medical practice business

Free stuff! Amazon promotion offering Laurie’s billing service ebook

Interested in learning how to get more from your relationship with your third party biller?  Or considering hiring a medical billing service? "Get the Best From Your Medical Billing Service" is Laurie Morgan's most popular ebook -- and Amazon is offering it for free on October 29. Although the book is optimized for the Kindle platform, it's no problem if you don't have a Kindle device -- the free Kindle software allows you to read on virtually any tablet, computer or smartphone. Don't miss your chance to receive "Get the Best From Your Medical Billing Service" at no charge. Mark your calendar to download this valuable guide on October 29! (Feel free to forward this message to anyone you know who might be interested. And to stay on top of all promotions related to Laurie's Management Rx ebook line, follow her on Twitter @managementrx  and Facebook.)

By |2022-01-01T22:52:03-08:00October 28th, 2014|
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The ACA grace period’s perverse payer incentive, and why hospitals would like to pay some patient premiums

Health Affairs has a nice analysis of the ACA's 90-day grace period on cancellation of enrollment for subsidized patients who miss premium payments.  But one piece of the puzzle that their article doesn't touch on is the perverse incentive for health plans not to vigorously pursue those missed premiums. Under the grace period, plans are required to reimburse providers for services rendered in the first month that the patient misses a premium payment, but not in the second and third months.  However, the services a patient might need in months two and three could -- perhaps even most-likely would* -- greatly exceed the value of the premiums missed.  This is why some hospitals, and now even some physicians, have started investigating whether they can pay these premiums on behalf of patients; they realize that they could be denied thousands in payments owed to them because of a patient's failure to pay a much smaller amount.  And this is why health plans would undoubtedly prefer that those patients not pay their premiums -- and are unlikely to make any special efforts to collect them. The idea of providers paying these premiums to protect their own position has analogs in other markets. For example, a bank might pay off a mortgagor's tax lien to avoid losing the entire value of the property if the government forecloses.  But in our world, it's not clear if other regulations that touch upon payment relationships could hold against providers who try to pay off patient premium obligations.  Health Affairs notes that CMS has already made a public statement discouraging such efforts. While the AMA, MGMA and others continue to urge reform of the grace period provision, it's reasonable to assume that payers will continue to argue that the related laws actually prevent providers from stepping in to pay premiums, and that the grace period rule should remain unchanged.  (And, presumably, they'd argue against another solution, such as deducting the value of missed premiums from provider reimbursements.) The bottom line is, the grace period seems unlikely to disappear any time soon.  It remains very important that physicians,

By |2014-10-26T14:09:05-08:00October 27th, 2014|
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If you missed Laurie’s webinar, “Front Desk Collections: the New Linchpin of Profitability,” here’s how to watch it now

If you missed Laurie's webinar, "Front Desk Collections: the New Linchpin of Profitability" (sponsored by Wellero) -- one of her most popular webinars ever! -- you're still in luck.  Sign up here and watch it whenever you like. This practical presentation hits on some ways you can immediately increase profitability while avoiding pitfalls that can erode your practice's financial health. Take a look (it's free to sign up), and, if you have questions or comments after watching, please don't hesitate to contact Laurie. [yks-mailchimp-list id="87d94b707e" submit_text="Submit"]

By |2022-01-01T22:52:03-08:00October 27th, 2014|
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Better scheduling, better workflow and profitability

Most medical practices aim to establish scheduling parameters based on perceived capacity and the appointment time needs or constraints of the physicians and providers that see the patients. But there’s so much more to maintaining an ideal schedule that meets demands of patients, offers smooth workflow for physicians, and ensures the physicians achieve ideal productivity standards. Begin by taking reviewing the schedule of the past 30 days. What went wrong (no shows, idle providers), what went right, and why? For example, what is the average number of visits per day for each provider? And is it consistent? How many holes are left in the schedule? Is this because schedulers are leaving gaps, or are missed appointments the problem? Identifying what's sabotaging your goal of an efficient schedule is the first step. The next is figuring out what can you do to fix it. It can be fixed, and one thing is for sure, ignoring it guarantees you will continue to experience the same (or greater) inefficiency then you have in the past and that’s going to hurt your profits. Toss out past habits and be willing to give your scheduling system and the attitude behind it a fresh start. Physicians must learn to maximize the percentage of their time spent with patients. Patients should be physician-ready when the doctor enters the exam room and that staff is properly trained so the physician can delegate tasks that do not require their level of expertise. Honor the appointment schedule. Let staff know what your expectations are and hold them accountable and above all – start on time to stay on time. This is the beginning of respecting the schedule and running a smooth system. If you don’t value the appointment schedule neither will your patients or your staff and you can bet the loss productivity this causes will cost you plenty. Medical practices are already feeling the pinch of constraints and changing dynamics brought on by marketplace and regulatory trends. Physicians and managers are concerned about the unpredictable future of private practice. But the best way to take charge of your future

