Integrated EHR and PM Solutions Show ROI over Manual or Standalone Tools

Lea Chatham December 16th, 2014

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Integrated EHR and PM Provide Improved ROIBy Scott E. Rupp

Electronic health records (EHR) and practice management (PM) solutions continue to provide worth and value beyond their initial investment. Tweet this Kareo story
Despite proven return on investment (ROI) from these solutions there are practices that continue use work arounds or standalone tools in place of and integrated EHR and PM system.

Those practices may be missing out on a number of profitable answers to tough financial questions, especially in small practices where every penny counts.

Staff Outlays
According to Health Affairs, small practices could save up to $25,000 per year for each employee when using an EHR because of efficiency gains and increases in revenue. “The increases in revenue arise primarily from more accurate higher level coding, but some providers also were able to see additional patients because of time saved using an EHR.”

Transcription
Practices employing a traditional dictation and transcription model are missing an opportunity for both cost savings and improved efficiency. Documenting with an EHR can reduce or eliminate transcription costs while speeding completion of notes and superbill and improving coding.

Coding Performance
Manual coding is filled with problems that cost time and money. EHRs enable more complete documentation of visit activities and can assist in accurate coding. With an integrated practice management system, the finished electronic superbill can be submitted instantly and quickly processed. One study showed coding level improves by 3.5% and charges increase by 5% when using an EHR.

Scheduling and Follow Up
Practices employing manual patient scheduling and follow up are putting themselves at a disadvantage from a logistical standpoint. Integrated practices are much better able to establish automated workflows through their EHRs and practice management systems when handling billing, patient scheduling, and follow up to visits. For example, with an automated system for scheduling versus a paper book or spreadsheet, you can adapt your schedule more easily for seasonal changes or to try a solution to wave scheduling. Research has shown that wave scheduling and modified wave scheduling can increase the number of visits in a practice by as much as 20% but it is hard to do without a customizable calendar.

Billing
Managing billing and accounts receivable is the one of the most labor-intensive and unruly processes within any medical practice. For those in smaller practices, staff often multitask, addressing care procedures followed by accounts receivable, patient follow-up, and even eligibility verification. Checking eligibility manually is very time and labor intensive. With a good practice management system, it can be done instantly with the push of a button for a single patient or an entire day’s patients. This can also reduce denials and speed payment of claims. Automating billing and collection systems can maximize profitability and increase time with patients. Enhanced productivity can be achieved through an EHR and practice management system that streamlines collection methods. Manual collections result in massive amounts of paper records, hard copy mailings and staff hours following up with patients on balances owed.

e-Prescriptions and Labs
Manual prescriptions and labs are historically problematic. When done by hand, nearly 30% of labs can get misplaced and need to be redone. Manual prescriptions often result in a high volume of calls from pharmacies. These are just some of the problems, and while standalone solutions can help solve these problems, they only go so far.

A full-featured EHR provides these electronic options, often from right inside the note. You get improved safety, faster turnaround, and improved patient care while also having access to everything in one place and the ability to see the whole picture of the patient’s care. You can also share results via a patient portal, which many patients say they want. In fact, two thirds of patients say they’d be more loyal to a physician with an EHR and portal.

While there are some benefits to standalone systems, they often don’t fully solve the problem. And they don’t offer many of the added financial incentives you can get with an integrated EHR/PM solution. Check out this infographic that lays out many of the benefits of an integrated solution for more.

About the Author

Scott RuppScott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.

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Free Webinar: Getting Paid in 2015, What You Need to Know!

Lea Chatham December 11th, 2014

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Register NowGetting Paid in 2015: What You Need to Know
Wednesday, December 17, 2014
10:00 AM PT, 1:00 PM ET

Learn tactics to improve your bottom line in 2015Tweet this Kareo story

Are you wondering how the Affordable Care Act, ICD-10 and the government’s value-based modifier will affect your practice in 2015? This is no time to go into retreat mode. In this high-energy educational webinar, national speaker and author Elizabeth Woodcock highlights the key changes in payment for practices in 2015.

