fbpx

Yearly Archives: 2013

Resolve to give better feedback to staff in 2014

Turnover and hiring are costly.  Staff are so important to your practice's patient service, financial performance and overall functioning.  Given these things, one of the best investments you can make in your own leadership abilities as a physician owner or practice manager is to develop the skill of delivering effective feedback to employees. The importance of giving effective feedback to staff really can't be overstated.  Your ability to nurture better performance and address inadequate performance impacts everything from employee skill development, to team morale, to legal risk. Every aspect practice performance depends on getting the best from your staff, and that depends on giving the right feedback at the right time(s) and in the right way. Giving employee feedback is not easy, and getting really good at it requires effort and focus. But your efforts will be rewarded many times over. One of the best recent summaries I've seen lately on delivering effective feedback comes from the Stanford Graduate School of Business -- a summary of a lecture by Carole Robin.  It's a short list of seven pithy tips, and you can act on it now!  Highly recommended reading.  (A couple of previews: "Do it now" and "Stay on your side of the net."  Read the piece for quick explanations of these ideas -- and five more.)

By |2013-12-24T10:06:33-08:00December 28th, 2013|
Read More

Will 2014 be a better year for your medical practice?

This is certainly a reasonable question to ask considering the rapid-fire change, threats and unknown factors medical practices face due to the Affordable Care Act.   But here are a few things you can do to deal with all of this. First, keep your eye on the ball.   Don’t throw up your hands in frustration, but follow the news and the legislation that is likely to impact the way you practice medicine, your future stability and the care and service offered to your patients.   Read everything you can and keep your cool. In other words, don’t throw your hands up in despair.  Put the emotions aside and be prepared to respond.  If you know what’s coming down the pike you can be practice-ready and take strategic actions rather than wait, feel the panic and be reactive, which typically leads to poor, costly decisions.  Well thought out decisions will explore not only the potential threats, but the opportunities that are available to you and your colleagues without compromising your integrity or patient care and service. Next, look at the numbers.  How well did your practice perform compared to prior year and compared to other practices in your specialty?  Benchmarking will help you examine the trends so you can examine areas where performance was disappointing and seek ways to bolster them for next year.   The numbers tell the story of past performance and give you an opportunity to set future goals that keep the practice stable and on financially solid ground. Don’t make squeezing cost a primary focus.  Sure, it’s normal to focus on costs when reimbursement is tight and may get tighter, but in reality you can only squeeze costs so much.  If you focus most of your efforts on costs you are likely to reduce quality and service. The highest expense for a medical practice is staffing, but the old saying: “You pay peanuts, you get monkeys” is true.  Hire well – highly skilled and experienced people; respect them, pay them well and set high expectation goals and staff well help your organization to me more profitable.  Physicians  and managers can

By |2022-01-01T22:52:11-08:00December 23rd, 2013|
Read More

Six steps physician leaders and practice managers can take to improve the patient experience

Leadership sets the tone for the entire practice.  Staff will model your commitment and follow your expectations.  Much of the manager’s role focused on managing practice finances, maintaining practice viability, and keeping a highly motivated and efficient staff that is respectful and trustworthy.  Add to the list a new yardstick that changes how physicians get paid based on a patient experience that improves compliance to result in better outcomes. Develop a plan and set up programs to help staff understand how the patient experience relates to both outcomes and practice finances. Show your commitment through continued communication and actions that reveal a consistent effort to improve the patient experience. Give staff the education and tools to succeed in delivery consistency in your customer service organization-wide. Coach staff to improve performance.  Provide them with the support and encouragement with implementing essential changes on the road to being more patient-centered. Manage progress well.  This means conducting a baseline patient satisfaction study based on key performance areas and periodic follow-up to be sure targeted areas of improvement results in satisfactory results. Set your goals for becoming a best practice. Be explicit in what you expect and intend to achieve.  Honor each person’s contribution and celebrate successes that achieved along the way. Leaders have the ability to set the stage for success, instill a sense of pride and hope within the organization, and meet the challenges of strengthening the relationship between the clinical practice and the patients they serve.  In the end, we seek to improve the health of our patients, enjoy the relationship we have with patients and be among the best.  

By |2022-01-01T22:52:11-08:00December 14th, 2013|
Read More

Upcoming webinar: know what patients really think

I will be conducting a webinar called “Nothing but the Facts: Find out What Your Patients Really Think, hosted by Kareo, on January 15th, 2014.   Physicians and staff typically focus on what’s clinically the matter with patients and how to make them better. No question this is paramount, but there’s more to the patient experience. It’s time to find out if you are really meeting the patient’s expectations.  This webinar will talk about the importance of conducting patient surveys to get the real facts about your patients’ level of satisfaction. You will discover key factors that influence the patient experience, and why healthcare reform is making this a priority.  You will discover the impact of patient satisfaction on the overall practice performance. You will learn the technical details involved with conducting surveys that tell you what your patients need from you, and how to get the most out of the feedback information you gain.   You cannot assume how patients feel about your practice.  Your patient service performance depends on getting facts and learning what it takes to be a best-practice when it comes to the patient experience.

