Are Patients Lost in Translation? An Interview With Dr. Charles Lee of Polyglot

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Universal Medication Schedule (UMS)
Sometimes you find the most amazing things in your own backyard. In Research Triangle Park, NC, I found the wonderful Dr. Chuck Lee, President and Founder of Polyglot. I was bemoaning the lack of good translation software for healthcare and Sims Preston, CEO of Polyglot, contacted me on LinkedIn and invited me to see their product Meducation. I was fascinated by Dr. Lee’s story and I think you will be too.

Mary Pat: Dr. Lee, you had a very personal reason for starting a healthcare company that focuses on communication in different languages, didn’t you?

Dr. Lee: First, as a clinician, I’ve always believed that we need to help all our patients understand their health information so that they can make better health decisions.  To me, it’s just common sense that better health outcomes starts with better informed patients.  The challenge is that much health information is not usually written with the patient in mind.  It’s often written in high grade reading levels using medical jargon, and often only available in English.  If it is available in another language, it’s usually only in Spanish.

About one of every three US adults has some difficulty understanding health information and almost 30 million struggle with the English language – almost 10 percent.  Because I am a first generation Korean immigrant – I came to the US when I was 7 years old – I saw how my grandmother struggled to understand how to take her medications.  This is one of the reasons I became interested in this issue.

Mary Pat: How did your own experiences drive your vision for your company ‘Polyglot”?

Dr. Lee: It became very apparent that other HIT companies had little interest in serving the needs of minority populations – they said that there’s not much money in it.  They said it was too difficult, too costly, and that the market wasn’t big enough.  If you look just at the numbers, yes it may not make sense – but how do we continue to ignore almost 10 percent of the population – thirty percent if you count low health literacy! That’s when I decided to form Polyglot Systems to show that creating technology to support language and cultural needs of underserved populations doesn’t have to be hard or costly.  If our small company can do it, the big guys will have no excuse.

Mary Pat: Can you talk about the state of healthcare communication for non-English speakers in the United States today?

Dr. Lee: Just think about what it would be like for you if you were in another country and they didn’t speak English.  If you got sick and needed medical care, would you know how to read the signs? Know where to go? Know what forms you are signing? Know what the doctors were saying? What your treatment choices are? Or how to take your medicine if the bottle didn’t have English instructions?  That gives you a glimpse into what it’s like for non-English speakers in the US.

After I saw my grandmother’s pill bottles with instructions written in English that she couldn’t read, I became aware that this was not an isolated incident.  So I asked myself this: How many medication errors are caused by language barriers? Last year there were about 4 billion prescription written – that’s not including over-the-counter medications.  Just based on statistics, that would mean about 400 million prescription were given to patients who are limited English proficient.  The need was obvious.  If you include English-speaking patients who have difficulty understanding health information, this number approaches 1.5 billion prescriptions.  Have you seen some of instruction they give you at pharmacies? Even I can’t understand what much of it says.  Also, a lot of the instructions are printed in such small print that I had a hard time reading them.  So one of the features we built into Meducation was larger font support for elderly and visually impaired patients.

Mary Pat: It seems that the timing for Meducation is perfect based on the recent emphasis on patient engagement, eliminating waste in healthcare, and increasing medication compliance. How does Meducation address these?

Dr. Lee: For me, it all comes down to common sense.  We submitted our first grant proposal to the NIH for Meducation almost 10 years ago – when all those issues you mentioned should still have been issues back then, they just weren’t popular things to talk about then.

Healthcare statistics usually say that a minority of the population utilizes the majority of our healthcare resources. This includes those with heart disease, diabetes, CHF, etc.  Do we ignore them because they are the minority? Of course not.  I bet you that a significant portion of the patients with heart disease, diabetes, CHF have low health literacy and/or language barriers.  If we can make even a few percent improvements in these populations, wouldn’t it be worth doing? This just made sense to me.

