scheduling Archives - Capko & Morgan

Avoid payment confusion while maximizing the service advantages of preventive care

When we work worth practices in adult primary care, OB/GYN, and pediatrics, we often recommend they consider proactively recalling patients for preventive visits. Because preventive visits are usually reimbursed entirely by insurance with no patient cost-sharing, helping patients stay current with preventive care can be a win-win for patients and the practice. A preventive visit recall effort can also help your practice address challenges like: Lower demand and productivity during the first quarter of the year, when patient deductibles reset Summertime revenue shortfalls because of lower visit volume Excess demand for pediatric check-ups during back-to-school and back-to-camp seasons Disengagement of patients who have lost touch with the practice and aren’t monitoring their own health Uncertainty about whether some patients are still connected to the practice Recalling patients for preventive visits allows you to better balance the demand for your clinicians’ time. If you add more preventive slots and book them during times when your practice is slower, you’ll also add predictable revenues. Your patients will benefit, too, because they’ll see their physicians when the practice is less hectic and more appointment options are available. When practices reach out to patients to book an overdue preventive visit, it’s usually a marketing effort that is well-received. Often patients hold off on booking a check-up because they are unaware that many preventive services are covered without a copay—so they’re delighted to hear that an annual physical is something that won’t cause financial pain. There is one avoidable snag in booking preventive care that often trips practices up, however, and it’s a pitfall that puts patient relationships at risk: Not all services that could be provided in a typical check-up are considered preventive from a billing perspective. That can lead to “surprise” patient costs and bills. These unexpected costs can be very upsetting. Even though the causes are usually just innocent oversights, some patients will feel they’ve been cheated or deceived. One way unexpected out-of-pocket costs occur is when a problem is discovered or revealed by the patient during a preventive visit. If the problem requires additional work or tests, that usually means an

By Morgan|2022-01-01T22:51:53-08:00January 26th, 2017|

Technology’s magic trick: making duplicate effort disappear

Technology for the medical practice front office has many benefits. It can speed up processes, keep critical data safe from fire and flood, allow practice staff to tap resources from other organizations via the Internet, and so on. The list is long and growing. But my favorite front office technology benefit by far is the ability to eliminate duplicate effort, especially duplicate data entry. The reason is simple: eliminating duplicate effort is like money in the bank! When you cut down on duplicate data entry, you don't just eliminate the cost of repeating steps; you also reduce errors, which can be even more costly to find and fix. Some errors -- like mistakes in patient demographics or coding -- cause a direct hit to the bottom line, since they affect billing and reimbursement. Get those demographics right the first time, and your likelihood of getting paid promptly just went up -- and the effort required to make it happen just went down. There are many technology tools that medical front offices can use to reduce duplicate effort. Here are just a few that most practices should explore, if you're not taking advantage of them already. EHR/PMS integration. When a practice moves from separate billing and EHR systems, or from paper charts to an EHR that integrates with the billing/practice management system, the gain in billing efficiency is profound. An integrated EHR/PMS set-up allows physicians and other clinicians to transmit superbills electronically from the EHR into the PMS. This means no data entry of CPT and diagnosis codes from paper tickets -- a huge time savings. But even more important, the data that's transferred over to the billing system is exactly what the physician or non-physician provider intended -- not what the biller guessed at based on a handwritten superbill. And if there are any doubts about the services provided or diagnosis codes, the chart note is right there in the system to provide clarification. EHR/PMS integration means faster, more accurate billing -- for faster, more reliable reimbursement. Fewer delays to clarify what's supposed to be billed, and no risk that

By Morgan|2022-01-01T22:51:54-08:00November 10th, 2016|

New ZocDoc survey spotlights patients’ reluctance to seek care, even preventive care

ZocDoc just published a compelling new article and infographic pulling data from a survey they recently conducted about patient behavior. The data put a quantitative face on what many of us have been observing anecdotally and reading in blog commentary online -- namely, that patients are increasingly reluctant to see their providers, and costs and scheduling challenges are a big part of why. One tidbit that jumped out at me, since preventive care is something I consider a win-win opportunity for practices and patients, is that 80% of patients surveyed were putting off preventive care. Some of the key reasons ZocDoc found were the inconvenience of keeping an appointment during work hours (in fact, more than 40% said they would likely cancel because work took priority) and the inconvenience of making an appointment in the first place. Preventive care should be increasingly valuable to patients as deductibles and co-pays have grown across all types of health plans. But many patients don't realize that this is usually a way they can take advantage of their coverage without cost-sharing. Many other studies have shown that patients are more confused than ever about their health plans; this puts the burden upon practices to fill in the information gap (but that also spells opportunity for practices that do so). Are you doing all you can to engage patients and encourage them to take advantage of their preventive care benefits? Some ideas to consider: Consider offering an early morning or early evening appointment option at least once per week -- or even occasional Saturday appointments Look into online scheduling to allow patients to book appointments without having to make a call during work hours Use EMR list tools (remember them from MU?) and your portal to reach out to patients who haven't had preventive services or are overdue Put information about what's included in preventive care -- and why it's important -- on your website

By Morgan|2022-01-01T22:51:59-08:00June 29th, 2015|

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 Judy Capko|2022-01-01T22:52:03-08:00October 24th, 2014|

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 Morgan|2022-01-01T22:52:12-08:00November 11th, 2013|

When it comes to no-shows, think like an economist

As medical practice management consultants, we're naturally always looking for 'best practices' we can share with all of our clients. There is often a rub, though: what's 'best' for one practice (or one practice type) may not be right for everyone. When it comes to the best way to solve practice management problems, sometimes the only correct answer, as economists like to say, is 'it depends.' No-shows -- how to deal with them, how to minimize them -- are a great example of this sort of problem. I've been participating in a lively discussion on the subject on LinkedIn in the medical office managers group. The discussion was kicked off via a link to an article that seemed to have the definitive list of to-dos (and not-to-dos) to maximize show-rate -- except that the comments from participants in the group suggested it wasn't so simple. Example: "don't use postcards as reminders -- they're a waste of money and don't improve show rates." But, the data cited in the article pertained only to a residency-based family practice, and the study didn't provide any information about the wording of the reminders. But, other studies that weren't restricted to academic family practices showed otherwise, although the relative benefits of postcards versus other reminder methods were less clear. And other data show that multiple reminder types used together -- a combination of postal and SMS text, for example -- might deliver still better results. Given the lack of clear data on an issue like no-shows, you may need to try different approaches and aim to continuously improve your practice's performance. The answer to the problem of the right mix of reminders for your practice is likely to be "it depends" ... but, on what? The good news is, you can think through some of the possible factors that will influence reminder success pretty readily, since you already know a lot about your patient base. For example, you know something about the age of your patients. A practice with mostly older patients -- say, cardiology -- might find that postcards are still among the best

By Morgan|2022-01-01T22:52:32-08:00April 18th, 2013|