By |2013-12-07T14:54:59-08:00December 12th, 2013|
Read More

ACA out-of-pocket costs: Vindication isn’t always sweet

The New York Times reported today that "On Health Exchanges, Premiums Maybe Be Low, But Other Costs Can Be High." This is something we've been talking about for a couple of months now -- often getting skeptical looks here in our super-blue home-town.  But it's not about partisanship.  The ACA is simply accelerating the trend of payers pushing more responsibility onto patients -- a trend that has been gathering momentum for many years.  It's not unexpected if you've been watching how health plans have been evolving. Still, it is discouraging if you had hoped the exchange plans would offer better patient protection against big out-of-pocket costs -- and it also means that the burden that practices face to collect more of their revenue from patients keeps growing. The AMA's 2013 National Health Insurer Report Card (NHIRC), published earlier this year, revealed that health plans across the country were placing about 25% financial responsibility for cost of care onto patients: Aetna Anthem Cigna UHC Medicare 20.40% 23.10% 25.90% 23.40% 24.60% The target 2014 patient responsibility proportions that were set for all ACA plans skew even higher than this -- even the "silver" level, where subsidies are targeted, pegs patient responsibility at 30%: ACA Bronze ACA Silver ACA Gold ACA Platinum 40% 30% 20% 10%   These "actuarial values" were fairly widely reported prior to the exchanges even opening (here's one link from MSN), so it's a bit of a mystery why the Times is reporting this as news at this point.  It's critical that consumers understand what they're getting into when they sign up for coverage, and the media should have been on top of this key information.  (Especially if you've not purchased coverage before, the terminology behind patient responsibility payments -- co-insurance, deductibles, copayments, out of pocket -- can be very confusing. Many new patients are likely to be confused and possibly quite disappointed.) We expect that this means practices will need to be even more careful and sensitive in dealing with privately insured patients, especially in January, when deductibles re-set.  Some patients will be more confused than ever --

By |2022-01-01T22:52:11-08:00December 9th, 2013|
Read More

Does your staff treat patients well?

Healthcare reform is placing the relationship between the patient and the medical practice front and center in hopes of improving compliance and clinical outcomes.   It’s all about strengthening the relationship between patients, their physicians and the entire practice and making patients feel valued.  Although physicians are working hard to strengthen their relationship with the patients, the staff seems to fall short. In 2013 Capko & Morgan conducted a patient satisfaction survey that spanned five metro areas of the U.S.  It revealed staff is falling short on making patients feel valued by their practices.  37% of the respondents felt the staff performed only adequately in terms of making them feel valued and respected, another 7% rated staff poorly, and suggesting there is much room for improvement.  So what can you do to get staff on board with providing a better patient experience? Talk about it.     Help staff understand that they are a reflection of the practice to every patient. It is an important role and they hold the key to making patients feel valued. Build in accountability.   Schedule a customer service planning meeting with staff to collectively set some performance standard dealing with staff-patient interaction. New Patients:  Every employee is expected to honor new patients and making them feel comfortable Get rid of the sign-in sheet. Introduce yourself and make a statement that welcomes them or thanks them for choosing your practice. Don’t just hand patients a clip board, explain why you need them to provide information and let them know you appreciate their cooperation. Thank them when they are finished. When rooming the new patient give some information about her new physicians to provide important reassurance that she is in good hands. All patients: Greeted with a smile and by name within one minute of arrival for a visit Kept informed of expected wait time in reception room and exam room Before ending the conversation with a patient ask “Is there anything I can help you with?” On the phone Staff will identify themselves by name. Callers will not be kept on hold more than 30 seconds without further communication

By |2022-01-01T22:52:12-08:00December 7th, 2013|
Read More

An embezzling story to learn from

A marketing director for Castle & Cooke, a mortgage firm, is believed to have stolen almost $200K from her employer in less than a year of employment -- until she was caught and charged with fraud. While the case does not involve a medical practice or healthcare organization, it does offer some reminders about protecting a small office from internal theft. The employee allegedly ran up large false expense reimbursements and forged company checks -- both possible in any small business with inadequate controls, including medical practices. Practices can learn from this incident.  Check stock should be protected, and managed by a physician owner.  No one should be allowed to sign checks except a physician owner -- no signature stamps!  And owners should reconcile the bank statement monthly, so that any unauthorized checks could be spotted. Unauthorized expense reimbursements or charges are common routes to embezzlement in medical practices.  Be cautious about allowing employees -- even a manager -- unsupervised control of a credit card or an expense account with a vendor.  Review purchases "for the office" carefully -- make sure that everything on the Costco or Amazon bill can be accounted for in the office. Remember, not allowing temptation is the best way to prevent embezzlement -- and the best way to maintain a relaxed, family like atmosphere in your office, because you have less need to be suspicious of anyone.  Internal controls are a gift to your practice -- they protect against profitability loss while also helping to support trust and morale.

By |2022-01-01T22:52:12-08:00December 3rd, 2013|
Read More

50% off Judy’s books: Secrets; Patient-Centered Payoff

Judy's publisher, Greenbranch, is offering a special holiday discount of 50% on all books through midnight (EST) on Monday, 12/2/13. If you were considering buying Judy's best-seller, Secrets of the Best-Run Practices, or her new book, The Patient-Centered Payoff, now is your chance to get them both at half off!  (The links go to the print edition, but ebooks are available, too.) Click here to shop at the Greenbranch site -- and use the code "Green" when you check out.