I sometimes like to compare our healthcare system to the cable industry.  The cable companies spend tremendous amount on research and expense for laying fiber-optic cables in streets in front our homes.  But unless we can connect the home to the corner – what they call “the last mile” – it means nothing.  It’s the same in healthcare. Unless patients understand and act to self-manage their own condition, all our advances in healthcare will have little effect.  Patient engagement is the last mile.

Mary Pat: How does Meducation interface with EMRs?

Dr. Lee: This is our biggest challenge now.  We’ve developed APIs to make it easy for EMRs to request and download our multi-language patient information.  The difficulty has been getting many of the EMR vendor’s attention.  They are so preoccupied with Meaningful Use and certifications that they have paid little attention to patient education and engagement.  But I predict that this will start to turn around as reimbursements will force them to do so.

Mary Pat: Meducation also has videos with demonstrations on medication techniques. What types of videos are available and how can patients view them at home?

Dr. Lee: The videos focus on techniques for taking complex medicines such as inhalers, eye drops, etc., so the patients are actually benefiting from the medicine and not wasting it by using it incorrectly.  We want to expand these to include other techniques such as wound care, port care, etc. in the future.  The demos are free to patients if their healthcare provider or pharmacies use Meducation. Patients receive a card with the website and video ID so they can view it as often as they like at home.

Mary Pat: Meducation uses a universal graphic that shows patients when to take medication which seems like a great idea for communication despite the language the patient speaks – can you talk about this?

Universal Medication Schedule (UMS)

Dr. Lee: Yes, this is called the Universal Medication Schedule (UMS).  It was developed by a group of health literacy researchers at Northwestern University and Emory University.  It breaks up medication times into four times of day: morning, noon, evening, and bedtime. Over 90% of all daily meds can fit into this schedule and make taking medicines much easier to follow.  The Institute of Medicine (IOM), the American College of Physicians (ACP), and most recently the National Council for Prescription Drug Programs (NCPDP) have recommended its use.  I really like it because it helps patients remember with pictures if they have difficulty understanding written instructions.

Mary Pat: You use the word “affordable” as part of your mission for Polyglot. I am always seeking solutions that are affordable in healthcare. Can you talk about the cost of Meducation for a solo primary care physician?

Dr. Lee: You know, I wish I could give this away for free to everyone.  But we have to make this a sustainable effort.  I’ve seen so many good projects die because they didn’t have a plan to keep it funded and going beyond the grant or some other funding source.  This is one of the reasons I left academics to start our Polyglot.  That being said, our products need to be affordable for front line providers – safety nets and federally qualified health centers (FQHCs) – because they interact most often with underserved patients – and have the least financial resources.

For provider practices, the subscription list price is $50/mo for unlimited use.  That’s less than $2 day for the ability to print instructions for all your patients in 16 languages – including elderly English-speaking patients in larger fonts.  As a comparison, $2 is about what it cost to use a telephone interpreter for about 1 minute.  Mary Pat, we would be happy to provide your readers a discount on Meducation.  Just have them contact me at lee@pgsi.com.

Mary Pat: What other projects do you have planned for the future?

Dr. Lee: I think the opportunities to improve communication for patients are only limited by our imagination.  There is so much that we can do create quality literacy and language solutions and deliver it inexpensively to a wide audience.  We are currently working on a solution to reduce hospital readmission through simplified multi-language discharge instructions that can be individualized for each patient.  We are adapting this for use during home care visits as well.

Charles Lee, MD, President and Founder of Polyglot
Dr. Lee: Polyglot Systems was founded in 2001 to help our US medical community care for the 26 million Americans who are unable to communicate effectively in English. Our mission is to deliver solutions that eliminate communication barriers at every stage of the medical encounter – improving the experience of both the patient and health care provider.

For more information about Meducation, Dr. Lee invites you to visit the Polyglot websiteHe is extending a discount on Meducation to readers of this article – please contact him at lee@pgsi.com.

