2013 planning Archives - Capko & Morgan

13 for 2013 Tip #12: Review your directory listings

If the doctors in your practice have been practicing for a while, odds are you've already got listings in the Vitals.com and Healthgrades.com, the largest online physician directories. However, there's no guarantee that those listings are correct -- in fact, it is not unusual for these sites to contain incorrect details such as defunct addresses and phone numbers grabbed from older public resources. The listing for one physician we worked with recently even had the medical school he attended incorrect. The good news is, it is usually easy to 'claim' your listings on these sites using their automated self-identification processes. Once you've claimed your listing, you can change all the details -- and add others that can help promote your practice, such as a photo and a link to your website. Besides checking out your physician rating site listings, the start of a new year is a great time to review your health plan directories as well. Make sure that you're listed properly in all the plans you accept -- including verifying the 'accepting new patients' information. And, don't forget to check that you've been removed from directories of plans that you've dropped -- to avoid any out-of-network surprises for patients that can turn into uncollectible bills for your practice. And don't forget about Google+ (aka Google Places) -- this easy to use listing process is a great way to get additional exposure for your practice and its website, with a link back, space for photos and the opportunity to add custom text about your practice and your philosophy. Customized listings stand out dramatically versus unedited ones -- and it's all free!

By Morgan|2022-01-01T22:52:35-08:00February 5th, 2013|

13 for 2013 Tip #9: Analyze payer performance

When is the last time you analyzed your practice's payers? Too often, physicians and practice managers feel powerless against health plans -- and don't even question whether to continue to accept a particular plan. Yet, even if your practice is located in a market in which you've found it increasingly difficult to negotiate higher reimbursement, that doesn't mean you must simply accept all other aspects of every payer relationship without question. Even when reimbursement amounts are similar across payers, differences in payer behavior -- what we refer to as 'hassle factors' -- can actually mean that some payer relationships are unprofitable. What are some of the hassle factors that add hidden costs and reduce payer profitability? They include: Consistently slower reimbursement than other plans Repeated requests for referral or authorization Frequent complaints from patients Poor support when help is needed to resolve problems Are multiple hassle factors a reason to drop a plan on their own? Not necessarily -- if you're reliant on a plan for a significant share of your revenue, or it reimburses better than others for important codes, putting up with the hassle may be necessary. (However, in that case, you will also want to do what you can to address some of the ongoing hassles with the payer.) I shared some further tips on analyzing your payers' hassle quotients in this article for Kareo -- and if you need further help evaluating and segmenting your payers, we hope you'll get in touch to learn more about our capabilities in this area.

By Judy Capko|2022-01-01T22:52:35-08:00January 31st, 2013|

13 for 2013 Tip #4: Patient service=patient care

Physicians only need to peek at their ratings on sites like Yelp, Healthgrades and Vitals to realize the unfair truth: patients lump every aspect of their interactions with your practice into their view of your "care." Worse, at times it seems like their reviews give more weight to things like staff courtesy and billing hassles than to their clinical outcomes! The good news is, however, is that this also means that making people feel cared for is a team effort at your practice -- and that means that the burden doesn't fall entirely on the physicians' shoulders. The key, though, is to make sure the importance of patient service is understood by everyone on the team, and that everyone takes responsibility for it. Some steps in the right direction: Educate your staff about the importance of patient service, and reward them for their good work. Let them know that your practice's reputation depends on their contributions -- and that you value it! Invest in training if improvement is needed. Survey your patients. Learning what's on their minds -- before they vent on a social media site or medical directory -- will allow you to address issues before they become problems. And, some patients will perceive your service to be better simply because you took the time to ask their opinion. Strive for a personal touch. Medicine is becoming bigger and more impersonal -- and that trend is only worsening with consolidation. But, this spells opportunities for small practices to stand out! Be sure your clinical routines allow for a bit of personal interactions with patients -- even just stating the patient's name at the start of the encounter conveys a touch of caring. Bring in outside help. If you're not 100% sure of how patients view your service and care, an objective analysis can be very valuable. Contact us* if you're ready for a comprehensive, cost-effective service review and action plan. When it comes to patient service problems, and ounce of prevention is worth a pound of cure! *our San Francisco office works on patient service projects -- contact us via email at "info" at capko.com,