By |2022-01-01T22:52:12-08:00December 1st, 2013|
Read More

The threads of payment reform and quality programs are coming together

It seems like forever now that practices have been dealing with multiple, complex, incentive and penalty initiatives from the federal government: Meaningful Use, PQRI/PQRS, eRx, PCMH and, more recently, "value-based" programs (value-based purchasing for hospitals, and the upcoming value-based purchasing modifier for physicians). If you're like us, the onslaught of these programs has seemed more like a series of separate carrots and sticks (amplified by private payer programs that have built on the government's pay-for-performance approach) than a coherent strategy for driving change.  Rarely do notices about these programs include helpful guidance as to how they're interrelated.  (Perhaps it would just be to hard to fit those details in amongst the deadlines, bureaucratic details and confusing specs!) That is why it is at least helpful to finally be seeing -- after years of programs popping up and interrupting practice operations, demanding attention without saying why (except when why was 'get a bonus' or 'avoid a penalty') -- the outlines of inter-connectedness among all of the government's many programs. For example, Medicare's Physician Compare website provides information about a physician's participation in various quality initiatives, like PQRS and ePrescribe.  (This is perhaps a good opportunity to remind you to check this -- and all -- the directories in which you or your providers are listed.  There are often errors -- if contact, specialty or location data is incorrect on a key directory, it can cost you patients.  And if the CMS has incorrect data about your participation in important incentive programs, you'll want to follow up on that immediately to remedy their data or your submissions.  As we say all the time, this need to check goes for payer directories (!) and public directories like Healthgrades and Vitals.) Anyway, a sample of quality participation data as it is displayed on the Medicare site appears below.  For some patients, knowing you're participating in these programs could make the difference in selecting your practice: Besides PQRS participation, the Physician Compare site shows participation in ePrescribe and Meaningful Use as well. Of course, the integration of this data into directories is just the beginning. 

By |2022-01-01T22:52:12-08:00November 26th, 2013|
Read More

Reduce medical ID theft risk: check patient IDs at your front desk

Are your front desk staff members verifying ID and insurance cards when checking patients in?  If not, they should be.  Here's why: Checking ID is your first line of defense against medical identity theft -- and your patients'.  By checking ID and comparing against the name in the record, you can confirm you are actually treating the patient (and not someone who stole or "borrowed" their insurance card).  By asking for ID, you protect your staff against accepting fraudulently presented insurance, and protect your patients from medical identity theft.  (Besides the hassle and financial consequences of medical ID theft for patients, there can be clinical consequences, too, because their records will be updated with the health information of the person using their insurance.  The consequences of this can potentially be deadly -- and very difficult to fix.) Checking ID provides a convenient way to verify address at the same time.  Patients may have moved and not realize how important it is to let your staff know.  Invalid address information can cause claims to be denied -- especially from the CMS.  This is an entirely avoidable hassle.  Checking ID gives your staff a chance to ask the patient, "is this your current address?" While your staff should always check ID, it's not necessary -- or desirable -- to scan or photocopy the ID; it is best not to store this personal information in your systems.  (Plus, if it is scanned one time, that might discourage your staff from checking the ID itself next time.)

By |2022-01-01T22:52:12-08:00November 26th, 2013|
Read More

Still time (but not much!) to avoid a PQRS penalty in 2015

There is still time for providers to avoid the PQRS penalty for 2013 reporting, which will mean a 1.5% deduction from Medicare reimbursements in 2015 (ouch!).  The following two methods still apply for individual providers: -Submit via a qualified EHR vendor -- if your EHR is provided by a vendor that has been permitted by the CMS to submit directly, submitting data could be much easier than you think.  Be sure to contact your vendor to find out what their capabilities are.  Even if not qualified to submit directly, your vendor may be able to help you submit via a registry -- the second method available to not just avoid the 1.5% penalty in 2015, but also earn a .5% incentive for 2013. -Submit a single, valid measure via a single claim.  You can do this!  This approach will not permit you to earn an incentive this year, but you will avoid the penalty in 2015 -- and you'll have gotten your feet wet for more comprehensive compliance in 2014.  (Do it now -- don't delay -- to be sure your claim is accepted and qualifies.)      

By |2013-11-24T17:46:46-08:00November 24th, 2013|
Read More

The faulty statin risk calculator: more on using your website and EMR to communicate

Well, the new, evolving, confusing statin news appears to be a gift that keeps on giving.  (Only practices that are fielding loads of calls from confused patients are probably considering it just the opposite.  An anti-gift that keeps on giving perhaps?) In case you haven't heard yet, the New York Times reports today that the risk calculator provided by the American Heart Association and the American College of Cardiology appears to be flawed.  The calculator may be significantly overstating patient risk and suggesting that millions of people who don't need statins should be considered candidates to take them.  (I won't get into the details here -- the Times article does a nice job of simplifying what might have caused the problems with the calculator.) But I will take the opportunity to point out, as I did last week, that confusing and unnerving media stories like this create an opportunity for your practice to use technology to help manage contacts from confused or nervous patients while also reinforcing your practice's bond with them.  Your website or social media presence can be a great way to remind people not to change their own treatment plans without advice from their physician (for example, if this is the message your physicians feel should be emphasized).  And your EMR can become a helpful tool to quickly identify your subset of patients who might be confused so that you can reach out to them proactively. Imagine how grateful an anxious cardiac patient might be to hear from your practice with clarification about this news, and whether he needs to worry about it.  Your EMR can make reaching out like this a lot easier (yes, an EMR can make something easier!) -- and you can possibly meet a needed Meaningful Use measure at the same time.