For another post on communicating with patients, read my post “Can Patient Safety Be Improved By Asking Three Questions?” here.

Posted in: Amazing Customer Service, Compliance, Day-to-Day Operations, Electronic Medical Records, Innovation, Quality

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Introducing a New HIPAA Privacy Notice for Patients and Practices

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HIPAA Notice of Privacy Practices

September 23, 2013 is the date that medical practices and other covered healthcare entities will roll out a new Notice of Privacy Practices to patients to be compliant with the HIPAA Omnibus rule enacted in March 2013.

What Does This Mean For Patients?

Patients should be aware that after September 23rd, their healthcare providers will have a new Notice of Privacy Practices (NPP) available. The new NPP should be posted in each office, on the website if one exists, and should be available as a handout for any patient requesting it.

The new notice will include:

    • Reasons that your Protected Health Information (PHI) can and cannot be disclosed to others.
    • Information for opting-out of communication related to fundraising activities, if your healthcare provider does any fundraising.
    • The ability to restrict your PHI from payer disclosure when you pay in cash instead of having the charges filed with your insurance plan.
    • Information about being contacted if there is a breach of your PHI due to unsecured records.

What Does This Mean For Practices?

    • A new Notice of Privacy Practices that is specialized to your practice must be developed.
    • The new NPP must be posted in your practice, on your website and available as a handout for any established patients who request them.
    • All new patients must be offered a copy of the new NPP and must sign an acknowledgement that they received it. (They may turn a copy of the NPP down, however.)
    • Policies that address the disclosure of information/records and notification of a breach, should one occur must be developed.
    • Old and new versions of the NPP should be on file in the practice, and patient acknowledgements should also be kept as long as the medical record is retained.

What else is required for compliance with HIPAA Omnibus?

One of our good friends, Steve Spearman at Health Security Solutions has posted great information on his site about the other requirements of the HIPAA Omnibus rule. His excellent posts help readers understand and comply with the new HIPAA guidelines in the following areas:

    • Business Associates Agreement (BAA) Update
    • Downstream Subcontractors Needing BAAs
    • New Breach Notification and Reporting Protocol
    • School Immunization Records Protocol
    • Electronic Fulfillment of PHI Request
    • Medical Record Protocols for Cash Payments

At Manage My Practice, we’ve offering a free sample Notice of Privacy Practices for your practice use. Please read the sample notice carefully, make changes specific to your practice and add your practice name. Note that language related to fundraising is NOT included, as it will not apply to most private practices. Insert fundraising language as follows if appropriate for your practice.

Fundraising Activities: We may use PHI to contact you to raise money. If  you wish to opt out these contacts, or if you wish to opt back in to these contacts, please contact our Privacy Officer.

Likewise, if your practice has a research function, insert relevant language:

Research: We may use and share your health information for certain kinds of research, however, all research projects are subject to a special approval process.

Check your state laws.

Your state law may require authorizations for certain uses and disclosures of PHI beyond those outlined in the sample notice. Be sure to amend your NPP to reflect any state-specific laws (resource hererelated to release of medical records. Remember to post your new NPP on your website and in your practice, and begin giving it to new patients September 23, 2013.

The new Notice of Privacy Practices is not required until September 23rd, but you can start using it as soon as you have yours ready.

For more on HIPAA, read my post “Three Big HIPAA Myths.”




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5 Ways Technology Can Help Your Patient Relationship Management

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Using Technology to Improve Patient Relationship ManagementPatient relationship management is about more than just healthcare issues; it’s about building a connection that leaves your patients feeling that you genuinely have their personal interests in mind. We all love to be recognized, and your patients appreciate it when you recall what their children’s names are, what you discussed with them during their previous visit, and where they went for their vacation.

It’s pretty impossible to keep track of everything if you have several hundred patients, however. That’s where technology can help you. Remember the old box of patient card files on which you’d make notes? Now, keeping track is just so much easier with the various tools available to physicians.

