Yearly Archives: 2011

Fight for your money

Did you know that 30% of  the insurance claims submitted for payment of  medical services in the United States are denied and of that amount 15% are  never resubmitted?  According to Medicare, 40% of their claims denials are never resubmitted. These are daunting statistics. Experts state that 70-80% of appealed claims are eventually paid - That's a good reason to fight for your money!  It may be time for you to audit your billing practices to make sure you aren't throwing money down the drain. Prepared by The Capko Team- Our missision is to make your practice shine! Sources: Healthcare Business Advisors, LLC, Albany, NY Centers for Mediare and Medicaid Services

By |2011-03-18T14:52:21-08:00March 17th, 2011|
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Profit with a Clear View of Your Practice’s Competitive Landscape

Whether you're contemplating expanding your practice, starting a new practice, or simply wondering what your practice's profit potential might be, your profits depend on your understanding of local patient demographics. With a host of free online services available, it's easier and less expensive than ever to understand your area's demographics and how they might represent threats or opportunities. You need to know how well your area is being served by your practice-type! One very useful website is www.city-data.com that supplies wide-ranging demographic information on thousands of communities. Among the most telling information is the population and growth trends of your service area -- where your patients come from or nearby areas new patients could come from. Often service areas are defined by geographical barriers, valleys, rivers, etc..  When we work with medical practices, we find that compiling data from the various communities in their service area (and other areas of interest) in a spreadsheet is invaluable.  First, we take note of these population demographics: total population, population growth, income and, naturally, any demographic segment particular to your type of practice, such as women, children or the elderly. Next, combine the separate community data so that you can have a single figure for "service area" for each demographic segment. Now that you've compiled data to define the demographics of your service area, you can compare how your service area compares to nearby or similar-sized areas anywhere in the country.  Is there a relatively high, low or average number of your practice-type in your service area when compared to similar other regions? You'll need to employ your first-hand knowledge to help you define the "service areas"  that compare to yours. Be mindful of population density, income and geography and you should be able to identify at least two competing service areas. You can plug these data from their respective communities into your spreadsheet to calculate the same measures you have for your service area. Now that you've become somewhat of an expert on the population, it's time to gather information on the physicians. You'll goal is to find the number of physicians (FTEs)

By |2022-01-01T22:52:56-08:00March 8th, 2011|
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Rate Practice Performance

Does your practice know how well it is performing - and if not, why not?   It's important for physicians and managers to examine performance each month by looking at specific Key Performance Indicators, KPIs.  This will help you understand your position and is powerful in guiding decisions to improve performance.  Medicine is a business and it's time to take this seriously. Here are a few basic KPIs  to look at each month: Income and itemized expenses as a total percentage of income. This will tell you where the money goes.  The highest expense is likely to be staffing costs. If this shows a jump it may be due to inefficiency that results in staff working overtime or adding another staff member to support the inefficiency. Then again it might be poor morale, resulting in lower productivity. Accounts receivable.  The average A/R for physicians runs around 1.5 months of charges, if yours is more than 2 months it is important to examine billing procedures and find out what's causing the problem.  Is it becomes someone is on vacation, the computer crashed, claims rejections or a lack of attention to aged accounts?  Speaking of aged accounts if  the amount 90 days aged of more is above 18% get more assertive with collection pursuit. Productivity reports are included in the month-end management reports typically produced by the practice manager and reveals the total charges, receipts and adjustments for the practice and should also compare each physician's individual production.  Keep an eye on fluctuations that need to be explained. Sure, one docs charges will be down if on vacation or ill,  but otherwise start looking  for the cause.  If adjustments are climbing, dig to be sure staff understands legitimate insurance adjustments and fights for your money when insurance plans make errors.  Industry expert, Healthcare Business Advisors, states that 30% of claims in the US are denied and of that 15% are never resubmitted, despite the fact that 70-80% of appealed claims eventually get paid.  Be proactive and get what you deserve! Missed appointments cost the practice plenty, so track them. More than one or two a day is not okay. 