By |2016-08-19T17:37:29-08:00November 18th, 2013|
Read More

The surprise statin news is a perfect use for your website or social media space

The recent, confusing, conflicting news about new statin guidelines presents a perfect opportunity for your practice to use technology to solve a pressing problem -- and engage with patients. To recap briefly,  new statin guidelines were released on Tuesday by the American Heart Association and the American College of Cardiology. The new guidelines include changes to both the recommended LDL targets for patients currently on statins (potentially reducing frequent blood testing for many patients) and the types of patients who should be on statins (potentially increasing substantially the numbers of patients who could be prescribed the drugs).  Additionally, the guidelines could affect the frequency of prescribing of drugs like Zetia that are intended to work alongside statins. But the new guidelines are controversial.  The New York Times attempted to illuminate the many angles to these new guidelines and also pointed out that the new recommendations are controversial within the medical community.  It quoted a cardiologist from the Cleveland Clinic noting that physicians may have different ideas on how to respond -- and that some may not change their recommendations to their patients.  The article has already attracted nearly 700 comments -- many very forceful and signed by physicians. Now, just two days later, the Times has published a strong opinion piece against the new statin guidelines. For cardiology, primary care, and other practices that prescribe statins and treat related issues like diabetes, these reports are likely starting to prompt calls from concerned patients.  Handling an unexpected flurry of these sorts of calls can be very disruptive -- and can lead to some unhappy, stressed-out patients if they're unable to get through to discuss their concerns. It's likely, though, that physicians in your practice have already begun crafting standard responses.  For example, perhaps your physicians have already told staff to tell patients that call in asking, "should I stop taking Zetia?" to continue their current treatment plan but make an appointment if they would like to discuss whether changing it makes sense in their case. Sharing links to articles that your physicians believe explain the new guidelines in an appropriate and

By |2022-01-01T22:52:12-08:00November 14th, 2013|
Read More

Remember, EFT is best

Mary Pat Whaley at Manage My Practice has posted great information about payers 'encouraging' practices to accept payment by virtual credit card, instead of by check or EFT. This method of payment is not a good deal for practices.  Merchant fees are deducted from credit card payments -- meaning a further reduction in the reimbursement received from health plans that use this credit card method.  Additionally, it adds costs because the virtual cards have to be manually keyed (increasing potential for errors and hassles -- and usually meaning a higher merchant fee than a swiped transaction as well).  If the credit cards are set aside to be keyed in batches (as it seems they would inevitably be in many busy practices), that introduces another delay in receiving payment that would already be in the bank if transmitted by EFT.  And, as the AMA pointed out in its letter to the CMS objecting to the use of virtual cards for VA reimbursement, credit card remittance advices are not standardized as payer EFT remittances are -- another source of inefficiency and cost. EFT is still the best way for practices to receive payments quickly, without any extra fee deductions, and without requiring additional, costly staff handling.  (Minimizing staff handling also reduces embezzlement risk.) All payers are required to meet federal standards for EFT in 2014 -- and that means that you can request EFT from any payer you work with.  As you know, we always recommend that practices use EFT with every payer: no checks in the office means less chance of one 'disappearing,' less aggravation taking them to the bank, etc.  Virtual credit card payments are just one more inferior alternative to EFT. As Mary Pat noted in her post, it's important to check any new contract you sign to be sure you're not inadvertently agreeing to credit card reimbursement.  (And, as we're always reminding you, this is another reason for a tickler to review your contracts annually, to be sure they don't already contain language that allows changing reimbursement mechanisms.  And watch those amendments and other mailings from plans, too!)

By |2022-01-01T22:52:12-08:00November 11th, 2013|
Read More

Could the ACA-mandated grace period be problematic for your practice?

Many practices already suffer losses from surprise payment retractions by health plans.  These can occur when patients attempt to exploit system update lags after leaving their employer (and therefore the employer's plan) or the grace period after failing to maintain payments on their own policy.  (So, the patient knows he's not paid his premium or that he's left the employer plan, but also knows he's still "covered" because of payment grace period or because of the 30-day window to elect COBRA coverage -- even though the coverage will eventually be retroactively cancelled to the last paid day.) Any retraction of payment for services already rendered is a blow for providers and their practices, but most state policies regarding timely payment of claims and premium grace periods help limit the exposure for retraction of reimbursement to 30-45 days. However, the Affordable Care Act (ACA) contains a provision that mandates a much longer grace period -- 90 days -- for subsidized plan participants.  The ACA authors intended that plan members who receive subsidies be allowed more leeway for missing payments because of lower incomes and possible hardship -- but, the longer grace period also creates opportunity for abuse and financial exposure for practices. Hospital and physician groups made note in the ACA comment period of the potential for the grace period to result in uncovered services being rendered.  Extending the grace period increases the likelihood that significant services can be provided before a plan can be cancelled for unpaid premiums.  Providers argued that plans should have to bear these costs -- especially in the case of subsidized membership, since plans would presumably be receiving at least part of the premium cost from the government.  However, in the final rule, the CMS allowed plans to deny claims in months two and three of the grace period.  This means that payments already issued to providers could be retracted -- leaving practices and hospitals on the hook for the cost of care already provided. How can practices prepare for and protect themselves from these unexpected costs?  A few things to evaluate: Has your state negotiated