By |2022-01-01T22:52:03-08:00October 24th, 2014|
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Healthgrades unveils new claims-based ratings

An article today on usatoday.com reports that Healthgrades has rolled out new metrics drawing inferences about physician and hospital quality from health plan claims data.  They're analyzing physicians' level of experience with specific procedures (based on frequency in the claims) and aiming to combine this data with patient reviews and other quality data they can tie back to their physician profiles, such as doctors' hospital affiliations and complication data from those hospitals. USA Today thinks the new approach could be "game changing." But even if doesn't dramatically change the game for the ratings sites themselves, certainly these new measures will be another data point that patients who already visit Healthgrades will consider -- and that means it's also one more way that incorrect information can silently undermine your practice and your marketing efforts. Say, for example, your surgery practice has affiliations with multiple hospitals, but somehow Healthgrades has only accessed the one with the most complications, or the one where your physicians have performed the fewest procedures. Omissions of the other hospitals from the calculations could cause Healthgrades to report that your physicians have less experience than they do, or that they're affiliated only with lower quality hospitals.  For a patient choosing between two physicians, data like this could easily persuade the patient to choose the other option over your practice.  Bottom line: an incomplete picture could do just as much damage as a negative review! This is just one more reason to be sure you're registered on Healthgrades and have reviewed and updated all of your listing information -- including verifying and updating things like hospital affiliations and procedures performed. (And once you've updated the facts, you'll have the chance to polish up the image portions of your profile, too, too.) And if you've been intimidated by the process of working with physician ratings sites and claiming and updating your physician profiles, my ebook -- The Quick Guide to Online Physician Reputation Management (Vol. 1) -- can help you get started quickly and without stress.  It will help you prioritize and show you just what you have to do. 

By |2022-01-01T22:52:05-08:00October 20th, 2014|
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Sermo poll: Doctors disagree with Ebola “czar” appointment

A not-too-surprising-but-still-interesting tidbit: a new poll by Sermo (the physician-only social network) shows that a majority of doctors disagree with the decision to hire a non-physician political professional as the "czar" leading the nation's Ebola defense. Read more about it on Sermo's blog: http://blog.sermo.com/2014/10/20/doctors-reject-ron-klain-as-ebola-czar/ Do you agree with the majority?  

By |2022-01-01T22:52:05-08:00October 20th, 2014|
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Everyone needs continuing ed — not just clinicians

When I was in business school, the idea of continuing ed for MBAs was occasionally bandied about.  It just seemed odd that other professions like law and medicine made ongoing education and improvement a priority while ours didn't. Of course, the most obvious response to this is that the competitive nature of the business world makes mandating continuing ed unnecessary for MBAs and other business professionals.  If you're not constantly learning and adapting, your skills can quickly become outdated -- and it's almost impossible to hide that in a typical business setting.  That's why companies invest in corporate training and conferences, and why ambitious managers read (or at least skim) all those hot business books and why they network so much more regularly than physicians.  In business, everyone takes charge of their own continuing ed -- and if they don't do so, someone else who is more in step with new ideas will come along and, as the saying goes, eat their lunch. In medical practices, though, we sometimes find physicians don't appreciate the need for ongoing business education for their managers.  I've personally even encountered physicians who describe their managers as "fully trained." Perhaps it's because continuing education for managers isn't a regulatory requirement that physicians don't understand how important it is.  Whatever the reason, if you're a physician who is not encouraging (and funding) ongoing education for your manager(s), you're making a mistake.  No field has as much constant change as medicine.  Medical practice managers, billing managers, and other practice business leaders need to not only stay on top of normal business evolution (e.g., technology change, marketing and communications change), they have to keep up with medicine-specific changes (e.g., regulation, research, clinical standards, insurance). Investing in continuing education for your managers is frankly cheap in comparison to the risk and costs associated with falling behind.  So when your manager asks for budget for a conference, book or online education program, think twice before saying no.  And if your manager never asks for these things, think about whether you've unintentionally discouraged a behavior that is essential to your practice's

By |2022-01-01T22:52:06-08:00October 3rd, 2014|
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Reminder: patient collections webinar next week!

If you haven't signed up yet, there's still time to join my upcoming webinar on patient collections on 9/23/14 (9AM/12PM).  "Front Desk Collections: the New Linchpin of Practice Profitability" is sponsored by Wellero and hosted by Physicians Practice.  It's free!  Register here.

