Juggling Multiple Phone Lines

Believe it or not, patients will happily wait if handled properly. It would be nice if telephone callers lined up in a row like well-behaved grade schoolers and quietly waited their turn, but that’s never the case. More often than not, the phone rings off-the-hook as everybody tries to get through at the same time. Here is some advice on how to handle several calls at once without making yourself crazy or patients angry.

One Ring Rule Try and answer the phone by the first ring. If that’s not possible, never make a patient wait longer than three rings - it will only make them mad.

Ask, Don’t Tell If you are on another call and it’s not an emergency, ask them "Would you mind holding for a moment?" Before putting someone on hold, ask permission. There is nothing worse than calling into a practice and being "told" you are going to be put on hold. Also, you don’t want to put a patient on hold who is calling with a medical emergency.

First in Line Return to each caller starting with the first to be put on hold and move forward in sequence. This will ensure no one waits too long.

Thank You Be sure to thank the patient for holding. Common courtesy can go a long way to head off a patient being annoyed for holding. This may sound simple but usually works.

Take Notes If many lines are ringing at once, be sure to write down the names of the callers on hold, the line they are holding on, and who they are waiting for before pushing the hold button. This way, they don’t have the give the information more than once.

Give Patients a Choice If things really get jammed up, return to a waiting caller after no more than a minute and ask them, "Would you like to continue to hold or may I call you back?" If they want to be called back, take their name and number and call them ASAP.

Take the initiative to prevent no-shows

Preventing patient no-shows has challenged medical offices since the invention of the appointment book. Some practices have gone so far as to charge patients a cancellation fee. Though that clearly communicates how seriously you view not showing up, you'll likely collect more hard feelings than revenues.

Consider a reminder system for routine follow-up and well-visits. Postcards mailed to patients a week before each appointment consistently reduce missed appointments.

When staffers go the next step and make personal phone calls one or two days before office visits, you'll usually see a still more dramatic decrease in no-shows.

Checklist to file clean claims the first time

Have you:

·         made sure the policy number and ID number are accurate?

·         obtained insurance eligibility verification?

·         verified other patient information (proper name, birth date, address, etc.)?

·         confirmed the information the provider gave you for posting charged entries?

·         checked that Current Procedural Terminology (CPT) and ICD-9 (diagnosis) codes are up-to-date and as specific as possible?

·         made sure that you have the referral authorization number on the form (if applicable)?

·         made sure that you included the referring doctor’s UPIN or HPI (if required)?

Keeping in mind disaster planning

This weekend I received the following email from a fellow consultant and friend, Owen Dahl (odahl@comcast.net) who reminds all of us about the importance of disaster planning:

 

With the weekend news on the “Swine Flu” outbreak in Mexico and is a few states, it seems timely to encourage all of your practice’s to review their disaster plan. I certainly don’t wish any major issue or illness for anyone; however, this is a great time to prepare for a disaster. There are a few basic questions that warrant thought:

 

1.    What will you do from a staffing point of view with several employees calling in sick? Your sick leave/PTO policy or short term disability? FMLA for those practices with more than 50 employees?

 

2.    How will you handle an influx in ill patients, do you have enough personal protective equipment in the office?

 

3.    Does your business interruption insurance cover outbreaks that cause the office to close for an extended period of time?

 

4.    How do you communicate with employees or physicians? Those physicians who may be in the call group and not directly involved with the practice?

 

While you’re at it, think about your disaster plan for a hurricane (note Ike last year), fires (note Myrtle Beach, SC this week)m floods (note North Dakota and Minnesota), and tornados (note too many to mention) . The same basic steps apply to all cases.

 

Please be extra cautious and make sure you take your time to think through what might happen and what impact any kind of disaster may have on your practice.

 

p.s. Owen and I are both members of the National Society of Certified Healthcare Business Consultants (www.nschbc.org). I highly recommend it for membership to anyone who provides consulting services to medical practices.

A positive attitude improves productivity

You don't have to re-invent the wheel when it comes to practice development. Rather, make it a goal to imitate identified management patterns in top-producing practices, like those tracked by MGMA. Here are five key personal traits common among most high-performing physicians:

1. Actively seek advice. Physicians in best-of-class practices show a willingness to entertain new ideas and concepts.
2. Be bold. With this same mindset, top performers unhesitatingly try new approaches. Even if changes don't work out as expected, the most productive groups avoid blaming the planner. Rather, they learn from their mistakes and move on.
3. Know what you do best. While open to new ideas, high-producing physicians don't follow every new fad. Instead, they constantly reassess themselves and their strengths.
4. Learn how to work smarter. While not afraid of hard work, high earners actively pursue new ways to maximize efficiency and productivity.
5. Understand-and exploit-all the ways you can generate revenue. See if daily practice patterns and interactions really demonstrate open thinking and a willingness to embrace progress. As long as your group culture continues to reflect core values, be willing to change anything else to reach your vision.

Measure charges and take action

I was recently quoted in the Part B Insider newsletter and here is the article; for a free sample of this and other publications, go to:

 http://codinginstitute.com/request_center2.html

 

BILLING : Avoid Separation Anxiety When It Comes to Submitting Claims

Measure charges and take action, experts say.