You’ll come away from this event:

  • Knowing more about the impact of the Affordable Care Act on your practice
  • With an overview the new CPT codes that will go into effect in 2015, as well as the implementation for ICD-10
  • Aware of the reimbursement changes to the 2015 Medicare Physician Fee Schedule, including the new Chronic Care Management Services
  • Having some ground rules for participating in the government’s incentive programs for 2015 to gain incentives – and avoid penalties

Join Elizabeth and get ready to be a best practice in 2015!

Register Now!

About the Speaker

Expert Elizabeth_Woodcock will explain best practices for appealing denied claimsElizabeth Woodcock, MBA, FACMPE, CPC is a professional speaker, trainer and author specializing in medical practice management. She has focused on medical practice operations and revenue cycle management for more than 20 years.

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December Kareo Newsletter Highlights Medical Billing Changes for 2015

Lea Chatham December 9th, 2014

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The December edition of the Kareo Getting Paid Newsletter highlights some of the changes coming for medical billing in 2015 along with tips on managing and renegotiating payer contracts. The newsletter also provides a chance to discover upcoming events, news, and resources from Kareo. Plus, you’ll learn about how to register for our upcoming free educational webinar, Getting Paid in 2015: What You Need to Know, presented by renowned medical billing and practice management expert Elizabeth Woodcock. Read all this and more nowTweet this Kareo story

 

December Kareo Getting Paid Newsletter

 

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Tips for Managing Social Media & HIPAA

Lea Chatham December 8th, 2014

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Download Now for Expert Social Media TipsBy David Harlow, JD, MPH

 

You can use social media and stay out of trouble on HIPAA—just be careful not to reveal too much patient information. Just because a patient posts about her condition publicly, you do not have license to respond publicly. Even if you were to post a comment about a rough day in the clinic, or losing a patient in the emergency room, with no patient identifiers, patient identities can be triangulated thanks to the vast amount of information online—and the total volume of information seems to double daily. Healthcare professionals have been sanctioned for such posts.

Physician bloggers can steer clear of HIPAA issues by only writing posts about composite patients, or patients with numerous key details changed, where a story illustrates a point without putting patient privacy at risk. Tweet this Kareo story

State laws and federal laws other than HIPAA, enforced by an alphabet soup of agencies, create additional minefields. With all of these potential problems, remember that reaching out to patients, families, referral sources, and the general public through social media is an incredibly powerful act. As long as you bear in mind just how powerful it is, you can do so responsibly.

For more great tips, tools, and tricks to making the most of social media in your practice, download 26 Social Media Tips for Your Medical Practice.

About David Harlow

David HarlowDavid Harlow is a seasoned health care attorney and consultant recognized as an accomplished, innovative and resourceful thought leader in health care law, strategy and policy.  His experience in both the public and private sectors over the past twenty-five years affords him a unique perspective on legal, policy and business issues facing the health care community.

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5 Tips to Improve Payer Contract Negotiation

Lea Chatham December 8th, 2014

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Tweet this Kareo storyBy Rochelle Glassman

It is common practice when a new payer contract or an amendment to an existing contract shows up that the manager takes the document to the physician or owner for signature. Often, this happens without reading the contract and understanding its terms and your obligations to the contract it is signed. Before you can approach a health plan to discuss the negotiation of your contract you need understand your contractual terms.

What is a payer contract?
In simple terms, it is an agreement that promises to the pay the practice or specific provider for “medically necessary” services it provides to the health plan members.

