Tips for Balancing Your Email and Staying Current on Important Health Care Topics

Chastity Werner, Health Care Consultant 

One of the greatest struggles for many healthcare managers is “How do I keep up with all of the emails?” While there is critical information in some email correspondence, there is also information that is not relevant to your particular job or responsibility. Email accounts get flooded with newsletters, articles and copy from a variety of sources, and it all starts running together.  If you do not have time to read them when you first receive them, next thing you know your email box has 1,500 emails and you don’t know where to start.  

Here are a few pointers to help you stay on top of hot topics: 

• Start Fresh!  Utilize your delete button and start from scratch.
• Be selective – choose only the topics that directly affect your situation.�
  • If you are the director of a multi-specialty practice, let’s be realistic, you can still be a high achiever and not know everything about every specialty!
• Designate different individuals in your department to stay on top of different topics.
• Meet weekly to briefly update the department on important matters that affect your organization.
• After you read a newsletter-delete it!  You can always do a Google search or go to the resource’s website and pull it up again if you need it.
• Subscribe to a couple of periodicals that pick the hot topics for you.  A good example would be Modern Healthcare.
• Remember, just because there is a new article on healthcare reform does not mean that there is new information related to the topic.  You can say the same information many ways!

Join a professional organization. Local and national organizations can be wonderful sources of knowledge and have great support groups.  Many of these organizations have periodic meetings which double-play as great networking as well as good content opportunities.  For some direction on choosing professional organizations – see our blog on Professional Organizations – Which is Right For You?

Does Your Body Language Reflect the Message you are Trying to Send?

Jerrie K. Weith, FHFMA, CMPE, Director of Health Care Services

More of our message is delivered through body language than through verbal communication.  Yet many of us don’t realize the importance of it.  In fact, body language can derail the verbal message we think we’re delivering.  

There’s an excellent book on the subject, “Strictly Business Body Language: Using Nonverbal Communication for Power and Success” by Jan Hargrave.  Here are some interesting tidbits from the book:

• Generally when people look to the left as they speak, they are recalling stored information and telling the truth. However, looking to the right, could demonstrate dishonesty.
• When people move their hands apart when speaking, they are signaling factual importance to the statements they are making.
• People who hold on to objects during negotiations show a need for support.  Do you find yourself holding on to a file or pen?
• If you’re one of those people who are “self-touching” (hands on chin, ear, nose, arm, clothing) you’re showing tension. 
• Did you know there are power or “control” positions in every meeting setting?  Check the book out for interesting information on this topic. 

Keep in mind that when you’re assessing someone’s body language (even your own); it isn’t only about the current movement, but more about the context of the movement.  It isn’t just the eyebrow raise, but also the position of the arms, legs and the eye contact.  It’s critical to each person’s success in communicating to understand body language to get the appropriate message across as intended.

Make Your Practice Healthy by Staying On The Right Financial Path

Chastity Werner, Health Care Consultant

Do you find yourself wondering what more you could do to help your practice succeed financially and increase your bottom line? 

Here are a few ideas that can put you and your practice on the right path: 

• Compare your practice numbers to relevant benchmarks, local and national. You can obtain this information from organizations such as MGMA or HFMA. 
• Stay on top of your trending reports.  Comparing your A/R month-to-month and year- to- year. By measuring the differences month-to month and year- to- year, you will get a clear picture of both areas where you excel and those that need attention.  Don’t forget your appointment counts and levels of service provided.  For example, how many 99215 codes did you bill for in 2010?  Did your production increase or decrease? How about 2011? The similarities as well as the differences will provide great insight.  
• Compare your payers’ fee schedules.  Determine your average reimbursement for those services and whether they increased or decreased.   Are your top payers paying according to your contracts?  If you don’t have the time to look at all payers, analyze your Top Five.  That will give you a baseline.  
• Study your denial management procedure.  Do you monitor and analyze your denials?  Are you proactive with the denials?  If you are getting an increase of a particular denial such as invalid ID number, investigate!  Make sure your front desk personnel are verifying patients’ insurance information and demographics, and checking insurance cards as well as the data entered in the system.  
•  Have a budget and stay on track throughout the year.  Budgets are great tools to monitor where your costs are for the year compared to where you thought they were going to be.  Examine your budget on a monthly basis and pay attention to what is both higher and lower than expected. 

Even though all of these suggestions are time-consuming and may seem tedious, they are critical to your practice.  If you are unable to handle the tasks in-house, seek help from trusted healthcare management professionals. That way, you can concentrate on patient care and they can keep your practice financially healthy.

