Don’t believe the hype: patient portals aren’t “largely unused”

A provocative headline got my attention recently. It proclaimed that patient portals are "largely unused." It caught my eye partly because it didn't sound all that plausible -- and because taking such a headline at face value could be unhealthy for your businesses, dear clients and friends of Capko & Morgan.  I decided to dig into the matter. The article text actually mentioned that 37% of patients have recently used portals. Could the author actually believe that 37% utilization is trivial? That seemed to be what they were saying, yet it's hard to imagine they believe that. (Would a 37% decrease in salary leave one's pay "largely" unchanged?) Perhaps, you may be thinking, this was just a forgivable, inadvertent misuse of "largely." But I tend to think not. This type of exaggeration is just too common in modern media, even in our world of the business of healthcare. I tend to think the headline intended to sensationalize. Yet even if that wasn't the intention, it's still not a benign error, which is why I'm calling it out. Mischaracterizing portal adoption has a hidden cost Clients often tell us they've held back on technologies that could make their practices more efficient because they're concerned patients won't use them. But that thinking usually means practices miss out on significant benefits, since the tools they delay adopting (or forgo altogether) could make interaction easier for patients or make their practices more profitable (or both). This tendency to hesitate has been especially true for patient portals, and it's often very costly. Somewhere along the way, the idea took hold that portals aren't worthwhile unless nearly every patient uses them. But this is not true. It's not even close to true. If even a small percentage of patients regularly uses a portal, those patients will benefit -- and their physicians will save time, too. (And that's strictly on the clinical side. Portals have the potential for even more dramatic benefits on the payment and administration side, even when utilization is very low.) What's more, relative to other recent technologies, portal adoption is arguably not that

By |2022-01-01T22:51:45-08:00December 20th, 2018|

Credentialing: is it time to upgrade your process with software?

Credentialing can be a frustrating, mysterious, time-consuming process. It can seem like a black box: you throw your (copious) data in (with no idea what will happen to it), then hope you'll get what you want out of the other side (eventually -- you have no control over when). Worse, unlike most other administrative tasks your staff handles, credentialing has seemed immune to process improvement. It's no wonder so many practices outsource this tedious, unpredictable paper-pushing. But that can lead to another set of problems. For example, when delays occur, how do you know whether there's a problem with the application, the payer is just slow, or your credentialing service dropped the ball at some point? Constantly checking in with a credentialing service for updates wastes valuable time on both sides -- especially since your credentialing service has no more control over how long it takes payers to respond than you do. Thankfully, dear reader, you and I are not the only people who've observed the built-in productivity drains in credentialing the old-fashioned way. In recent years, technology whizzes have stepped in to improve the process. There are still frustrating pieces of the puzzle that technology can't yet fix -- like the need for physicians to gather all that information in the first place, and like the uncertainty about where submitted applications stand with payers. But technology can help with: maintaining a single source of credentials -- to avoid submitting out-of-date information or incomplete information tracking key dates enabling physicians to enter their own information via a portal -- to avoid double entry of data, and the associated costs and errors automating the completion of many forms in some cases, automatically updating or communicating electronically with important third parties like CAQH If you are not yet using a credentialing software product, now is the time to check your options out. And if you're outsourcing, it may be more efficient to bring the task back in house, supported by up-to-date software. Or if you continue to use a credentialing service, be sure that your partner uses a cloud-based system that you

By |2022-01-01T22:51:45-08:00December 4th, 2018|

Responding to external trends that threaten practice profitability

When we work with physicians and managers who've found their financial results have inexplicably declined, they often wonder why the profit numbers changed when the practice is still managed in the same careful way as before. It's a puzzle and a disappointment and a huge source of frustration! But therein lies the rub: As managers, our job is often to respond to changes that happen outside our business. Doing things the same way, even when executing perfectly, is often not enough to assure good results. Things are happening in the broader market that affect our patients and their behavior. It's our job to recognize when trends that have nothing to do with medicine still require a response from our industry. One really powerful example of a completely external trend that is nonetheless affecting every practice business is the rapid adoption of online payments by consumers. If your practice hasn't responded to this trend, it's probably already affecting your collections negatively. The shift in payment behavior by consumers has been dramatic. I created the chart to the left using USPS data showing that single-piece stamped mail has declined more than 50% in the past decade. The Post Office attributes this decline to shifting consumer preferences, especially for bill payment. The days when it was normal behavior for consumers to sit down once a month and review paper statements, write stacks of checks, stuff the checks in return envelopes, then stamp the envelopes and drop them into the mail are rapidly disappearing. Patients' strong preference for paying electronically is both an opportunity and a threat to your practice business. Give patients an easy way to pay online -- better yet, give them electronic statements, too -- and you'll get paid faster, with less labor required, and reduced paper and postage costs, all while making patients happier. Now that's some serious upside! But if you don't make online payments possible, you're also risking getting paid more slowly, with higher collection costs. That's because it's not just a matter of patients preferring to pay online. They're organizing their budgets and managing their money in