By |2022-01-01T22:52:06-08:00September 19th, 2014|
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Send your staff to conferences

Sending a key staff member - whether a biller or a practice manager - to a medical practice management or billing conference can seem like an expensive perk. It can be an especially difficult decision for a small practice.  But there's just no substitute for the learning and connections that are possible by spending a few days at a high quality conference. Case in point.  I just returned from the HBMA conference, where I presented to about 200 motivated and engaged billing service managers and owners.  Attending as a speaker gave me the opportunity to listen in on some of the other speakers, and to hear attendee feedback.  Now, the HBMA is a vibrant organization that provides plenty of valuable information throughout the year through its list-serv, payer-focused groups, and other resources.  But the conference adds another layer of value -- and it does it very efficiently. For example, I sat in on a presentation about changes in bundled payments and other coding and payment issues -- including the four new modifiers the CMS recently announced.  Everyone in the room valued an update on this (so far, still confusing) new information from the CMS.  When you're working by yourself in your practice office, juggling all the normal day-to-day tasks and priorities, it can be all-but-impossible to get a clear answer on some of these kinds of issues.  Programs like PQRS and PCMH are very difficult to parse through alone; it's hard to feel confident that you're on the right track, and the consequences are expensive.  Being taught by an expert at a conference can be a lot cheaper than going it alone and getting it wrong. Of course, not all conferences are created equal.  Be picky.  Choose events by respected organizations, with well-regarded speakers.  Review the agenda to be sure it hits the topics most relevant to your practice.  And don't forget to consider the value of the audience: conference networking creates connections that can help your managers get help problem-solving long after the conference ends.  So think about who will be there when selecting.  It might cost a bit

By |2022-01-01T22:52:06-08:00September 17th, 2014|
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Upcoming (free) webinar on patient collections — 9/23/2014

Front desk collections are more important than ever before.  Trends in insurance plan terms mean that patients are more responsible for the cost of their care than at any time in recent memory.  Mastering front desk collections is not just a way to be more profitable -- it's essential to maintaining any level of profitability and keeping your practice healthy!  And there are important implications for patient relationships, too. This is why my new, free webinar is called "Front Desk Collections: the New Linchpin of Profitability."  It's simply essential that front desk staff are empowered to fulfill this critical task.  To learn more about the whys and hows of collecting from patients at the time of service, join me on September 23.  I'll share some of my observations about how to optimize your front desk collections, plus there will be time for any question you'd like to ask. Join me for "Front Desk Collections: the New Linchpin of Practice Profitability" on 9/23/14 (9AM/12PM) -- sponsored by Wellero and hosted by Physicians Practice.  It's free!  Register here.  

By |2022-01-01T22:52:06-08:00September 14th, 2014|
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Group visits: Improving patient access, service and compliance in a profitable way

Group visits can be a great complement to many medical practices that provides many benefits. The emergence of group visits, sometimes referred to as shared medical appointments (SMAs), began when physicians and their managers recognized access for patients with chronic illnesses was inadequate. Patients with chronic conditions such as asthma, COPD and diabetes ended up coming in when their symptoms were exacerbated and out of control. This was either because they couldn’t get an appointment sooner or they were simply non-compliant with keeping regular appointments. Their health condition was being compromised and physicians were frustrated because there was not enough time to address complications sufficiently during the typical time allotted on the schedule. Group visits enable a practice to bring a small group of patients with the same disease together to discuss the common issues they share and how to better manage their chronic condition. At the same time, each of the attendees has individual time with the physician or other provider for an examination and specific treatment recommendations. In 2002 this was defined as a revolutionary access solution in a Group Practice Journal article authored by Edward B. Noffsinger, PhD, a pioneer in the development of group visits. The first clinical applications of this mod Many patients like the group practice visit and getting support from people that share their problems. It can be very affirming. The shared visit often contributes to improved compliance, as some patients report their condition improving when they adhered to their treatment regime.   It’s a win for the patients, the practice and the payer as access improves, cost of care goes down and better clinical outcomes are achieved. Physicians can actually see more patients in less time and the practice gets paid for the level of care provided, since each patient is billed the same as an individual appointment and the co-pay amount remains unchanged. The insurance companies don’t seem to care as much about where the patient is seen as they do about the level of service the patient is getting. It is expected that the group visits will expand rapidly to provide

By |2014-10-20T23:10:33-08:00September 3rd, 2014|
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Front desk collections and patient-centered service