Use Presentations to Demonstrate Credibility

Jerrie K. Weith, FHFMA, CMPE, Director of Health Care Services 

It is a well-known statement that the number one fear people cite is the fear of public speaking – even more so than death!  While it can be intimidating to speak in front of a group, regardless of size, it’s an excellent way to demonstrate your expertise.  Presentations build your credibility by:

• Allowing you to speak on a subject about which you have a strong knowledge base. 
• Provides an opportunity to deliver your professional perspective on topics.
• Lets people get to know you as a person, not just a name.  Provides that “face recognition” that’s so important in business relationships. 

What should you speak about?  Always speak on topics on which you are familiar.  If you’re passionate about quality patient care, you’ll deliver a meaningful talk on that topic.  You might add statistics to your presentation, but you’ll want to present the topic in your own unique style. 

How do I get over the anxiety?  Professional speakers as well as the mentors in Toastmasters, International offer several suggestions:

• Be prepared.  Speak to something with which you are very familiar.  Know your topic.  Research any areas that you need a little support in. 
• Prepare a professional presentation.  Most audiences will expect PowerPoint slides and handouts.  Proofread your presentation and have others proofread as well – for content as well as typos and format.
• Rehearse as necessary, but don’t over-rehearse.  Just practice until you’re comfortable.
• Develop your own style.  Some people like to be behind a podium; some like to walk around.
• Don’t read your presentation.  The audience can read it for themselves.  Look at the audience, making sufficient eye contact.
• Smile.  The audience wants you to succeed.  Smile and it makes it easier for them to work you through your nervousness. 

Getting over “presentation anxiety” takes practice.  But the effort is certainly worth it!

You Might Not Want to Take that Work Home with You, Doc: Medicare changes Claim Form Rule

Brian D. Meyers, CPA, Health Care Consultant 

I was recently at one of the monthly MGMA luncheons and the speaker was from WPS Medicare.  As she spoke on changes coming from Medicare to medical practices during 2012, one item really caught my attention – a new Medicare rule related to the place of service shown on a claim form. 

Quite frankly, this is more than likely only going to affect a portion of the medical field.  But if you are in a radiology specialty where the professional services (the readings) are distinctly separate from the patient’s technical service, you will want to pay close attention. 

Under the old rule:

• Practices had to match-up the place of service code (office, in-patient, out-patient, etc.) and the physical address where the service was performed on the clam form.  This is no longer the case. As we were informed, the place of service code will continue to show where the service was performed.  If an MRI was done at an imaging center, then the place of service code will reflect that.  However, the change is in the physical address shown on the claim form Box 32.   

Under the new rule:

• Practices much show the address where the image was read and analyzed by the provider when billing for the radiologist’s reading/interpretation. So, under this scenarios, if the doctor was reading from his house, then that would be the address at the bottom of the claim form. 

Also, the provider would bill the Medicare contractor covering the locality where the image was read.  For example, a radiologist has his practice in Illinois but decides to read some films from his administrative office in Missouri.  On those claim forms, the place of service code would indicate where the service was performed (imaging center in Illinois), but the physical address in Box 32 would be the doctor’s office in Missouri.  The claim would be filed with the Missouri Medicare contractor and not with the Illinois contractor.  If he is not enrolled with the Missouri contractor, then he will need to enroll with them in order to get paid. 

To be honest, this struck me as a bit odd. Why does Medicare need to know that the doctor read the image from his administrative office?  This also breaks the previous link between the place of service code and the address in Box 32 of the claim form. 

Does anyone else have any thoughts on this issue?  For right now, I’m sure doctors everywhere are deciding to not take that work home with them.

Increasing Medical Practice Referrals

Brian D. Meyers, CPA, Health Care Consultant

The lifeblood of any medical practice is new patients.  One of the surest ways to get new patients is from referrals, whether it be from other physicians or current patients.  There are a number of ways in which to increase the referral base of your practice.  Here are just a few: 

• Provide feedback quickly:  If a current patient refers a friend, be quick to send a thank you card.  For a referral from another physician, be sure to get your consultation report back quickly, and include a thank you note at the same time.  Another option would be to meet the referring doctor for coffee and discuss the visit there. 
• Be available:  It is important for you to be accessible by phone, email, or for another doctor to drop in to your office.  Discussing a possible referral can lead to more referrals in the future.
• Get patients in quickly:  Your idea of “quickly” and the patient’s or referring physician’s idea of timeliness might not have the same meaning.  Work the referral in, even if it means you have to work longer some days or shuffle some other appointments.
• Mingle with other doctors:  Consider eating lunch in the physician areas of hospitals where you have privileges.  Attend “meet and greet” meetings with other physicians.  By being visible, people will start to remember who you are.  Hopefully, this “glad-handing” will result in some future business. 
• Focus on the customer:  Patients and referring physicians are helping you out by sending new patients your way.  Do whatever possible to ensure that it is easy for a new patient to schedule his appointment.  Too many practices, it seems, do not realize the positive impact friendly phone staff can have on patients. 

