office Manager’s Writing Contest on the topic of “Practical Advice for Running an Efficient and Effective Medical Office.” In our last issue, we published the first and second-place entries. (Click Here to access them in the Efficiency in Practice Article Archive.) In today’s edition, we are pleased to present the third-place and honorable mention entries. We hope you enjoy hearing from your fellow managers.

Third Place - Article Writing Contest

2011-02-09T10:39:00.000-05:00

Mine is a humorous take on...
Practical Advice for Running an Efficient and Effective Medical Office
by Barb Webb

My office is a kaleidoscope of personalities and I truly enjoy working with each one, regardless...

We are a typical medical office complete with our diva's, whiners, complainers, jokers, suck-ups, tattle tellers, self proclaimed over achievers, and gossipers, just to name a few. I categorize them without any malicious intent because the bottom line is they are all very good employees and manage to keep our fast paced office operational.

I never know on any given day what awaits me when I arrive at the office, but usually I am greeted at the door by a complainer who immediately rattles off, their rather lengthy, list of complaints all before I can even take my jacket off and turn on my computer. It usually sounds something like this; so-and-so is not being nice to me, my chair is uncomfortable, the computer screen makes my eyes hurt, the TP is too rough, the office is too hot or too cold, I don't like the soap, we don't have any good magazines, I don't like the radio station, a light bulb needs to be replaced, can you tell so-and-so to stop chewing gum, the toilet needs plunged, I saw a bug, etc. And even after they have spewed their complaints and left my office, I get the pleasure of spending time on documenting the conversation and trying to rectify the problems. To be honest, at that point, all I want to do is scream.

I feel like a character in a newspaper cartoon strip, you know the one who has the little bubble over their head that holds their comments. I listen, and listen, and listen, to their complaints, like I have previously done thousands of times before knowing that nothing I say or do will change their personality, nor cease the complaints.

Some days their words tend to resonate... aggravate... and penetrate, so deeply that I fear a sharp needle is just about to prick my bubble and ..."Pop"! …. Wow! I would be in trouble then.

The "Pop" can never, never, never, happen because the accumulation of the years and years of the pent-up words my bubble contains are not anything a professional should ever let escape. I have been lucky, or should I say, the employees have been lucky, thus far, because I have been able to contain my bubbles contents.

As a professional, I must keep the smile on my face as I provide words of encouragement and assurance that I will do my best to remedy their issues, knowing that tomorrow I will again be greeted at my door with more of the same complaints.

The best way to run and effective and efficient office is to never let your bubble "POP". I will never be able to change the employees personalities or tendencies to complain, but I can continue to practice patience, be supportive, provide guidance, and keep my bubble intact... thus staying employed... hence the office runs efficiently and effectively!

Honorable Mention - Article Writing Contest

2011-02-09T10:38:00.000-05:00

How to Maintain a Positive Approach in a Negative Environment

by Tina Housman

Question yourself, are you one who sees the good in everyone and everything? If so, then you can review and rehabilitate those you work with. I say rehabilitate because I am positive that given the opportunity, everyone can adjust and refocus their approach to their jobs if given the right tools and example to follow.

Find out how your staff views their job, do they view themselves as helping people or as “just doing their job” for example when a patient comes into the office is the employee looking to help the patient or intentionally “too busy” to notice them? There are only a few people who are devoid of peripheral vision, when I walk up to a counter and the person or people behind the desk cannot or do not make eye contact with me, I know there is a problem.

In our office, my office is front and center with a clear view of our front office, if someone approaches the counter and no employee responds within seconds, I leave my desk and offer the person assistance. I am always friendly courteous and genuinely willing to assist. The next person to come in is greeted in the same manner by any member of our staff. It is a small gesture but we have been complimented on numerous occasions for our positive and friendly office staff and providers.

No office is perfect and as is human nature so comes the tendency to avoid work. I was beginning to notice a lot of “empty” appointment times on our schedule. It was a time for the staff to “relax” throughout the day and it became apparent that it was occurring daily. I started paying closer attention to why we had so many openings, I got the usual excuses, “the patient was a ‘no show’ or the patient cancelled at the last minute.” There was no incentive to re-fill the appointment slot. Same work day, less work, same pay mentality. The solution was simple, for every full schedule the front office staff would earn an hour of comp time. The results were amazing! It is a win-win situation.

There are more details to the incentive program which of course created additional work for me and a demand for other incentives for other staff members but I still believe it is well worth it. My staff feels even more appreciated and eager to find ways to make our practice more successful.

From Sue . . .

2011-01-18T11:45:00.000-05:00

Dear Readers,

Happy New Year!

Here in Atlanta, the weather has been playing tricks on us. Not only did we have our first white Christmas in more than 100 years this past December, but we’ve spent most of the beginning of 2011 digging out from under a snow/ice storm. Temperatures have stayed well below normal, and we simply can’t get rid of the stuff! Grocery store shelves are empty; school has been canceled all week long; and cabin fever has set in for most of us. While I’m sure our readers in other parts of the country are rolling their eyes, we’re just not used to this.

Each day this past week, my children would anxiously await the announcement that school was canceled for the next day. When the announcement came, they’d be excited while I’d be left wondering if they were ever going back to school again. During this process, I realized that “Snow Days” truly only apply to school children. For the rest of us, particularly those of us in the business world, snow days amount to a loss of momentum, productivity and revenue.

In addition to school closings, medical facility closings were also listed on our local news websites. For most of this past week, many of the practices in Atlanta were either closed completely or working on a very reduced schedule.

I’m working on a short article for the next edition of Efficiency in Practice about preparing for and recovering from situations such as these. I’d love to hear from you regarding how your practice handles it when you are forced to be closed. Please email me at editor@efficiencyinpractice.com.

At the end of last year, we sponsored an Office Manager’s Writing Contest on the topic of “Practical Advice for Running an Efficient and Effective Medical Practice.” We appreciate all of you who submitted entries. I am very pleased to announce the following winners:
First Place
Elizabeth Escalante
Business Services Manager
Atlanta Gastroenterology Associates, LLC
$150 Gift card and 12 months free membership in Efficiency in Practice Managers Association.
Second Place
Donna Weinstock
Former Office Manager
Office Management Solution
$100 Gift card and 6 months free membership in Efficiency in Practice Managers Association.

Third Place
Barb Webb
Personnel Administrator
Urban Family Practice
$50 Gift card and 3 months free membership in Efficiency in Practice Managers Association.

Honorable Mention
Tina Housman
Medical Practice Administrator
Mesa Family Practice
$25 Gift Card and 3 months free membership in Efficiency in Practice Managers Association.
In today’s edition of Efficiency in Practice, we are sharing with you the articles submitted by the first and second-place winners. In our next edition, we will publish the other two articles.
Until next time, keep striving for efficiency in your practice!

First Place Winner, Article writing contest

2011-01-18T11:43:00.000-05:00

Practical Advice for Running an Efficient and Effective Medical Office

by Elizabeth Escalante

To run a successful and efficient medical office, the manager must learn to juggle the needs of the patient, the needs of the physician, the needs of the employee and the needs of the administration. What is the key to keeping the many different aspects of managing the office in play effectively, without one aspect or another suffering? As any juggler will tell you, there are several key things that require your attention.

• Set things in motion

An efficient and effective office has systems in place that will run smoothly without the manager’s personal involvement in the day to day. This requires hiring the right people to the key positions and ensuring that they have been adequately trained for the roles they are filling.

• Study the movement

Evaluate the needs of your office and determine which matters require your personal and immediate attention. What is happening in your office that is an obstacle to efficiency and effectiveness? Are there procedures in place that are only “how things are” because they are “how it has always been”? What works and what does not?

• Make small adjustments

Rather than diving in to make huge changes to the structure of things, start with small adjustments to the function of the office. As you formulate new plans and new procedures, involve the staff that does these jobs on a day to day basis. Enlist the input of the physicians and even the patients in your office for suggestions and ideas.

• Focus your attention

Prioritize the issues that require your personal involvement and most active participation. An issue that is big enough should have the manager’s hands on efforts to correct it. Figure out your biggest obstacle and work personally to remove it. This often means getting into the trenches yourself to work out the reason for the problem and the most effective solution. Your employees will appreciate you for taking those steps.

• Keep things going

Once the big problems are sorted out, keep the balls in the air by repeating all of the above steps continuously. Keep looking for ways to improve the functionality of your office, not just putting out the fires and fixing the problems as they occur, but looking ahead at how to make improvements to procedures before there are issues.

• Stay balanced

Above all, as the manager of the office, you are its primary source of balance. If you stumble, the office will falter. If you drop one of the balls, the office will wait on you to pick it up and start again. The important thing is not that a ball never falls to the ground, but how long it stays there and how well you get it moving again.

In short, keep your balance as you handle the obstacles and challenges of managing the medical office. In so doing, you and your office will be successful.

Second Place Winner, Article writing contest

2011-01-18T11:41:00.000-05:00

Practical Advice for Running an Efficient and Effective Medical Office by Donna Weinstock
Running a healthcare practice is like teetering on the edge of a cliff; never quite sure if you will fall over. Balancing patient satisfaction, employees, physicians, personalities and receivables is a true test of endurance. From day to day you never know what will happen or what hat you will have to wear.

Keeping in mind that the goal is high quality patient care, I believe that the most effective way to run a medical office today is to be creative, positive and focused. It is important to look for new ideas to grow and improve the practice while maintaining the positive attributes of your office.
As a manager, it is essential to find creative ways to keep your employees satisfied and loyal while making sure that the patients get what they need, when they need it and how they want it. It is not enough to say, “We keep our patient’s best interest in mind.” Rather we must continually work to ensure that they are receiving the highest quality of care in a timely fashion. Motivating employees and keeping their morale high transfers to the increased satisfaction of patients.

I know that my attitude affects everyone in the practice at all times. If I get upset or lose control, everything seems to spiral out of control. I was often the rock that supports everything around. I could not let that rock go over the cliff. Keeping a positive attitude allows everyone to gain strength and stay focused.
What we focused on was our mission and goals; we know that not everything will run as we want. Physicians will run late, emergencies happen and personalities get in the way, but if we can draw strength from one another and work as a team we are able to accomplish more. Our focus is always the best interest of our patients. A practice manager needs to be part of the team. Staff needs to know that we share the responsibilities in the practice.
With the economy doing poorly, low reimbursements from insurance, collections down, it is important to find creative ways to market a practice and to stay financially solvent. As a practice manager, I needed to continue to look for ways to succeed in these areas.
Physicians treat patients; they are responsible for providing medical care. My role is to run the day to day operations. I love when I can say all is calm, but in a busy practice that is not always the case. Perhaps a more appropriate title should be “Problem Solver” or better yet “The Go to Person.” Either way, being part of a successful practice, knowing that you are overseeing your employees’ needs, the well being of your patients and being part of the team makes it all worthwhile. Keep the goal in sight!

The Medicare Learning Network:Our “Favorite” Resource for All Things Medicare

2010-11-29T11:55:00.002-05:00

The Medical Learning Network (www.cms.gov/MLNGenInfo) is full of information and tools f or Medicare Fee-for-Service Providers. You will want to add this website to your “favorites” and visit it often. Listed below you will find an overview of the different resources available.

1. The Medicare Learning Center Product Catalog (Click here to link) – this catalog contains all Medicare Learning products available to healthcare providers and includes Guides, Educational Tools, Booklets, Brochures and Fact Sheets. All products are FREE and can be ordered either as a hard copy or as a download.

A special section of the catalog includes Fact Sheets on CMS Special Initiatives. Some of the sheets currently available include:

• 2010 Physician Quality Reporting Initiative (PQRI) Made Simple

• Electronic Prescribing Incentive Program

• New Healthcare Electronic Transactions Standard Versions 5010, D.0, and 3.0

To order hard copies of any of the resources, you will be required to register with the Medicare Learning Network. Click Here to link to the MLN Product Order Page.

2. MLN Matters Articles (http://www.cms.gov/MLNMattersArticles/) – this resource includes national articles designed to inform the physician, provider and supplier community about the latest changes to the Medicare program. This section of the Medicare Learning Network includes more than 3500 articles written by clinicians, consultants, experts and CMS subject-matter experts.

3. Web-Based Training Modules – Click Here – This section of the Medicare Learning Network allows you to view and enroll in courses that are available online. They are free of charge and many of them offer Continuing Education Credits. Currently there are 16 online courses available on a variety of topics including PQRI and E-Prescribing, HIPAA EDI Standards, and Medicare Fraud and Abuse.

4. CMS Email Updates (http://www.cms.gov/AboutWebsite/EmailUpdates/list.asp) – CMS offers a free email update service which allows cms.hhs.gov users to receive email notifications when new information is available. Not only will this allow you to receive timely information, it will now be sent to you instead of you having to frequently check the website for updates.

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com/.

"Creative Recruiting Techniques" Tele-class

2010-11-18T13:33:00.001-05:00

Are you recruiting? If not, perhaps you should be even if you don’t have any openings at the present time. I’m a big fan of ongoing, consistent recruiting. No one ever resigns at an opportune time; and, we’re all probably guilty of hanging on to someone longer than we should because the thought of finding a replacement is just too overwhelming. Having a reserve of qualified candidates makes both of those situations easier to deal with.

Join Us For A

FREE TELE-CLASS

“Creative Recruiting Techniques”

December 2, 2010

12:00 PM (EST)

REGISTER NOW

Topics Include:

• Recruiting through Social Media;

• Network your way to high-caliber candidates;

• Use of Healthcare-Specific Job Boards;

• Should you consider a Staffing Agency?

Speaker Andrea Santiago is the Health Careers Guide for About.com and the Director of Communications for The Medicus Firm, a national recruiting firm.

From Sue . . .

2010-11-05T11:51:00.000-04:00

Dear Readers,
October was a busy month! I spent a great deal of time recruiting this month. It gives me great pride to share with you that both Efficiency in Practice and InHealth Systems and Services are growing in this tough economy. We’ve recently added staff to InHealth Record Systems, InPractice Dispensing Services, InControl EHR Systems, InHealth Technology Services and InHealth Transcription Services.
During my years at InHealth, I’ve done quite a bit of recruiting and never have I had more resources available to me than right now:

• Due to the tough economy, there are many qualified, experienced and intelligent professionals looking for work. I was pleasantly surprised at the pool of great candidates available.