What are the terms of the contract?
It is important to know what the terms of your contract are;

  • Reimbursement rates. You need to know how much the health plan going to pay you for your services. Never sign a contract that does not have a fee schedule attached.
  • Filing deadlines. This is the amount of time you have after you have seen the patient to file the claim.
  • Payment deadlines. What is the amount of time the health plan has to pay you after receiving a “clean claim”. That is a claim that has been submitted accurately without any coding or demographic errors.
  • Dispute resolution procedures. These are the contractual procedures on how either party will work towards a resolution of a disputed claim
  • Notice to renegotiate. Most contracts spell out the notice period you have to provide them, in writing, of your intent to renegotiate the terms of your contract.
  • Notice to terminate the contract. This lays out the terms of how either party may terminate the contract either for cause or not for cause.

Read the contract carefully
There are often hidden terms in payer contracts that practices do not notice, but they are very important.
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  • What fee schedule is being used and how is it calculated?
  • How often is the fee schedule updated?
  • Are amendments unilateral or bilateral and how must notification take place if unilateral? (some sneak it in an electronic newsletter that is easily overlooked)?
  • Is there reciprocity in the agreement or does the plan put all the responsibility on the provider?
  • Are you being charged for referring patients out of network?
  • Is there a fine if you terminate your contract early? (some payers can charge back 2% of all payments paid the practice for the previous 24 months)
  • What are the compliance obligations and do you have the internal resources to implement and manage them?
  • Almost all the policies, procedures, quality assurance, and quality management prior authorization and referral programs are provided in a provider manual. Be sure to also read this manual.

It is important that you read, understand the terms and can abide by “all” the contractual terms before you sign the contract. The contract legally binds you to the terms of the contract and by signing it you are agreeing to perform and abide by the terms spelled out.

Tips to Negotiate Contracts
Once you understand the terms of the contract you can decide what terms you would like to change. Here are five suggestions to help you renegotiate:

  1. It is easier to negotiate contractual terms and reimbursement rates before you sign a contract. Often, practices want to renegotiate terms within the first year of executing the contract. While it is possible to do so, it can be challenging.
  2. Payer contracts are one of the practices biggest assets. Therefore it is critical that you prepare a formal request to the health plan detailing what you would like to change in the contract.
  3. Make sure you have the supporting documentation to support any claim that you are making in the request.
  4. Identify the value proposition and how it benefits the health plan, health plan members, and your practice.
  5. Never be afraid to ask for what you want and be prepared to say NO if the contract does not make financial sense.

Remember, reviewing, renewing and renegotiating contracts is something you need to do every year. Also, be sure to update your practice and other fee schedules in your practice management system. Not doing this could result in lost revenue!

About the Author

Rochelle_MG_1811Rochelle Glassman is President & CEO of United Physician Services. Rochelle brings a passionate, very practical “do it today” approach to making medical practices successful and getting physicians paid more.

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2015 Medicare Fee Schedule Finalized

Lea Chatham December 8th, 2014

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Register Now for Updates on Medical Billing in 2015by Elizabeth W. Woodcock, MBA, FACMPE, CPC

The 2015 Medicare Physician Fee Schedule (PFS) goes into effect April 1, 2015. While the current Medicare Fee Schedule stays around until March 31, 2015, the new PFS will bring a 20-plus percent drop in physician reimbursement unless Congress steps in first. While Congress has reversed the cuts in previous years, there’s truly no guarantee that Congress will take action prior to the spring decline.

With Medicare the bellwether for our industry, let’s take a look at the highlights of the new schedule and how it will affect your reimbursement in 2015. Tweet this Kareo story

Chronic care management. The Centers for Medicare and Medicaid Services (CMS) will begin reimbursing physicians for chronic care services with dates of service of January 1, 2015. Instead of creating a new G code, CMS will use the established CPT® code, 99490, which will pay approximately $40. The code is applicable to non-face-to-face services related to managing the care of a Medicare patient with two or more chronic conditions, and can be used by a physician of any specialty. Practices must be using a certified EHR system to qualify, but the work can be performed by staff under “general” supervision of the physician. While $40 may not sound like much, the code is billable each calendar month for 20 minutes or more of activity, making it potentially lucrative.