To support the last suggestion, the other day I was talking to a friend who was having knee trouble.  She was trying to schedule an appointment with an orthopedist, but was extremely put off by the staff answering the phones.  She told me that the staff person was rather rude, which is making her a bit nervous regarding the actual visit.  Is this the first impression your office reflects over the telephone? 

As you can see, there are a wide variety of things a physician can do to increase the referrals to their practice.  The ideas above are only a few of the things that can help to increase their patient base.  Have fun and good luck to you on expanding your referral base!

Increase Your Revenue without a Change in Patient Volume

Jessica Johnson, CPA, Health Care Consultant 

We all probably think that increasing the number of patients walking through the practice doors is the surest way to see an increase in revenue.  While this is our first thought regarding desired profit growth, there are several actions your office can do to increase revenue before the patient is seen. 

Under most circumstances, the initial contact an office has with the patient is over the phone while scheduling an appointment.  Developing telephone scripts for office staff is essential to ensure that all necessary information is collected at this time.  Also, be sure to develop scripts that follow the sequence of the practice management system so information can easily be entered.  Collecting all required information enables your practice to perform patient eligibility verification, receive appropriate referrals if necessary, inform patients of their financial responsibility such as deductibles, co-payments, and coinsurance, prior to the office visit. 

Another factor impacting the bottom line that should be evaluated is your hours of operation.  Is your first appointment at nine in the morning and your last appointment at three in the afternoon?  If so, you might be limiting yourself to a smaller patient population, one with the ability to schedule an appointment during those times.  Consider implementing extended office hours one evening a week to accommodate those patients unable to schedule a visit during the day. 

Although all office visits for the day are complete, the revenue cycle still continues. Another element impacting revenue includes charge entry and claims submission.  Best practice is for office charges to be entered within one day and for hospital charges to be entered within two days of receiving all necessary information, such as, operative notes and demographics.  This is typically an area where lost charges can occur, and by preparing a monthly reconciliation, these lost charges can be decreased or eliminated. 

It is essential to evaluate your key indicators to determine which areas are in need of additional attention and concentration.  The beginning process of obtaining demographic information, eligibility verification, pre-certifications, authorizations, referrals, and entering of charges can either accelerate or postpone the speed at which the practice receives its earned money. With effective internal processes, you can definitely impact your revenue without increasing the number of individuals entering the practice.

Professional Healthcare Organizations, which is right for you?

Many times we run across the question of whether our clients should participate in one or more of the many professional organizations that are available to medical executives today.  If so, is there one better than the other?  

To help you make the decision, here is a list of several organizations and a brief description of their purpose: 

MGMA - Medical Group Management Association
www.mgma.org
MGMA is national, state, and local, although separate dues are required for each level.  The primary focus is management of medical practices.
The organization offers educational programming, support and resources to practice management professionals, with an opportunity to become certified. 

HFMA - Healthcare Financial Management Association
www.hfma.org
HFMA is a national, state and local organization.  The primary focus is healthcare executives engaged in financial leadership within the hospital and healthcare environment.                       

ACHE - American College of Healthcare Executives
www.ache.org
ACHE is national and local.  ACHE is an international organization with a focus on executives in hospital and other healthcare systems. 

AHIMA - American Health Information Management Association
www.ahima.org
AHIMA is national, state, and local.  AHIMA’s primary focus is EHR, coding and Health Information Management.                               

AAHAM - American Association of Healthcare Administrative Management
www.aaham.org
AAHAM has local and national membership.  The organizations primary focus is on patient accounts management in the hospital environment 

Professional organizations hold their weight in gold if they are active, structured organizations with seasoned members involved in the planning of meetings and content.  Observably, an organization can be an invaluable resource in one area of the country and a waste of energy in another.  So do your research.  Go to a couple of meetings as a nonmember before committing to a membership.  At the meeting(s), ask yourself:

• Do you mesh well with the other members?
• Will this organization help you and your facility grow?
• How often does the organization meet?  Do the meeting times work with my schedule?

Does the organization provide resources primarily in the areas you need?