• For some of the positions, I was specifically looking for candidates with a medical background. By using a Job Board (like Career Builders) specifically for healthcare, my search time was specifically reduced.

• I even posted all of the positions I was looking to fill on my Facebook page and had a friend refer someone to me who was the perfect candidate for my InHealth Technology Services position. I hired him.

Are you recruiting? If not, perhaps you should be even if you don’t have any openings at the present time. I’m a big fan of ongoing, consistent recruiting. No one ever resigns at an opportune time; and, we’re all probably guilty of hanging on to someone longer than we should because the thought of finding a replacement is just too overwhelming. Having a reserve of qualified candidates makes both of those situations easier to deal with.
Or perhaps you’d like to take your caliber of practice personnel to a new level? There are many quality candidates out there willing to take positions that might not have interested them in the past.
How can you turn this unique job market into an advantage for your practice?

Join Us For A

FREE TELE-CLASS

“Creative Recruiting Techniques”

November 18, 2010
12:00 PM (EST)

Topics Include:

• Recruiting through Social Media;

• Network your way to high-caliber candidates;

• Use of Healthcare-Specific Job Boards;

• Should you consider a Staffing Agency?

Andrea Santiago, the Guide To Health Careers for About.com, a New Your Times Company, will be my guest. Andrea has worked in healthcare since 1998. Since 2001, she has focused on medical and executive recruiting and staffing, and currently serves as the Director of Communications for The Medicus Firm, a national recruiting firm. She has also contributed to four books in 2009-2010 regarding job search, recruiting and social media and has been cited by numerous media outlets including the Associated Press, Fox News Channel, and Washington Examiner. Additionally, she has appeared locally and nationally as a featured career expert sharing professional advice and job search tips via broadcast radio, TV and internet radio. Andrea also contributed the article for today’s newsletter.

You don’t want to miss this tele-class. In addition to presenting it live and giving you the opportunity to ask questions, you will also receive access to a recording of the tele-class (in the event your schedule does not permit you to listen live.)

TO REGISTER [CLICK HERE]

Until next time, keep striving for Efficiency in your practice!

Sue Kay, Editor Efficiency in Practice

Medical Providers Look for Formula One Pit Crews by Andrea Santiago

2010-11-05T11:45:00.000-04:00

[Editor’s Note: The Medicus Firm is a Physician Recruiting Firm. The article below is specifically in reference to physician recruiting; however, all of the same tips and suggestions apply to general medical office recruiting as well.]

The American Medical News ran an intriguing story this week about how the medical community can benefit from implementing “pit stop protocols” into medical treatment. By looking at the precision, coordination, and speed with which the Formula One racing pit crew handles a car, some physicians are learning to apply these methods to patient care to improve outcomes.

Upon reading the article, it became clear that these pit crew methods are proving effective for refining and improving processes and procedures in general, and there are many that could also be applied to physician recruiting.

True, split-second speed is not necessarily a factor in physician recruiting. However, overall efficiency, accuracy, communication, team-work and effective processes are all a part of a successful physician recruiting model.

How defined is your physician recruiting process at your facility? Are the processes clearly planned, duties delegated to respective parties, and opportunities for communication in place? There are many details and pieces of information that must come together seamlessly in order for a qualified physician to be permanently placed on your physician staff or within your hospital community.

Here are a few key pointers, employed by the Formula One racing pit-stop crews, which are now being utilized in patient care and could also help improve upon your existing physician recruiting efforts:

1. Checklists, databases, and well-defined processes. According to the article, pit crews have a “well-established culture of using checklists.” Chances are, your current physician recruiting model may have none of these types of defined checklists or check-points in place. Clearly defining each stage of the physician recruiting process, step by step, from initial identification and sourcing of a potential candidate, through the on-boarding of a hired physician, can help to ensure that all involved parties are on the same page. It takes a village to recruit a doctor: recruiting staff, other physicians, hospital executives, and community leaders often play a role in attracting physicians to a community. Therefore, involving them on a more formal level by informing them of official best practices will help everyone work together as a team to bring qualified physicians into the fold.

2. “Situational Awareness” and Leadership. The article notes how the race car driver is always aware of all the processes taking place around the car, even though they are being conducted simultaneously at lightning speed. Who is the “driver” or point-person managing your recruiting efforts? Often, there may be a battle for control amongst executives, physicians, and the hospital physician recruiting team. Who is calling the shots? Turf wars, or even confusion over who is doing what, can slow down your physician recruiting process, or even bring them to a grinding halt. Be sure that each party involved in recruiting knows who is in charge at each stage of the recruitment process. Ideally, there should be one person who ultimately is responsible for overseeing the recruiting process from start to finish, like a project leader.

3. Training. According to the AMED News article, Formula One has a “fanatical approach to training and repetition of pit stop” practices. What type of (formal) training do you provide to your physician recruiting team? Many hospitals do not even have any training program for physician recruiting. Ideally, training should involve not just the “official” hospital recruiting staff, but anyone else involved in the process. Additionally, training should be formalized so that it is easily executed, repeated, and evaluated as needed. If your training is haphazard and disorganized, most likely your physician recruiting will also be haphazard and disorganized.

4. “Communication is Key.” One important practice that physicians have learned from pit crews, according to the report, is to communicate often and well for optimum success in patient care. “Share any problems or concerns” the article states. “Discuss any family issues.” This is important in physician recruiting as well. How often have you set up a physician for an interview only to find that there was a background issue or some other major obstacle preventing you from hiring the physician? This is the type of thing professional recruiters, such as those of us at The Medicus Firm, are trained to uncover and communicate early, but often these things can be easily overlooked if there are too many people involved in the recruiting process internally.

For example, if there are many people from various departments involved in the recruiting process, and the steps and responsibilities of each person are not clearly communicated, one person may assume that the other is checking into the candidate’s background or covering important information with the candidate, while in fact the other person may be relying on someone else too!

That’s not to say you should not have a comprehensive team to help execute your physician recruiting efforts – again, one person alone cannot cover all the bases. However, they must all be involved in the regular communication, and there should be one person to help coordinate the communication, including summarizing all input on the candidate and from the candidate, and laying out a plan of action moving forward.

Kevin Perpetua, managing partner (and part owner) of The Medicus Firm, also happens to be an avid racing fan. He adds, “While the pit crew is the part of the team you see, there is another whole team of even more people behind the scenes, communicating via headset and monitoring the racecar’s data and status via a sophisticated IT system.” This helps to manage the manageable aspects of the race, and prepare for any unexpected mishaps or obstacles on the track. “Much like racing, the competition is very tight for physicians, and one seemingly small omission or issue in the process can derail months of recruitment work, which can be costly and demoralizing to the team.” Therefore, the training, preparation, communication, and design of clear-cut protocols used by race teams is paramount in executing a successful physician placement.

From Sue . . .

2010-10-07T11:04:00.000-04:00

Dear Readers,

As I write this, I am currently flying from Atlanta to Pittsburgh, and I have Wi-Fi access while in the air! When I land, I will rent a car with a built-in GPS system that will guide me to my first destination in Cleveland, Ohio. While there, I will have full access to my computer in Atlanta as I will be able to dial in over a virtual private network (VPN). And I’ll be able to text my kids every afternoon as they are getting home from school just like I do when I’m in Atlanta, and I’ll probably log on to Facebook to make sure my son isn’t logged on when he should be doing his homework. Wow! Technology sure has changed over the years. In years past, most of this technology was not readily available when I found it necessary to be on the road for business.

The technology available to your practice has changed quite a bit over that same period of time. And now, as many of you are considering implementing an EMR/EHR system, now is a good time to stop and take a look at your IT infrastructure. If you are like most practices, your infrastructure has not kept pace with what is available and what is now required by many of the EMR/EHR systems.

I consider myself one of those people that knows just enough about technology to be dangerous. I understand it when someone explains it to me; but, I’d have a hard time turning around and explaining it to someone else. I truly find it overwhelming at times.

That’s why when InHealth was faced with many decisions about our IT infrastructure and our need to continue staying on the cutting edge of technology for our clients; we made the decision to outsource all of our IT. We chose to work with a company here in Atlanta called MDTechPro (www.mdtechpro.com) and it was one of the best decisions we ever made. Our operation is running smoother than ever before, we had the necessary expertise to upgrade our internal computer system recently, and MDTechPro provided the expertise necessary to ensure our computer division, billing division and transcription division each met all of the HIPAA security requirements. I sleep better at night knowing that they are taking care of all things IT related.

Today’s article is simply food for thought….should you consider outsourcing your IT needs? In my opinion, you should at least stop and seriously ponder the possibility.

Things continue to be very busy here at Efficiency in Practice. Be sure to check out our upcoming Fall Seminars. We are offering two: Mastering Medicare and Conquering Chart Audits. Both are worth 6 CEUs through AAPC. We’ve extended the Early Bird Registration price of $119 through October 21, 2010. We’ve had such a great response that we wanted to make sure that you were still able to attend at the lowest Per CEU price available. Click on the links below for additional information or to register. Hurry though – seats are filling up fast.

Be on the lookout next week for a special email where we will be publishing our upcoming Tele-Class list and letting you know how you can access them monthly for Free!

Until next time, keep striving for Efficiency in Your Practice!

The Case for Outsourced IT Services

2010-10-07T11:03:00.000-04:00

Technology has changed dramatically in recent years. Our cell phones have become mini-computers that take and store pictures while providing access to email and the internet; many of us can only get from Point A to Point B with the help of a GPS system; and you can access wireless internet connections everywhere from McDonald’s to local coffee shops to hotels to your own home. And just when you think you are up-to-date with the latest technological gadget, something better and faster with more bells and whistles seems to come out.

As difficult as it may seem to keep up with personal technology tools, it can be even more difficult keeping up with all of the technology available to your practice. And with more and more of our readers/clients beginning the process of evaluating EMR/EHRs, understanding those technology options is very important.

The IT infrastructure choices you have and the decisions you make are equally as important (and in some cases can cost just as much) as the actual EMR/EHR software package you select.

Previously, when a practice’s computer system/network included a billing/practice management system, individual PCs and several printers, the need for IT expertise was limited. Many practices simply contracted with a local computer company for as-needed support or perhaps had someone on staff who “was good with computers” and able to keep the system up and running. These IT resources may no longer be adequate as you look to take your practice and your use of technology to the next level.

For many smaller practices, it’s hard to justify a full-time practice IT technician; and for many larger practices, having an in-house IT professional that must be recruited, hired, and managed may seem like an overwhelming task – not to mention the fact that all of their IT eggs are in one basket. What happens when the in-house IT professional resigns?

For those reasons, now may be the time to consider either bringing in an IT consultant or outsourcing your entire IT operation – preferably to an organization that specializes in the medical industry.

Consider the following IT infrastructure areas that must be researched/addressed prior to going live on an EMR/EHR:

1. Wiring/Cabling – what kind of wiring/cabling does your practice currently have and what will be required when you add your EHR system? An experienced IT professional can analyze your current system, determine what is needed to maximize your use of your EMR/EHR, and coordinate the work that must be done to bring your wiring/cabling up to specs prior to installation/go-live.

2. Wireless Access – most consumer wireless networks today provide spotty coverage. Signals weaken as you get farther away from the wireless router or as you go from room to room. While getting dropped from the wireless network may not be that big of a deal to the casual user, it is unacceptable for a physician in the middle of a patient encounter. An experienced IT professional can complete a wireless survey of your facility and make recommendations for strengthening your existing wireless network.

3. Connectivity/Bandwidth – according to www.techterms.com, Bandwidth refers to how much data you can send through a network or modem connection. It is usually measured in bits per second, or "bps." You can think of bandwidth as a highway with cars travelling on it. The highway is the network connection and the cars are the data. The wider the highway, the more cars can travel on it at one time. Therefore more cars can get to their destinations faster. The same principle applies to computer data -- the more bandwidth, the more information that can be transferred within a given amount of time. Once you go live on an EMR, you will be sending a lot more information through your network. You need to make sure you have enough bandwidth so that your entire system does not run “slow.” There are many options available today to increase bandwidth (additional T-1 lines; Metropolitan Area Networks etc.) An experienced IT professional can evaluate your needs, make recommendations, explain the pros and cons of each option and then coordinate installation with all of the parties involved (local phone services, phone vendors etc.).

4. Hardware Selection – there are many decisions that must be made when it comes to the type of hardware you will use (servers, printers, scanners, desktop PCs, laptops, tablet PCs, thin client terminals or actual computers). There are pros and cons to each, and each one may affect some of the other decisions you make in terms of wiring, cabling, bandwidth and connectivity. An experienced IT professional will be able to review the hardware specifications and requirements of the software; explain the pros and cons of each choice; make recommendations and then actually make sure your infrastructure is set up to accommodate the choices you have made.

5. Security – once your patient data is electronic, security of your system takes on a whole new meaning. Areas to consider include wireless security (access points need to have built-in security); firewalls (limits the data that can pass through it and protects a networked server or client machine from damage by unauthorized users); Desktop Security (anti-virus protection; limited access to the internet); and Communication Security (encrypted email and fax capabilities). An experienced IT professional can set up your initial network security and then provide ongoing monitoring services of network servers and PCs to ensure ongoing security.

6. Back-up – many back-up options are available including but not limited to data back-ups to tapes; data back-ups to external hard drives; or data back-ups to offsite data repositories. An experienced IT professional can help you analyze your practice’s needs, make recommendations on the appropriate solution; and help implement that solution for your practice.

At Efficiency in Practice, we offer tips, suggestions and resources for helping you run an efficient and effective medical practice. Sometimes the most efficient and effective thing that you can do is acknowledge that you need outside experience and expertise – and then get it. When it comes to the quick-changing world of technology that is definitely what we would recommend. As a matter of fact, it’s exactly what we did when confronted with upgrading/installing our own new computer system recently.

Do you have any practice IT words of wisdom you’d like to share with our readers? If so, please email me at editor@efficiencyinpractice.com. We’ll include your advice in future issues of Efficiency in Practice as well as post your comments on our blog.

© 2010 Efficiency in Practice
Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information, seminar listings, products and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com/.

From Sue . . .

