Sunday, May 19, 2019

Help patients better understand your medical practice’s financial policies

While the business of healthcare is somewhat in flux, the average medical practice continues to render medical services under the existing framework of health insurance. This can be a particular challenge these days due to high deductible health plans, where patients are responsible for a larger portion of their healthcare bills.


Additionally, patients are starting to pay more attention to the value and quality of the healthcare they are receiving, and are more likely to question their bills than ever before. What does this mean for your practice and how can you improve the manner in which you are handling your patients and your patient billing and collection process?

The average person feels obligated to pay for items and services they have received. However, healthcare is intangible and, unlike a piece of clothing or a car, once a patient leaves the doctor’s office (empty-handed but feeling better, hopefully) they can begin to feel separated from the value of the services received. This means practices must be diligent about collecting payment or establishing effective payment options as close to the time of service as possible.

How do you collect money from your patients? Making it more convenient makes it more likely your patients will pay quickly, if not on the spot. Does this mean offering credit card payments? Setting up automated payment plans? Practices also need to adjust their collection approach to meet the expectations of their patients. Younger patients expect to pay electronically and may not even look at paper invoices arriving in the mail. Older patients may still prefer paper invoices and/or payment by check. Most patients are willing to provide a credit card for the practice to keep on file and/or establish a payment plan, though too many practices fail to even ask for a card to be provided. There is no reason a variety of approaches cannot be offered at the same time, as long as they are spelled out clearly.

Another issue which often makes it challenging to collect from patients is when the cost of the services/bill comes as a surprise. Patients, like any consumer, can become angry when the cost of what they “bought” is more than expected. Unlike going to the store, patients often have no idea upfront what they will be spending on healthcare and whether they even can afford the service. This lack of information also makes it difficult for patients to shop around for comparable services. While it is not always clear exactly what a patient’s bill will be before services are rendered/tests are run, most of the time, my practice clients can offer at least an estimate of costs and are usually quite accurate in their estimates. Practices that are upfront about potential costs find that their patients are more cooperative in making payment arrangements and following through on such payments. The same patients are often willing to choose a practice that is more transparent with its costs over a competitor that is not. This is also an important factor for practices to consider.

Most importantly, whatever your practice policy may be regarding pricing, payments, and collections, every practice must have a sound financial policy which explains the process by which services are billed and how payments can be made. The more information shared with patients—and the more often it is shared—the greater the chance that patients will fully understand and comply with the policy.

Some additional tips to help patients better understand the practice’s financial policies:

1. Break down the policy into parts and have the patient initial their understanding of each part. Lengthy policies with long paragraphs are rarely read or understood.

2. Have the staff review the policy with patients. This can be especially helpful for older patients or those who do not speak English as well.

3. Ask for the policy to be signed each time a patient visits the office. I find this annoying myself as a patient; however, my practice clients have reported that patients who visit often and are asked to review and sign the policy each time are more familiar with the policies as a result.

4. Review the policies regularly to be sure they are clear, accurate, and still reflect the practice’s policies. Be sure your practice is also billing and collecting in compliance with the law.

Addressing a patient’s ability and willingness to pay for services upfront can go far towards a practice’s financial health. Think about how your practice can make some changes to develop a better relationship with its consumers and improve its bottom line at the same time.

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Saturday, May 18, 2019

The Executive Suite: 4 ways to boost your medical practice profits

The Executive Suite: 4 ways to boost your medical practice profits: When medical practices look back over their billings for 2018, many will find they lost the most revenue collecting directly from patients. ...

Friday, May 17, 2019

Grow your practice with patient relationship management software

Studies confirm what you already know: Patients of independent practices have lower costs and better health outcomes. Both are also key indicators of high patient satisfaction. Staying independent seems like a no-brainer, but it's getting harder and harder for providers to do so.

It can be tough to grow a thriving practice and remain competitive in the marketplace given the rise in reimbursement challenges, patient consumerism, and care delivery options. Consequently, many practices find themselves choosing between joining a hospital network or closing their practice altogether.

While joining a larger network may bring providers some initial relief in terms of job security, those benefits are not long-lived. Providers who keep their practices independent tend to make more money and have higher job satisfaction than their employed counterparts. Plus, independent providers can often avoid the office politics and bureaucracies that sometimes exists in larger health systems.

Rather than join a consolidating, selling, or closing, independent providers need to consider an alternative option. They can implement technology to help increase revenue and expand their practice. Small investments in the right software can reap big rewards for independent practices.
 

Expanded patient base


Patient relationship management (PRM) software offers a variety of tools that help a practice expand its patient base. The key is building loyal relationships with current patients, as strong patient relationships can help attract new patients. One way to grow your patient base is through regular communication.

Patient communication software allows practices to create newsletters and schedule their delivery. Not only does this consistent communication build loyalty with existing patients, it’s also a great opportunity to ask for referrals. A “Refer a Friend” button can be added to newsletters, prompting patients to easily provide the name and contact information for the friend they would like to refer. The PRM software gathers this information centrally, which also makes it easier for practice employees to follow up on these referrals.