Would you believe that failure to collect consistently and adequately at the front desk can actually create a negative impression of your practice's patient service? And that skipping financial conversations to keep the focus on patient can actually backfire? Money conversations can be hard for all involved.  And, when a practice staff is very focused on patient-centered service, it can seem counter-intuitive to emphasize financial details -- especially when patients are ill or injured.  But, ironically, not being clear about financial terms and not collecting appropriately can actually cause your patients to feel worse about your practice than a conversation about money ever could. When you fail to collect adequately at the front desk, your patients will receive a bill -- and, if you are waiting for their insurance to pay its portion first, that bill may not even be mailed until a month or more after their visit.  By that time, the patient may have forgotten all about the visit -- and never even considered they would owe a balance, especially if staff never mentioned that they would or provided an estimate.  It's likely they've already allocated their monthly budget to other things.  And maybe they're confused about the bill -- and now will spend time trying to figure it out, perhaps on hold with their health plan, or feeling they have to call your biller.  All of this adds up to aggravation.  And if they don't believe (or don't want to believe) they owe the money, they can become quite angry with your practice. Nobody likes unexpected bills.  Properly estimating patient costs and alerting patients that they have financial responsibility for all or part of their service is one of the kindest things  you can do for them -- and critical to maintaining a positive relationship. Learn more about front desk collections at my upcoming webinar on 9/23/14 (9AMPST/12PMEST) -- sponsored by Wellero and hosted by Physicians Practice.  It's free!  Register here.

By |2022-01-01T22:52:06-08:00August 26th, 2014|
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Will hospital-physician alignment work or is it déjà vu?

A feature in June's issue of the Los Angeles County Medical Association's Physician Magazine put the spotlight on increasing efforts by hospitals to "align" with doctors -- whether by creating customized contract arrangements designed to better match doctor and hospital incentives, or whether through compensation structures implemented after acquisition of physician practices. (Naturally, acquisitions make alignment even more important, as hospitals race to make these costly investments pay off.) In fact, the article pointed out that -- based on American Hospital Association (AHA) data -- more than one-third of the surveyed hospitals use integrated physician salary models today. This all seems familiar to me as I recall the flurry of primary care practices seeking opportunities for hospital acquisition back in the late '80s. The motivation for physicians then was the fear of managed care combined with the lure of hospitals offering attractive purchase prices and lucrative guaranteed salaries. Physician-hospital alignment didn’t work so well back then, but will it work now? I’m not so sure. The first time around the objectives of the physicians were in stark contrast to those of the hospitals, which wanted to secure referrals and gain a competitive advantage. Physicians bought into the security of employment and a guaranteed salary with little thought about the implications of becoming hospital employees. The physicians within these acquired practices did not do well when demands were made by their new employer. Physicians also assumed that large hospitals with more business savvy would be better equipped to manage medical practices efficiently. However, hospitals with corporate mindsets, slow decision-making processes and no experience with running practices were not prepared to manage the acquired practices. The relationships became adversarial. Soon hospitals began to see some of these practices as simply a sea of red ink. Soon consultants across the country were recruited to deal with the situation and unwind the deals. Fast forward to 2014 and there are some major differences in the healthcare climate surrounding alignment. A new fear has emerged for physicians. It is the Affordable Care Act and its potential implications. Mature physicians wonder if private practices will be

By |2016-08-19T17:48:04-08:00August 3rd, 2014|
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New rounds in the patient satisfaction debate

On July 8th Medscape presented a thought provoking discussion with three primary care physicians titled “The Good and Bad of Patient Satisfaction Measures.” This fuels the ongoing debate of the value and  scores as part of physicians’ payment for their patient services -- a subject of keen interest to me. In March 2012 the Archives of Medicine published a study conducted by Joshua Fenton, MD, MPH, and colleagues at the University of California, Davis. The study analyzed data from more than 50,000 adult patients, indicating the most satisfied patients were 12% more likely to be admitted to the hospital and their healthcare and prescription drug costs were 9% higher. One of the most interesting findings to the study’s readers was that the report revealed more than 26% of these patients were more likely to die. What a startling fact! One of the strengths of this study was its nationally representative sampling. The findings were derived from the assessment of satisfaction based on 5 measures from the well-known CAHPS survey, emergency department visits and inpatient admissions. The tension between patient satisfaction and patient outcomes and cost savings continues two years after the study was released. There is discussion about whether physicians motivated by payment structures based on patient satisfaction are influenced in the ordering of diagnostic studies typical treatment standards in order to keep patients happy. An article in appearing in Forbes on July 21, 2013; “Why rating doctors is bad for your health” by Kai Falkenberg discusses this issue. "THE MATH IS NOW SIMPLE FOR DOCTORS: More tests and stronger drugs equal more satisfied patients, and more satisfied patients equal more pay. The biggest loser: the patient, who may not receive appropriate." When physicians are pressured and financially incentivized to keep patients happy an ethical dilemma occurs and some physicians succumb to appeasing patients by ordering tests they might not otherwise order. Forbes reported that the South Carolina Medical Association asked its members whether they’d ever ordered a test they felt was inappropriate because of such pressures, and 55% of 131 respondents said yes. Nearly half said they’d improperly prescribed

By |2022-01-01T22:52:06-08:00July 21st, 2014|
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Where will your superstar employee grow?