2010-09-16T09:58:00.000-04:00

Dear Readers,

Wow! What a week! Last week was the kind of week that made me realize why I love what I do. Here’s a synopsis of all of the great things that occurred:

We hosted our first complimentary tele-class last week, “Medicare in a Minute: The Things You Must Know for 2011.” I was joined by InHealth Consultant and Medicare Expert, Mary Kustermann. We had 66 people register for the tele-class, and the feedback has been great. If for some reason you missed it (either missed registering for it to start with or missed listening to it live) and would like a link to an audio recording of the class, please email me at Editor@efficiencyinpractice.com. I love sharing timely resources and great information with our readers.

If you know of another office manager who does not currently subscribe to our newsletter but who might be interested in receiving a link to the audio recording, please have them email me as well at Editor@efficiencyinpractice.com. I’d love to subscribe them to the newsletter and send them the link.

We finalized a series of workshops that we will be offering this fall called “Mastering Medicare” and “Conquering Chart Audits.” They have both been approved for 6 CEUs. And if you register before September 29, 2010, you get our early-bird price of $119 per attendee per workshop. I love offering our valued readers/clients top-notch information at a bargain price. You won’t find a better seminar at a lower per CEU price. Click on the link below for dates/locations/registration details. [PS Mary Kustermann, our tele-class speaker, will be presenting several of the workshops.]

And last but not least…we launched our updated website. Please visit us at www.efficiencyinpractice.com and check out the updates/additional information available. We’d love your feedback. As part of the launch of our new website, I’m also very proud to introduce the Efficiency in Practice Managers Association – a membership-based organization designed to bring you the tools and resources you need to run an efficient and effective medical office. Check out the box below for details on the association and on our special introductory offer.

Thank you so much for being a valued reader of our newsletter. If you have any ideas or suggestions on information you’d like for us to research, please email me at Editor@efficiencyinpractice.com.

Until next time, keep striving for Efficiency in Your Practice!

We Survived Our Recent Computer Upgrade and Lived to Tell About It…

2010-09-16T09:55:00.000-04:00

6 Things Your Medical Practice Can Learn From Our Recent Computer Upgrade

During the month of June, we upgraded our entire computer system (hardware and software) here at InHealth – the culmination of two years of planning, testing and hard work.
Although everything seems to have worked out fine in the end (we successfully made it through “Go Live”; two month-end closes and a fiscal year-end close), there were definitely times when we all turned to each other and said “What were we thinking and why did we decide to do this?” As we worked our way through this process, I realized it was not unlike what some of you are facing as you make decisions regarding EHR/EMR implementation.

Here are 6 things we learned (sometimes the hard way), which may help you as you consider your options and make your choices as they relate to technology in your medical practice.

1. We didn’t necessarily want to upgrade; but, we felt as if we had no choice. InHealth installed its first computer system in the late 80s/early 90s. It was a Unix-based accounting/manufacturing/order entry system that we customized to include a sales and customer-tracking program. Over time, though, while the software itself continued to work and did what we needed for it to do, it became more and more difficult to find the hardware on which it ran and technicians who knew how to support it. We made the decision to move forward with an upgrade because we were at an ever-increasing risk of the system crashing without the ability to be able to get it back up and functioning in a timely and efficient manner. We simply could not risk being down or losing data. Perhaps you’re in the same position – your practice management system is a Unix-based system running on obsolete hardware – and you’re worried about what might happen if your system were to crash?

2. We decided to UPGRADE our existing software system as opposed to implementing a brand new software package. I’m not 100 percent sure we made the right decision. We decided to do so for the following reasons: we thought the conversion of data would be easier and more accurate; we thought the training of our 300+ associates would be easier if they were learning an upgraded version of what they already knew; and we thought it would be more cost-effective. When all was said and done, we upgraded our system through 13 different versions. The conversion was difficult (maybe even more so than if we had started fresh with a new system); the training was just as intense due to the sheer number of changes to the software; and it wasn’t more cost-effective because we ended up having to customize the existing software to meet our needs. When you begin your search for the right system for your practice – be open-minded. Don’t assume that your only option is to upgrade your current practice management system. There are many options available to you. Explore them and do your due diligence on all of them without giving your existing system a higher ranking than it earns.
3. When the vendor says “Our system does that,” ask to SEE it. Don’t simply take the vendor’s word for it. We ended up spending a great deal more than originally budgeted for customizations because we didn’t ask to see it. While their system did indeed do it; it didn’t do it the way we needed it to do it. And once you’ve signed the paperwork and you’re well into the implementation plan, you don’t have any choice but to pay it. Had we done our homework in advance, we could have made some if not all of the customizations part of our negotiations with the vendor.
4. Acknowledge that technology has changed and yours probably needs to be upgraded. While we knew we would be changing out all of our existing main hardware (servers, monitors, PCs, etc.), we did not pay as close attention as we should have to the cabling/wiring throughout our building. We experienced a delay when we went to install some of the hardware as we had to stop and have someone come in and run cabling. We also experienced problems as part of our Go-Live process due to a few wiring issues in the server room which were the cause of some data corruption errors we experienced during the first week. If I had to do it all over again, I would have paid an expert to come in and check our cabling/wiring from one end of the building to the other. It doesn’t make much sense to install brand new hardware throughout the building but to connect it with inadequate cabling/wiring.
5. Don’t scrimp on ancillary hardware. Each of our associates is connected to the main server via a thin client device. We had used thin client devices previously and decided to save some money by using those instead of buying new ones – after all a thin client is a thin client is a thin client. Right? Wrong! Once we went live, we realized that we were sending a lot more data back and forth from the thin client to the server – and our existing thin clients simply could not handle the work load. The result? The system was crawling (and frustrations were running high). We ended up purchasing new ones and installing them during the hectic Go-Live week. If I had to do it over again, I would not have assumed the existing hardware would work with the new system. And, once I determined it would not, I would have purchased all new thin clients in advance and saved everyone a lot of stress and frustration. It’s amazing how one little piece of equipment can slow down an entire system.

6. No matter what anyone tells you, plan for a loss of productivity during the weeks after Go-Live. We did everything possible to plan for the training of InHealth associates on the new system: we limited staff vacations the week before and the week of Go-Live; we staggered training times so we always had associates available to assist customers; we trained some of our outside sales associates after hours so that they could still be in the field visiting clients during the day; we provided customized training manuals and cheat sheets and we had a team of implementation people roaming the office during the week of Go-Live answering questions and helping staff remember how to do it “in the new system.” Bottom line, though, the new system slowed us down significantly and our productivity was severely impacted during the month of June. As a matter of fact, we didn’t reach peak productivity again until the latter part of July. While I anticipated some loss of productivity, I was not prepared for the reality of the situation and its impact on revenues, invoicing and cash flow. My advice to you – prepare for the worst in terms of loss productivity.
Hindsight is always 20/20 – but I hope seeing our upgrade through our eyes might help you avoid some of the same mistakes or, at the very least, give you food for thought. In our next article, we will discuss more in depth some of the technology requirements of a new system and what you should be doing now to make sure you are ready.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com
This article can be reprinted freely online, as long as the entire article and this resource box are included.

Value-Added Continuing Education Seminars

2010-09-07T09:26:00.004-04:00

Our Consulting & Educational Services division presents a new series of workshops:

InHealth's Value-Added Continuing Education Workshop Series

Our workshops add value to you and your practice through advanced, in-depth course content; guaranteed up-to-the-minute information on relevant laws, regulations and rulings; and the lowest price per CEU of any workshop anywhere.

Register early - Our two newest seminars, "Mastering Medicare" and "Conquering Chart Audits" are only $119 each until September 29. You cannot afford to miss these seminars!

Visit www.efficiencyinpractice.com/seminars for more information and to register.

From Sue . . .

2010-08-18T11:32:00.001-04:00

Dear Readers,

We are heading into one of my favorite times of the year – Fall! I’m looking forward to cooler temperatures (please!); the start of the school year and Friday night football games watching my son march the half-time show; and to be honest – a little bit more structure. While I enjoy the slower and less scheduled pace of summer, I’m usually ready for the focused routine that fall brings.

Here in Georgia, most of the districts have started back to school. With school comes one of my other favorite things – school supply shopping! I love the bins of binders, paper, pens and pencils and the shelves of agendas, planners and calendars. I’m still a paper girl when it comes to my calendar. I’ve tried all kinds of electronic planners, but, I always come back to my trusty paper Franklin planner.

Whether you use a paper calendar or an electronic one – stop right now and:

MARK YOUR CALENDAR
FOR
AUGUST 31, 2010
12:00 PM (EST)

You are invited to join us for the
FREE TELECLASS

“Medicare in a Minute:
The Key Things You Must Know for 2011”

TO REGISTER, CLICK HERE.

This free tele-class will be presented by Mary Kustermann, one of InHealth’s Senior Consultants. Mary is a certified professional coder with more than 35 years of coding and medical administrative experience. She holds a Health Care Administration degree and owns a full-service medical consulting firm in St. Mary’s, Georgia. She is an expert when it comes to Medicare and has been getting rave reviews as the speaker for the Medicare Client Appreciation Seminars we have hosted this past year. She also contributed most of the content for today’s article on ICD-10.

You don’t want to miss this tele-class. In addition to presenting it live and giving you the opportunity to ask questions, you will also receive access to a recording of the tele-class (in the event your schedule does not permit you to listen live.)

REGISTER YOURSELF
CLICK HERE

INVITE YOUR
COLLEGUES AND OTHER OFFICE MANAGERS
YOU KNOW TO REGISTER

(In addition to registering for this tele-class, they will also receive a subscription to this newsletter as well as invitations to other future complimentary tele-seminars.)

We’d love to hear from you about other topics you’d be interested in having us present. Please email me at editor@efficiencyinpractice.com.

Until next time, keep striving for Efficiency in your practice!

Sue

ICD-10: The Code That Cried Wolf

2010-08-18T11:26:00.002-04:00

Do you remember the story of the little boy who cried wolf? It goes something like this…

There once was a shepherd boy who was bored as he sat on the hillside watching the village sheep. To amuse himself he took a great breath and sang out, "Wolf! Wolf! The Wolf is chasing the sheep!"

The villagers came running up the hill to help the boy drive the wolf away. But when they arrived at the top of the hill, they found no wolf. The boy laughed at the sight of their angry faces.

"Don't cry 'wolf', shepherd boy," said the villagers, "when there's no wolf!" They went grumbling back down the hill.

The little shepherd boy did this over and over again. One day, he saw a real wolf chasing the sheep. But when he called out to the villagers, no one came. They had been fooled too many times before.

Many of you may feel the same way about ICD-10. We’ve been hearing that ICD-10 was coming since 1992 and perhaps you have lost trust in the fact that it would actually ever happen. Rumor no more, the transition into the ICD-10 classification is fast approaching and now is the time for you to sit up, take notice and take action.

After many years if not decades of delays, ICD-10-CM will be mandated throughout the health care industry as of October 1, 2013. In January of this year, Health and Human Services also released an additional rule dealing with HIPAA 5010 transaction sets. The final rule calls for compliance by January 1, 2012. With both of these deadlines looming, practices must not delay getting prepared.

ICD-10 will consist of two parts: ICD-10-CM for outpatient diagnostic coding and ICD-10-PCS for inpatient procedure coding. ICD-10-CM will be used in all health care settings while the ICD-10-PCS will only used for inpatient hospital settings. For purposes of the rest of this article, we will focus on details as they relate to ICD-10-CM.

What are the major differences between ICD-9 and ICD-10?
· The number of codes: There are approximately 14,300 ICD-9 diagnostic codes. With ICD-10, you’ll have more than 69,000 to choose from.
· ICD-10-CM codes start with a letter and can be up to 7 characters.
· ICD-10-CM offers and requires a higher level of specificity. There are fewer NOS (not otherwise specified) code options and the coding has been expanded to include right and left designations.

And most experts agree that there are some significant advantages to ICD-10 over ICD-9 including its flexibility, its ability to be more detailed and its ability to capture advances in medicine and technology. Even the increased number of codes offers an advantage in that it’s oftentimes easier to determine the correct code to use if the list from which to choose is more specific.

The potential challenges of implementing ICD-10-CM? It’s another thing in a long list (EHR, Meaningful Use, Red Flags) that must be addressed and acted upon in the coming months.

What should you do to prepare?

According to the CMS website, these are the things you should be doing to prepare:

• Identify your current systems and work processes that use ICD-9 codes. This could include clinical documentation, encounter forms/superbills, practice management system, electronic health record system, contracts, and public health and quality reporting protocols. It is likely that wherever ICD-9 codes now appear, ICD-10 codes will take their place.

• Talk with your practice management system vendor about accommodations for both Version 5010 and ICD-10 codes. Contact your vendor and ask what updates they are planning to your practice management system for both Version 5010 and ICD-10, and when they expect to have it ready to install. Check your contract to see if upgrades are included as part of your agreement. If you are in the process of making a practice management or related system purchase, ask if it is Version 5010 and ICD-10 ready.

• Discuss implementation plans with all your clearinghouses, billing services, and payers to ensure a smooth transition. Be proactive, don't wait. Contact your payers, clearinghouse, billing service with whom you conduct business, ask about their plans for the Version 5010 and ICD-10 compliance, and when they will be ready to test their systems for both transitions.

• Talk with your payers about how ICD-10 implementation might affect your contracts. Because ICD-10 codes are much more specific than ICD-9 codes, payers may modify terms of contracts, payment schedules, or reimbursement.

• Assess staff training needs. Identify the staff in your office who code, or have a need to know the new codes. There are a wide variety of training opportunities and materials available through professional associations, online courses, webinars, and onsite training. If you have a small practice, think about teaming up with other local providers. You might be able, for example, to provide training for a staff person from one practice, who can in turn train staff members in other practices. Coding professionals recommend that training take place approximately 6 months prior to the October 1, 2013 compliance date.

Stay Informed!

Many changes will continue to challenge practices, so start today and the impact will not be insurmountable. Take part in the national provider teleconferences sponsored by CMS.

The websites below will provide you with the latest information regarding the implementation of the ICD-10.