Specialty cuts. The 2015 PFS brings cuts to a handful of physician specialty services. Radiation therapy centers and payments for radiation oncology escaped a massive cut, based on CMS’s desire to classify equipment costs as indirect rather than direct practice expenses. This reclassification is expected to be addressed in the 2016 fee schedule. The only specialties with negative impacts of more than one percent will be dermatology and ophthalmology, each incurring a two percent reduction due to resource value scale (RVS) adjustments.

Screening colonoscopies. Medicare beneficiaries no longer must pay for anesthesia provided separately during a screening colonoscopy. As of January 1, 2015, the deductible and coinsurance are both waived as CMS rewrites its definition of the screening service to include separately provided anesthesia.

PQRS measures. Physicians and other eligible professionals must report on nine measures in 2015 for the Physician Quality Reporting System (PQRS). Successful reporting avoids the two percent penalty that will be imposed in 2017 based on 2015 participation. No more bonus payments are available through this government initiative; it converts to a penalty-based program in 2015.

Value-Based Payment Modifier (VBPM). After starting with the large practice market in 2014, this initiative will be rolled out to all practices next year. Physicians, regardless of practice size, must report it or face negative payment adjustments. The penalty increases to four percent for practices with 10 or more eligible professionals, but even smaller practices should take heed as CMS’s definition of an eligible professional (EP) is quite broad.

Global periods. The 2015 PFS confirms the phase-out of the global period for surgery codes – 10- and 90-days. When finally eliminated in 2018, all global periods will be replaced by 0-day global codes, thus migrating all surgeries and procedures into per-service coding.

The full package of Medicare physician fee schedule changes coming in 2015 is packed into the Final Rule. Expect your specialty society, if it hasn’t already done so, to release its assessment of the new rule’s impact on your practice.

To find out more about the coming changes in 2015, join me for the free webinar, Getting Paid in 2015: What You Need to Know.

About the Author

Elizabeth Woodcock explains how to to get your medical billing appeals program in gearElizabeth Woodcock, MBA, FACMPE, CPC is a professional speaker, trainer and author specializing in medical practice management. She has focused on medical practice operations and revenue cycle management for more than 20 years.

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Should You Hire a Nurse Practitioner?

Lea Chatham December 5th, 2014

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Tweet this Kareo storyIn the recent webinar, Planning for 2015: Make It a Best Practice Year, an attendee asked about  hiring a Nurse Practitioner (NP). Whether or not to add new providers, especially NPs, is a hot topic right now for many practices. And, in a lot of different circumstances it is a great option.

However, practice managers and physicians worry about how patients will perceive seeing a NP instead of a physician. NPs can be a great addition to your practice,” says practice management consultant Judy Capko, who hosted the webinar. “It often depends on your demographics and competition or specialty. If you have retail clinics staffed by mid-level providers in your area, it may not be unusual to people at all and could allow you to offer the same type of last minute, same day, and walk in appointments as those clinics. Many people are open to seeing a midlevel to get faster access, especially for urgent needs. In some specialties like orthopedics and surgery where patients can have many pre-op or post-op visits, offering services from NPs or PAs can also improve and speed access to care. Whatever the situation, one way to help ensure patients are comfortable is to always appear as a united team of providers dedicated to your patients’ wellbeing.”

Building a practice with a mix of providers is a growing a trend as practices look to stay competitive with retail clinics. Tweet this Kareo story
Recent studies suggest that by next year there may be as many as 3,000 retail clinics nationwide. Independent practices will need to find ways to offer more flexible access to care. That could be with extended hours, same day, and walk-in appointments, or by offering specialty services.

Adding a NP can also help patients who are paying more of their own healthcare expenses. While many preventive care visits are now fully covered, patients have to pay more for urgent needs like flu or a sprain. With high deductible plans and HSAs, the whole burden of that cost could fall on the patient now. Often the charge for seeing a NP is less than it is for seeing a physician. Practices that offer a NP as an affordable option that is also quickly accessible are actually meeting patients needs more effectively.