#1: Keep Electronic Records

If you’re a typical technophobe and don’t relate well to unfamiliar software programs, your record-keeping can be as easy as a Word or Text document for each patient. Set up a template for yourself that lists the data you want to keep track of, and simply enter the information into the file after each patient visit. Information could include fields such as:

  • Personal info
  • Family details
  • Chronic illnesses
  • Allergies
  • Medication
  • Visits

As long as you update the patients’ records diligently after every visit, this patient relationship management system will work for you, although it doesn’t enable you to communicate regularly.

#2: Use a Spreadsheet

A slightly more sophisticated way of keeping records than basic documents, Excel spreadsheets offer data sorting abilities that are useful. You can also keep all your patients’ information in one file, which saves you having to track and open multiple files. Use the worksheet tabs to categorize and group patients by type of illness or some other criteria that’s meaningful to you.

#3: Set Up a Database

There are multiple free and paid database programs available that you can use to set up a patient relationship management system. From Microsoft Office’s Access program through to Apache Open Office’s Baseand the software will not only store the information you add but generate reports, graphs, reminders and a mailing list that you can use with an email marketing program for communication purposes.

#4: Get a CRM Program

Commercial CRM programs such as InTouch CRM and BatchBook enable medical practices to store patient information,communicate via email or text message, and keep track of message opens and click throughs.  A customized CRM program can do the same for your practice. Not only does the program have the ability to store all relevant information about each patient, but you can set up alerts to identify critical changes in the patient’s condition based on data input from one visit to the next – without having to do a manual evaluation.

The patient relationship management program compares current data with data from previous consultations, such as blood pressure readings and cholesterol screening results. If the comparison generates an alert, you can proactively contact the patient to discuss it. At the same time, the system can generate automatic emailing of information to the patient to help educate him.

#5: Implement a Patient Portal

Cream of the crop is the digital patient portal, which enables you to store all information about your patients including test results. Patients get a secure login that lets them view their health records as well as make appointments online or communicate with you via a question facility or a discussion forum. You can set up automated emails based on criteria such as birthdays (personal info), allergies (seasonal) and medication refills needed.

Whatever method you choose to help you with your patient relationship management, keeping the information up to date is vital to enable it to be successful.

Greg FawcettAbout the Author: Greg Fawcett is President of leading North Carolina medical marketing firm Precision Marketing Partners. In this capacity Greg helps healthcare service entities to research their target markets, build their brands and develop creative strategies to reach patients.

Posted in: Amazing Customer Service, Day-to-Day Operations, Innovation, Leadership, Practice Marketing

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How Are Physicians Returning to Private Practice?

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Cresting Wave

The healthcare industry has gone through a lot of change very quickly in the past five years, with still more to come. Independent practices and smaller physician groups have a lot of reason to “seek higher ground” in mergers, partnerships, and buyouts by larger groups and hospitals that have the resources to better deal with lower reimbursement and increasing regulation. Still, just as we are seeing the crest of the wave of physicians selling their practices to hospitals, we are also beginning to see a lot of the reverse trend – physicians leaving hospital employment and starting their own practices.

We have a number of new solo physician practices among our clients and each of these practices can make the numbers work for the three reasons outlined below. Their new practices may look much different from the practices they once had, but they now can bypass the crushing financial burden of start-up costs and find ways to cut expensive overhead. As hospitals ratchet down physician salaries and present new hoops from them to jump through, more and more physicians will look to these new tools for independence and financial viability.

Free EMR

In 2008 I was living in Seattle and I attended a conference at Microsoft in Redmond, Washington. It was there that I met Dr. Bill Crounse, the Senior Director of Worldwide Health for Microsoft. He was kind enough to sit down for a few minutes and talk to me about the future of physician practices. He told me something at the time that I didn’t really understand. He said, “Something is about to happen that will be  game changer for physicians.” At the time I didn’t understand what he meant, but today I believe he was hinting of the pending launch of Practice Fusion, the first free electronic medical record (EMR.)