Additional resources;

http://www.cms.gov/ICD10/02c_CMS_Sponsored_Calls.asp#TopOfPage -look for downloadable presentations, written and audio transcripts of national provider calls

www.cms.gov/ICD10 - Tools - GEM, General Equivalency Mapping is a crosswalk tool that will allow for forward and backward mapping from ICD-9 to ICD-10 codes.

http://www.cms.gov/ElectronicBillingEDITrans/03_EDISupport.asp#TopOfPage -Free billing software for Medicare fee for service providers

www.cdc.gov/nchs/icd.htm - General ICD-10 information

www.ahima.org/icd10 - American Health Information Management Association

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com

Mary Kustermann, RMC, RMM, CPC, CPC-H is a Senior Consultant at InHealth and a certified professional coder with more than 35 years of coding and medical administrative experience.
This article can be reprinted freely online, as long as the entire article and this resource box are included.

Register for our fee seminar - Are You Ready for RAC? - click HERE

From Sue . . .

2010-07-27T10:56:00.002-04:00

Dear Reader –

Here in Atlanta, the official countdown to the end of summer/beginning of the school year has begun. My son leaves for a week of band camp on Sunday; my twins turn 16 on August 4; and school starts on Monday, August 9 when it’s back to extremely early mornings and very busy schedules.

I’m planning to use the final weeks of summer to get a lot of work accomplished so I head into the busyness of fall a little ahead of the game. (Besides, with 98-degree temperatures here in Atlanta, being in my air-conditioned office has a lot of appeal.)

Here’s what I’ll be working on for you, our valued Efficiency in Practice readers:

· Staying up-to-date on the many important issues facing healthcare practices today to bring you timely articles with up-to-the-minute information;

· Today’s article is an update on RAC (you need to sit up and take notice if you haven’t already); future newsletters will provide you with information on upcoming Medicare changes; details on ICD-10 (ugh!); and a guide for analyzing your practice’s IT infrastructure to make sure you are prepared when and if you decide to implement an EHR.

· In addition to the free client appreciation seminars we offer (see details to the left and check out our new online registration process); watch your email for details on two free tele-classes we will be offering in August and September. The topics will be “Medicare Changes” and “Conducting an Internal Chart Audit.”

· We’ll be updating our current free report “The 8 Things You Must Know About RAC” and publishing a new one in the next several weeks that will provide you with a complete listing of our top resources for running an efficient medical practice.

· We’ll be introducing you to three new Senior Consultants who will be joining InHealth Consulting and Educational Services. They will be contributing to this newsletter as well as offering workshops, seminars and tele-classes.

For today’s article, “RAC Updates: Assessing Your RAC Risk,” I was provided valuable information by one of our new Senior Consultants Carol Coots. Carol will be presenting one of our free Client Appreciation Seminars on this topic in the Chicago area in September. Please see details to the left. We’d love to have you (or any of your friends) join us.

Speaking of friends…we’d love to connect with some of yours. If you know of any office manager whom you feel would benefit from the content of this newsletter, our free Client Appreciation Seminars or our upcoming free Tele-Classes, please forward this newsletter to them and encourage them to subscribe (see the box in the upper left.) We have a goal of having 2500 subscribers by the beginning of October – and we need your help!

Until next time, keep striving for Efficiency in your Practice.

RAC Updates: Assessing Your RAC Risk

2010-07-27T10:54:00.001-04:00

The adage “no news is good news” definitely does not apply to physician offices when it comes to the RAC (Recovery Audit Contractors) program. For the past several years (during the 3-year demonstration program and during the past year of national expansion), RACs have primarily been focused on hospitals and not individual physician offices. This false sense of security has caused many office managers to put RAC preparations on the back burner. Between now and the end of the year, we will start to see RAC rear its ugly head in private-practice physician offices. This article is intended to provide you with some RAC background information, up-to-date status information on the RAC program, and tips for assessing your practice’s potential RAC Risk.

Background

The Recovery Audit Contractor (RAC) program was authorized by Congress as part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). As part of the legislation, Congress directed the Centers for Medicare and Medicaid Services (CMS) to conduct a three-year recovery audit demonstration program in a small number of states.

The goal of the RAC program is to detect and correct improper Medicare payments and to collect those overpayments from providers.

From March 2006 through March 2008, the Medicare Recovery Audit Contractor (RAC) demonstration project identified more than $1 Billion in incorrect Medicare payments – including some $900 Million on overpayments to facilities and providers.

The obvious success of this demonstration program led to the RAC program being made permanent as part of The Tax Relief and Health Care Act of 2006. This authorized CMS to expand the program in all 50 states.

In the Spring of 2007, CMS began the open bidding process to select four RAC contractors for the permanent RAC project. In October 2008, CMS announced the four (4) new national RACs that had won contracts to serve the Medicare RAC program – roughly one RAC for each ¼ of the country.

Those RACs and associated contact information are as follows:

Region A
Diversified Collection Services (DCS)
www.dcsrac.com
info@dcsrac.com

Region B
CGI Federal
http://racb.cgi.com
racb@cgi.com

Region C
Connolly Healthcare
www.connollyhealthcare.com/RAC
RACinfo@connollyhealthcare.com

Region D
HealthDataInsights (HDI)
https://racinfo.healthdatainsights.com
racinfo@emailhdi.com

Up-to-date RAC status information:

According to the American Hospital Association, recovery audit contractors denied $2.47 Million in claims during the first quarter of 2010;
Originally intended for fee-for-service Medicare only, the new health care reform law calls for expansion of the RAC program to Medicare Parts C and D by December 31, 2010.
The new health care reform law also calls for RAC expansion into Medicaid programs as well by December 31, 2010.
President Barack Obama is expected to sign a bill into law today that will expand recovery-audit-type contractor programs beyond Medicare. The Improper Payments Elimination and Recovery ACT requires federal agencies to put audit/corrective action plan programs in place to reduce overpayment errors. The White House cited the success of the current RAC program when announcing plans for additional audit programs. This means that RAC is just the start and that you should anticipate additional audit recovery programs being implemented moving forward.
Non-governmental insurance companies are taking note of the audit recovery success as well. Anthem and Humana are starting to perform similar audits at hospital and physician levels. Be prepared for the flood gates to open as more and more insurance companies put similar programs into place.
Different RAC contractors seem to be focused on different issues. Visit each of the individual contractor websites above for a complete listing of issues in each region.

Assessing Your Risk

Knowledge is key in terms of assessing your potential RAC Risk. You need to be aware of where previous improper payments have been found and then take a close look at your own billing tendencies. Here are some tips and resources for doing so:
You can find a listing of what improper payments were found by RACS during the demonstration period by visiting the CMS website at www.cms.hhs.gov/rac.
Permanent RAC findings will be listed on the individual regional RAC websites. Visit your region’s RAC website frequently to keep up to date as new findings/issues are posted regularly.
Sign up to receive email notifications with up-to-the-minute RAC information. I receive weekly updates from www.racmonitor.com. All it took was signing up for a free registration account via their website.
Be proactive! Start watching and tracking your denied claims. Look for patterns in the denials to see if you are consistently doing the same thing over and over. Take corrective steps now to avoid incorrect claims and improper payments. If you uncover improper payments as part of this self-audit, report it to the claims processing contractor. With the contractor’s approval, these claims will be excluded from RAC review.
Watch for updated information from Efficiency in Practice through our newsletters, on our website and via upcoming complimentary tele-classes.

Bottom-line, recovery audits of all types are here to stay. You need to be aware of the risk, continually seek education and resources on the topic, and be proactive with your preparation.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-07-07T13:44:00.001-04:00

Dear Readers,

Happy 4th of July! I hope each of you had a relaxing three-day weekend, and that you were able to spend it with friends and family. As you read this, I’m out of town for vacation. My husband and I are celebrating our 20th wedding anniversary!

One of the consultants with whom we partner, Carol Hoppe, is our contributing writer this week. Carol is the Director of Billing, Coding and Credentialing and has written the article, “Ten Tips for Revenue Cycle Management.” Not only is Carol very knowledgeable on this topic; but, revenue management is an area you indicated you are concerned with in our recent reader’s survey.

Until next time, keep striving for Efficiency in your Practice.

Revenue Cycle Management: Ten Tips to Maximize Revenue by Carol Hoppe

2010-07-07T13:35:00.004-04:00

Healthcare is one of few industries where services are not paid for when they are received. Typically, one party (such as a doctor or hospital) provides services to a second party (a patient), but a third party (a health insurance carrier) is often involved in facilitating financial reimbursement for the services provided.

Money keeps the practice in business. Each phase of the revenue cycle is important, from payer contracts to charge capture and collections. Knowing how to manage the revenue cycle not only ensures the financial viability of the practice, but also minimizes the time and effort spent collecting payment for services rendered.
The purpose of this article is to gain a better understanding of what you can do to efficiently manage the revenue cycle and how to maximize potential revenue.

1: Review payer contracts
Payer contracts often contain complex reimbursement language and formulas that can be difficult to monitor and manage. It is important to know what you are agreeing to when you sign any contract, but especially when it comes to payer contracts. Be sure you know and understand the expected reimbursement and contractual allowances before you sign. Contract negotiations can be difficult, especially if you are a solo practitioner. You have limited power to negotiate unless your specialty is in high demand and there are limited providers available in your geographic area. When negotiating, be sure to optimize trade-offs and to understand the total value of the agreement prior to contract execution. It could be beneficial to take less reimbursement on office visits if you can get more money on high dollar surgical procedures, but make sure you evaluate this against your current or expected volumes.

2: Know the Law
Here in Indiana under the “Prompt Pay” law, payers must pay or deny a clean claim within 30 days of receipt if filed electronically and within 45 days of receipt if filed on paper. Check the laws in your state to see if there are payer deadlines. While the definition of a clean claim could be disputed, no response from a payer within the 30 to 45 day window should result in immediate follow up. Medicare reimbursements are dispersed within 14 days of electronic claim submission, so inquiry on those unpaid claims should occur within 15 to 20 days.
Most practice management systems will allow batching of unpaid claims by insurance type so that inquiry can be made on multiple claims with one phone call or internet inquiry. Pending claims should be worked on a daily basis, beginning with accounts with the highest balance and oldest age first, such that every unpaid account is reviewed at least once every 30 days.

3: Clean claims = fewer denials
A serious concern in healthcare reimbursement today is decreased or delayed reimbursement due to claim denials. The challenge is how to quickly identify the source of the denials and fix the problems. Education is the key to clean claims. Providers, front desk, billers and clinical staff all contribute to the information that is submitted on a claim. Each individual needs to understand how their role impacts claim payment. When denials are received, they should be identified with a reason code and posted in the practice management system so a denial report can be generated at month-end. This gives managers a clear picture of where further education is needed.

4: Respond promptly to claim denials
After receiving a claim denial it is important to correct the claim and rebill it to the insurance carrier promptly. Claims often go unpaid and bump up against timely filing limits when the biller keeps a “zero pay folder” to work in the future. Denied claims should be addressed daily as they are received.

Each insurance carrier handles resubmitted claims differently so it is important to know what each carrier expects. With some carriers, if the claim is simply rebilled electronically with no notation, the claim will be denied as a duplicate. Some carriers will allow the provider’s office to fax a corrected claim directly to their claims processing department. Others require that the claim be resubmitted either electronically or on paper.

5: Review payments carefully
Payers will often make mistakes when processing claims that need to be appealed for proper reimbursement. The person posting payments must pay attention and question anything that does not look right. Some things to watch for include:

· dropped or missed procedures
· one procedure bundled into another and paid based on one code instead of two
· modifiers dropped that justify bundled procedures
· multiple units ignored
· payment based on the wrong fee schedule

The best practice management systems have the ability to load payer fee schedules so you know when payments are posted whether they were paid correctly or not.

6: Appeal claims paid in error
Any services paid incorrectly should be appealed. Sometimes errors can be addressed over the phone, but often they require a formal appeal letter. It is important when appealing claims that a cover letter be submitted explaining why the claim is being appealed. The cover letter also notifies the carrier of any attached documentation accompanying the claim. Further documentation may include progress notes, lab or other test results, operative notes, fee schedules, copies of CPT guidelines or Medicare policies to support the appeal. Keep copies of all appeals and the results for reference with future appeals.

7: Don’t get frustrated, get help!
Practices should not hesitate to contact their State Insurance Commissioner’s office if they feel they are getting the run-around from a particular payer after reasonable attempts to collect.
Find your state insurance commissioner at the National Association of Insurance Commissioners website.
Commissioner’s offices may be called with general questions, but in order for them to investigate a disputed claim they must have written documentation with as many details as possible. Documentation should include a copy of the insurance card, the claim form, and documentation reflecting all efforts to resolve the claim, as well as responses from the payer. A separate complaint should be filed for each patient involved. Most insurance companies respond quickly when the State Insurance Commissioner becomes involved.

8: Patient balances
Sometimes asking patients for payment puts the office staff in an uncomfortable position, especially when the patient becomes disgruntled. However, most insurance companies require that the patient’s co-pay be collected at the time service is rendered. Staff members working at check-in and check-out should be comfortable asking for payment. Often providing a script requesting payment helps staff members to be more comfortable and consistent with requesting payments. Contracted providers are obligated to collect the co-pay at the time of service. Failure to do so could be a breach of contract.

The most important thing an office can do is to develop an office financial policy with regard to patient payments. Developing an office policy is important to ensure that all patients will be treated the same with regards to financial payment. A financial policy makes the patient aware of their responsibilities with regards to payment for services. Outline in your policy the exact process which will be followed should the patient refuse to pay on their account.

Attempts to collect outstanding balances should be made each time the patient is seen. The cost of pursuing payment after the patient leaves only decreases the value of the dollar collected. The more time that passes the less valuable the dollar becomes and the more difficult it is to collect. Patients know whether you are an office that expects payment or one that will extend free credit. The most successful practices use one or more of these techniques:

· Notify patients when scheduling and confirming appointments that they should 1) bring insurance cards and photo ID to each visit; and 2) come prepared to pay copays and outstanding balances at the time of service. Let them know up front what credit cards you accept.

· Collect copays and outstanding balances at check-in rather than check-out. Staff should be direct without being rude when asking for money. Confidently stating “Your copay is $35. Will you be paying with cash, check or credit card?” is better than asking “You have a balance of $132. Would you like to make a payment today or should we bill you?” Why pay today if you don’t have to? Your office is not a bank and should not routinely extend credit.