By |2022-01-01T22:51:46-08:00July 21st, 2018|

Fix the problem, not the blame [practice management tip: operations and workflow]

“Fix the problem, not the blame” is a well-known Japanese proverb. It sounds like common sense – isn’t fixing problems what we all ultimately want? But when mistakes happen, the search for culprits instinctively begins – and with it often comes demoralization and tension. Worse, the search for a scapegoat usually won’t keep problems from recurring. Bad systems create more problems than bad employees. When workflow is faulty, the mistakes are built into the process. Figuring out who was working the process when it failed does nothing to prevent failure in the future. As organizations grow and silos (i.e., departments) form, so do opportunities for workflow inefficiencies to masquerade as staff incompetence. We’ve worked with medical practices that have grown so fast, they haven’t noticed their processes aren’t keeping up.  But even more than growth, market evolution has put new tasks on everyone’s plate. These tasks may not fit well with jobs as originally configured – and that may mean more errors. Here’s a common example. Insurance has become increasingly complex for patients and staff alike. Higher deductibles have also made front desk collections a priority, but it’s a new priority added on top of everything else. Are front desk employees already trying to answer phones, check patients in, answer questions, collect demographic information, and verify insurance? When patients are seen and it turns out they weren’t covered or aware they owe a deductible, it may seem “obvious” that the front desk staff is to blame – especially to your billers, who must deal with the errors. But more likely, front desk employees are simply juggling too much. As jobs evolve, mistakes may increase. Resentments can fester between departments. But the answer isn’t to find someone to blame – it’s to find out where the process breaks down. In the case of the front desk, a better response would be to reconfigure roles, to let staff focus on the tasks in front of them, without multitasking. As work gets more complex, making people feel embarrassed and afraid won’t help them do their jobs better – retraining staff and refining their

By |2018-06-11T16:36:02-08:00June 27th, 2018|

Don’t confuse personal finance and business finance [practice management tip: financial management]

When presented with ideas to update your medical practice’s technology, better support your clinicians, or market your practice in a new way, is your go-to reaction “we don’t need that” or “we’re doing fine without it”? Is your financial management approach simply to always minimize expenses? (Perhaps because you remember the old maxim of taking care of the pennies and the dollars will take care of themselves – or, its more modern cousin, “the latte factor”?) If you’re thinking about business spending in the same frugal way personal finance experts recommend you run your household, you may be missing out on opportunities to grow and increase your profits. Keep it up long enough and you may jeopardize your practice’s future profitability. The good advice to skip a few lattes and pocket the money simply doesn’t correspond to many business expenses. While a latte is a fleeting pleasure, upgrading practice technology is an investment that can increase productivity for months or years to come. Similarly, keeping headcount at the number needed to “get by” may mean your physicians, NPs, and PAs will be less productive – an opportunity cost that quickly outpaces the “savings” from bare-bones staffing. Just because a business investment requires a decision doesn’t mean it is analogous to that forgone latte that puts money in the bank. Not pursuing an investment may actually cost more in terms of lost revenue and profit. Over time, under-investing in productivity tools, visibility for your practice, and modern, convenient patient service can make it harder to attract patients and retain staff. Rebuilding from that sort of decline can end up being much more difficult and costly than investing in keeping your practice up-to-date and well-staffed would have been. Before rejecting investments in your practice’s infrastructure, marketing, and staffing out of habit, be sure you’ve considered whether the upside you’ll pass up is greater than the savings.