By |2013-11-09T18:08:14-08:00November 11th, 2013|
Read More

Obamacare scam alerts: a great use for your site and social media

A few days ago, Megan McArdle of Bloomberg offered a helpful introduction to the emerging scams inspired by Obamacare.  Scary stuff. Spreading the word about these risks is a great way to connect with patients and reinforce that you're watching out for them.  And it's a great use of your practice's Facebook page or blog -- a quick post takes just seconds, but will immensely benefit patients who follow your feeds.  

By |2022-01-01T22:52:12-08:00November 9th, 2013|
Read More

Medicare Advantage plans dropping doctors: what does it mean?

News reports have been trickling in over the past couple of weeks -- growing in number -- about Medicare Advantage (MA) plans dropping doctors. First, we heard about UnitedHealthcare in CT dropping doctors -- then news came out about the same carrier dropping patients in NY, FL, RI, NJ, and, just yesterday, OH.  Sam Unterricht, MD, the head of the State Medical Society of New York, said in a Fox Business interview a few days ago that other plans like Empire Blue Cross and Emblem were following UHC's lead in his state -- and that he expects this MA plan activity to spread nationwide. What's driving this (by all accounts, extremely sudden) behavior on the part of MA plans?  The Tampa Bay Times reports that UHC attributes it to quality ratings ("[providers that] demonstrate the highest quality at the greatest value will be rewarded for their efforts.")   But, the effort to trim MA costs as part of the funding plan for the ACA probably plays a role. Unterricth said that one of the plan representatives he spoke with said that an anticipated 8% reduction in reimbursements to MA plans from Medicare as part of the ACA was at least partly behind all the physician cuts.  The timing -- coming on the heels of news of thousands of patients dropped from individual health plans -- does suggest a connection to ACA-mandated changes in 2014. Certainly, UHC's statement that quality ratings drove the decisions isn't incompatible with Unterricht's view that ACA cuts to MA reimbursement were behind them.  After all, if reimbursements to MA plans from the CMS are going to decline, then quality related bonuses are going to be that much more important to plans going forward.  It makes sense that they would try to goose their rankings to make up lost ground on reimbursements through bonuses. What does this mean for practices that serve MA patients?  Some practices in some markets might have argued that MA is a pain: it's like the restricted, non-negotiable reimbursement of Medicare combined with the hassles of dealing with a private payer.  But, we suspect

By |2022-01-01T22:52:13-08:00November 5th, 2013|
Read More

Time to update your practice’s cash fee schedule?

As independent professionals, the partners at Capko & Morgan have purchased insurance privately for many years.  I've been a member of my HMO for 20 years, and have been paying for it myself as a small businessperson/independent professional since 2001.  I had a good plan that seemed to generously exceed all of the ACA requirements, and then some -- I was very satisfied with it.  Unfortunately, that wasn't sufficient to protect me from cancellation.  I was notified about a month ago that I had been shifted into an exchange plan that is significantly more expensive, with huge increases in copays and deductibles, and numerous excisions of benefits I valued that I would now have to pay for 100% out of pocket. Now, lest you think this little anecdote has nothing to do with the headline for this post, let me get to the point.  Like so many others in my predicament, I'm pressed to look at options.  I have never in my adult life contemplated doing without a comprehensive health plan.  But, I have heard from others in my position that they're considering 'going naked.'  The logic?  Paying for coverage that doesn't really kick in until you've paid about $11K into the system might make less sense than paying cash, then signing up for coverage in the unfortunate event you'll actually need to use it.  For some people who lost much lower-priced, catastrophic-only coverage, the financial realities are even more stark -- they just may feel they cannot afford to pay thousands of dollars more each year for coverage, even though they may receive considerably greater benefits in return. If a significant proportion of the independently insured population opts to pay the ACA penalty instead of purchasing or continuing to purchase coverage, what might that mean for your medical practice?  One possibility is that more people will want -- or need -- to pay cash for services. For primary care and urgent care practices, this means it's more important than ever to set up your cash-only fee schedule -- and to let patients know that it's available.  Cash pay could be a real opportunity for primary care practices -- and you

By |2022-01-01T22:52:13-08:00November 2nd, 2013|
Read More

Amazon ebook promotion ends today

The four-day promotion on Amazon offering Laurie Morgan's just-published ebook -- Get the Best From Your Medical Billing Service (Management Rx) free ends today. If you're using a third party billing service or considering engaging one, don't miss the chance to get this comprehensive, 15-page guide at no charge. The book includes 30 screening questions for interviewing services, tips on how to manage the relationship, and a list of key reports and how to use them to evaluate billing service performance. The regular price is just $6.88 (already a bargain :)), but why not download it today for free?  (In exchange, it would be a nice gesture to share a rating/review of the book.) The book is published in Kindle format -- easy to read not just on Kindle devices, but on any smartphone, PC, iPad or other tablet using the free Kindle software. (If you are a Prime member of Amazon, you can borrow the book for free at any time -- not just during the promotion. If you're not a member, you can sign up for a free trial of Amazon Prime. If you miss your chance to download for free during the promotion, a free trial of Prime can allow you to borrow it.) We hope you appreciate this free promo from Amazon, and that you will check the book out and share your thoughts on it with a review!