· Start payment plans at a maximum of three to six months and a minimum of $25. It costs money to send statements and process multiple payments. Offer discounts if the balance is paid in full to get the account settled quickly.

· Don’t spend money on statements to collect $5 and $10 balances. Collect small balances the next time the patient is in the office.

9: Hire and retain the best employees
Generating revenue is the most important task in the financial success of the medical office. The people hired for these roles should be seen as an investment. Ongoing training is critical to their success as the rules and regulations are constantly changing. The cost of one seminar could easily be recouped in a couple of correctly billed surgeries. Incorrect claims or missed charges could be costing you millions. Invest in your billers and do everything you can to retain the best employees. Workers who feel valued will usually deliver exceptional results.

10: Monitor benchmarks and key performance indicators
Benchmarks and key performance indicators should be reviewed monthly. Let your billers know what is expected so they can monitor and achieve the goals. Analyze trends on a monthly basis and identify any warning signs before they become serious. The following benchmarks are “best practice” and may be used as a baseline, but each specialty and/or practice may want to adjust these or reference MGMA benchmarks by specialty:

· Average number of days revenue in A/R at a maximum of 35 days
· A/R greater than 90 days less than 20% of total A/R
· Credit balances less than 4% of total A/R
· Bad debt write-off less than 2% of total charges
· Net collection percentage 96% or greater

There are many other things you can review monthly that will help you monitor financial performance, including:

· Procedure analysis compared to CMS Norms
· Ratio of charges to payments and adjustments
· Drop in reimbursement by individual payers

We are living in difficult times that require offices to do everything they can to keep the practice in business. Every employee is valuable and should take responsibility for their role in the practice thus helping the revenue cycle to be clean and efficient. This article has shown not only how to manage the revenue cycle and ensure the financial viability of the practice, but also minimize the time and effort spent collecting payment for services rendered.

Carol Hoppe is a Senior Consultant at InHealth, and the Director of Billing, Coding and Credentialing at Indianapolis Medical Management. She can be reached at carol.hoppe@inhealthconsulting.com

Efficiency in Practice is the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-06-30T10:12:00.001-04:00

Dear Readers,

Wow! It’s been a busy week on the healthcare front with key information announced in the following areas:

· Meaningful Use
· EHR Certification Process
· Medicare’s Proposed 21.3 percent Cut

In today’s article, we’ve provided you with up-to-the-minute updates on each of those important issues.

I’d love to hear your thoughts on all three topics. Email me answers to the following questions at editor@efficiencyinpractice.com no later than 5:30 pm on June 30, 2010 and you’ll be entered into a drawing for a FREE IPOD TOUCH!

Questions are as follows:
1. Where is your practice in terms of EMR/EHR implementation?
2. If you’ve already implemented a system, which one did you choose?
3. Are you pleased with your decision?
4. If you haven’t yet implemented an EHR, have you established a timeline for doing so?
5. Have you selected a system yet? If so, which one?
6. What role did the potential stimulus payments play in your decision(s)?
7. What is your practice doing in anticipation of the potential Medicare reimbursement cuts? What affect have they had on your practice?
8. What keeps you up at night? What the single biggest issue/concern facing your practice today?

Speaking of IPODs, did you know you can download medical practice management podcasts from iTunes? Click here to check it out.

Until next time, keep strive for efficiency in your practice!

Sue

PS – Remember to email us the answers to your questions no later than 5:30 pm on June 30, 2010. An efficiency tip: It’s more efficient to just stop and email the answers to us now as opposed to adding it to a list with intentions of taking care of it later. Oftentimes, later never comes and you have the added burden of having one more thing on you to-do list. [Truth be known, I’d probably add it to the list after the fact just so I could cross it offJ Have you ever done that?]

Updates on Key Issues Facing Your Practice

2010-06-30T10:10:00.001-04:00

Meaningful Use
As we’ve previously written, during the last week of December, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced a proposed rule to define “meaningful use.”

At the time, CMS identified three proposed stages of meaningful use criteria as follows:

a. Stage 1 focuses on the electronic capture and tracking of codified health information, use of data for the coordination of care, and on the reporting of clinical quality measures and health information to CMS. For Stage 1, which begins in 2011, CMS proposed 25 objectives for eligible professionals and 23 objectives for hospitals that must be met to be considered a “meaningful user” of EHR technology.

b. Stage 2 (which will be finalized at a later date thereby making meaningful use somewhat of a moving target), will expand upon Stage 1 in the areas of disease management, clinical decision support, medication management and support for patient access to their health information among other areas.

c. Stage 3 (which will also be finalized at a later date), will focus on achieving improvements in quality, safety and efficiency.

After a period of public comment and further discussion/debate by CMS and ONC, we’re expecting Health and Human Services (HHS) to finalize Stage 1 criteria within the next two weeks.

Although many healthcare practitioners have expressed concern over the quick timeline, national IT coordinator Dr. David Blumenthal seems to think we’re not moving fast enough.

Read his recent blog on the topic here.

EHR Certification Process
On Friday, June 18, 2010, The Office of the National Coordinator for Health Information Technology released a final rule establishing a temporary electronic health records certification program.

You can find a copy of this rule (in a non-final format) here.

It will actually be published on June 24. A final rule for a permanent certification program probably won’t be available until this Fall.

A few highlights of the temporary program:

CCHIT (Certification Commission for Health Information Technology) was not automatically deemed the certifying agency. They will have to apply along with other organizations who want to be the certifying entity.
There is no “grandfathering” of existing CCHIT certified EHR systems. All EHRs will need to be re-certified.

For additional information on the certification process and associated timelines, click here.

Proposed 21.3% Medicare Cut
On Friday, the Senate took action on the proposed 21.3 percent Medicare cuts by passing legislation blocking the cuts from going into effect until November 30. Now, the House must also vote. That vote is expected next week.

If it passes into law, Medicare providers will not only avoid the 21.3 percent cut, but will actually receive a 2.2 percent increase for claims with dates of service from June 1 through November 30.

In conjunction with the Senate’s action, Medicare announced it would begin processing claims is has already received for June (which were previously on hold) at the lower rate. Once the House approves the bill, claims processed at the lower rate will be automatically reprocessed.

For additional information, click here for an article published by the American Medical News.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com or check out our blog at www.efficiencyinpractice.blogspot.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-06-15T11:15:00.000-04:00

I hope you are enjoying the beginning of your summer. Here in Georgia, school has been out for several weeks and both of my children are definitely in “summer mode” – staying up late; sleeping in; reading books for pleasure instead of for school and looking forward to church camp and a trip to Pennsylvania to visit family. (I don’t know about you but I miss the “lazy, hazy days of summer” from my youth.)

During the recent Memorial Day weekend, I had the privilege of taking my son to Pensacola to visit a friend’s son who is a recent graduate of the Air Force Academy and stationed there for flight training. We visited the base and my son got to sit in one of the fighter jets (the highlight of the trip for him). We also visited the Naval Museum while there. If you are ever in that area and have the chance to visit, it is a great museum and definitely worth seeing.

I hope you have plans for some well-deserved time off this summer. While we all look forward to vacations, that topic presents a unique challenge for managers when it comes to handling staff vacations requests and schedules. Today’s article offers some tips, suggestions and resources for making that task a little less stressful.

Here at Efficiency in Practice, we have been very busy. In addition to going live on a new company computer system (a story for another newsletterJ), we’ve been working on some exciting Efficiency in Practice projects as well. In the coming weeks, be on the lookout for:
Our revamped website (finally!)
A new Special Report
An update to our current RAC Special Report
A special invitation just for our readers
And a Big Announcement!

Stay tuned! Until then, slow down a little bit and enjoy the summer and remember to Keep Striving for Efficiency in YOUR Practice.

Take care,
Sue

Strategies for Developing Effective Vacation, Time-Off and Holiday Policies

2010-06-15T11:13:00.001-04:00

For many people, the word summer brings to mind warmer weather, a break from school, outdoor activities, backyard barbeques, and summer vacations. For office managers and practice administrators, though, summer vacation protocols and schedules can be stressful. Add to that the fact that there are also three popular holidays between the end of May and the beginning of September, and that stress turns into a major headache.

How should you handle vacation requests, paid-time off, time off without pay and holidays not only during the summer months but year-round as well? Here are some tips and suggestions for handling these issues efficiently, effectively and correctly:

1. Set policies and respond to employee requests with the patient in mind. Your goal is to provide the best patient care possible while ensuring that the patient leaves your practice with a positive perception. Meeting this goal should factor in (and oftentimes be the sole factor) in how you make decisions regarding practice policy.

For example, many office managers ask the question if it’s a good idea to close early on Fridays during the summer. Most times, they are thinking that this might be a nice perk for practice employees and perhaps reduce the number of employee requests for Fridays off.

The real question they should be asking is, “How will not being open on Friday afternoon affect our patients?” Many of our practices tell us that Friday afternoons are busy (especially pediatric offices, family practice offices and internal medicine offices) as patients who wake up not feeling well want to get in to be seen prior to the start of the weekend.

If you make decisions from the patient perspective, communication of your policies/decisions becomes easier as well. Instead of sounding inflexible or simply saying no, you can truthfully tell employees “I’d love to honor your request for Friday afternoons off; but, it’s simply not in the best interest of our patients.” Or “I’d love to allow all three of you to be off on the same day; but, we have a lot of appointments that day and doing so would not be in the best interest of our patients.”

2. Know the Federal, State and Local laws and regulations as they pertain to employee time-off, vacations and holidays.

There are two resources you may use to determine if any such laws/regulations either exist or pertain to your practice:

· Department of Labor – click on the link below and you will be directed to a map of the United States found on the US Department of Labor website. Click on your state and you will be directed to current information on labor laws in your area along with a link to your state’s Department of Labor website.
http://www.dol.gov/dol/location.htm

· Society for Human Resource Management – while this is a membership-based organization/site, there are many valuable resources available to non-members as well. One such resource is the section of the website dedicated to “Legal Issues.” Click on the link below and then on the “Legal Issues” tab and you will have access to general employment law information, state and local resources, and federal resources.
http://www.shrm.org/

3. Have a written policy and follow this policy consistently.

· Practice employees will appreciate having it in writing as oftentimes they simply want a clear understanding as to what your policy is so that they can plan within that framework.
· A written policy keeps you from making decisions on the fly without having time to carefully consider their practice ramifications and/or precedence. When asked a question about time-off, you can answer the question with, “Our practice policy is [blank].” This helps you to respond to questions from a practice perspective and not a personal one.
· It’s always a good idea to get new associates to sign-off saying that they have received and reviewed all of your company policies. You should then keep this form in the associate’s personnel file. This will help you avoid the “I never knew that” statements that employees sometimes make.

If you would like to see a copy of the standard template that we used at InHealth/Efficiency in Practice when developing our PTO/Holiday policy, please email me at editor@efficiencyinpractice.com and we’ll send you a copy. Many of our office managers find that simply having a template to use as a starting point for your own policy is helpful.

4. Say “YES” as often as possible. Once you carefully consider and implement number 1-3 above, say “Yes” to employee requests as often as possible. This is good advice whether you are responding to a request for time-off or to some other employee request. Oftentimes, we simply get into the habit of saying “No” all the time. The next time you find yourself saying “No,” stop and ask yourself why you are saying “No.” Will saying yes negatively impact the patient? Will it break any law or regulation? Is it consistent with your policy? Then say “YES!” Doing so will create a more loyal and productive employee in the long run.

We welcome your comments or thoughts on the topic of employee vacation policies, paid-time off and holiday policies. Feel free to email us at editor@efficiencyinpractice.com.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com/ or check out our blog at http://www.efficiencyinpractice.blogspot.com/.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-05-11T12:31:00.002-04:00

Dear Readers,

Here at Efficiency in Practice, our goal is to provide you with information and resources for both personal and professional development. Most of our articles focus more on the professional side (Medicare, CMS, Meaningful Use, Practice Finances etc.) of your job.

Today’s article is more focused on your personal development as a professional manager and focuses on the difference between being “busy” and being “productive.” Over the course of my career, I must admit to being confused at times by the two terms, and I have spent more than my fair share of time being busy as compared to being productive. While I’d love to have some of that time back, the best I can do is to make some positive changes in how I handle my day and my time moving forward. In addition to focusing on your personal development, today’s article is a little more personal than usual for me as well as I have decided to share with you some of what I’ve learned as I’ve tried to take more control of my day and my schedule.

In addition to the article, I’ve included some resources below that I have found to be very helpful in my personal journey toward being more productive. I hope you find them helpful as well.

Until next time, keep striving for efficiency in your practice!
Sue

Dave Allen
Book: Getting Things Done: The Art of Stress-Free Productivity
Website: www.davidco.com

John Maxwell
Books:
Today Matters
Make Today Count: The Secret of Your Success is Determined by your Daily Agenda
Website: www.johnmaxwell.com

Krishen Kota, Certified Project Management Professional
Website: www.adminitrack.com
Sign up for newsletter: Practical Productivity Now: Tips and Tools for Busy Professionals
http://www.adminitrack.com/newsletters/PracticalProductivityNow.aspx

The Difference between “Busyness” and “Productivity”: Are You Confusing the Two?

2010-05-11T12:27:00.001-04:00

As an Office Manager of a medical practice, you are responsible for many things:
Overseeing the day-to-day operations of the practice;
Coordinating physician schedules;
Recruiting, hiring, training and managing front-desk staff;
Recruiting, hiring, training and managing billing staff;
Billing, collections, credentialing, contract negotiations;
Managing practice finances;
Marketing the practice; and
The all-important “any and all other duties as assigned.”

Whew! With that many responsibilities, your days can be very “busy.” Some of you even describe your practices that way as in, “we have a very busy 4-doctor Ob/Gyn practice.” But is “busy” always good? Perhaps not.

Many consultants that I talk to and work with think of “busy” as a negative term (and state of being) that should be avoided. They describe busy as:
Frantic;
Rushed;
Overwhelmed;
Reactive;
Feeling distressed;
A state in which you are constantly doing something but you never seem to get anything accomplished.

