Another interesting (dispiriting) take on medical billing

A recent New York Times article and follow-up blog post discuss the challenges patients have understanding medical bills, through the eyes of a consultant named Jean Poole who has made a career of deciphering (usually highly erroneous) medical bills and helping patients recoup incorrect charges or reduce their outstanding bills. Billing is so challenging for practices -- even though specialized staff are usually handling the task, they have to contend with constant changing rules, reluctance of some payers to address issues, and the myriad of payment schemes with varying patient responsibility.  But imagine how it is for patients -- who don't have any specialized knowledge to help them deal with the strange language and calculations of their bills.  Ms. Poole's service would seem to be a godsend for patients who find themselves unexpectedly owing thousands of dollars (as the article points out, patient out-of-pocket obligations and opaque hospital fee schedules can lead to big surprises).  It's great that she offers this service, for sure -- but how frustrating that it's so needed.  The frequency of errors and lack of transparency in insurance company documents to patients is a big source of difficulty for practices.  When patients feel they've been incorrectly charged or can't understand their bills, it undermines the trust they have in their physicians and other care providers.   When your practice provides services in conjunction with a hospital, their billing clarity and accuracy (or lack thereof) can rub off on  your patient relationships.  While you can't control how hospitals manage their side of billing, you can at least make sure you're communicating as clearly and directly as possible with patients about what your practice will bill and how much of that bill their payer has declared to be the patient's responsibility.

By |2022-01-01T22:52:39-08:00June 27th, 2012|

Costly (and easily correctable) telephone mistakes

All of us by now have had the feeling of being held captive by a merciless phone tree or being asked, "Can you please hold?" before being left in limbo for five, ten or even fifteen minutes or more.  Like you, patients don't like having their time wasted when calling your practice. Nonetheless,  many practices have taken high demand and technological developments as an excuse for failing to review and refine the systems they have in place for serving their patients over the phone.  If you've recently reviewed your online presence and encountered a negative review, you can appreciate how important it is to establish with your patients a sense that you are dedicated to taking good care of them regardless of whether they are in or out of the exam room. Improving patient phone service needn't be an overwhelming chore for your all-ready busy office. In fact, this process is ideally suited for working on around your schedule as there are many components that can be improved in fifteen minute blocks. Most modern telephone systems have impressive reporting capabilities, despite the fact that most practice staff usually know nothing about them. Make it a priority to generate reports that can serve as benchmarks for your practice's performance in this area. How long do callers wait on hold? How many calls come in relative to your patient visits? When are calls coming in? One very common problem is the rush of calls that often occurs as the practice opens up after the lunch hour. As the lunch hour is the most convenient times for many of your patients to call, the simple fact is that you should have telephone coverage over lunch.  Rotating this assignment through your staff is easy to implement -- you'll get more new patient bookings and smooth the flow of calls, meaning happier patients and staff. You should have a current diagram of your phone tree that illustrates that patients can find their way through the tree in a timely manner.  Consulting with your systems reports, eliminate branches of the tree that are infrequently accessed. You've

By |2022-01-01T22:52:39-08:00May 10th, 2012|

Hotel Hôpital

What if hotel billing were like medical billing? A funny-but-sad video by Costs of Care in partnership with Harvard Medical School and the University of Chicago explores the possibility in a tongue-in-cheek way (click "continue reading" to view the video). "Surprise" medical costs do more than just frustrate patients -- they hurt practices, too.  By helping patients understand the costs of their care, practices can help patients make more informed decisions, plan better, and maintain a positive relationship with the practice.  And, patients who are better informed and understand what they'll be charged are more likely to pay their bills.

By |2022-01-01T22:52:40-08:00March 25th, 2012|

Office Squabbles? Three Areas to Look for a Fix

Do you have conflicting personalities in your office? Do such differences result in petty squabbling?  While inter-office conflicts are common, there are a few things an administer can do to greatly reduce conflict in the workplace.  It's important to address conflicts before they affect the professionalism of your practice, the morale of your staff, and your practice's productivity. Most of what is attributed to personality conflicts in the workplace can be traced to a just a handful of sources for which you most likely are responsible! Job descriptions: It's all too easy for disputes to emerge when responsibilities are not well defined. In today's changing medical field, jobs change -- don't let those job descriptions lead to finger-pointing in the office. Clearly delineated responsibilities allow staff to both receive credit and take responsibility for tasks. Without clear definitions it's too easy for misunderstandings (of differences in performance) to escalate into personal resentments. Cross-training: The counterpart to clearly job descriptions is that your staff should be well cross-trained and able and willing to fill-in where they are needed. Cross-training has the benefit of helping everyone in the office truly appreciate what important roles the others are fulfilling.  Additionally, it shows that you are interested in the well-being and career and skill advancement of your staff.  There's a fine line between a groove and a rut!  To the extent you are able, provide variety in the work environment so that your staff doesn't fall into an abyss of boredom. Fairness: If your staff perceives that some receive preferential treatment, morale will suffer and, with falling morale, it's only to be expected that friction will increase.  An under-appreciated fact is that perceptions of fairness and openness to communication go hand-in-hand. If your staff feels they can approach you to complain because you have a sincere interest in their well-being, you are well on your way to resolving squabbles among your staff. Challenge yourself to hear that which is difficult for you to hear. No one is free from biases and your staff can serve as a mirror to your own policies -- it's important

By |2022-01-01T22:52:42-08:00September 30th, 2011|

Stop Wasting Energy & Money

Medical practice revenue is tighter than ever. It's time for you to take critical steps to keep costs under control and improve profits. The first step to fixing the bottom line is to look for the waste. Wasted energy results in a loss of potential revenue and lots of frustration.  There is waste throughout the typical practice, but most of it is silent and doesn't get the attention it should.  Here's some common threads we see in your world: A lack of clearly defined job responsibilities that result in duplication of effort. Accepting poor performance and inferior outcomes Mistakes that one person makes and another one corrects because it seems faster or easier. The good news is all these things are fixable.   Make the commitment.   Look at the action that needs attention. Is it the scheduling, patient visit or billing and collections, or something else? Then  flow chart the processes involved and identify the cause for errors and inefficiency, discuss the possible solutions and pick the one that makes the most sense.  Then  [and this is important]  assign someone the responsibility to see it through, set a reasonable time-line to get each change completed and  schedule meetings to review progress along the way.  You may need to hire a consultant to get the ball rolling and develop a process improvement plan, but it will be worth the effort.  Start thinking lean and reduce the waste! Once you see improvement it's time to celebrate.  Your bottom-line will improve, staff will enjoy their work more and patients will be happier.  Sounds like a win-win-win.   So just  do it! Capko & Company, experts in practice management and markeeting - We are here to help make your practice shine. s

By |2022-01-01T22:52:56-08:00April 5th, 2011|

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|

What’s Bugging You?

Hey Doctors and administrators, I know you have frustrations and issues that plague you in this volatile healthcare environment. Tell my readers what's bugging you. What you share with them can lead to a discussion where everyone benefits. So follow this blog and let's talk. Judy Capko is one of America's leading practice management and marketing consultant and author of the runaway top-selling book Secrets of the Best-Run Practices available at www.capko.com

By |2022-01-01T22:52:58-08:00May 19th, 2010|
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