By |2022-01-01T22:52:13-08:00October 29th, 2013|
Read More

Conference attendance is so important for practice managers

Just back from speaking at the wonderful Association of Otolaryngology Administrators (AOA) annual conference -- what a valuable event. It's such a great experience as a speaker to participate in such a well-attended, well-run event. In both of my sessions, attendees  were so attentive, taking notes, asking great questions, and making great comments and sharing anecdotes about their own practices.  The attendees were helping each other as well as benefiting from content from all of us speakers. I have no doubt all attendees will go home with dozens of ideas to improve their practices' profitability. I was just one of dozens of qualified presenters -- what a download of information for the attendees.  And they were clearly so motivated to soak up as much information as possible.  (For example, I tried to sneak into the talk before mine -- which started at 7:30 AM! -- on the Affordable Care Act.  Standing room only, despite the early hour.) Physicians may sometimes doubt the value of sending a manager off to a conference like this.  The cost may be in the neighborhood of $2,000 when travel and downtime are figured in, so it's not a trivial expense.  But just one coding tip that brings more revenue or marketing tip that brings more patients -- or compliance tip that avoids an audit -- would pay for that expense many times over.  And the network that attendees can form is absolutely priceless.  This is especially true when your specialty has a dedicated practice administrators association like the AOA -- but, even at the larger/general practice management events like MGMA, medical office managers will meet like-minded professionals they can bounce ideas off of and gain advice from in the future. In tight times, cutting out conference attendance may seem like an easy choice. However, you may be unknowingly hurting your practice's chances to grow new revenues, stay ahead of regulatory issues, or nip costly problems in the bud.  It's useful to be picky about attending events -- make sure they'll have a variety of relevant subject matter that is important to your practice.  But don't

By |2022-01-01T22:52:13-08:00October 26th, 2013|
Read More

Medical billing service ebook promotion starts today!

Laurie Morgan's just-published ebook -- Get the Best From Your Medical Billing Service (Management Rx) -- will be available free on Amazon.com starting today! This one-time promotion runs from October 25 - October 29. This detailed, 15-page guide is the easy way to get up to speed on selecting and managing a billing service. You'll learn tips for screening potential services (including 30 screening questions), managing the relationship, and using reports to evaluate billing service performance. The regular price is just $6.88 (already a bargain :)), but you can get it free over the next four days.  (In exchange, it would be a nice gesture to share a rating/review of the book.) The book is published in Kindle format -- easy to read not just on Kindle devices, but on any smartphone, PC, iPad or other tablet using the free Kindle software. (If you are a Prime member of Amazon, you can borrow the book for free at any time -- not just during the promotional period. Use this link if you'd like to sign up for a free trial of Amazon Prime. If you miss your chance to download for free during the promotion, a free trial of Prime can allow you to borrow it.) We hope you appreciate this free promo from Amazon, and that you will check the book out and share your thoughts on it with a review!

By |2022-01-01T22:52:13-08:00October 25th, 2013|
Read More

Monitor your physicians’ directory listings for accuracy

We often point out to our followers how important it is to monitor your payer directories and the online physician directories aimed at consumers for accuracy.  Now, from here in California, is more proof of how important it is to do so: Covered California, the state's health insurance exchange, has just disabled its provider directory because it contains too many errors.  (This story from the Los Angeles Times notes some -- like listing obstetricians as ophthalmologists and wrongly denoting whether physicians are speakers of languages like Russian and Farsi.) This post is not intended to pile on about exchange and ACA (Obamacare) glitches!  Rather, this move by Covered California offered an opportunity to reinforce how easy it is for incorrect information to enter a provider directory.  Once incorrect information is published, it can be replicated all over the internet -- as happens especially with the physician ratings directories.  (This is one more reason that Covered California did the right thing by disabling their directory until they had more confidence in its accuracy.) This problem was not caused by practice managers or physicians, but, unfortunately, it is one more thing that practices need to take some responsibility for -- lest their patients become misinformed (or unintentionally turned away, for example when a plan incorrectly lists a physician as not accepting new patients or fails to denote specialty/subspecialty properly). Practice managers: get in the habit of checking directories periodically, or assign this responsibility to a staff member.  Every practice should establish a tickler to check payer directories -- at least once a year.  You can tie it to contract renewal (another thing you need a tickler item for), or, better yet, find out if there is a schedule for new directories to be prepared from each of your health plans.  And check your listings on online consumer directories like Google+ Local, Healthgrades and Vitals at least annually; this is a great opportunity to both correct errors and add custom information (pictures, URL, custom text) as permitted (free marketing!).