Whereas, “productive” is a positive word and typically means that you are:
Calm;
Focused;
Engaged;
In Control;
Proactive;
Making progress on mission-critical tasks and projects.

Truth be known, I have my fair share of “busy” days as opposed to “productive” days. One of my goals over the past few months has been to become more consistently productive, and I’ve been reading books and articles on the topic. Listed below are the three things that I have learned (and implemented) that I have found to have the most positive impact on my daily productivity. Perhaps they’ll give you food for thought as well.

1. Match your energy level and focus to the task – We all have different times of the day when we feel more focused and alert. For me, that’s first thing in the morning. I can get more accomplished first thing in the morning than I can at any other time of the day. I have started blocking off from 7 am (the time I typically get to the office) to 10 am for priorities, projects, writing etc. For example, it’s 7:20 am as I write this article. I don’t schedule my first meeting until 10 am or later. My staff knows this time is sacred and that I’m only to be interrupted in any emergency (i.e. The building had better be on fire!). The result? I’m getting so much more accomplished and I head into my day with my priorities already complete; so, my day is calmer and I feel more in control.

On the other hand, a friend of mine here at the office finds that she is a late afternoon person. She has now started blocking off from 3:30 pm to 5:30 pm to focus on mission critical tasks and projects. By doing so, she, too, is getting more accomplished and she also heads into each day feeling more in control.

What is your most alert and focused time of day? Try rearranging your schedule so that you are working on practice-critical tasks during that period of the day. Stay consistent and watch your productivity soar.

2. Trim down your daily to-do list – if you’re like me, your daily to-do list sometimes runs for pages and pages. I’ve often said that my Franklin Planner doesn’t have enough lines in the “To Be Done” section for each day. I’m now rethinking that statement. I’ve become fascinated with how other people plan and prioritize their day – especially other managers, division heads and CEOs; so, I’ve been reading books and articles on the topic, and I’ve uncovered an interesting similarity among those I would consider very successful. Their daily to-do list is actually very small.

It includes their 2-3 top priorities for the day; the 2 or 3 things they should do that will have the most positive impact on their organizations. Many of them write them down on a small piece of paper or a 3 x 5 index card and carry them with them all day. The result? By focusing on only 2-3 mission-critical tasks each day (and not worrying about the smaller, less-important tasks), they are getting all of the important things done and their organizations are thriving.

If you could only do one thing today that would have the most impact on your practice, what would it be? Do that one thing before you do anything else.

3. Technology is not always efficient! With cell phones, Blackberries, texting, call-forwarding, email, and instant messaging, it should be much easier to be productive – right? WRONG. Oftentimes, this access is a distraction that can have a negative impact on your productivity – especially if you are trying to stay focused on a mission-critical task.

I will admit that I can sometimes be addicted to email. I’ll check it from my phone when I’m away from the office or I’ll dial in at night just to “check “it. I’m trying to break those habits and to use email as a tool to help me accomplish important tasks as opposed to a distraction from those tasks.

Now, when I get to the office first thing in the morning and make my list of 2-3 priorities that I need to focus on, I don’t even open my email. I use the time I have blocked off for the priorities of the day and wait to check email until 10 am. Guess what? Nothing has suffered; no one has felt ignored; and, I’m getting a lot more done than before.

How many times per day do you check your email? Are you too connected to your office through technology? Try putting some parameters around those areas. Focus on your one mission-critical task BEFORE you check email, check voicemail or answer the phone.

As I mentioned, I’m fascinated by how other people plan and schedule their day/priorities. If you have a tip or suggestions, we’d love to hear about it. Email us at editor@efficiencyinpractice.com and we’ll share them with readers in upcoming newsletters. (I promise I won’t read your email until after 10 AM!)

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com/ or check out our blog at http://www.efficiencyinpractice.blogspot.com/.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-04-26T13:39:00.001-04:00

Here in Atlanta, spring has finally sprung. Along with nice weather, pretty flowers and green lawns, we’ve also had more than our fair share of pollen! On any given day, my black Jeep Liberty looks like it got a new bright yellow paint job.

No matter where you go (home, the office, the school, the grocery store), you hear people sneezing. While in years past the pollen hasn’t bothered me too much, this year is different. Yesterday alone I must have sneezed 50 or 60 times – so I’m paying a lot more attention to tips and suggestions for alleviating allergy symptoms. When it comes to over-the-counter products, they all recommend that you take them in advance if you know you’re going to be outside or if you know the pollen count will be high. These products are far less effective if you wait until after you develop the symptoms (itchy eyes, running nose, sneezing etc.)

You could draw a similar analogy to today’s article topic of patient collection policies. (Okay, I know it’s a bit of a stretch; but, work with me here.) It is much easier to collect from patients if you tell them what your payment policies are in advance and if you attempt to collect co-pays and deductibles in advance. If you wait until after the patient arrives to let them know that you expect payment at the time of service, your policy (and your collection rates) will be far less effective!

After reading today’s article, I’d love to hear from you about how your practice handles patient payment policies. Do you have any other ideas/suggestions that have worked well for your practice? Email them to me at editor@efficiencyinpractice.com. With your permission, we’ll share them with our readers.

Check out the box to the left as well for our upcoming Client Appreciation Seminars. We’d love the opportunity to meet some of our readers in person!

Until next time, keep striving for efficiency in your practice!

Revenue Cycle Management: The Patient Component- 4 Tips for Improving Patient Collections

2010-04-26T13:36:00.002-04:00

In the past, a discussion of how to improve practice billing and collection procedures primarily focused on the back office and the practice’s insurance billing/collection processes. Over the past few years, we have seen a dramatic shift toward increased patient payment responsibility as evidenced by the following statistics:

In its April 16, 2010 report, the Bureau of Labor Statistics shows the national unemployment rate to be 9.7 percent.
Patient deductibles in general are increasing. In 2008, the median PPO patient deductible was $1000.
The number of patients with high-deductible health plans is continuing to increase. According to the National Center of Health Statistics, 22.7 percent of people under the age of 65 with private health insurance are enrolled in high deductible health plans.
Patient Bad Debt is on the rise as well. According to the McKinsey report, 36 percent of patients have a balance of 60 days or more past due.

With that in mind, a discussion on improving practice billing/collection procedures must also shift – from the back office to the front office where most patient interaction and communication occur. Here are 4 tips for improving patient collections:

1. Analyze your practice’s processes and protocols by asking yourself the following 40 questions. The MGMA Health Care Consulting Group recently published a list of 40 questions for practice administrators/office managers to ask themselves in relation to patient collections. You can find these 40 questions here.

We at Efficiency in Practice find the MGMA to be an extremely valuable resource to our practices. When you click on the link above, you may also find it helpful to subscribe to their practice blog. You can do so on the right-hand side of the same page.

2. Establish (and document) a clear patient payment policy. The best policies are straightforward and simple. Decide exactly how your practice will handle:

a. co-pays (paid at front desk at time of service)
b. deductibles (due at time of service not 60 days later after you’ve filed an insurance claim and determine the patient has not yet met his deductible)
c. payment plans (establish your parameters in advance. Many consultants recommend you determine a practice policy for the maximum length of time you would allow for a payment plan and the minimum monthly amount you would accept as part of that plan. For example: No longer than 6 months with a $50.00 minimum monthly payment required. You may also choose to require a credit card to be kept on file for patients with payment plans. If they miss a scheduled payment, you are then authorized to charge the remaining balance due to the card on file.)

3. Make sure your staff understands the patient communication/patient payment connection. You must educate your patients on your payment policies as they relate to uncovered services, co-pays and deductibles. It is recommended that you communicate these policies in the following ways/at the following times:

a. in a practice brochure (preferably mailed to new patients in advance of their initial visit to your practice.
b. When the appointment is made, remind patients that payment is expected at the time of service. (Write out in script format the exact verbiage you want your front office staff to use when communicating this information to patients over the phone. For example: Just to confirm – I have you scheduled for an appointment on [Date] at [Time]. So that you can be prepared, I also wanted to make you aware that we will ask for any deductibles and co-pays to be paid in advance at the time of check-in.)
c. At check-in. (Again, write out in script format what you want your front desk personnel to say. For example: Mrs. Smith, your co-pay is _______. How would you like to pay for that today?)

4. Accept Debit/Credit Card Transactions. If you want to collect payments from patients at the time of service, you must get your practice set up to accept debit/credit card payment. This is the primary way that your patients pay for all other services provided to them, and they expect you to be able to process such transactions as well. Although you will pay a fee to process such transactions, this fee is considerably less in the long run than the cost of repeated attempts to collect patient obligations after the fact.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com or check out our blog at www.efficiencyinpractice.blogspot.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Medicare - Resources, Resources, Resources

2010-04-07T09:58:00.000-04:00

Many of you have heard the saying “It’s not what you know; it’s who you know.” From a Medicare perspective, that saying could be “It’s not what you know; it’s where to find it,” (especially as “it” continually changes).

At our recent Client Appreciation Seminar in Chattanooga, TN, InHealth’s Senior Consultant Mary Kustermann demonstrated that she’s an expert when it comes to “where” to find information about Medicare Coding and Billing requirements.

Listed below are a few of her top Medicare resources:

The Office of Inspector General – oversees Medicare fraud and abuse and publishes an annual report of the services within medical practices that are targets for audits during that year. By knowing what areas are targeted for audits, you can be proactive in conducting your own internal audit of your practice to determine if you are at risk. You can access this information by:

Going to the OIG website (www.oig.hhs.gov)
Selecting the Publications link on the right hand side of the page
Selecting The Work Plan from the list of Publications
Click on “FY 2010 Entire Office of Inspector General Work Plan” to download the report
Or simply click here:

Medlearn – The Medicare Learning Network According to the Medlearn website (www.cms.hhs.gov/MLNGenInfo), The Medicare Learning Network uses a variety of mechanisms, such as the Internet, national educational articles, brochures, fact sheets, web-based training courses, and videos, to deliver a planned and coordinated provider education program. The Network uses these different mechanisms to provide educational opportunities that accommodate the healthcare professional's busy schedule, with the least amount of disruption to normal business functioning. Our goal is to provide you with timely, easy-to-understand educational materials to accompany the release of new or revised Medicare Program policies. You’ll be able to click on links within this website to access free Medicare training and webinars; front office training and free practice/patient educational tools and materials. For example: During the seminar, Mary Kustermann passed around a 4-page laminated brochure called “PQRI Made Simple” that she had ordered for free from the Medical Learning Network website.

E-Prescribing You may be able to get help paying for your E-Prescribing system. If you invest in and use an E-Prescribing system the incentive you get may offset your initial setup and operating costs. However, as part of an effort to encourage E-Prescribing, Federal, State and private sources are also offering financial aid for physicians. For more information, visit www.ehealthinitiative.org. You can also click here to download “A Clinician’s Guide to Electronic Prescribing.”

Sign up for Listserv Notifications at www.cms.hhs.gov You can sign up for email notifications and alerts from CMS through a Listserv that is maintained by the National Institutes of Health. Simply click on the information on which you are interested in keeping up-to-date and you will receive an email when new information is posted on this particular topic. It’s a great way to stay current on important topics in the most efficient way possible. Click here for a listing of all possible Listserv options. If you want to take efficiency to the next level, set up folders in your email inbox for each of the different Listservs to which you subscribe. As soon as you receive a notification and read it, file it in the appropriate folder.

We hope that you find these resources to be as helpful as our seminar attendees did. If you have any other resources you use on a regular basis, please email them to us at editor@efficiencyinpractice.com. We’d love to share them with all of our readers.

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com or check out our blog at www.efficiencyinpractice.blogspot.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-03-17T12:21:00.001-04:00

Dear Readers,

Are any of you fans of the Olympics? I have been a major fan of them since I was a child. As a matter of fact, I know exactly where I was when Dorothy Hamill won the gold medal in skating in 1976, when the USA Hockey Team won gold in 1980, and when Mary Lou Retton scored perfect 10s in 1984. And I’m just now starting to feel normal again after being very sleep-deprived staying up past midnight too many nights in a row to watch the recent Winter Games in Vancouver.

In addition to the competition itself, I’m fascinated by the stories of the individual athletes. They put so much time, effort, and training into preparing for that one chance at a gold medal. I’m particularly impressed with those athletes that face (and overcome) great obstacles and adversity to reach their goal. I’m sure there are days that they wonder “Why am I doing this?” I must say that Joannie Rochette, the Canadian figure skater who won the bronze medal after losing her mother days before, captured my heart at the recent games.

While none of us are training for Olympic Gold, there are parallels between these athletes and what you do on a day in and day out basis. Running a medical practice is challenging– especially in these tough economic times. You face daily obstacles and perhaps wonder “Why am I doing this?” Additionally, you spend great time and effort training (reading, studying, learning, staying on top of current events) to be an effective office manager.

Our goal at Efficiency in Practice is to be a trusted and valuable resource for you – to help you train. With that in mind, we have four upcoming Client Appreciation Seminars that you can attend free of charge: Macon, GA on March 18, 2010; Chattanooga, TN on March 25, 2010, Indianapolis, IN on April 29, 2010 and Atlanta, GA on May 20, 2010. Please see details to the left regarding topics and how to register. If you can’t attend in person but are interested in the content, you can order an audio/electronic copy for only $9.95.

I hope you find today’s article helpful. It’s our second in a series on Evaluating the Financial Health of Your Practice. Today’s topic revolved managing the four Ps of a healthy practice: payers, payments, physician productivity and patients. We’re planning our second quarter newsletter topics now and would love to hear from you about the topics you would find most helpful. Please email us at editor@efficiencyinpractice with your suggestions.

Keep striving for efficiency in your practice!

Improve Your Practice’s Financial Health: Focus on the Four Ps in a Pod

2010-03-17T12:17:00.004-04:00

This is the second in a series of articles on the financial health of your practice. In the first article, “Conducting a Practice Financial Analysis: Three Critical Calculations,” we discussed three critical ratios you should calculate regularly in order to know where your practice stands from a financial perspective.

In today’s article, we will discuss credentialing and contracting with managed care companies to achieve the right payer mix for your practice’s better financial health. The right patient mix boils down to knowing critical data on what we call the “Four Ps in a Pod: Payers, Payments, Physician Productivity and Patients.”