Another great way to ensure continued medical practice growth is by maintaining a positive online presence. Seventy-two percent of patients look at online reviews before they choose a new provider, so ensuring there are plenty of positive reviews can have a huge impact in persuading potential patients to book an appointment.

As with referrals, the best way to increase the number of online reviews is to reach out to existing patients. PRM software allows everyone in the practice to get involved. When team members have a positive interaction with a patient, they can ask the patient if he/she would be willing to write an online review. If the patient agrees, the staff member can send a text message to the patient’s phone with a link to the practice’s Google or Facebook page. This makes it simple for patients, who only have to click the link and write their review.

Optimize practice workflows


PRM software can also impact the practice’s bottom line by increasing its efficiency. Many of the tasks required to keep a practice running are time-consuming. Simple tasks such as confirming upcoming appointments, informing patients about balances, and sending appointment reminders are all tasks that, if done manually, can mean a lot of time spent on the phone. But with patient communication software, these tasks can all be automated.

Appointment reminders are automatically sent to every patient before every appointment. The practice can decide how often the reminders are sent, and patients can choose to receive those reminders by text, email, or phone call. The reminder messages can also include appointment-specific information, such as a reminder to fast or bring their medication(s) with them. Patients can confirm the appointment or let the practice know they need to reschedule. The PRM software gathers all the data in one place for practice staff so they can respond accordingly.

Automated reminders aren’t just for existing appointments. They can also be used to remind patients they have a balance or schedule a future appointment. Patients receive the message in the way they prefer to be contacted, so they are more likely to see the message and take the requested action. With so many tasks to do every day, practice staff can spend more time interacting with patients and less time on routine calls.

Independent practices are feeling the financial burden of trying to compete with bigger clinics and hospital networks. Instead of giving in to the pressure to merge or sell, providers can use technology to make simple changes to help them continue running a successful practice with all the benefits that come with remaining independent.

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Thursday, May 16, 2019

Sunday, May 12, 2019

Digital transformation in healthcare: Time to focus on the patient

Digital transformation was supposed to revolutionize the healthcare industry by improving patient care and operations and reducing costs. To date, while digital transformation has led to positive changes, it has not radically changed services, processes, or business models.


The focus thus far has been primarily a conversion of analog processes to electronic form: the increased use of mobile devices and the adoption of EHRs, cloud-based services, and applications. The result has been improvement in patient engagement, increased efficiencies and reduced costs in back-office functions, and greater ease in dealing with third-party providers. These steps have been promising, but nothing transformational. This is about to change.

We are now at the early stages of a second phase of digital transformation that focuses on using technology to revolutionize the way patients are diagnosed, treated, and monitored and to deliver more timely, precise, and efficient care. The following are four examples of truly transformational technology:

Analytics


Big data analytics — the computational analysis of data to uncover trends, patterns, and associations — can be used to reduce costs, track, and prevent epidemics and detect medical fraud and identity theft. Big data software can lower the rate of medication errors by alerting doctors and pharmacists to inconsistencies between a patient’s health and drug prescriptions. Analytics can also help a practice manage staffing more efficiently and streamline workflow.

Artificial intelligence


In a broad sense, artificial intelligence (AI) makes it possible for machines to perform human-like tasks and learn and adapt from experience. The more data an AI application receives, the more accurate it becomes. The ability to gather, process, and act on information without human input eliminates routine tasks, improves efficiency, and minimizes risks.

AI provides precise and accurate data that leads to better diagnoses, treatment plans, and patient outcomes across all practice specialties. In oncology, AI powered software can analyze thousands of pathology images of various cancers to deliver highly accurate diagnoses and predict the most effective anti-cancer drug combinations. Surgeons can use AI for real-time guidance to increase precision in removing tumors. Radiologists using AI can spot details that escape the human eye. Similarly, lab tests can be quickly analyzed for patterns of existing or missing data to predict easy to miss conditions.

On the administrative side, AI makes EHRs easier to navigate and automates routine processes associated with them. The use of chatbots to help patients with care plans and answer routine questions is increasing as well.

Internet of Medical Things


The Internet of Medical Things (IoMT) refers to medical devices, equipment, and software applications capable of collecting and exchanging data via the web. WiFi enabled devices link directly with cloud platforms for data storage and also communicate with similarly enabled devices.

These devices, including wearables, implanted devices, infusion pumps, and more, can monitor, inform, and provide objective actual data to identify issues, and allow for earlier intervention before they become critical. The large amounts of real-time data they collect and generate about patients creates a more efficient healthcare system with more accessible, personalized, and proactive healthcare services for all, andalso provides data to help train AI.

Diagnosis, treatment, and monitoring can be done remotely, reducing the need for routine office visits and checkups. Patients can spend more time at home, rather than in a hospital or doctor’s office, and doctors can spend more time with patients requiring critical care.