By |2022-01-01T22:52:13-08:00October 21st, 2013|
Read More

Free promotion from Amazon: Laurie’s new medical billing service ebook

Laurie Morgan's just-published ebook -- Get the Best From Your Medical Billing Service (Management Rx) -- will be available *free* on Amazon.com from October 25 - October 29. If you're using or considering using a medical billing service, this detailed, 15-page guide is for you.  Learn tips for screening services, managing the relationship, and evaluating billing service performance. The regular price is just $6.88, but why not get it for free during the promotion?  (In exchange, it would be a nice gesture to share a rating/review of the book.)  Mark your calendar! The book is published in Kindle format -- easy to read not just on Kindle devices, but on any smartphone, PC, iPad or other tablet using the free Kindle software. (Incidentally, if you are a Prime member of Amazon, you can borrow the book for free at any time -- not just during the promotional period.  Use this link if you'd like to sign up for a free trial of  Amazon Prime.)

By |2022-01-01T22:52:13-08:00October 19th, 2013|
Read More

New study about workplace theft; are your internal controls in order?

A new study from the Rotman School of Management in Toronto about workplace theft and cheating may have important implications for medical practices. The study found that deprivation effects -- such as being harmed by the recent recession, or by new public policies -- reduce employees' commitment to ethical behavior.  Prior to feeling deprived, people tend to believe they'll maintain their moral standards regardless of circumstances; however, when put to the test of reduced financial well-being -- especially compared against peers -- the study found that people may relax their standards, especially when they believe their change in position is unfair. This is a helpful reminder to practices to make sure internal controls are in place, to reduce temptation.  The recession (ongoing in some markets), deep resentment of the ACA among some staff, and the added workload from new regulations all may contribute to employees feeling disadvantaged versus peers outside of medicine, or even versus patients.  (Some employees may also feel sympathy for patients whose health plans will carry more patient responsibility payments in the coming year, too -- perhaps resulting in losses from co-pay waiving and the like.) Internal controls are the kindest way to protect your practice against internal theft.  By setting up procedures and structures that reduce temptation and make theft more difficult, you reduce the need to be suspicious or personally monitor employees -- and allow your practice the freedom to cultivate the family-like atmosphere that so many of us want.  If your internal controls need a review, please don't hesitate to get in touch.

By |2022-01-01T22:52:14-08:00October 17th, 2013|
Read More

A taste of MBA training for doctors — without the hassle and cost

If you follow this space, you may already know that I'm dubious about the value to physicians of stopping out for an MBA.  As an MBA-holder myself, I think the coursework can be overkill for independent physicians who just want to run their practices better (this is less the case for those that intend on corporate careers, of course). So much of modern MBA training focuses on things that aren't generally relevant to the small/medium business owner (and, therefore, the typical private practice physician partner).  Even worse, some of the business basics that doctors need most usually aren't well covered by MBA programs -- managing people; the minutia of local, state and federal regulations; the marketing of a small, local business; real estate finance; negotiations, etc. The other issue facing physicians (and sometimes practice managers, too) is the opportunity cost -- and actual cost.  The opportunity cost is the income lost by taking time off from practicing/working to attend an MBA program, and the actual cost is the (often very high) tuition at business schools.  For many, perhaps most, private practice owners and managers, it just may not 'pencil out' to take the time and invest the money*. One solution that can work well as a substitute is taking local classes (e.g., nights and weekends) that focus just on what you really need and want to learn.  This can be a reasonable approach -- and even a trial to see if further investment in MBA education is of interest.  But, there is also the issue of having to attend class at set times -- not always convenient ones. Now, though, there is a better alternative: MOOCs, massively open online courses.  Incredibly, some of the most prestigious business programs in the country, including Stanford, Wharton and Columbia, are making some of their most valuable content available through the free platforms like Coursera and EdX.  And it's not only self-directed -- i.e., you take the classes at your convenience -- it's FREE!  (Yes, unbelievable.) Lest you think this is just throw-away content, Business Insider has kindly assembled a list of some of

By |2022-01-01T22:52:14-08:00October 16th, 2013|
Read More

Does your smartphone pose risks to your practice?

Let's take a few moments to consider what risks you may be carrying around with your phone.  One common vulnerability is stored passwords on your phone, e.g. within a “notes” program.  Imagine the harm that could come of a thief having access to your banking accounts or practice management software.  Your firm could suffer an immediate financial hit, malicious mischief or a potentially devastating breach of patient data. The start of such grief can be your unattended phone meeting with a disgruntled employee or dissatisfied patient. These risks mean that phone security justifies your consideration. Phone security starts with maintaining disciplined control over the physical device. Naturally, your phone should not be left untended in your office, on a shared counter-top or anywhere else where it might be easily stolen.  While it seems obvious, it’s very common to see busy administrators leaving their phones behind as they scurry about the office.  Luckily, most phones have security features that can significantly mitigate your risk – although many of these features are not enabled by default.  In many phones, a four-number passcode can be readily “cracked” by a thief. Better is a quality passcode (avoid common English words) that uses letters and numbers – with iPhones this can be changed under settings/general/passcode lock.  Keep you phone’s software updated, as security vulnerabilities are fixed as they are discovered. If you use an iPhone, make sure you have the application Find My iPhone installed (and updated) and enabled. iOS 7, the latest iPhone operating system, security has been greatly improved – potentially making your phone valueless to a thief, but you must first have an Apple ID (and remember it!). Phones using Android 2.2 or greater have a built-in application that can help locate or your phone and/or completely delete the contents of your phone and any installed memory (SD) cards.  You’ll need to make sure these features are enabled on your phone (settings/security/device administrators). Regardless of what device you use, be careful when accessing sensitive information when you’re out and about as your phone may connect to an insecure Wi-Fi connection, allowing others