By Morgan|2022-01-01T22:52:36-08:00January 10th, 2013|

13 for 2013 Tip #3: Cash management quick-check

Do you accept cash payments at your practice? The start of a new year is a great time to review how your practice handles cash -- to determine if your internal controls could use some tightening up. With cash, the biggest temptation is to handle these "small" amounts more casually than other payments. When cash payments are rare -- a $30 co-pay here, a $25 co-pay there -- it can seem that they're less important to the bottom line. But, over the course of a year, even a single $30 cash payment per day amounts to close to $8,000! Keeping tabs on those "unimportant" cash payments is actually very important, indeed. The biggest pitfall: mixing cash receipts with petty cash. This all but ensures these amounts won't be deposited and may not be properly tracked. Petty cash should never be more than about $50 or so -- just enough to handle small payment amounts for the office that cannot be handled by credit card or check. Allowing petty cash to grow creates a temptation for misuse -- or worse, theft. Cash should be deposited regularly -- ideally, every day -- for security and for effective tracking for practice evaluation and tax reporting. Receipt stock should be monitored, and the cash received should be reconciled against the day's postings by some at the practice who doesn't collect it and post it to the billing system (in smaller practices, this might need to be the physician/owner).

By Joe Capko|2022-01-01T22:52:36-08:00January 10th, 2013|

13 for 2013 Tip #2: Analyze your E&M code utilization

For most practices, E&M codes represent a significant portion of billings -- and, for some practice types like pediatrics and other primary care, E&M codes can approach 100% of billings. Physicians and non-physician providers are often so sensitive to the risk of down-coding, denial or audit that they develop a bad habit of 'defensive' E&M coding -- i.e., sticking to the lower range of the codes for virtually every patient. Far from being an effective defense, though, this type of habitual coding may actually create more audit risk, since it leads to a distribution of codes that is skewed rather than the expected bell-shaped curve. And, it does so while also leaving thousands of the practice's dollars on the table! The end of one year and the beginning of another is the perfect time to analyze your practices E&M coding patterns -- and set new habits for the new year. Run a report for each physician by code for the full year, and you can create a table like this that totals how many times each provider used each code: code 99201 code 99202 code 99203 code 99204 code 99205 Total Anderson 12 252 900 12 24 1200 Buford 0 132 996 348 0 1476 Cochrane 12 996 96 0 0 1104 Delaney 0 36 732 432 120 1320 Elliott 12 48 1092 156 24 1332 From this data, you can easily calculate percentage utilizations to get a clearer idea of distribution -- and from there create a chart to spotlight any skewed coding: E&M Distribution Chart E&M Distribution Chart Notice the skewed utilizations of Cochrane, Anderson and Elliott? It's unlikely these codes are accurate -- especially Cochrane, who appears to be habitually and defensively under-coding. (Note, also, the addition of the CMS averages to the chart -- available from the CMS website. This is a great double-check to see the typical coding mix based on all practices billing Medicare -- and to get a sense if your coding patterns will look odd (or audit-worthy) to the CMS.) Next step: identify the number of instances of

By Morgan|2022-01-01T22:52:37-08:00January 8th, 2013|

13 for 2013 Tip #1: Master the deductible re-set

Too often, patients and practices alike are caught off guard by the resetting of deductibles on January 1. When patients forget they'll be responsible for a larger portion (or all) of the cost of their services, it can be difficult for front desk staff to handle the situation if they're not prepared -- and even physicians and managers find it hard to refuse a request to "please just bill me." The best solution to the problem is to prevent it. Make sure everyone in the practice knows that more patients will be responsible for payment until their new deductibles are met -- and that patients need to be informed and reminded before their visit. That means mentioning that deductibles have re-set when they set appointments, and checking patient responsibility amounts and outstanding balances before reminder calls -- and alerting patients to what they'll be expected to pay at visit time. Knowing that patients have been informed about their responsibility should make it easier for the front desk to collect in a matter-of-fact way. ("How will you be paying today, Ms. Jones?")

By Morgan|2022-01-01T22:52:37-08:00January 5th, 2013|

New series: 13 tips for 2013

All of us at Capko & Company want you to start 2013 off right! We're rolling out a series of quick tips -- short bites that will take just a minute to read -- to help you make the most of all the opportunities of a brand new year. First up: don't let the deductible re-set short-change your first quarter revenue.

By Morgan|2022-01-01T22:52:37-08:00January 5th, 2013|