Robotics


While robots have long been a part of healthcare performing tasks, such as assisting a human surgeon or performing surgeries autonomously, their use in medicine has recently been expanding. Here are some examples:

  • As life expectancy has increased, robot companions are being used to interact with aging patients to help them remain independent and alleviate loneliness.
  • Robotic nurses designed to perform repetitive tasks, such as taking vitals, monitoring a patient’s condition, restocking supplies,and drawing blood, free up human nurses to perform tasks requiring empathy and human decision skills.
  • Several projects are working to develop microrobots that can travel through bodily fluids to precisely deliver medication or repair damaged cells.

Other emerging technologies similarly provide vital tools for patient care. Virtual reality and augmented reality tools are helping Alzheimer’s and dementia patients retrieve memories; genomes are being sequenced faster, leading to better diagnoses and more accurate treatments; and 3D bioprinting is allowing doctors to look into the body more accurately than with any X-ray or scan.

The potential of these digital technologies being harnessed is leading to the best available treatment at reduced costs.

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Friday, May 10, 2019

How to renegotiate payer contracts

Often, physicians think their signed payer contracts are set in stone for the duration of the agreement.


For example, I was working with a physician group that thought they couldn’t renegotiate their contact with a large payer. They were losing money on those patients but thought they were stuck. Wrong. We were able to successfully renegotiate a stronger contract.

If you feel stuck in a lousy deal with your payers, you can renegotiate. Here are six steps to renegotiate your contracts and improve your revenue.

Do your homework


Start by locating your contracts and, if they don’t already have one, give them a designated home in your office. If you cannot locate the agreements, request copies from payers.

Gather all your contracts, review the terms, and know the effective dates of your contracts. Study your payer mix and learn who is your largest payer. Create a database where you can track the terms of every contract and when each is up for renewal. Keep copies or detailed notes of all interactions with your payers, including the last time you renegotiated the contract.

Payers are hoping you have so many payer contracts and too little time to review all the agreements, especially at small practices that don’t have a dedicated team to review them. They are counting on you to not be diligent. That gives them the opportunity to skimp here and there. Don’t let your payers cheat or hoodwink you.

Warning: This will be a time-consuming process.

Know your fee schedule


Anticipate that each payer will establish speed bumps to slow down your claims process. Some payers might require different procedures to submit claims, such as the use of a web portal, special emails, and the like. They will use vague language to give them wiggle room—and the opportunity to deny claims. Beat them at their own game.

Create another database for your most common codes separated by each provider. Note how each code should be submitted. Make sure you capture all of them. Building this central repository will require time upfront, but it should ultimately speed up the daily claims process, reduce the number of days bills are in accounts receivable/accounts payable, lower the volume of denied claims, and make it easier should you to resubmit. 

Let the games begin


Once you have assembled all of your data, you can compare each payer to one another. Now you have the information you need to begin the process of renegotiating your contract with a specific payer.

Initiate the process according to the terms of your agreement but do so with a formal notice. Pick a payer that you think you’ll be able to get the desired changes from. It might be based upon the fee schedule, the time to the end of the contract, or the volume of business you do with them. I would recommend starting with payers that offer the lowest rates and those with the least amount of time left on the contract.

Research who you should send the notice to and ask for confirmation of receipt. I would recommend sending your notice to as many people at the payer’s organization as possible.

Remember: These payers aren’t your friends and being friendly won’t yield the desired results. You must approach this process without fear.

Hold the line


Now that formal negotiations have begun, hold the line. Remember, negotiations start with a “no.” Payers will push back and even refuse to open up talks. Press on, and don’t give up.

Stay focused on your mission and purpose. The key to any successful negotiation is knowing what you want. Be specific with your desires. Don’t let their fear tactics intimidate you, and always be comfortable exercising your right to veto.

Begin with the end in mind.


Know what you want—and the outcome you seek—even before you start the renegotiation process the. You’re renegotiating these contracts so that you have capital to continue to provide excellent care to their beneficiaries. If the payer isn’t moving the needle enough, don’t be afraid of walking away. Remember, the payer sold a contract to the patient or their employer, and they must fulfill the terms of that contract. Their contract with you helps them meet their contractual obligations to the other party.

Know what you want and why you want it. Plan your negotiation steps carefully and accept that you might need to change things as the talks progress. However, you should understand what you want from a specific negotiation event, meeting, or email. It might be another meeting with someone else, an acknowledgment of your proposal, or acceptance of your offer, but you must be explicit on this issue.

Seek help when needed


If you ever feel you’re in over your head, ask for help from someone who isn’t as emotionally invested as you are, such as a negotiation coach. Having someone with experience and a fresh set of eyes on your talks can provide insight and propel your success. More importantly, bringing on someone who is not as emotionally involved to help you through the negotiation will help you stay calm and obtain the best results for you and, ultimately, your patients.

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