By |2022-01-01T22:51:47-08:00April 17th, 2018|

Technology for patients: Think good, not perfect

(c) Barclays PLC* A few days ago, the ATM turned 50. The first ATM in the world debuted in London in 1967; we got our first one in the US in 1969. Wow! I bet that the ATM has been around longer than many of you reading this. It's hard to imagine a time when this technology wasn't on every street corner. Yet when the ATM was first introduced, it was slow to catch on. In fact, it took about 30 of those 50 years for the ATM to be used by 2/3 of consumers -- and even as recently as 2013, more than 10% of consumers still had yet to pick up the ATM habit. The ATM's slow-but-steady path to everyday use got me thinking about technology in the medical practice. Technologies to connect patients and practices, especially on the administrative side, have emerged at a fantastic pace in the past few years. But many practices we've worked with have hesitated to implement them, for fear that the majority of their patients won't use them. Some practices that have implemented, say, a patient portal or online scheduling, have been disappointed because only a portion of patients seem excited to use it. "Laurie," they say, "we tried that. Only 20% of our patients used it. It was a failure, so we abandoned it." But when the ATM was first introduced, the adoption rate was much slower even than a 10% or 20% utilization your practice might see on its new payment portal or online schedule. So why didn't the banks give up? After all, implementing an ATM network is a massive, risky, very costly undertaking. So why were the banks undeterred by their meager initial results? And what can we learn from it for our own technology initiatives? The key is to focus less on the people who don't try the technology, and more on the people who do. For every one of those few customers who used the ATM in those early days, the bank could declare a victory. The consumer who wanted to use an ATM

By |2022-01-01T22:51:48-08:00July 4th, 2017|

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

Appreciating the art of the possible

I stumbled upon this quote by Facebook CEO Mark Zuckerberg recently: I think a simple rule of business is, if you do the things that are easier first, then you can actually make a lot of progress. This makes so much sense for any enterprise. If you're stuck, try chipping away at the easiest part of a problem. It also strikes me as especially relevant to front office tasks and automation in medical practices. The need to embrace automation, to use technology better, to provide more self-service, etc., is, I think, becoming more understood in practices of all sizes. But that doesn't make the thought of these things any less daunting! Practice managers and physicians may hear "technology" and immediately think, "Oh no, not that again." Visions of EHR implementations that wreaked havoc are vivid and pretty easily recalled. It can be hard to imagine an ROI large enough to make reliving that pain seem worthwhile. But in the front office tech space, many solutions are emerging that are easy to implement -- either wholesale or in parts. And ticking off just one box at a time can give your practice business a boost, even if you're not ready to take on a full-scale automation overhaul. For example, payment portals and email statements have become much easier to implement. Many PMS vendors offer these as built-in tools. Activating these features may (literally) take only a few moments. And if even just one patient finds the convenience encourages him to pay more promptly, the effort you and your team invested will likely be repaid. One of the very best things about how technology for the front office is evolving is that there are more and more targeted solutions to specific, costly problems. You usually don't have to engage in a massive conversion to a new platform to take advantage of any one solution. Chipping away at front office inefficiencies by trying one or more new technologies is a very realistic way to tackle problems that seem very complicated and daunting when taken as a whole.

By |2022-01-01T22:51:55-08:00July 21st, 2016|

Avoiding insurance errors, problems tops the list of medical billing priorities

Capko & Morgan has had the honor of collaborating with the MedData Group on several recent MedData Point surveys. This month, we worked together on one of our favorite subjects: billing and collections. The results may reflect some subtle but interesting changes to recent trends. For the past few years, it has seemed that the dramatic increase in patient payment responsibility was the focus for most practices.  According to this new survey, patient payments are still a very pressing concern for most practices (53%). But this issue was edged out for the top concern by coding errors and other denial causes, which 59% of respondents considered very pressing. We wonder if this is related to narrowing of networks, increasing pre-authorization demands from some payers (mentioned by 49% as a pressing issue), lingering ICD-10 issues, or some combination of the three. Not surprisingly, AR and bad debt are still top-of-mind medical billing problems (49%). We were a bit surprised, though, that preparing for new payment models was only a pressing concern for about a quarter (28%) of respondents. But the CMS is also projecting that most practices will hold off on alternatives to fee-for-service payment, at least for now. Only 25% of respondents put adding or enhancing billing technology on the list of key concerns. We’d love to see more practices take advantage of the growing array of innovative, affordable tools to improve collections from patients and health plans alike. These results seem consistent, though, with what we found in another recent MedData Point survey: practices may not be aware of all the new front office solutions that can make their practices more efficient and profitable. Our consulting group is delighted when we get the opportunity to help practices get more from technology, including systems they've already invested in, especially to improve billing and revenue capture.  Contact us if you'd like to explore how we can help.