The free EMR has indeed been a game changer for physicians. The ability to e-prescribe and report PQRS to avoid Medicare financial penalties and to collect the EHR Stimulus money (aka Meaningful Use) without the typical $25 -$30K outlay per physician has been a boon for many practices. How can an EMR be free? With advertising and the agreement that they blind and sell your data to third parties. (Have EMR companies been doing this all along and not telling you? A topic for another post.)

Physicians still need a billing system to run their businesses, but today software vendors are bundling billing packages with practice management and/or EMR software. For anywhere from 2.9% – 5% of net revenue, physicians can use the software and receive insurance billing services as a package. The two largest vendors providing this service are Athena and eClinical Works.

Social Media

The second reason physicians can start a private practice is the replacement of traditional (quite expensive) traditional marketing with social media. For a fraction of the cost of a direct mail campaign, a physician can use social media to establish a digital presence via a website, blog, YouTube and Facebook. These mediums are not free, but they are long tail, meaning that they will continue to drive patients to the practice long after a direct mail postcard has been thrown in the trash.

New Practice Models

Physicians and other care providers have a choice of self-employed practice models today.  Here are a few choices they have:

    • Concierge – concierge can mean different things to different people, but I am using it to describe a practice that accepts insurance and also requires an additional fee from all patients on top of insurance payments.
    • Medicare Subscription – similar to concierge, but applies the additional fee for Medicare patients only to pay for additional services not covered by Medicare, particularly an annual physical examination.
    • Direct Pay – this is a primary care model where patients pay a monthly fee each month that covers unlimited primary care (sick and well visits) and some in-house laboratory services. This model also includes direct-contracting with employers.
    • Telemedicine – gaining popularity for more than just rural specialty care, telemedicine is seeing patients via a secure video connection.
    • House Calls – this model is coming back as a pure practice model because physicians and other care providers do not have to invest in a brick and mortar office. Coupled with the ability to accept payments via their smartphones and the influx of baby boomers, this model is gaining popularity quickly.
    • Nursing Home – Another “rounding” type of practice like the House Call practice, physicians spend 100% of their time in nursing homes seeing patients.
    • On Call Specialty Practice – specialty physicians, typically surgeons, see patients pre and post-surgery in the office of the referring physician and have no brick and mortar office.
    • Cash Practice – this is a 100% cash model with no insurance payments accepted. Typically, physicians will provide patients with what they need to be reimbursed from their insurance plan. Because insurance is not filed, the practice can afford to discount their prices.
    • Co-op Practice – this is a time-share-type practice where one practice or a non-physician owner leases space to physicians, providing everything for one fee except billing, EMR and a medical assistant.
    • Micropractice – an even skinnier form of the co-op practice, the physician works without any assistants and does everything him/herself with just a computer, utilizing one exam room. Micropractice physicians see on average 8 to 10 patients a day.

For more information on different practice models, see our posts Yes, You Can and Should Start a Solo Medical Practice in 2013!How Physicians Can Offer Direct Primary Care to Employers: An Interview with Dr. Samir Qamar of MedLion,  The Direct Pay Physician Practice Model: An Interview With Scott Borden and Physicians are Leaving Hospital Employment and Starting New Practices on Their Own Terms.

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Ten Golden Rules for Every Medical Practice – A Manage My Practice Classic

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Important Rules for Employees

 

Although I originally created this list for medical practices in 2009 and republished it in 2011, I think it still stands true today and applies to all workplace situations.

Sometimes employees do not understand or follow the most basic workplace guidelines. Here is a simple but comprehensive list that you can tweak to make your own. It covers about 25 basics in a short list of ten “Golden Rules.” Make it part of each job description or personnel handbook and/or post it in strategic places.

Report to work on time daily.

Be ready at your desk to begin work at the designated time. Leave promptly for lunch and return to work when you should, unless you’ve made special arrangements with your supervisor. Take breaks on the honor system and do not abuse the privilege. Clock in and out faithfully.