First Impressions in a Physician Office

Chastity Werner, Health Care Consultant

We have to remember every new patient is a first impression.  As we know “first impressions” last forever.  These impressions can become one of your strongest marketing tools or one of your worst nightmares.  Depending on their condition or reason for visiting your office, more than likely your office will become one of the hot topics during a family get together and other social event in the next several weeks.  Here are a few pointers to ensure the patient leaves with the best first impression: 

• Make sure to be observant of your tone and dialogue while scheduling the appointment.  Make sure your tone is upbeat and your dialogue reflects the fact that you are “glad they chose your practice”.
• After you finish recording the patient demographics, give the patient a briefing on what will happen at the appointment and make sure they know where your office is located.
• When the patient arrives, greet them as if they were coming to your house for dinner.  “Hello, Mrs. Smith!  Do you have your paperwork with you today?  Great!  Please have a seat and we will be with you momentarily.”
• Make eye contact and smile, smile, smile! If the patient is talking to you make sure to look them in the eye while they are doing so.  If they are talking, stop and listen!
• When putting them in the room, if they are going to have a bit of a wait then let them know. 
• After their appointment, as they check out make sure to tell them “thank you for choosing our practice.  Have a Good Day”.
• Send them a thank you card. 

The best compliment you can receive is a referral!  Appreciate your patients and they will appreciate you!

Bridging the Physician-Patient Communication Gap

Brian D. Meyers, CPA, Tax Supervisor

After a recent trip to the Mayo Clinic in Rochester, Minnesota, I understand the communication gap in a very real way.  My father was diagnosed with small cell lung cancer a few years ago and was at Mayo for a checkup when a scan showed a small blotch.  This blotch was later determined to be a different type of cancer and the course of action was surgery.  My father is now resting comfortably at home during his recovery, but my family’s unfamiliarity with the procedures led to many questions.

Luckily, the doctor was gracious with his time and answered every question my mother, brothers, and I had regarding the diagnosis, the surgery, and the recovery.  It is a well-known fact that today’s medical practices are busy and medical professionals are pressed for time.  However, patients and their families must remember to ask questions and get clarity before leaving.  This is the most effective way to close the communications gap.

Here is an article from Physicians Practice which talks about the ways in which patients and providers can misunderstand each other.  The author provides good insight about how to close the gap.

The Communication Gap

By Sue Jacques | August 3, 2011

On countless occasions when investigating a sudden death it would become painfully apparent that the person’s demise wasn’t that unpredictable after all. Yet, despite the evidence of a medicine cabinet full of cardiac meds and coronary arteries full of plaque, the families I dealt with would often be flabbergasted to hear that the cause of death was heart-related.

The same confusion can apply to a patient’s understanding of a simple lab test or surgical procedure. Why? Because what’s commonplace for medical professionals usually isn’t as straightforward for patients.

You and your staff are fluent in the language of medicine, but the majority of your patients are not. They take your word as gospel, and even when they have no idea what you’re talking about, most people won’t question you for fear of appearing to be naïve. Plus, they know you’re in a hurry.

The results of medical misunderstandings can be inconvenient at best, disastrous at worst. Every morning, in hospitals around the world, people show up for surgery after eating a full breakfast because they didn’t understand the NPO order. That’s a costly inconvenience. But more expensive is a life lost over situational semantics.

A misinterpretation that leads a patient to insert a suppository in the wrong orifice is one thing, but one that leads them to repeatedly inject a double-dose of heparin(Drug information on heparin) is quite another. That’s what happened to my uncle when he had a DVT. He thought it was okay to play catch-up with his anticoagulant after somehow forgetting a few doses. Though his INR was all over the map, thankfully he suffered no serious consequences. The fact that his thrombus was even diagnosed in the first place was a miracle, because he didn’t want to “bother” his physician. He only mentioned his swollen, warm, red calf as an afterthought when he went to get a prescription for a completely unrelated ailment.

The biggest opponent of clinical clarity is time. A busy medical practice simply doesn’t provide practitioners with the luxury of explaining every last detail of a diagnosis, test result, or prescription.

How can you efficiently communicate your medical messages with clarity?

Here are five CLEAR tips for making sure that your patients really hear what you’re saying:

C ― Clarify your messages by using lay terms as much as necessary to ensure comprehension
L ― Listen carefully to questions and concerns voiced by patients
E ― Explain things in a different way if patients are confused by what you’ve told them
A ― Ascertain that patients understand what you’ve said by asking them to repeat it
R ― Recap the conversation in a single “bottom line” sentence

The next time you’re tempted to tell someone that they have the heart of a 20-year-old or they’re as healthy as a horse, think twice. Patients and their loved ones will take you at your word. Make sure it’s accurate.

Sue Jacques is The Civility CEO™, a veteran forensic death investigator turned corporate civility consultant who helps individuals and businesses gain confidence, earn respect and create courteous corporate cultures. She can be reached at editor@physicianspractice.com or www.TheCivilityCEO.com.