Just remember that you need to present this new option to patients as a benefit to them. As with all new services, be sure to create a marketing plan and communicate with patients consistently and regularly through your newsletter, website, and/or social media channels. Focus on your dedication to meeting patient needs. Help them get to know your new provider. With changing patient expectations today, focusing on your relationship with the patient and your dedication to meeting their needs will only benefit your practice in the long run.

For more great tips on planning for 2015 and staying competitive in changing times, watch Judy’s webinar.

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Asking for Patient Payments: 3 Ways to Ease the Pain

Lea Chatham December 2nd, 2014

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Kareo patient collections videoBy Cheryl Bisera

The shift toward high deductible plans isn’t going away. Tweet this Kareo story
Preliminary survey findings show that 73% of large employers plan to introduce a high deductible plan to employees within the next three years and 20% of those employers say it will be the only choice offered.[1] It’s more important than ever that your staff is empowered and effective at collecting point of service patient payments. But asking patients for larger amounts of money is not easy for some of your staff who have traditionally only had to ask for small co-pays or nothing at all.

Here are three things you can do to help ease the pain while succeeding at point of service collections:

  1. Explain to staff that patients benefit. Yes, stepping up your point of service collection efforts will protect your profitability, but direct communication with patients about their financial responsibilities is better for them too! By taking the initiative to prepare patients for their medical expenses your practice becomes a stronger partner, advocate, and resource to patients by reducing patient shock and frustration over unexpected expenses and shedding light on unfamiliar lingo. Your practice is expressing that you’re on patients’ side when you accept an array of payment methods and offer payment plans for larger balances, thus helping patients to afford the healthcare they need. When staff can grasp that the practice is helping patients receive and pay for the care they need, they can stop feeling bad and be more matter-of-fact about asking for payment.
  2. Show staff the numbers behind the methods.  Nowadays, patient portion accounts for as much as 30% of practice revenue. Tweet this Kareo story
    You can’t afford to leave that money on the table by risking that patients pay late, pay only partially, or worse, not pay at all. But saying just that isn’t enough; your staff need to know the real numbers for your individual practice and participate in setting specific improvement goals. Sharing the hard numbers with your staff can make all the difference because it helps them see how their job directly contributes to the success of the practice. And you’re sure to see more enthusiasm when they are a part of the process with goal setting!
  3. Back your staff up with patient-friendly tools and communication. You’re asking your staff to change how they communicate with patients and put themselves ‘out there’ by initiating financial conversations. That might feel like an uncomfortable stretch for them. Scripts, workshops, webinars, role-playing, and shadowing are all great ways to equip staff to keep it positive and matter-of-fact. Another way to support their efforts is by having a patient financial policy that is communicated clearly to patients. By giving your staff the tools and training they need to keep positive options for patients at their fingertips–like credit card on file, a payment plan, or third party health credit services–they are empowered to take an advocacy tone with patients and be more successful with their collection efforts.

About the Author
Cheryl Bisera photoCheryl Bisera is a consultant, author and speaker with extensive experience in marketing and business promotion that spans more than ten years in which she worked with professionals to strengthen their position in the marketplace. She is the founder of Cheryl Bisera Consulting, a California-based image development and marketing company that focuses on the healthcare industry and author of the book, The Patient-Centered Payoff. Cheryl has spoken for regional medical management organizations, conducted customer-service workshops, and written numerous articles for publications such as KevinMD, Physician Magazine, and the Journal of Medical Practice Management.

 


[1] “Survey predicts health benefit cost increases will edge up in 2015” Mercer Newsroom, www.mercer.com

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Where to Invest in 2015: Top 7 Strategies for Medical Practices

Lea Chatham November 26th, 2014

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Tweet this Kareo StoryBy Lisa A. Eramo

Few physicians and practice managers enjoy the dreaded task of budgeting for the upcoming year. There never seems to be enough money to accomplish everything, and with the growing list of regulatory requirements, this probably won’t change anytime soon.