By |2022-01-01T22:51:55-08:00July 20th, 2016|

Are you missing out on excellent solutions to front office challenges?

Capko & Morgan recently collaborated with MedData Group* on a physician survey about front office technology awareness and plans. The results seemed to confirm what we see among our clients: many physicians are unaware of the full array of excellent innovations that have recently emerged to support the medical practice front office. Check out this chart from the infographic that MedData created from the survey data.   It's interesting to see that even the tools that are most commonplace, check-in tablets and automated reminders, widely available for a decade or more, still barely passed 50% awareness.  This is consistent with what we experience when we talk to practice administrators and physicians about front office technology solutions. Often, administrators and physicians also assume that such tools are aimed primarily at large health systems or hospitals and aren't affordable or even feasible for independent practices -- but this is not the case. As technology has proliferated among consumers, so have ways to use it to make working with your practice more convenient for patients, and to make processes more efficient for you. For example, studies from other industries have shown that consumers mostly prefer to pay electronically, and reward the businesses that let them do so with more loyalty and more reliable and prompt payment.  Most practice management systems offer email statements, payment portals, and other tools that make offering online payments very easy, but practices too often assume that implementation will be difficult.  It usually isn't complicated at all -- in fact, we've worked with two different practices recently that were able to get their online payments solutions up and running within an afternoon.  These practices found money waiting for them, deposited via online payments from patients, when they arrived at the office the very first morning after implementation! There are many other front office technology solutions that can help practices enormously, but that aren't getting the attention that they should.  These tools can make some of the most frustrating and tedious practice challenges -- no-shows, patient collections, payment plans, front desk paperwork -- a lot more manageable. And they impress patients

By |2022-01-01T22:51:57-08:00February 11th, 2016|

Ready for the deductible re-set?

It's almost that time again: deductibles re-set in less than a month. Got your game face on? For many practices, the end of the year is so busy, it's hard to think about planning for slow business in January, February and March.  Ironically, the cause of the busyness in Q4 is related to the cause of slower demand in January: deductibles. At year end, patients are eager to bring any known problems or elective procedures in to practices, because their deductibles have been met or nearly so; in January, many patients delay care because their deductibles re-set to their original amounts (or even higher amounts in many cases). It may also seem like there's little you can do to deal with the deductible re-set. But you do have options, and making even a small dent in the downturn can make a big difference in overall profitability. So isn't it worth trying? If you're in a pediatrics, adult primary care, or OB/GYN practice, of course one of the best steps you can take to smooth your revenue is to let patients know you have availability for preventive services in the beginning of the year. Let them know that your practice may be less crowded (barring, of course, a wave of flu or another virus coming through your neck of the woods).  Make sure patients are aware that preventive services usually come with no copayment or deductible.  (It can be helpful to create a list of common tests and vaccines that are preventive per the USPSTF, to avoid confusion.) Here's where your EHR can shine: use list-generating capabilities to identify patients that are due for preventive services, or who have chronic conditions are overdue for a regular visit.  For example, it's usually easy to isolate healthy patients you rarely see that are overdue for pap smears, hepatitis screening or check-ups. Tapping your system a little more creatively, you can identify patients that have just crossed a threshold to qualifying for a preventive service such as herpes zoster, pneumococcal pneumonia vaccine or cancer screening. Patients that turned 65 in 2015 may also be identified and offered an

By |2022-01-01T22:51:58-08:00December 8th, 2015|

Ready to take the CCM plunge?