By |2011-03-08T12:36:41-08:00February 26th, 2011|
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Be Respectful

Respectful engagement is about real behaviors that make a difference in patient safety, productivity and financial performance - your bottom-line, according to Dr. Mitchell Kusy and Dr. Elizabeth Holloway of Zolo Healthcare Solutions and authors of the fabulous book: Toxic Workplace!  Managing Toxic Personalites and their Systems of Power.  Here are a few tips from these experts. Develop zero tolerance strategies to reduce productivity losses Support staff engagement to uncover bad behaviors Designate an accountability partner for every leader Certainly a blog does not give this topic the attention it deserves.  I highly recommend you buy the Kusy-Holloway book as an investment in your permanent library and make it required for every physician and manager.  It is your responsibility to keep things civil and protect the workplace environment. Failure to do so will cost you plenty!  Capko & Company is a leading  healthcare consulting firm.

By |2022-01-01T22:52:56-08:00February 3rd, 2011|
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The Way We Look

Get serious about your practice image.   First impressions are powerful and your image leaves a lasting impression - so make it positive!   The office space See your office from your patients' eyes.  Walk in the front door and take a critical look at everything from the paint to the floor, to the lighting to the furnishings,  the equipment and even the reading materials.  If it's shabby or worn it needs to go!   Beyond the space If you think scrubs are the in thing for staff to wear, get a grip.  Patients, who are often sick, take time to get dressed for the office visit only to be greeted by employees dressed in scrubs that look like slept-in pajamas.   Scrubs are inappropriate for front office and even look shabby in the clinic.   A tailored uniform or lab coat with the practice name and logo works nicely for the clinical staff and will make the patient feel they are in good hands. Front office staff might dress in this attire, but nice causal business attire makes a positive impression that separates front office staff from the clinic in the patient's mind.   Little things mean a lot The power of image extends to the little things.  Set a policy on no gum-chewing, conservative jewelry, and no food at work stations that are visible to patients.  These are things we don't often address, but should be part of the dress code that is discussed with each employee during their orientation.    Engaging patients Get name tags for everyone - include their name,  title and the practice logo - all in a font size big enough for patient to easily read.  Then patients will know who they are talking to and who to address when they have a question or need help.  Call patients by name and introduce yourself and you will begin to engage patients and build a patient-centered practice.  

By |2022-01-01T22:52:56-08:00January 25th, 2011|
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Marketing Your Practice with a Code Update Event

By Joe Capko, Capko & Company Every year, changes to the CPT codes take medical practices by surprise -- even though everyone knows the updates are coming.  Whether it's because doctors and administrators assume that coding changes won't likely apply to their specialty, because it's hard to find time to go through the materials, or just due to old-fashioned procrastination, most of the practices we work with wind up ignoring the new codes until they start finding out the hard way that the codes they've been using are no longer valid -- i.e., once claims start to be rejected. Naturally, this is a costly problem for all practices, as these rejected codes can mean payment delays of six months or more. Here's the good news.  Since most (if not all) of the other practices you work with as referring partners are facing the same pain-in-the-neck, why not turn this hassle into a marketing opportunity?  You can do it by hosting a Code Update Seminar -- call it a "code party" if you want to be less formal about it -- and invite the practice managers and administrators from the other practices you work with to learn about the changes.  You arrange for a coding consultant to present an overview of the changes, along with a meal or some snacks -- depending on the size of the group you're inviting, you may need to rent out a large conference or event space at a nearby hotel or business center.  Depending on your preferences (and those of your colleagues), you could schedule an early morning breakfast event, a lunch event, or an evening or weekend seminar. If this seems like too much effort or expense, you can try the "lite" version: a smaller, more intimate, group hosted in the office reception area during non-clinic hours. Helping to solve a problem that your colleagues all share while also giving your administrative staff the chance to network with their counterparts at your key referring partners is a wonderful way to promote your own practice without "selling."  Be sure to have some tchotckes (pens, post-it

By |2011-01-17T19:03:22-08:00January 17th, 2011|
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Monkey Business

Did you know that  American workers spend nearly 20% of their time goofing off on the job?  That's what a 2006 survey conducted by Salary.com and AOL revealed.  I doubt that medical practices are excluded from this phenomenon. Here's what these employees are doing the most when they should be busy at work: Surfing the net; Socializing; Errands;  and Spacing out. Why is this happening and what can you do about it?  I believe the primary reasons for monkey business happening on your time are boredom, a lack of direction or people not really liking their jobs very much.     Stand up and take notice.  Make sure you are clear on your expectations and provide a work environment that makes people feel important and helps them succeed.  Employees can make a break your future - you need everyone on the team contributing and feeling valued. Capko & Company experts in healthcare business management and marketing.  Call on the Capko consulting team: www.capko.com  

By |2011-01-11T17:46:09-08:00January 5th, 2011|
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