Command respect…

….from the physicians, managers and employees of (your practice/business name here) by demonstrating total professionalism in the workplace with your dress, your demeanor and conversation. Represent the business/practice in a way that would make your Mother and your boss proud of you. Treat your co-workers as you would like to be treated.

Be economical…

…by not wasting time or supplies or doing sloppy work that must be re-done.

Give every customer/patient your total attention, patience and courtesy.

Do not assume you know what the customer/patient is going to say, but listen carefully to the patient (in-person or on the phone) so you can assist them to the best of your ability. Remember how good it feels to be the center of someone’s attention and give that gift to every single patient.

Keep your supervisor aware…

…of any problems in your workload, whether too much or too little. Do not expect your supervisor to know if you are falling behind or caught up.

Document…

…all interactions with customers/patients and other businesses/medical facilities to assist your co-workers in knowing what you have done, and document your resolution of the situation to the customer’s satisfaction.

Strive for a positive attitude every single day.

Don’t whine.

Be a team player.

This means both covering for your co-workers and knowing that they will cover you. This means supporting your co-workers to their faces and behind their backs. This means having (your business/practice name here) goals for your goals, and knowing that your success will be your team’s success, and ultimately, the success of the business/practice.

Clean up your own messes…

…and act as an adult acts in the workplace: responsibly, maturely, and with thought for others. Accept blame for your own mistakes, knowing that everyone makes them, and that if no one is making any mistakes, nothing is improving.

Contribute…

…to making (your business practice name here) a good place to work. Only you can create a place where everyone enjoys working. Only you can make this place a good place to be.

 

For more medical office rules, read 21 Common Sense Rules for Medical Offices.

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Posted in: Amazing Customer Service, Day-to-Day Operations, Human Resources, Manage My Practice Classics

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[Guest Post] – 7 Tactics to Improve Patient Retention in Your Medical Practice

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Tactics For Retaining Patients in your Medical Practice MarketingAttracting new patients to your practice is one thing, but keeping them can be an entirely different issue. The days when you got to treat all members in a family from the cradle to the grave are long over, and regular attrition is an ongoing concern. You may not be able to avoid losing patients who move from their current location to another city or state, but you can try to avoid losing patients to other medical practices.

From primary care physicians through optometrists and gynecologists, patient retention is an important factor in the success of the practice. Here are 7 tactics you can use to keep your patients coming back for more.

Tactic #1: Think of Your Patients as Clients

Let’s face it, your patients need you probably more than you need them. Far too often, however, medical professionals treat patients as if they are doing them a favor by seeing and treating them. Even if it isn’t true about your practice, how certain are you that your patients feel as if you value them? By thinking of them as clients and fostering a customer service attitude among your practice staff, you can ensure that your patients feel important and cherished. The customer doesn’t always have to be right – he just always has to be king!

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Posted in: Amazing Customer Service, Day-to-Day Operations, Innovation, Leadership, Practice Marketing, Quality

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The Danger Signs of Picking the Wrong Medical Billing Company

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Dangers Signs with your Medical Billing Service

 

Outsourcing your billing can be a great decision.

Practices typically outsource billing when they feel they don’t have the people, space, resources, bandwidth or finances to keep billing in-house. There is a strong difference of opinion as to which model is less expensive. Most billing companies will charge 4% – 8% of net revenue, which is medical revenue minus any payer and patient refunds. Most medical billing companies charge on the lower side of the range for surgical groups and other high-dollar specialties and on the higher side of the range for primary care and other medicine specialties. Some states require billing companies to charge on a flat fee as opposed to a percentage, as it is felt that paying a percentage of revenue incentivizes billing companies to “game” the system in trying to maximize revenue.

We work with many practices that either want to bring their billing back in-house again or want to outsource their billing again. For those wanting to outsource their billing, we offer a list of the danger signs to watch for when choosing a medical billing company you’ll be tied to in the years (contract are usually 3 years) to come.