When you have a stellar employee -- say, an amazing MA or RN, or a superstar patient service performer at your front desk -- it's likely that this hard-working, dedicated employee is hoping you're noticing.  And it's also likely they're hoping that you're noticing because you're thinking about giving them more responsibility, allowing them to develop more skills, and nurturing their aspirations. Too often, though, physicians and medical practice managers react to notable displays of talent and dedication by doing everything they can to keep that superstar employee in the same job.  It's understandable: who wouldn't want to have the world's best MA supporting them at a busy practice?  But when that superstar is looking to grow and advance, they'll eventually only resent your efforts to keep them in the same role 'because they're so great at it.'  They're going to start to feel punished for their excellent performance.  And when that employee realizes that you're never going to allow them to grow because they're 'too good' at their current role, he or she will start looking for a better growth opportunity elsewhere. Even if your practice is small, you can give employees a feeling of growth and development in their jobs. If your practice is so small that it's inevitable that strong performers will feel compelled to leave eventually, manage for this outcome. Help employees to grow and expand their responsibilities and earn recognition while they're with you.  You'll enrich their experiences while they are on your team and help keep morale high -- and, you'll be more ready if it unexpectedly becomes necessary to promote someone new to practice manager or team lead.  Regardless of the size of your practice, cultivating 'bench strength' is important to protect your business -- and the process of doing it can help your staff members feel more excited about their future prospects (either with you or in their next role).  Even when employees end up moving on, if they've had a wonderful experience working with you, there's always the chance you'll be able to hire them back at a higher level when,

By |2022-01-01T22:52:06-08:00July 7th, 2014|
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Increase productivity and enjoyment with a larger monitor

It’s commonplace to see staff and physicians hunched over their computer monitors squinting as they work.  When you consider the amount of time each day that people are working on their computers, the benefit of alleviating eyestrain with larger monitors is clear.  While many off-the-shelf computer bundles (CPU and monitor) purchased a few years ago came with relatively small monitors, perhaps 15 to 17 inches, much larger monitors can be purchased for very little – high quality 27-inch monitors currently run under $300! While we highly recommend at least 24-inch models wherever space allows, there are a couple of considerations to keep in mind.  First and foremost, while nearly all monitors are plug-and-play making basic set-up a snap, it is still crucial to fine tune your graphics settings to optimize both the resolution and the type size – even though the maximum resolution (number of pixels, sharpness) of new monitors is high and the screens large, you may find that they type size is too small. Do not reduce the screen resolution to increase text size.  It’s far preferable within Windows-based systems, to adjust through the control panel/display and adjust text size without sacrificing clarity and resolution. If your routinely use multiple pieces of software concurrently, it may well be worth exploring two-monitor configurations so that they can display more than one system at a time. Setting up a these systems, may require special hardware such as an additional video card, while it isn’t tremendously difficult, it is a task best left to professional. Monitor upgrades are a frequent recommendation in our practice assessments and I've never seen a single person that wasn't delighted to have more screen space. I trust that you’ll see the same gains in productivity that we've seen.

By |2022-01-01T22:52:06-08:00June 30th, 2014|
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Google Places, +Local renamed and reorganized again: Google My Business

Google seems to change up the marketing and integration of its business listings offering about twice a year; the newest incarnation, "Google My Business," continues the search giant's efforts to better integrate its various directory, map and social tools for local businesses. Given that the change just happened a few days ago, we're still digging in to see if there is any significant impact on medical practices and their physician listings.  So far, it all looks reasonably familiar, but the process for setting up listings is perhaps a bit more streamlined. If you've heard us speak about claiming your Google Places or Google+Local listings and haven't yet gotten started, head to www.google.com/mybusiness to get started -- the process hasn't changed much, and it is still pretty intuitive and easy to complete.  

By |2022-01-01T22:52:07-08:00June 30th, 2014|
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Doc’s new doc(umentary) aims to illuminate the challenges of the ER — and the EHR

All Things Considered (NPR) has a great story that I think any doctor or healthcare professional will find worth a listen (~5min).  Emergency physician Ryan McGarry talks about the new documentary film he directed called Code Black, which goes behind the scenes at always-busy LA County Hospital's ER.  Click here to listen on the NPR site. McGarry speaks passionately about the changes he's seen in his time in the ER -- including the intrusion of regulations and record-keeping into the patient relationship. For more on the movie itself -- include release dates for various cities around the country -- visit the Code Black movie site.