So you’ve got a handle on your accounts receivable (A/R) and you know roughly how long it takes to get paid once you submit a bill. Congratulations -- now you’re ready to get started.

Getting a grip on your days in A/R is only half the battle. You can’t have any A/R unless you actually bill something. So you need to know how long it takes your practice to bill for services after you provide them.You also need to measure whether you’re billing all the services that you provide.

That’s why you need to measure your “gross charges,” which are the total amount of money you bill every month. You should be figuring out that number every month and comparing it against the previous year’s number for the same month. If the doctor looks busy, but the charges are going down or are stagnant, you may have a problem, says Randall Karpf with East Billing in East Hartford, Conn.

Sometimes this means you’re not billing all the services your doctor provides due to a coding problem.

But also, you may not be getting out the charges adequately. A healthy standard is to post all office visits or charges within 24 hours after the date of service, and all other services within five working days, says Reed Tinsley, CPA, CVA, CFP, CHBC, a health care accounting consultant in Houston, Tex. “Any practice that can’t get an office visit claim out the next day has something terribly wrong,” Tinsley says.

The goal is for your gross charges to be higher than the year before, Tinsley explains.

Many practices either don’t measure things like days in A/R or gross charges, or else they don’t know what to do with those numbers once they have them.

Then the next thing to track is collections. If your charges are going up but your collections are going down, you need to investigate why.

Keep in mind: If your practice has declining profitability, don’t succumb to the temptation to cut staff,Tinsley urges. If anything, this may be a signal that you need to hire an extra person to speed up billing or work on collections.

“When you start cutting out overhead as a knee jerk reaction to profitability, you are harming the practice,” Tinsley says. “You can nickel and dime overhead but you can’t significantly cut it without harming the practice. The whole focus of management should be how to grow the top line.”

Best bet: Create a long-term plan to address the issue of declining profitability by identifying the real issues your practice is facing and creating ways to tackle them -- rather than using a “Band-Aid solution” of cutting people, Tinsley says.

Watch out for HIPAA’s ‘Incidental Uses and Disclosures’

You’ve heard all about HIPAA by now, but did you know that you (at the front desk) could easily be the first line of defense in your office against a potential HIPAA violation? Can you spot the difference between an "incidental disclosure" of protected health information (PHI) and a HIPAA privacy-rule violation? Better yet, can you hear the difference?

You can minimize most incidental uses and disclosures involving paper or electronic forms of PHI by moving medical charts or computer screens out of ready view. But more often than not, incidental PHI disclosures would likely result from overheard conversations within your office. It’s easier to overhear and harder to fix those overhearing problems than it is to move a physical piece of equipment or documentation.

Have a look at these four conversations and determine for yourself whether each is a permitted incidental disclosure under HIPAA or an impending privacy violation:

Conversation #1: A patient waiting in an examination room overhears a nurse relaying another patient’s test results to a physician in the next room.

Conversation #2: A patient overhears two staff making unkind comments about the waist measurement of a patient who’s expecting triplets.

Conversation #3: A patient overhears a conversation between a receptionist and an insurance-company representative during which the receptionist is attempting to secure preauthorization for another patient’s procedure.

Conversation #4: A bartender overhears your medical assistant telling a friend about a famous actor who visited your office today.

HHS Publishes First HITECH HIPAA Guidance

On April 17, 2009, the U.S. Department of Health and Human Services (HHS) published its first guidance under the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act. The HITECH Act amends the privacy and security provisions of the Health Insurance Portability and Accountability Act (HIPAA). This new guidance provides key information to health care providers, health plans, health care clearinghouses and their business associates about the security of protected health information. Read more...

Physician Self-Referrals for Imaging Services May Increase Medicare Spending

From Fulbright Jaworski’s Washington Update (www.fullbright.com):

In a public meeting on April 8, 2009, the Medicare Payment Advisory Commission ("MedPAC") discussed the impact of physician self-referrals for imaging services on overall Medicare spending. MedPac reported that the volume of imaging services per beneficiary is growing faster than other physician services. MedPac determined that this increase is likely driven by multiple factors, including technological innovation, incentives in the Medicare payment system, defensive medicine, consumer demand, lack of research on the impact of imaging on clinical decision-making, inconsistent adherence to clinical guidelines and physician ownership of imaging equipment. MedPac staff further reported that physicians who own imaging equipment are more likely to refer patients to their practices for imaging services. Greater use of imaging was also found to be associated with greater use of all services, and therefore increased costs. For more information regarding the self-referral discussion at the MedPac public meeting, click here

Doctor Liable for Sleeping With Patient, but Fault Shared

It’s not funny but sometimes a good reminder of stupid things that can you one in trouble…………..A New York judge has upheld a $416,500 jury award in a malpractice action against a doctor accused of sleeping with a patient he treated for depression. However, the judge declined to strike the jury's 25 percent apportionment of responsibility to the plaintiff under the doctrine of comparative negligence. Plaintiff Kristin Kahkonen Dupree, a former model, visited family medicine practitioner James E. Giugliano for anxiety and depression after her infant daughter was diagnosed with cerebral palsy.

http://www.law.com/jsp/article.jsp?id=1202430009273