Payers
Before you can analyze your payer/patient mix, you need to determine what percentage of gross charges each of your payers represents.
Start with your Total Gross Charges for a period of time (month, quarter, or year).
Make a list of all of your payers (you may choose to limit the list to your top 5-10 payers)
Determine your gross charges for each payer over the same time frame as #1 (month, quarter, or year).
Determine the percentage of Total Gross Charges by Payer (#3 divided by #1).

After completing such an analysis, you may end up with a breakdown as follows:
Medicare – 35 percent
Medicaid – 12 percent
Blue Cross – 15 percent
United Healthcare – 12 percent
Aetna – 10 percent
Cigna – 10 percent
Other – 6 percent

Payments by payer
Next, you need to analyze payments by payer for your top CPT Codes.
Make a list of the top 30-35 CPT codes you bill.
Put them in a spreadsheet with the CPT codes down the left hand side and your top payers (determined above) across the top.
Determine your reimbursement for each code by payer. The best way to do this it to review EOBs from each payer to determine their “allowed” amount for each code. For analysis purposes, it is important that you focus on the “allowed” amount and not the “paid” amount as the paid amount doesn’t include any co-pays or deductible payments made by the patient.

Physician Productivity
For purposes of this analysis, you want to look at the number of patients seen per working hour per physician per payer. This will take a little investigative time, but, the data will be invaluable.
Take the number of patients the physician sees each day.
Divide this by the number of hours worked each day by the physician. (For example: 30 patients seen per day divided by 7 hours per day equals 4.3 patients per hour). This will give you a baseline from which to begin your analysis.
Next, take a closer look at several typical days. Break the number of patients down by payer to see if a certain patient profile requires more physician time. (For example: You will probably determine that physicians find it necessary to spend more time with older patients who are more than likely Medicare patients.)

Patient Mix
Analysis of the data captured above is oftentimes an eye-opening experience for practice managers. Many determine that the majority of their gross charges come from payers with the lowest allowable amounts per CPT code for patients who require more than the average amount of the physician’s time per encounter.

What Can You Do?
Consider revamping your patient scheduling system by blocking off new patient appointment times by payer in order to keep your payer/patient/payment mix in balance. For example: You may determine that you only want to accept a certain number of new patients per month from certain plans and so you block off the appropriate number of new patient appointment slots for that payer in your schedule. [Note: Make sure you review your contract to make sure this doesn’t violate anything you have agreed to do in terms of accepting new patients.]
Are there certain patient/payer ratios you would like to increase for your practice? Establish referral relationships with physicians/practices that have a greater likelihood of referring patients from those plans. Market to local businesses who offer those plans as part of their Employee Benefits Package.
Use this information during your next contract negotiation with a payer. You may find that you are able to negotiate small increases in certain CPT codes even if you aren’t able to negotiate an overall increase. If you are successful in doing so with your most common CPT codes, this could generate considerable additional revenue for your practice.
See how you measure up. Benchmarking yourself against other physicians/practices is a great way to determine if you are doing all you can to maximize practice revenue/profits. Here are some resources to help you benchmark your practice’s performance:

The MGMA - www.mgma.com/physcomp
The AMA - http://search0.ama-assn.org/search/search?database=public+amnews&query=benchmark+your+practice

© 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com or check out our blog at www.efficiencyinpractice.blogspot.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-02-17T13:56:00.000-05:00

Dear Readers,

I apologize for being a few days late getting this week’s newsletter out to you. I was out of the office all last week with what was probably the flu. I was down for the count and felt miserable. I should have seen it coming. The signs were there - a busy holidy season; too many long work days; not enough sleep; it was too cold to walk/exercise; exposure to too many people with colds/viruses, etc. My health was at risk, and I didn’t really do anything proactive to reduce that risk.

What about your practice’s financial health? Are you at risk? Are the signs all there? Are you doing anything proactive to head a case of “financial flu” off at the pass?

With this edition of Efficiency in Practice, we begin a series of articles on the financial health of your practice. We’ll be discussing some of the key areas of your practice that have the greatest impact on your financial situation:
· Conducting A Financial Analysis
· Credentialling and Contracting with Managed Care Companies – What’s the Right Patient Mix for Your Practice
· Improving Your Billing and Collection Procedures
· Key Indicators – The Numbers You Should Measure Regularly

We start today with some basic financial analysis information. Today’s article is compliments of Duane Sheldon, one of InHealth Educational and Consulting Services Senior Consultants.

Duane will also be conducting a complimentary Client Appreciation Seminar in Jacksonville, FL next Thursday, February 18, 2010. See details to the left. If you are in the Jacksonville area and interested in attending, please feel free to contact us at 800-809-5131, ext. 268 or via email at editor@efficiencyinpractice.com.

Until next time – stay warm, stay healthy and keep striving for efficiency in your practice!

Take care,
Sue

Conducting A Practice Financial Analysis:Three Critical Calculations by Duane Sheldon and Sue Kay

2010-02-17T13:52:00.003-05:00

In order to keep your medical practice financially sound, you must be able to collect financial data and understand what this data is telling you about your current collection rate and your future collection rate.

Financial health can be as symptomatic as your physical health. Identifying the symptoms and treating them early can help your practice avoid a major financial illness in the future.

The following are three critical ratios that you should calculate regularly in order to know where your practice stands from a financial perspective:

1. Gross Collection Rate – the gross collection rate is calculated by dividing the total payments by the gross charges for the same period of time. You should calculate this on a monthly, quarterly and annual basis. The gross collection rate will tell you what percentage of your total charges is collectable with respect to your managed care contracts and patient mix.

Total Payments / Gross Charges

2. Net Collection Rate – the net collection rate is calculated by dividing the total payments by net charges for the same given period of time. Again, you should calculate this on a monthly, quarterly and annual basis to get a true picture of your practice over key timeframes. The net collection rate will tell you what percentage of your collectable revenue you are actually collecting. Please note that net charges are calculated by subtracting contractual write-offs, write-offs and adjustments from gross charges. [Gross Charges – Total Write-Offs and Adjustments = Net Charges.

Total Payments/ Net Charges

3. Days in Accounts Receivables Ratio – will identify how long on average is takes from the time of service to the receiving of payments for that service. This calculation includes payments from insurance companies and patients. To calculate the ratio, divide the practice’s total accounts receivable by the net charges. (See how to calculate net charges in #2 above). Then you must multiply this calculation by 30 (average number of days in a month) to get the average number of days in accounts receivables.

Accounts Receivables/Net Charges X 30

We challenge each of you to take the time from your busy schedules to calculate those three critical numbers for your practice for the month of January and then to commit to doing so each month during 2010.

If you have any questions or concerns, feel free to email us at editor@efficiencyinpractice.com. We will work with our Senior Consultant, Duane Sheldon, to get your questions answered.

© 2010 Efficiency in Practice

Duane Sheldon is a Senior Consultant with InHealth Consulting & Educational Services, specializing in the analysis of medical practices’ billing and collections processes. For Duane’s complete biography and to contact him for consulting services, visit the Consultants page at www.efficiencyinpractice.com.

Sue Kay is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com.

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2010-02-01T12:42:00.004-05:00

It has been brutally cold here in Atlanta during January. We’ve had temperatures in the single digits and even a snow day! (My Dad was in town visiting from Pittsburgh and found it very amusing that we closed schools the day before based on just the threat of snow; they’d had 10 inches the day before in Pittsburgh and nothing closed!)
Here at Efficiency in Practice, January was the perfect time to stay inside and get a lot accomplished. We’ve had a very busy and very productive month! Some of the things we’ve been working on include:

Our revised website (http://www.efficiencyinpractice.com/) will be up and running by the middle of February. Look for a new home page; a new FREE Report on the financial health of your medical practice and additional resources.
We will be launching another website (http://www.inhealthconsulting.com/) in conjunction with our sister division InHealth Consulting and Educational Services at the beginning of March.
Many of the senior consultants of that division will begin contributing articles and content to both this newsletter and the Efficiency in Practice website. Their areas of expertise include: Coding and Billing, Medicare, Practice Management, Personnel, Compliance, Risk Management, Healthcare Technology and Professional Development. I am very excited about the great content and valuable resources we will be able to offer our readers during 2010!
Starting with our next newsletter, we’ll be featuring a series of articles on the financial health of your practice.
In conjunction with another of our sister divisions, InHealth Systems and Services, we co-sponsored our first complimentary Client Appreciation Seminar “Chart Audits and E & M Guidelines” here in Atlanta. The response was overwhelming both in terms of attendance and in terms of response. This topic was obviously something that appealed to our InHealth customers. We recorded (audio) the seminar and are making an MP3 download along with the corresponding workbook available to our Efficiency in Practice readers for a very low price ($9.95) simply designed to cover our administrative costs. See the details to the left if you are interested. Additionally, we have 15 Complimentary Client Appreciation Seminars scheduled in various locations around the country throughout 2010. If you are interested in receiving email updates on dates, locations and topics, please email us at editor@efficiencyinpractice.com.

In today’s article, we’re providing an update on the proposed “Meaningful Use” definition that was released at the end of December.

We are working hard to stay on top of everything going on in healthcare today and to provide you with concise and efficient information and resources. In addition, we love to hear from you regarding your thought-process and opinions on the things affecting your practice. With that in mind, please email us at editor@efficiencyinpractice.com and let us know your thoughts on the following:

1. Where is your practice in terms of considering, evaluating, selecting and installing an EMR? Is the stimulus package and the new meaningful use criteria affecting or driving your decision-making process?

2. How has the Obama Administration’s push toward healthcare reform affected your practice? What bearing, if any, has it had on your practice’s strategies and plans for 2010 and beyond?

Please take a few minutes and let us know your thoughts. One of my New Year’s Resolutions was to stay more connected to our readers in an effort to make sure we are focused on the issues and topics most important to you.

Until next time, keep striving for efficiency in your practice!

CMS Defines (sort of) “Meaningful Use”

2010-02-01T12:39:00.002-05:00

During the last week of December, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced a proposed rule that moves us closer toward a final definition of the term “meaningful use” of Electronic Health Records (EHRs).

According to the CMS website (http://www.cms.hhs.gov/), The American Recovery and Reinvestment Act of 2009 (Recovery Act) was signed into law by President Obama on February 17, 2009. The law includes the Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act," which established programs under Medicare and Medicaid to provide incentive payments for the "meaningful use" of certified electronic health records (EHR) technology.

· Under the HITECH Act, CMS administers the EHR incentive programs under Medicare and Medicaid. CMS prepared a proposed rule on the EHR incentive programs and has made that rule available for public comment. Click here to view. (Note: Click on “Show Details” to view the proposed rule; Click on “Submit Comment” if you would like to provide your feedback/opinion of the proposed rule.)

· Under the HITECH Act, ONC has responsibility for developing standards, implementation specifications, and certification criteria for EHR technology. Click here to view the Interim Final Rule and to submit a public comment.

THE BASICS:
1. CMS has identified three proposed stages of meaningful use criteria as follows:

a. Stage 1 focuses on the electronic capture and tracking of codified health information, use of data for the coordination of care, and on the reporting of clinical quality measures and health information to CMS. For Stage 1, which begins in 2011, CMS proposed 25 objectives for eligible professionals and 23 objectives for hospitals that must be met to be considered a “meaningful user” of EHR technology.

b. Stage 2 (which will be finalized at a later date thereby making meaningful use somewhat of a moving target), will expand upon Stage 1 in the areas of disease management, clinical decision support, medication management and support for patient access to their health information among other areas.

c. Stage 3 (which will also be finalized at a later date), will focus on achieving improvements in quality, safety and efficiency.

2. The interim final rule from ONC describes an initial set of standards for secure health information exchange in the areas of prescriptions, procedures, labs etc.
Both of these proposed rules are subject to change after the 60-day public comment period. Our initial research seems to indicate that many healthcare providers and professionals consider the 25 objectives mentioned above to be overly burdensome and complex and, in some cases, a deterrent to EHR adoption. For more information, click here.

What do you think? We’d love your feedback on the topic of meaningful use and stimulus money. Please email us at editor@efficiencyinpractice.com

© 2010 Efficiency in Practice
Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com

This article can be reprinted freely online, as long as the entire article and this resource box are included.

From Sue . . .

2009-12-15T13:04:00.001-05:00

One of our main goals at Efficiency in Practice is to help keep you up-to-date on topics important to you and your medical practice. Throughout this past year, we have published a number of articles on topics such as RAC (Recovery Audit Contractors), ICD-10, The Stimulus package and “meaningful use,” and the “Red Flags” rule. As we approach the end of 2009, we thought it might be helpful if we updated you on the changes/status of each of these topics. In the article below, you will find not only updates but new resources as well that will help you to keep up-to-date as “efficiently” as possible.

Speaking of efficiency, I’m a huge fan of Dave Allen. I’m currently re-reading his book “Getting Things Done: The Art of Stress-Free Productivity.” I would highly recommend it if you are looking for an end-of-year personal growth book that will help you get 2010 off to a productive (and of course, efficient) start. Additionally, Dave has a great website (www.davidco.com) that has a ton of free resources and information available. Today’s Efficiency Tip on how to manage all of the email you receive comes from his website. I downloaded the full article by simply setting up a free account by going to his website, clicking on “Free Articles,” selecting the article I wanted to download and setting up my account. Please know that Efficiency in Practice is not affiliated in any way with this organization nor do we receive anything by virtue of referring you there; we’re simply fans passing what we feel is a valuable resource along to you.

We have some exciting things planned for you for 2010! We are currently working with a group of approximately 10 leading consultants who are experts on specific healthcare-related topics – everything from managing the financial side of your practice to marketing your practice to managing employees. Beginning next year, our consultants will be keeping an eye out for topics you might be interested in and submitting articles for the newsletter. Additionally, we plan to host free tele-classes and Webinars as well as introduce a continuing education membership program. Stay tuned for more details over the next several weeks. As always, we appreciate our new readers. Please feel free to forward this email along to any of your colleagues that you feel might benefit. We’d love to have them join our growing list of readers.

Until next, keep striving for efficiency in your practice!