By |2022-01-01T22:52:07-08:00June 22nd, 2014|
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Windows XP – It’s time to move on and quickly!

Since April of this year, Microsoft has ceased to offer security updates for Windows XP which means that practices with even a single network-connected pc running Windows XP are violating HIPAA and ineligible for meaningful use. If any of your computers are using XP, you should move immediately to replace these computers – any hardware that came running XP is almost certainly underpowered to make upgrading software alone a worthwhile endeavor. Before you dismiss the urgency of this matter, consider that hackers often actively target non-supported operating systems because their vulnerabilities are easily revealed simply be looking to see what patches are being offered for supported systems.  Once identified, these weaknesses are relatively easy to exploit, which potentially puts your entire network at risk.   Costs of any security breach will certainly exceed the costs of buying and configuring a new pc, which is typically under $1,000.

By |2016-03-04T11:50:12-08:00June 20th, 2014|
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Didn’t win a complimentary copy of Laurie’s ebook? There’s another way to get one.

If you weren't one of the 100 lucky winners of my medical billing service ebook, Get the Best From Your Medical Billing Service (Management Rx), you might be able to borrow it for free.  If you're an Amazon Prime member, you can borrow the ebook for free for up to a month.  (If you're not yet a member but are thinking about it, click here for Amazon Prime Free 30-Day Trial-- once you sign up, you'll be able to borrow my ebook and loads of other interesting stuff (one at a time) as well.)

By |2014-06-18T13:54:50-08:00June 18th, 2014|
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It’s a great time to be a medical billing professional

During our webinar with Kareo (@gokareo, #kareowebinar) today on choosing and managing a third-party medical billing service, one of our attendees commented that it seemed like we were predicting that billing professionals were going to lose their jobs in droves, thanks to the trend toward outsourcing medical billing.  Nothing could be further from our view!  If you're a medical biller currently working inside a practice, and you're wondering if the outsourcing trend is a negative for your career, our take at C&M is that the trend towards outsourcing medical billing (which itself is driven by two other key trends: increasing billing complexity and improvements in billing and EHR software) should mean more opportunity for you in the future.  But you might need to expand your vision for how your career will unfold. As billing services proliferate -- and cloud-based tech companies like Kareo, eClinicalWorks, Athenahealth and others up the ante by creating their own services to take advantage of their integrated practice management and EHR platforms -- demand for experienced and knowledgeable billers will only increase. The key difference is that new jobs for billers are being created more quickly in billing services than in practices. While jobs inside practices may gradually become harder to come by, the growing market for outsourced medical billing services will not only maintain or even expand the total number of billing jobs available, there will be much more variety in the types of jobs, too.  Billers will have the chance to work in organizations with other like-minded professionals, perhaps even specializing on a medical specialty or other billing niche if they are so inclined. And cloud-based tech platforms like Kareo's allow motivated and entrepreneurial billers to set up their own services much more quickly and easily than ever before -- and allow billers to offer great technology to their practice clients as well. We foresee a great future for medical billers -- with more options, whether as employees or business owners, and more career growth and flexibility in the future. It's a great time to be a medical billing professional!

By |2022-01-01T22:52:07-08:00June 18th, 2014|
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Reminder: Tips for choosing and managing a medical billing service (free webinar)

Reminder: I'm presenting a free webinar this Wednesday, June 18 (10AM Pacific, 1PM Eastern) with Kareo, offering tips to maximize the benefit of outsourcing your medical billing .  Whether you're already using a third party billing service or just considering switching to one, this webinar will provide you with ideas, insights and pitfalls gathered from Capko & Morgan's years of experience working with practices that have chosen the outsourcing route. PLUS, best of all, 100 lucky attendees will get a free copy of my ebook on the subject, Get the Best From Your Medical Billing Service (Management Rx). Woohoo! Hope you will join me next week! Click here for the sign-up page on Kareo.com.

By |2022-01-01T22:52:07-08:00June 16th, 2014|
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The minimum wage conversation and your medical practice