As you may know already, I've been working on a series of papers on Medicare's chronic care management reimbursement program (CCM) for the Medical Product Guide. (Click on 'resources' after visiting the Medical Product Guide link if you're interested -- they're free.) Talking to practices that have already started working on CCM, along with others that have held back, has been a learning experience.  The ability to take on CCM quickly depends a lot on your current practice set-up and, especially, your EHR. On the current set-up side, if you're working on or already have set up a medical home (PCMH), and have one or more case managers in place to support it, you may find it easy to use the same staff structure for CCM. Your case managers could become the coordinators for CCM as well -- perhaps personally contacting patients and doing the other care management tasks that contribute to the required 20 minutes per month for billing. Perhaps there will be overlap between the PCMH and CCM that could be beneficial -- if, for example, you're looking at a similar mix of conditions, that might allow for some standardized communications or tracking tools.  Or perhaps you could add a group visit program that would serve patients from both programs. (A group visit program wouldn't contribute to the CCM monthly time requirement, since that's strictly non-face-to-face time, but it still could be well received, and fit with the patient engagement goal of the program.) On the other hand, if your practice hasn't yet taken on PCMH, CCM could be a stepping stone. Many primary care practices believe they're already doing many of the tasks that are meant to be compensated by CCM -- they're just not tracking them, and they haven't had a way to bill for them, either.  That last problem is expressly addressed by CCM -- the key is solving the former problem of tracking. EHR vendors vary dramatically in this area. Some have already created dedicated modules that allow for templates for clinical staff contacts to be tracked, and for the time to be calculated. Others

By |2022-01-01T22:51:58-08:00October 31st, 2015|

Choose the right billing service, get more than professional billing

Choosing a new medical billing service is stressful. Few activities have more of an impact on practice profitability, after all.  But with the risks of choosing comes upside, too -- and not just in the opportunity to have your billing handled by dedicated professionals. Switching to a third party billing service (or a new service) offers an opportunity to upgrade your technology at the same time. By making the platform(s) your new biller uses part of your evaluation, you can improve other parts of your practice business besides billing itself. Today's billing technology has continuously improved in recent years. Competition has spurred innovation and a wealth of new features. The cloud platform, especially, allows these vendors to roll out upgrades more cheaply and easily (and make them mostly painless for customers, too).  Billing services that use the most up-to-date billing platforms can offer these advantages to their clients as part of the service. When you use a practice management system as part of your billing service relationship, that usually provides you with scheduling, reporting, reminders, verification, and other tools automatically. A more flexible, modern scheduling system can help you maximize provider productivity and reduce costly no-shows. Better reporting allows you to easily analyze the value of your contracted health plans. Verification tools built right into a practice management system save staff time and reduce costly booking mistakes. These are just a few of the benefits you can get by making top-tier billing/PMS technology a requirement of any new billing service you're considering. Of course, you don't necessarily even have to switch services to switch up technology -- if you made a good choice of partner in the first place, that partner will work with you to make a transition if you need to.  (A small, independent billing shop -- even a one-person shop -- can be a wonderful solution for your practice, but it is very important that they commit to keeping up with technology trends and opportunities. In fact, great technology is one of the best tools independent billers can use to shine, by allowing them to focus on

By |2022-01-01T22:51:59-08:00August 10th, 2015|

Your smart phone’s lurking dangers

The iPhone, Android or other cell phone you depend on for everything – besides texts and calls your phone is likely keeping you busy with games; productive with email, to-do lists and calendars; in touch with Facebook, LinkedIn and Twitter; and convenienced with applications as straightforward as a simple flashlight. But how much do you really know about this rapidly growing library of applications? How well do you read the obligatory user-agreement before you install the application? Well, of those “free applications” that most of us have installed more than a few represent some potentially serious risks, especially if you have HIPAA data on your phone.  Most free applications can access your contacts, calendar and other data on your phone – and for purposes of convenience, there are perfectly legitimate reasons for this, but can you be sure the publisher will only use this data for legitimate reasons?  One shocking example came from a flashlight application for Android that, once installed, had access to nearly all the data on the phone. The potential threat from applications, malware and viruses is very complex within a BYOD environment – even the basics of keeping device system software current can be a nightmare when one is facing a multitude of different hardware and operating system platforms.  Naturally, risks of this sort should be thoroughly defined in your HIPAA risk assessment that is a requirement of meaningful use. Regularly updating and refining your risk assessment alone could become overly burdensome very quickly.  Accordingly, it's worthwhile, given the complexity and ever-changing nature of technologies, to consider a very conservative approach – we recommend practices own and manage all devices accessing patient and other critical data.