Efficiency Tip – Managing Your Email

2009-12-15T13:01:00.000-05:00

According to David Allen (www.davidco.com), you must think of your email as an inbox that receives both actionable and non-actionable items. His tips for managing that inbox include:
Use the Delete Key as soon as you receive an email that you don’t need or want to keep. Most of our email inboxes are filled with emails that should be trashed. Sometimes it is easier to clean house by clicking the “From” button which will sort them by their source. You can oftentimes eliminate many emails at one time this way. (Editor’s Note: I personally use this tip on a regular basis and find it very helpful.)

File emails just as you would items that flow into your physical inbox. Create a folder by either topic or source and file all emails related to that in the specific folder. (For example: You should create an “Efficiency in Practice” folder to file your newsletters in for future reference. As you receive an email from us, open it, read it, forward it and file it.)

Organize emails that require action and follow-up! Create two more folders – one that says “Action” and one that says “Waiting For.” File your actionable emails accordingly.

For the complete article on “How to Manage Your Email,” visit www.davidco.com and click on Free Articles.

Just to keep you updated…

2009-12-07T13:59:00.003-05:00

As 2009 draws to a close, we thought it might be helpful to provide you with updated information on some of our most popular newsletter topics from this past year. As always, it is our goal to make it as efficient as possible for you to keep up with information pertinent to the running of your medical practice.

RAC (Recovery Audit Contractor) Update

In the midst of everything else that has been going on in healthcare during 2009, RAC audits have somewhat taken a back seat. With the Obama administration’s goals of reducing waste, fraud and abuse in Medicare, look for this topic to gain renewed interest in the coming months.

Click here for a recent press release from CMS titled HHS EMPLOYS NEW TOUGHER STANDARDS IN CALCULATION OF IMPROPER MEDICARE PAYMENT RATES FOR 2009 for an update on the Administration’s tougher stance on overpayments.

From a RAC perspective, it continues to make sense for you to be proactive instead of reactive. A good first step is to review the overpayments found by the RACs and to do your own internal audit of some of your practice’s past claims. To Continue Reading . . .

7 Successful Delegation Tips

2009-12-01T10:37:00.002-05:00

Select wisely. Matching the job requirements to the right person’s strengths and skills will help ensure success.
Set expectations clearly. Explain the project or task in detail along with the expected outcome. Define time tables for both the final deadline and progress reports, if required.
Define authority boundaries. Make sure your employee knows what level of authority they have including decision-making and approvals, cost limits and enlisting help from others.
Inform others what the task is and to whom it has been delegated, as well as how they should communicate about the project.
Expect Mistakes. Taking on new responsibilities and learning new skills comes with a learning curve. Use mistakes as teaching moments.
Be available for questions and coaching, but don’t hover.
Provide detailed honest feedback once the task is complete. Praise and reward success, discuss ideas for improvement if needed, and publically congratulate them on their achievement.

Efficiency in Practice is the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit www.efficiencyinpractice.com
This article can be reprinted freely online, as long as the entire article and this resource box are included.

An Easy Solution to Reduce Anxiety: The "Full" Philosophy

2009-11-23T09:19:00.003-05:00

by Leigh Ann Rodgers

I had an "ah ha" moment last year that has changed my life. Or at least the perception I have of my life.

Like so many people, I was busy, busy, busy. I was juggling lots of balls in the air at once… two young children, a business, a house to manage, volunteer work to do, not to mention tennis, my Bunco group and Book Club, and on and on. I would start the day running and often fall in bed after midnight with only half of my to-do list checked off. "Next week things will settle down," I’d tell myself, only to discover that next week was just as busy. I was always looking forward to that time when things would slow down – but that time never arrived.

Sound familiar? I bet it does because I rarely meet people who aren’t stressed and overwhelmed trying to get everything done. To Continue Reading . . .

Words to Avoid and Use on the Telephone

2009-11-05T12:03:00.002-05:00

Word choice is an important part of every telephone call. The words you use need to not only be clearly understood by the patient, but they need to convey a positive and professional impression.

Here are some words to use and avoid:

"Yes" instead of "OK"

"Certainly" instead of "Yeah"

"Of course" instead of "Uh-huh"

"Good-bye" instead of "Bye"

"No" instead "Nope"

"Fine" instead of "Alright"

From Sue . . .

2009-11-03T13:52:00.000-05:00

Dear Readers,

While on a recent business trip to Tampa, FL, I had a series of events occur that turned into a customer service nightmare. It gave me not only cause to pause and think about our InHealth and Efficiency in Practice offices and how we handle incoming calls – it also made me realize that phone etiquette may be one of those often overlooked “basics” that might warrant a review in your practice.

What happened? I used my bankcard to put gas in my rental car before heading back to the airport. While using the card, I was prompted for my billing zip code. That’s where the problem started:
Due to problems with the keypad, I had to enter my zip code multiple times.
Evidently, this flagged my card for “possible fraudulent activity.”
How did I find this out? My bankcard was declined at both the newsstand and Starbuck’s at the airport. And, my husband called to say that there was a message on our home phone from our bank alerting me to the possible fraud and giving me a phone number to call.

Long story short…I ended up spending 30 minutes on two different occasions trying to get a “LIVE” person on the phone but was not successful. First, I ended up in a voicemail loop and could not get out. I then ended up holding for the “next available customer service representative” up until the flight attendant told me I had to turn off my “electronic device” as we were about to take off.

I ended up having to go in person to a bank branch the next day to get the situation resolved.

The takeaway? Something positive (the bank’s fraud alert service) turned into something very negative (the bank’s poor customer service/phone service.) In this case, the negative far outweighed the positive. How many positive things do you have in place in your practice that are perhaps outweighed by negative or frustrating phone encounters with patients? Today’s article discusses 6 areas you can both evaluate and improve when it comes to front-desk phone etiquette.

Until next time, keep striving for Efficiency in YOUR Practice!

Send the Right Message to Your Patients: 6 Tips for Proper Front Desk Phone Protocol

2009-10-29T12:29:00.004-04:00

We’ve all heard the adage “bad first impressions are hard to overcome.” That is definitely true when it comes to your medical practice. How you answer the phone and how you handle patient inquiries says a lot about your practice. Does your front-desk phone etiquette send the message “We’d be honored to have you as a patient” or “We couldn’t be bothered”? You might be surprised. Please find below 6 tips for evaluating and improving how your practice handles patient phone calls.

1. Get Personal – Make sure that patients (especially potential new ones who might be calling for the first time) speak to a “live” person. While an automatic attendant system may not bother some patients, others may be very frustrated by it. Why risk alienating 50 percent of potential patients when a live person answering the phone will satisfy all of them? Many practices choose automatic attendant systems due to their perceived efficiency. While we are certainly big fans of efficiency – efficiency must serve the greater goal of customer (patient) service and satisfaction. An efficient use of an automatic attendant system that also serves the best interests of your patients might be a prescription refill line or a lab-results dial-in system.
To Continue Reading . . .

Dear Readers

2009-09-29T19:07:00.001-04:00

I have spent a great deal of time during September out in the field visiting with InHealth prospects and customers. Most of my discussions with the practice managers with whom I met were on the topic of where they stood in terms of implementing technology into their practice. Invariably, the topic of EHR and the HITECH Act came up.

During these discussions, several things became clear:

There is a lot of confusion regarding the HITECH Act and the stimulus package and exactly how they will affect your practice;
Many practice managers (and physicians) were disappointed in the program and felt that the overall investment (and its affect on practice cash flow) required to implement an EHR system far outweighed any potential incentive that they might receive as part of this program;
Most practices are leery of the moving target associated with the definition of “meaningful use”;
Incentive or not, many practices are holding off making major decisions until they see what is going to happen with healthcare in general and once they have meaningful use clearly defined.

We’d love to hear your thoughts on the topic as well. You can either comment on our blog at www.efficiencyinpractice.blogspot.com or email us your thoughts at editor@efficiencyinpractice.com.

Understanding the HITECH Act: The Stimulus Bill, EHR and You

2009-09-29T18:55:00.004-04:00

On February 17, 2009, President Obama signed the American Recovery and Investment Act of 2009. The HITECH (Health Information Technology for Economic and Clinical Health) Act is part of this legislation and is designed to encourage physicians and other healthcare organizations to adopt and use (in a meaningful way) Electronic Health Records (EHR).

The HITECH Act will be administered by the Office of the National Coordinator for Health Information Technology (ONC) and appropriates $19.2 Billion dollars, most of which will be used as incentive money for hospitals and physicians who adopt Electronic Health Records. The incentive payments are structured in a way that rewards early adopters and ultimately penalizes those physicians who have not implemented an EHR by reducing their Medicare payments beginning in 2015.

Incentive funds will be distributed through both Medicare and Medicaid to physicians and hospitals who are “meaningful EHR users.” Physicians will be able to choose program participation through either Medicare or Medicaid but can participate in only one of the programs, not both.
To continue reading . . .

Did You Know . . .

2009-09-16T11:31:00.001-04:00

As a general rule, time is more expensive than space.

Use the "Stretch Test" on your medical records filing system. ARMA (American Records Management Association) suggests:

If you cannot easily insert and withdraw your open hand between charts at any point within the filing system without moving the records on either side of your hand, then the records are too densely housed for efficient, active retrieval and return.

From Sue . . .

2009-09-10T12:59:00.002-04:00

Dear Readers:

My 15-year-old twins recently headed back to school, and I was amazed at not only the list of school supplies that I had to purchase but also the amount of technology they are required to use. Graphing calculators for Accelerated Geometry; Non-graphing calculators for Chemistry; Power Point for presentations; all Language Arts assignments typed and saved to a jump drive; weekly internet research for AP Economics and Government, etc., etc., etc.

It made me wistful for the days of black and white composition books; #2 pencils and my trusty Smith-Corona typewriter (a cutting-edge self-correcting one no less!).

After having spent most of the ninth-grade year refereeing fights over whose turn it was to use my computer, my husband and I decided to bite the bullet and purchase them their own.

I’m not sure about you, but I find purchasing technology to be overwhelming at times – there are so many options – many of which I simply do not understand. I was fortunate to have access to the IT Specialists here at my office. Although I’m sure they were rolling their eyes at me behind my back, they patiently answered all of my questions and provided me with invaluable advice.

I’m sharing some of that information/advice with you in today’s newsletter. Today’s feature article is by Sheryl Cherico, President/COO of mPACTs, an IT firm here in Atlanta that specializes in medical technology. As I mentioned in a previous newsletter, we recently outsourced our internal/external IT to mPACTs. I’ve also included a listing of some basic computer terminology and some additional resources you might find helpful.

If you have any specific questions about selecting the correct computer for your office (or personal use), please email us at editor@efficiencyinpractice.com. We’ll have Sheryl answer your questions and post both the questions and the answers on our website and in our Efficiency in Practice blog.

As for the twins, they ended up with used laptops and the student version of MicroSoft 2007 (basic operating system plus the student versions of word, PowerPoint and Excel). They’re still fighting over who used the last of the color cartridge in the printer; but, that’s another story.

Until next time, keep striving for efficiency in YOUR practice!

Efficiency in Practice

Practical and Achievable Approaches to Compliance - Tips for Preventing Coding/Billing Audits, and What to Do If You Get Audited

Five Tips for Helping Patients Pay off a Balance

From Sue . . .

How to Respond to an Initial Request for Records, Medicare & Medicaid Audits

From Sue . . .

Warning! HIPAA is now larger, with teeth and ready to strike!

Website Design, Content and Legal Considerations in the Medical Practice

From Sue . . .

Measuring Office Visit Cycle Time

From Sue . . .

Communication: Improving the Patient Experience

Documenting a Preventive Visit

New Tele-class just added!

"Maximizing Patient Communication"

Just $24.97 (First time attendees register at no charge)Click HERE for more information and to Register

Starting a Physician Liaison Program to Market your Practice

ARE YOU READY FOR ICD-10?

Are You Marketing Your Medical Practice?

Preparing To” Market” Your Physician Practice

From Sue . . .

Five Steps for Auditing Physician Charts

Join us for this informative free tele-class

From Sue . . .

The Lost Art of Employee Orientation

From Sue . . .

Five Customer Service Tips I Learned From the Orthodontist

Maximizing Your Patient Communication with Technology

Identifying and Reducing Employee Turnover

From Sue . . .

Say Yes to PQRS: 5 Things You Need to Know for Successful Reporting

From Sue . . .

Preparing for ICD-10: The Basics

From Sue . . .

The Five Must-Have Meetings for Your Medical Office

Third Thursday Tele-class Series

The Case for Certification

From Sue . . .

Reduce the Risk of Embezzlement in Your Practice

From Sue . . .

Stimulus Dollars: Medicare vs. Medicaid

HITECH & Meaningful Use Free Tele-class

From Sue . . .

Third Place - Article Writing Contest

Honorable Mention - Article Writing Contest

From Sue . . .

First Place Winner, Article writing contest

Second Place Winner, Article writing contest

The Medicare Learning Network:Our “Favorite” Resource for All Things Medicare

"Creative Recruiting Techniques" Tele-class

From Sue . . .

Medical Providers Look for Formula One Pit Crews by Andrea Santiago

From Sue . . .

The Case for Outsourced IT Services

From Sue . . .

We Survived Our Recent Computer Upgrade and Lived to Tell About It…

Value-Added Continuing Education Seminars

From Sue . . .

ICD-10: The Code That Cried Wolf

From Sue . . .

RAC Updates: Assessing Your RAC Risk

From Sue . . .

Revenue Cycle Management: Ten Tips to Maximize Revenue by Carol Hoppe

From Sue . . .

Updates on Key Issues Facing Your Practice

From Sue . . .

Strategies for Developing Effective Vacation, Time-Off and Holiday Policies

From Sue . . .

The Difference between “Busyness” and “Productivity”: Are You Confusing the Two?

From Sue . . .

Revenue Cycle Management: The Patient Component- 4 Tips for Improving Patient Collections

Medicare - Resources, Resources, Resources

From Sue . . .

Improve Your Practice’s Financial Health: Focus on the Four Ps in a Pod

From Sue . . .

Conducting A Practice Financial Analysis:Three Critical Calculations by Duane Sheldon and Sue Kay

From Sue . . .

CMS Defines (sort of) “Meaningful Use”

From Sue . . .

Efficiency Tip – Managing Your Email

Just $24.97
(First time attendees register at no charge)
Click HERE for more information and to Register