However, setting a budget—and sticking to it—is one of the most important steps that practices can take toward ensuring financial viability, says Heather Greene, MBA, RHIA, CPC, CPMA, vice president of compliance at Kraft Healthcare Consulting, LLC in Nashville, TN. Regardless of your practice’s size, specialty, or location, there are several important areas in which physicians should invest in 2015.Tweet this Kareo story

Greene provides a summary of the top seven investment opportunities.

#1: ICD-10 education and training. The best way to mitigate denials and revenue loss in ICD-10 is to provide comprehensive training for all staff members. This includes administrative staff, clinical staff, and coders. According to a February 2014 report published by the American Medical Association and Nachimson Advisors, LLC, approximate practice expenses related to training could include the following:

  • $300 for an ICD-10 coding manual
  • $600 per coder for attendance at an ICD-10 coding boot camp with additional costs (25%-50% more) for specialty training
  • $500 per coder for large on-site group training
  • $1,000 per coder for online boot camps/training courses
  • $300 per clinician for three-hour specialty-specific ICD-10 training
  • $700 per administrative staff member for attendance at a two-day ICD-10 boot camp

Practices should also budget for travel expenses, material costs for trainings, practice time for coding in ICD-10, as well as ongoing refresher training leading up to the October 1, 2015 implementation date.

2. Compliance plan. When practices operate using what Greene refers to as a “skeleton budget,” the compliance plan is often one of the first items to be forgotten. However, practices that don’t develop a formal, written compliance plan put themselves at risk for audits and recoupments. Don’t have enough money to hire a consultant or develop one internally from scratch? Physicians on a strict budget may be able to team up with other local practices of similar size and specialty to compile a list of vulnerabilities and then create a plan to address those vulnerabilities. Also consider contacting local hospitals to determine whether the practice can tailor the hospital plan to fit its own needs. Many hospitals are willing to share this information with practices when they ask, says Greene. The OIG Work Plan, which is updated annually, is another great resource on which practices can base their plans. The OIG also provides other guidance for how practices can develop compliance plans.

3. Meaningful Use. Though it may seem labor intensive, it’s worth it for practices to attest to Meaningful Use. 2014 is the last year in which eligible professionals can begin participation and receive an incentive payment. Beginning in 2015, eligible professionals who do not successfully demonstrate meaningful use will be subject to a payment adjustment. The payment reduction starts at 1% and increases each year that an eligible professional does not demonstrate meaningful use. The maximum penalty is 5%.

Greene says it’s important to evaluate whether your EHR is meeting your expectations, including whether it is enabling your progress toward Meaningful Use attestation. Don’t continue to invest in a vendor that isn’t working for you, she says. You may need to cut your losses and move on.

4. Internal audits. Heading into ICD-10, it will be paramount for physician practices to perform proactive audits regarding coding and documentation quality. Working with a consultant to perform these audits may be most effective. Some consultants can also provide audits to make your practice more efficient. This will be particularly important heading into ICD-10 when both coder and physician productivity are expected to decrease.

5. Certified coders. Some practices may rely on individuals who don’t have formal coding training or credentials to perform the coding function. Although this may have been acceptable, the practice of hiring non-credentialed coders may become obsolete as physicians continue to undergo billing and documentation scrutiny by external auditors. Consider investing in a seasoned, certified coder or at least providing formal coding certification training for existing staff members. The American Academy of Professional Coders provides many resources on coder salaries, including an annual salary survey. Keep in mind that one certified coder would likely pay for him or herself annually by preventing denials and costly recoupments.

6. Non-physician practitioners. As patients continue to flood the healthcare system due to the Affordable Care Act, it may be worthwhile for physicians to invest in non-physician practitioners. The Medical Group Management Association published a report in March titled “NPP utilization in the future of US Healthcare” that can help practices determine how an NPP might benefit them. The report also answers other questions, such as how to recruit and retain an NPP, whether a full-time or part-time contract is appropriate, and more.