A few months ago, when the idea of raising the federal minimum wage over $10/hour first became a hot topic in the news (with some federal workers even getting a minimum wage bump), we worked with an internal medicine practice in a rural area that had many employees earning around that proposed new figure (or even a little less).  Although the news really had no effect whatsoever on the practice's compensation structure or even the local economy (where $10/hour was still well above market rate), it still caught the attention of employees, and had started to eat at their morale. "So now I could be paid just the same if I worked at McDonald's?" said one front desk employee, whose hourly rate was right around $10, during our confidential interview.  "I might as well work there.  I'd never have to stay late," she lamented.  She was not the only employee thinking this way.  Many team members were deeply affected by the idea that their compensation level -- which in every case was at least 20% higher than the actual prevailing minimum wage in their area -- was what some people now considered the minimum standard for people with no experience and no credentials. Even though no change to the minimum wage had taken place, these employees already felt like they'd been demoted! This particular practice really prides itself (justifiably) on its attention to employee satisfaction and to paying employees a living wage -- and the minimum wage discussion in the news, and its unexpected impact on employee attitudes, really threw them a curve ball.  Employees who had previously felt appreciated and well-compensated versus their alternatives in their little rural town were suddenly wondering if they were underpaid -- or worse, under-valued. Medical practices are (unfortunately) accustomed to the unexpected impact of government actions on their business.  But in this case, the impact happened before any action has even happened.  Some markets may not be affected at all by new minimum wage rules, which seem to be much more likely (at least for now) to be driven by local market conditions

By |2022-01-01T22:52:07-08:00June 14th, 2014|
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Working with — or considering — a medical billing service? Here’s what you need to know.

If you're considering working with an outside medical billing service -- or are working with one now -- my free webinar next week with Kareo can help you get the very most from outsourcing.  Using a third party medical billing service can be a great way to improve cash flow and collections, and minimize hassles for your practice -- provided you know how to choose wisely and manage the relationship.  Perhaps the biggest mistake practices can make when deciding to outsource to a medical billing service is to lose focus and interest in the billing process -- making sure your practice gets paid is still ultimately your responsibility, even when you've got an outsourced team helping you make it happen. The key is knowing what questions to ask and to establish a relationship of communication and teamwork with your billing service partner. To explore these ideas -- and many more ways to maximize the benefit of outsourcing your medical billing -- please join us next Wednesday, June 18, for a free, lively and informative webinar that will help your practice work with an external medical billing service to improve profitability -- and your peace of mind! PLUS, best of all, 100 lucky attendees will get a free copy of my ebook on the subject, Get the Best From Your Medical Billing Service (Management Rx).  Woohoo!  Hope you will join me next week! Click here for the sign-up page on Kareo.com.

By |2022-01-01T22:52:07-08:00June 12th, 2014|
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An easy cure for password headaches

Solid, complex and properly-protected passwords are the foundation of your technological security. Maintaining good passwords is surprisingly challenging.  For one thing, the quality of solid passwords inherently makes remembering them difficult. Add an ever increasing number of passwords and you’ve got a perfect recipe for the frustration of constant password resets – a time consuming and costly headache for you and your staff. Fortunately, there are some excellent, low-cost and easy-to-implement solutions in the form of password management programs. The basic idea is that a single program keeps all of your passwords in an encrypted database. My favorite solution is the free and open-source Password Safe. After downloading and installing, simply enter your passwords – entering 30 passwords took me about 20 minutes. Thereafter, simply use this program to access all your passwords.  Any of your passwords are at your disposal with a simple click that copies it to your clipboard. It really couldn't be simpler. However, be sure to back-up your database, perhaps by sending to your gmail account, and be sure not to forget your password!

By |2022-01-01T22:52:07-08:00May 16th, 2014|
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Could an incentive ‘nudge’ improve your medical practice patient flow?

The idea of 'nudging' in behavioral economics gets a lot of play in healthcare. But most of the attention is on the public health/patient side -- i.e., how to persuade patients to do what public health administrators believe is best for them.  These ideas often focus on negatives and can be controversial -- prompting cries of 'nannying' and 'coercion.'  But some fascinating recent research by Balaji Prabhakar of Stanford shows that positive, incentive-based nudging can help reduce traffic and even help people have a little fun at the same time -- and it got me to thinking, should we take a look at this type of positive nudge as a way to improve medical practice workflow? If you have a minute, take a look at this brief article on the Stanford Business School site -- it explains how Prabhakar was inspired to try to help address the insane traffic problem he observed when visiting Bangalore on business.  A commute of 9 miles to his client's office in one of the busier areas of the city took employees an average of 71 minutes!  Prabhakar thought a scheme of incentives might help persuade employees to commute at off-peak times. His goal was to apply a key insight from his work as a computer scientist: that reducing peak load by just 10% would dramatically improve other metrics like wait times.  Could this insight also help your practice? Prabhakar used an interesting incentive to encourage off-peak commuting: lottery entries.  Each early arrival earned an entry into a weekly lottery -- so more early arrivals meant more chances to win. This was a positive approach (unlike some nudges that are perceived as punishments), and it helped make the program fun and created weekly excitement. So what if your practice wanted to reduce congestion -- say, due to late-arriving patients?  What about rewarding patients who arrive on time with a thank you and a scratch ticket or other small gift?  And are there times of day that are harder to book at your practice?  Perhaps a little reward for patients that can come in at those less