Danger Sign #1: They have no existing clients in your specialty.

It’s true that most physician coders and biller are trained on all specialties, but coding and billing rules change annually, and if the billing company isn’t up to speed on the nuances of your specialty, how long will it take them to get there?

Danger Sign #2: They will not give you any references except the ones on their pre-printed list.

You know that saying – a company is not going to put any name on their reference list that won’t give them a glowing reference. Some companies give you their entire list of clients – they’re not afraid! If they only give you 10 names and you know they have 100 clients, you have to ask what’s wrong with the other 90?

Danger Sign #3: They do not give you access to their system to look up patient accounts.

This is where a system on the cloud makes everything so easy – the vendor assigns you a login and initial password and you can look at everything. Why wouldn’t you expect to have 100% access to your own data? Recently I heard of a billing company that would not give their practices access to their system because it was “proprietary.” What is proprietary about a billing system and what are they afraid you will see?

Danger Sign #4: They do not allow you to run your own reports.

This is similar to #3, but I have had billing companies provide me with reports that are not system-generated. In other words, they took the data from the system reports and entered it into a spreadsheet. So I don’t know if the numbers are real or not. I insist that all reports given me by a billing company be system-generated. They can give me a snapshot report that simplifies the information, but I want the system-generated reports as well.

Danger Sign #5: They do not allow you to have an interview with the lead biller on your account.

I want to know who will have this crucial role in my client’s financial wellbeing and who the staff will be communicating with over the coming years. I also want to know if the biller is a data-entry person or a real thinker.

Danger Sign #6: You’ve never heard of the billing software they use.

There are hundreds of billing systems out there and I am sure I haven’t heard of all of them. If I’ve never heard of this billing software, I’d like to know more about it. How long has it been around? How often is it updated? How many practices are using the software? What do you mean the billing company owner’s wife wrote the software and you are the only ones using it? Is the company big enough to put enough resources into ICD-10 or will they be one that will fall by the wayside before the big switchover?

Danger Sign #7: They will not give you a daily report of their work completed.

You need a daily report on charges, adjustments and payments. If you have access to their system, or they are working on your system, you’ll be able to generate this report yourself, but otherwise, you don’t know what they are doing until month-end. Think of what could potentially happen (or not happen) in four weeks.

Danger Sign #8: They do not give service turnaround guarantees (charges entered 24 hours after receipt, claims processed daily, etc.)

A service guarantee is one of the biggest reasons you outsource your billing. If they don’t have the bench-depth to cover staff losses or unexpected staff shortages, why are you even considering them?

Danger Sign #9: They will not agree to do your billing on your software – they insist on using theirs.

A lot of billing companies will only use one brand of billing software. Take it or leave it. Their profit is dependent on the efficiency and duplication of the same process over and over again. I understand that. But what if you have a system you like, and it is loaded with years of data, but for whatever reason you want someone else to staff it? You can outsource your billing, but don’t commit to losing your system when you’re happy with it.

Danger Sign #10: They cannot integrate electronically and accept your charges from your EMR.

Providers are taking the place of superbills (encounter forms, charge slips, etc.) by having their EMR orders translated into CPT codes. If you are doing this in your EMR (and you should if you’re not!) and you can’t feed that info into a billing system, you’ll have to go back to a paper system such as a superbill. Ask the billing company if you will have to print out anything on your side for them to do their work and use the answer to gauge the additional work outsourcing billing might be for your practice.

The Contract

If you do sign a contract with a billing company, make sure the contract language is very clear on how problems will be resolved. What happens if they don’t meet the service guarantee? What happens if they don’t have adequate backup and your claims aren’t sent for a week while someone is on vacation? The most dangerous time is in the early days when you are in transition from one system to another. Have a timeline for the switchover with very specific goals and penalties if the goals are not met. It’s always good to have a line of credit or a little padding to draw on during a billing switchover – you never know how smoothly things will go. Make sure the termination clause or end of contract term has language on when and how you will receive your data if the billing company is not using your software, and what the cost will be.