By |2013-10-21T16:13:04-08:00October 9th, 2013|
Read More

Beneath recent KLAS small practice EHR rankings lies more than one story

Medscape's story last week about new KLAS research ranking EHRs for practices of 1-10 physicians had some helpful insights. The top system, Athenahealth, was praised for its high level of service and continuous improvement of the product -- despite getting dinged by some respondents for its "high cost."  (Specific product improvements or features that were most appreciated were not mentioned, but I have to wonder if Athena's tight integration of EHR and PMS was one reason its clients were happier.  As I've posted before, I think this integration is a huge factor in getting the most from billing technology -- and will only become more apparent with the ICD-10 conversion.)  Athena wins, even though it is the high cost provider -- does that mean low cost solutions can't satisfy? Not necessarily, according to the survey: PracticeFusion, the famously free EHR, came in third -- and its score of 86.3 was not far off from Athena's 86.9.  Like Athena, it got points for ongoing development, but did get a few criticisms, though, for missing features.  We have often suggested that practices check out PracticeFusion if cost is their primary concern, but to be prepared to evaluate if it fits their specialty; this data seems to bear out the idea that PracticeFusion can be a great solution for many practices, but there's no substitute for actually trying it out for your own to be sure it fits your specialty, meets your functionality expectations and can be efficiently integrated into your patient flow. Unfortunately, while I don't want to call out any particular offenders, suffice to say that many of the EHRs on the bottom of the pile have been troublesome for practices we've worked with.  In some -- but not all -- cases, this is at least partly because the vendors have historically been much more focused on (and effective with?) larger networks and hospitals. Perhaps the most interesting aspect of this story from our point-of-view is that churn in the EHR market continues -- and it's a good thing.  When more practices feel free to switch from an unsatisfactory EHR, we'll see more benefit from these (painful)

By |2022-01-01T22:52:15-08:00October 9th, 2013|
Read More

Teaching your medical practice employees vs. coaching them

Today's Harvard Business Review  features a wonderful tip for medical office managers: Know when to coach versus when to teach. Teaching -- i.e., demonstrating or instructing an employee on exactly what to do -- is key for bringing new employees up to speed (aka, training).  It can also be useful when corrective action is needed -- e.g., "Emily, please be mindful of HIPAA when speaking with patients about private information -- ask them to step out of the reception area, like so." Teaching can backfire, though, with competent and motivated employees who just need a little help with problem-solving. Coaching -- supporting and gently helping staff find the right solution -- is the right approach in that case. For example, let's say one of your receptionists is having trouble collecting co-pays -- but, she's a quick learner who's eager to try new things. Giving her ideas and asking questions about what she's already tried could help her develop an effective style she's comfortable with -- and that she'll be able to use routinely. By coaching employees with ideas and, most important, asking questions, you help your employees feel competent and trusted. What's more, even though it might take a little longer to solve today's problem, your coaching might lead to your employee finding a better solution that will pay off over the long run.  For example, if your instinct would have been to pick up the phone to get urgent payer feedback, but your encouragement leads a biller to find an important source of information via the payer's portal, that could save a lot of time for you and your biller down the road.

By |2022-01-01T22:52:15-08:00October 8th, 2013|
Read More

Introducing Capko & Morgan

We’ve changed our name to reflect the immeasurable value provided to our firm and our clients over the last five years by Laurie Morgan. If we’ve had the pleasure of working with you over this period, you’ve surely benefited from Laurie’s uncanny knack for uncovering problems and zeroing in on the most effective, elegant solutions.  For her friends and colleagues – some of whom share her stellar academic credentials and many years of experience – she has long been the go-to-source for solutions to seemingly intractable business problems. Few have Laurie’s combination of academic understanding, in-the-trenches management experience, ability to deeply observe, and her resolute determination to find solutions. We couldn’t be more pleased to recognize her contributions and to have her working beside us on your behalf at Capko & Morgan.

By |2022-01-01T22:52:16-08:00September 26th, 2013|
Read More

A Harvard Business Review Daily Idea that’s perfect for practices

Harvard Business Review recently published a "Daily Idea" about leadership that seems tailor-made for medical practice managers and doctors.  The idea: the best leaders are both tough and nice. Those of us who've worked primarily in business know that the question of whether toughness or niceness drives more productivity from employees is almost as old as business study itself.  Everyone has a theory.  But, HBR's analysis suggests that common sense wins out in the end: while a small percentage of employees with each polarized type of boss will ultimately be highly engaged, bosses that blend both styles get employees fully engaged a whopping 68% of the time. Beyond these results, though, the tough+nice approach seems ideal for medicine in particular because it so aptly matches what healthcare is really about.  It's a tough field in which errors are much more damaging and crucial to avoid than just about any other business, but it's also a field that people pursue primarily because they are personally drawn to helping and caring for others.  It only makes sense that the best physician leaders and practice managers would combine high standards and expectations with compassion and kindness.

By |2022-01-01T22:52:16-08:00September 26th, 2013|
Read More
© Copyright 2013 - Capko & Morgan | All Rights Reserved | Powered by WordPress
FacebookXRssEmail
Go to Top