By |2015-01-26T16:54:09-08:00January 26th, 2015|

You’re only one bad login away from trouble

Physicians and practice managers love using online tools to help run their practices. Whether you’re submitting payroll, doing some online banking, reconciling a credit card statement or confirming patient eligibility you’re using a connected network of devices, any of which could pose a serious threat to the well-being of your practice. While I’ve blogged here on the importance of strong and regularly changed passwords, it’s every bit as critical to be disciplined and conservative with respect to connecting to Wi-Fi networks. Every time you venture out to a hotel, conference or café you’re likely seeing a variety of Wi-Fi networks with nothing to identify them other than a short name. Should you connect to “Starbucks-FREE” Wi-Fi? The following link describes just how simple it is for a hacker to set up a simple network with the goal of stealing the passwords and data of people just like me and you. The straightforward best policy is to never connect to an unknown network (and it’s hard to “know” a network if you’re away from home and work!). For this reason, I strongly recommend using the “share internet” feature of many smartphones – typically there is a monthly cost, perhaps $15 for access, and data usage counts against your monthly phone allowance. Click to learn just how one hacker gains control over computers like yours.

By |2022-01-01T22:52:03-08:00October 30th, 2014|

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|

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|

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|

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|

Windows XP: a potential HIPAA risk — and an opportunity to boost productivity

Microsoft recently announced it will end support for the Windows XP operating system on April 8, 2014 -- and this may have HIPAA implications for your practice. What could 'support' have to do with your HIPAA compliance? The biggest implication is that hackers could discover new ways to breach XP security -- and no support means Microsoft will no longer issue patches to plug the holes.  That means you'll potentially expose protected health information to hackers if you continue using the unsupported operating system. Even if you're using cloud-based EMR and other systems, your office PCs may still contain protected information -- for example, if documents are scanned and saved to their drives. The good news is, PC prices are lower than ever, and upgrading can make your team more productive.  (In virtually every practice we visit, we find at least a couple of computers that are so slow that they are adding to patient wait times at check in, check out and while scheduling on the phone -- and cutting into staff productivity.  Inevitably, the practices believe they're saving money by not upgrading, but at today's prices, faster computers would likely pay for themselves very quickly.) If you act fast, you might even be able to get Windows 7 machines -- you'll miss out on the pizzazz of the new Windows 8 interface, but also skip the longer learning curve when transitioning from XP.

By |2022-01-01T22:52:09-08:00March 10th, 2014|

Dashboards: Practice performance at a glance

A medical practice performance dashboard is a great time-saver to help keep your finger on the pulse of practice performance and understand your position in real time. It is similar to the one in your car – a set of indicators  provide a simple, practical way to know what’s going on and to let you know when you’re headed for trouble. The dashboard is a metric reporting tool that makes it easy to look at business performance so you know when the practice is doing well and are alerted when something is wrong.  Dashboards provide a layered interface that conforms to the way you work.  When performance dashboards are aligned with the practice’s operations, productivity, finances and strategic plan, managers and physicians begin to work more efficiently and effectively toward achieving shared objectives. Typical indicators revealed on the dashboard focus on practice productivity and finances. However, the power of the dashboard can be extended to include other data. For example, if a new provider was added recently or you opened a new satellite clinic, monitoring growth and financial progress of this entity can be added to the dashboard. The dashboard can be designed to compare internal performance from the prior year or to look at how you compare to your colleagues across the nation. Medical Group Management Association’s (MGMA) has conveniently packaged a set of dashboard metrics with its Cost Survey on disc.  This enables the user to create a dashboard based on six indicators that are benchmarked against other practices in a few short minutes. The spreadsheet used to prepare the dashboard shows your ranking when compared to the MGMA database. If you find yourself on information overload with management and financial reports screaming for attention, think about implementing dashboard technology to monitor your practice's business performance at-a-glance.   With web-embedded technology some applications can update information automatically eliminating the need to repopulate the spreadsheets.  Charts and tables can be configured to support drill-down capabilities. Keep in mind, though, that dashboards are only as good as the data that supports them.  Success is dependent on the quality and flexibility of

