How To Make This The Best Year Ever for Your Medical Practice

January 4th, 2016

There is an old saying:  “Penny Wise and Pound Foolish.” The saying pokes fun at the miser who clips coupons to save a few pennies while rats eat away at the currency horded beneath his bed.

The last few years providers have focused on qualifying for “meaningful use” and on being penalized a few percentage points because a litany of back breaking burdens weren’t satisfied (which cost significantly more than a few percent to implement).  Some of these same providers are the same ones who have seen their census decline and bottom lines shrink.

Maybe we have all been paying too much attention to the pennies we may loose by being slow to comply with government mandates; and ignoring the profitable pounds of our business...superior patient care.

Let’s take a look at some of the ways to protect your pounds and to make this your best year ever…both in  profitability and personal satisfaction:

Understand your greatest asset is a satisfied patientLet me count the ways including:

  • A satisfied patient refers other patients.
  • A satisfied patient comes back for additional services.
  • A patient, whose needs are met, requires less of your staff time for follow-up.
  • A satisfied patient complains less and is far less likely to sue.

Be sure your phone is answered!  How hard is it for someone to get an appointment at your office? 

Recently I’ve had the need to make doctors' appointments for loved ones.  Not wanting to take advantage of my personal relationship with some of the offices, I've tried normal channels.  In one case I left a message three days in a row without ever getting a phone call back! 

My name is known at that office.  How many current and future patients do you think that physician has lost because of how his phones are handled.  How many are YOU LOOSING because you've relegated your phone to voice mail?  Recruit a friend to help you get a realistic answer to this question.  If it’s “ broke,” FIX IT!

Remind your staff that patients pay their salary.  We are all in the service industry.  Ultimately the kind of service we provide dictates our success level.  Is your staff respectful to all your patients?  Do they make your patients feel as if they are the most important thing when interacting with them; or are they walking the patients down the hall while texting or joking with other staff members?

Communicate with your patient.  Don’t expect your patients to understand the nature of their problems through a patient portal!  What you do is complicated!  After all, only the brightest and best become MDs.  Take the time to explain health issues to your patients. There may even be some reimbursement dollars available for doing so.   

You may also communicate health information including new services via newsletters or social media.

Bill for what you do!  So many providers are leaving dollars on the table because of what they perceive as heavy documentation requirements.  STOP IT!  Get the scribing help you need to document and capture charges for everything you do. 

If you don’t have a good certified coder on staff, get one!  In the meantime pay for a good consultant to come in and review your charges. So many office managers consider themselves as knowledgeable coders but they code as if it were the year 2000!

We have seen more than one practice that didn’t know how to bill for materials used inside a shot; or that didn’t know that there were different shot procedures.

Other offices no longer bill consulting codes to any payors...many privates still pay consulting codes.  Others are unaware how or when to use prolonged services to capture the time involved with a new consult.

Start with a review of well patient services...areas frequently unbilled.  This link is for Medicare, but most services are required to be paid by the Affordable Care Act.

Also take a look at some of the new services that can be billed for in 2016.  Your professional society likely has supplied information.  If not, follow KLA.  We are always on the lookout for new opportunities for you and have already addressed some of 2016's new billing opportunites on our blog.

Verify insurance, referrals and obtain necessary precerts.  Not checking that your patient's  insurance is current and all necessary referrals and precerts in place, will cost your practice thousands a year.  If you do high dollar procedures, the cost could be hundreds per case.

Take the time to personally review your high dollar procedures.  Check their payment status after forty-five days.  If they haven’t been paid, can your billing person tell you why?  Again, FIX IT!

We had a client who kept a list of each of his procedures and checked it against the billing records monthly.  This was brilliant. Not only was the doctor able to check that everything he did was billed, he also had a list that couldn’t be altered with a stroke of the practice management software making the procedure disappear from past due lists.   ( Most practice management software either does not offer a true double entry audit trail or such a trail is turned off for the ease of the billing staff. )

Collect patient cost share.  This is not an easy task, but grows more important with each year.  With the Affordable Care Act we have seen deductibles and copays/coinsurance consistently rise.  Ensure your front desk attempts to collect any unpaid balance at the time of service.  If the patient can’t pay, offer a payment plan.  Do not write off balances absent a properly completed hardship waiver.

Consider asking the patient to sign a credit card authorization that allows you to bill any balance after receiving an explanation of benefit from the insurance company.  If the patient is worried about the amount, include a limit in the agreement.  (Be sure to check your state laws about the proper form for this.) 

If the patient won’t pay his bill (and doesn’t have a real hardship), discharge the patient.  There are plenty of patients who would like the type of care you are providing.  Why take up space, time and spend extra dollars billing a patient who doesn’t value you enough to pay your bill?  Statistics also show that these types of patients are also those most likely to sue. 

Add a new service.  As our population ages, perhaps training in anti-aging medicine could provide a new reveue stream.  This has the added advantage of NOT being covered by most insurance.  Thus, you don’t have to bill insurance.

Sending a staff member to training and offering diabetic nutritional counseling is another possibility.  Most insurances pay for one on one or group counseling.

Telehealth offers is full of potential for specialists.  With a connection where you can see and hear a patient examination from afar, you and a primary care physician can both bill for the service AND provide specialty care to an underserved population.

It's time to get excited about your practice again.  Ultimately, it’s all about taking good care of your patients!  Isn’t this why you went into medicine in the first place? 

Happy 2016!

Tags: Billing and Collections


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