7. Marketing. Although the Affordable Care Act may continue to bring in new business for your practice, it’s important to think strategically for long-term success. Marketing the practice via a Website or social media can help establish a brand, highlight areas of expertise, and more, according to amednews.com.

Other advice
Keep budgets for each initiative separate, says Greene. For example, keep one budget for Meaningful Use and another separate budget for ICD-10 training. This helps practices track spending and assess the impact of changes to each budget.

Practices should also think about creating a “rainy day” fund to minimize the impact of payment delays related to ICD-10. The Healthcare Information and Management Systems Society (HIMSS) provides an ICD-10 preparation and contingency planning resource for large practices as well as one for small to medium practices.

For more on how to plan for the coming year, watch the recorded webinar, Planning for 2015: Make It a Best Practice Year.Tweet this Kareo story

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal and AHIMA Advantage. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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How to Handle Not Getting a Raise

Lea Chatham November 25th, 2014

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6000911_57260_1_14087535_300-300x200By Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

OK first off…even though the economy is improving, many businesses are still wary, and a lot of people aren’t getting raises, so it’s not just you. In healthcare, specifically, practices have concerns about changes in reimbursement, the cost of ICD-10, and coming penalties from CMS in 2015. The one thing you should absolutely NOT do is get in a snit and go storming out of your boss’s office. That will do nothing for your next evaluation, your next shot at a raise, or your standing at the practice.

You do, however, have the right to know why your raise was turned down, and there might be a number of different reasons:

  1. Company finances. With things being what they are in healthcare, there’s a real good chance that this is going to be the case. And if they tell you that, there’s a real good chance that they are being honest with you, especially if nobody else in the practice is seeing a raise. If that’s the case, there’s not much that you can do but accept it, get over it, and move on. As the economy continues to improve so will your chances of you raise down the road.
  2. Poor timing. Some healthcare businesses are more seasonal that others. It may not be the right time. Or, it may be that a recent large investment in the practice makes it difficult to invest in raises today. If that’s the case, once again, there’s not much you can do about it. Of course, that doesn’t do you much good if your own expenses are going up, your spouse lost a job or your kids need braces. Discuss the possibility of overtime or incentive pay. Some practices are offering incentives to staff who increase appointments through recall programs or increase patient collections. Unfortunately, if the practice is feeling the pinch (as in the above scenario) they may also be cutting back on bonuses, overtime, and incentives to scale back on payroll expenses. So…if you’re going to have to wait until the next quarter, next year, or next evaluation (and overtime isn’t an option) your best move is going to be to keep the nose to the grindstone and do the absolute best job you can manage so that when the time comes, you’ll get that raise after all!
  3. Poor performance. If your raise was declined due to performance issues, this is when you need to be proactive, stand on your own two feet and find out the specifics. Chances are you’re going to find this out when it’s evaluation time anyway, but regardless, ask your manager what areas need to be improved. Find out where your weak points are, and do your dead level best to improve on them. Or, your alternative might be to start looking for another job elsewhere, with better pay and better opportunities. But a word to the wise here: if you’re moving in that direction, keep it to yourself. Nothing can sabotage your future quicker than making it known that you’re thinking about moving on.

It can be hard when you don’t get a raise you expected, but the reasons may be valid.Tweet this Kareo story
It may also be an opportunity for you to bring new ideas and challenge yourself. Suggesting incentives for employees based on certain performance measures like increasing appointments is one way. Another way is to take advantage of educational opportunities to grow in your field. There are many free programs out there than can help you excel at your work.

About the Author

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

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Welcome to Getting Paid, a weblog by Kareo offering ideas, news and opinions about medical billing and practice management with the goal of making medical billing easier and yes, getting you paid. Visit the Product Blog for more information on our products.

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