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Explaining the State Health Insurance Exchanges in Seven Minutes: A Video for Your Medical Practice Website

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Seven Minutes to Learn About State Insurance Exchanges

I came across this video from the Henry J. Kaiser Family Foundation and thought “This is exactly the kind of content medical practices can use for their website and social media content.” In this seven-minute video, the “YouToons” learn how the coming healthcare reform will affect them by placing consumers into one of four insurance categories: employer covered, government covered, privately insured, and privately uninsured.

The video is a straightforward, approachable overview of a complicated subject, and would make a fantastic post on the website of a physician or medical office. Even providers without a website could educate patients  by posting this link to Facebook or Twitter, or by including it in an email newsletter. My partner Abraham wrote a primer on talking to patients and staff about reform last July, but this video is even simpler, and is everyone’s favorite – an entertaining movie! It even has clickable icons inside the video for calculating premiums and finding out the status of state health insurance exchanges by state.

Why is a video like this a great piece of content to share with your patients and readers? Here are three reasons:

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Posted in: Amazing Customer Service, Headlines, Leadership, Medicare & Reimbursement, Practice Marketing, Social Media

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Learn How One Practice Used a Credit Card on File Program to Collect Patient Balances and Increase their Cash Flow

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Collect Patient Balances and Improve Your Practice Cashflow with a Credit Card on File Program

It’s always a fantastic feeling when other people speak on behalf on your products or services, so we were thrilled to see a very nice comment on a recent article at Physician’s PracticePatient Balances: Get Them or Get Ready to Close Your Practice.” The article details the importance of collecting patient balances as quickly and effectively as possible as doctors face declining reimbursements and increasing overhead and regulation. We have long championed the Credit Card on File system – where patients leave a credit card securely on file with the practice’s gateway and the card is charged after insurance is billed for any patient balances under $100. Balances above $100 (or whatever limit a practice may set) are either placed into a payment program, or paid in full after contacting the patient. One of our very successful clients whose practice has implemented such a program commented on the article about her own experience.

We started a year ago with a Credit Card on File program, on the advice of Mary Pat Whaley. After 1 year, our patient balances are very small, and for practically every balance over 90 days old, the patient is on a payment plan, but since our overall patient A/R is very small, it doesn’t represent a lot of outstanding income. We have over 2000 credit cards on file. Patients are not allowed to see the doctor without leaving a card on file, and they agree to this over the phone when they make an appointment. I’ve found it very challenging to understand and charge patient balances upfront, so we’ve opted for Credit Card on File instead. We charge the copay, file the claim, then charge any remaining balance to the card, once the EOB is received. We charge the card if the balance is under $100 (with an email receipt), and if over $100 we call the patient to determine if they want to pay in full or in installments. Most pay in full, and most appreciate the call. We do not send out paper statements. It takes about 1/4 FTE to manage the credit card collections, but I have an excellent receptionist who handles this very nicely with the patients. There are some issues when the card declines, but we follow up with a weekly phone call, and if necessary, a paper statement (not often). There will always be a few that will never pay, but you can’t escape that in this business. We are proud of our credit card collections, which is why I’ve detailed it here so you can consider it for your practice.

Marian @ Tue, 2013-07-23 11:12

Why, thank you very much, Marian!

If you’d like to learn how to start a Credit Card on File program in your own practice like Marian did, then you’ll want to join us next Thursday, August 8th at 3pm EST for “How to Start a Credit Card on File Program in Your Practice” our popular 60-minute webinar and Action Pack that will give you the tools and plan you need to implement the policies.

Spending one hour of your time and $59.95 now can mean all the difference in your bottom line tomorrow.

Click here to register now!

 

 

 

Posted in: 12 Ways to Supercharge Your Practice, Collections, Billing & Coding, Day-to-Day Operations, Finance, Innovation, Medicare & Reimbursement

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