By |2022-01-01T22:52:07-08:00April 30th, 2014|
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Payer, hospital directories get in on the ratings act

There have been some interesting developments in the world of physician directories and ratings sites.  First, payers have started opening up their directories, allowing prospective patients to see which doctors are participating before deciding on a plan.  This is useful for practices, too, since it makes it much easier for you to see if your listing information is incorrect (without, for example, needing to contact your rep or access the data through a physician portal). A second interesting trend is that payer sites -- perhaps inspired by the success of commercial physician review/rating directories -- have started adding reviews and ratings to their directories.  While some of you may be groaning as you read this, I think that this is mainly a good thing, provided that patients need to log in as plan members before rating (as seems to be the case where I've seen ratings on payer sites).  This validation of membership helps ensure that the people doing the rating are actually patients -- and not, as sometimes seen on generic reviews sites, people who don't seem to be patients, but instead are just friends with opinions or even disgruntled employees attempting to pose as patients. Hospital directories have also joined the bandwagon -- providing more data about doctors with privileges and affiliations, and even adding ratings in some cases. Which relates to another trend -- it's becoming more common to see a whole bunch of directories at the top of the results for virtually any physician category in many local markets.  With hospital directories, payer directories, physician reviews and ratings sites, generic reviews sites like Yelp and Angie's List, and even Google's own Places/+ directory listings all competing for the top spots, it is becoming much rarer for any practice's own site to make it onto the first page of search results (much less the top half).  Which means it's more important than ever to take the initiative and manage your practice's (and individual physician) online image and reputation. My upcoming ebook will feature practical and quick tips on how to do it -- to be alerted when

By |2022-01-01T22:52:08-08:00April 26th, 2014|
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Authentic strategic planning for your medical practice

Medical practices are taking note of the importance of strategic planning, as they tread the unknown waters of healthcare reform and adapt to changes they may not have invited if given a choice. But do the key stakeholders of most private medical practices really understand what it takes to succeed with efforts to create and successfully execute a strategic plan? Do they know the importance of developing an authentic and that in order to be authentic it must be driven by the practice mission? If the strategic plan is not authentic in consistently delivering on the mission it is likely to fail.  But if it is authentic, it will guide the practice in achieving its strategic goals. Start on your path to strategic success by keeping these essentials in mind while going through the strategic planning process. Begin the strategic planning process by making sure the plan encompasses what the practice is all about and what it represents to the community. This means the goals and the decisions outlined in the strategic plan must be aligned with the practice’s mission and vision.  It is important to articulate the significance of this from the onset and revisit it as you go through the many processes of strategic brainstorming, goal-setting and formulating the written plan. This helps ensure that the decisions and actions identified in the strategic plan are authentic to your very purpose in being a medical practice. Next, identify what differentiates your practice from its competition. It is critical to examine market data to understand external factors that may impact the practice now and in the future. It is also critical to take an objective look at the practices strengths and weaknesses, exploring what opportunities this presents and what obstacles must be overcome.  Sometimes, this is referred to as a "SWOT" analysis, for "strengths, weaknesses, opportunities and threats."  These analytical steps help the practice address issues it must contend with and make appropriate strategic decisions based on the reality of your market position. Practice-wide engagement is needed to succeed with implementing a strategic plan.  This means communicating your strategic goals

By |2022-01-01T22:52:08-08:00April 22nd, 2014|
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The patient-centered specialty practice (how special are you?)

In 2013 NCQA rolled out the Patient-Centered Specialty Practice, PCSP, Recognition Program to distinguish specialists that achieve specific marks with: Developing and maintaining referral agreements and care plans with primary practices; Providing superior access to care (including electronically) when patients need it; Tracking patients over time and across clinical encounters to ensure patient care needs are met; and Providing patient-centered care that includes the patient, and when appropriate, the family or caregivers, in planning and setting goals. The motivation behind the PCSP program began when reporting discrepancies were identified between referring physicians and the specialists they refer to.  For example, referring doctors claimed that between 25 and 50% of time they were unaware if the patients they refer are actually seen by the specialists.   Another discrepancy was the specialist claiming they sent consult reports 80% of the time, but the primary care physicians state they receive this information only 60% of the time. With the PCSPs intent on improving care coordination and communication between specialists and their primary care physician, managing chronic and acute conditions across continuum of care will be better accomplished. The PCSP program also evaluates medication management, test tracking and follow-up and information flow over care transitions. This recognition program is expected to result in a better patient experience and improved outcomes.

By |2014-04-17T18:31:36-08:00April 21st, 2014|
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