By |2022-01-01T22:52:09-08:00January 31st, 2014|

Trade shows – there’s so much to gain

There are lots of reasons to spend time in the exhibit hall when attending practice management and other medical conferences. By visiting the exhibit hall you will learn a lot about what’s going on in the industry, how vendors are seeking to meet your future needs and what technology changes have emerged that can make a practice more efficient and profitable, while improving service and outcomes. Yes, there are lots of reasons to get down to the exhibit hall, but it's also important to plan how you can do this without being overwhelmed or wasting your valuable time.  Forget about seeing everything – it’s just not possible and can lead to unnecessary frustration. However, with thoughtful planning you can see those things that can make a difference in your very own practice. Get off to a good start. Conference materials at the convention will include a list of all the vendors that are exhibiting. Match these with your interests. Then check-out their location on the exhibit floor. This will allow you the opportunity to plot your course.  Visit your selected vendors, by covering one section of the floor at a time. It’s a strategic move that will get you off to a good start. Refer back to your vendor list as you move through the convention. You might want to take photos using your mobile phone or make notes. This will be valuable for follow-up and decision-making when you get back to the office. Pace yourself.  Be realistic in evaluating how much time must be spent on the floor of the exhibit hall to achieve your goals and meet with the different vendors you have targeted.  Allow an average of 5 minutes for each of the vendors on your list. When you meet with an exhibitor, it’s important to be a good communicator and get right to the point.  Let the sales representative know what information you want and why.  At the same time, if the sales rep is not a good listener you could be wasting valuable time.  Don’t allow him or her to lead the conversation to information

By |2022-01-01T22:52:10-08:00January 21st, 2014|

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|

ICD-10: The only thing to fear is fear itself

Did any of you catch the ICD-10 TweetChat Kareo hosted on Tuesday?  I participated representing our team(@capkoandcompany); three other panelists from different segments of the medical management world joined in as well (@brad_justus, @modmed_EMA, @hitconsultant).  Kareo does a wonderful job reaching out to its clients and the entire practice management community with events like these -- and we were delighted to have the opportunity to participate!  (Kareo published a summary on its blog -- and you can also search all the tweets using #kareochat .) As expected, there were many smart, informed comments -- and some really good questions by the Kareo folks in particular.  But, I was struck by the relative silence from people who weren't from the billing/practice management/technology expert community (i.e., from actual billers, coders and practice managers) -- especially because one of the themes that emerged from our chat was the sense that small and medium private practices (in particular) have been holding off dealing with ICD-10.  Did the audience that could benefit the most shy away from the chat altogether? The drumbeat of journalists, bloggers and other experts about the need to deal with ICD-10 NOW (or face likely disaster!!) has gotten louder and louder in recent months, and I sometimes wonder if it sometimes has some negative unintended consequences. In our zest to create helpful urgency (and dispel the dream that ICD-10 will be delayed again), are we pushing people towards fear-induced denial and procrastination? Seemingly every week, we work with medical practices that have not begun to prepare for ICD-10 at all -- and they're scared.  But while their foot-dragging has not been ideal by any means, it's also not a guarantee of disaster.   Converting to ICD-10 is not going to be easy, but it's also not something that's beyond the reach of any practice to manage -- especially because so much help will be available from vendors and payers (provided you ask!). It seems from our vantage point that too many practice administrators, billers and coders have already decided -- without even really getting started -- that ICD-1o will be an unavoidable

By |2022-01-01T22:52:16-08:00September 13th, 2013|

Another reason to distrust cute little thumb drives

Great post by Babylon Mediaworks about hackers' clever tactics in cafes -- and, it turns out, one of the ways is by leaving thumb drives behind that are loaded with malicious software!  (The idea is to tempt curious users who see an opportunity to snag a free drive.) If you use a practice device in a cafe -- not something we necessarily recommend :) -- the post offers some valuable tips for keeping your computer safe, including never sticking an unknown thumb drive into your computer, and being wary of open hotspots that aren't affiliated with the cafe.  Read all the tips here.

By |2016-03-04T12:07:03-08:00April 30th, 2013|

13 for 2013 Tip #5: Review your maintenance contracts

Starting a new year is a great time to review your equipment maintenance contracts and evaluate alternatives.  Independent service organizations compete for your business -- if your contract costs keep rising, consider putting your contracts out for bid.  In some cases, rising maintenance costs may also mean that replacing outdated medical equipment is more cost-effective than continuing to service older assets. The same thinking applies to office technology assets.  If the Geek Squad tech who helps you fix your PCs or your network is on a first-name basis with everyone in the office, you may be better off upgrading.  And practice management software that requires costly upgrades may be better replaced with a cloud-based solution that updates automatically.

By |2013-01-15T14:32:54-08:00January 15th, 2013|
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