October Kareo Newsletter Takes a Look at Social Media for Physicians

Lea Chatham October 9th, 2014

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The October edition of the Kareo Getting Paid Newsletter takes a look at using LinkedIn, some best practices for work life balance and some handy tools to improve your medical billing. 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, Define Your Online Reputation: A Social Media Approach, presented by physician social media expert Kevin Pho, MD. Read all this and more now!Tweet this Kareo story

October Kareo Getting Paid Newsletter

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Why I Recommend LinkedIn to Physicians by Kevin Pho, MD

Lea Chatham October 8th, 2014

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LinkedInBy Kevin Pho, MD

When I talk to physicians about dipping their toes into the social media waters, I advise starting with LinkedIn. Spend about 45 minutes or so and create a LinkedIn profile, which is essentially a digital translation of your CV. LinkedIn profiles get ranked highest among the social media platforms, and can push down the influence of negative news stories or physician rating sites.

Howard Luks is a social media thought leader, and whose opinion I respect tremendously. He wrote an insightful piece explaining why LinkedIn may not be right for doctors:

“As a physician on LinkedIn, not only do you have a virtual “please sell to me” sign on your forehead, most will perceive their presence on LinkedIn as a huge waste of time. Unless you are an aspiring entrepreneur, etc. you will find that the connections you make on LinkedIn are weak at best. In addition, while your patients are looking you up online, for the most part they are not looking at your LinkedIn profile.”

He goes on to suggest doctors spend their time on physician rating sites like Vitals or Healthgrades, Google+, or Yelp.

When it comes to establishing an online reputation, there are essentially two ways of doing it.Tweet this Kareo story

  1. “claiming” a profile on an existing physician rating site
  2. creating your own online presence, either with a website or through a social media platform

While I generally recommend the second approach of proactively defining yourself with social media, the first option of utilizing existing sites is viable.

First, much of the information in Vitals or Healthgrades is inaccurate, and can lead to the so-called Google Maps problem, where Google may use the information on these sites.

Second, physicians can leverage the high search engine visibility that these sites generally garner.

The downside of this approach is that these sites are for-profit and generally don’t have physicians’ best interests at heart.  Their physician profile pages are littered with ads, which can subtly imply a physician’s endorsement.

Also, consider the terms of service of one of these sites, which are heavily skewed against the doctor:

“You acknowledge that your Physician-Provided Material may be used without restriction for any purpose whatsoever, commercial or otherwise, without any compensation or obligation to you.”

Because of those reasons, I prefer doctors create social media profiles instead, where they have more control over how their online identity is controlled and presented.

Howard also recommends Google+ and Google Places for Business. However, there is more friction in taking this approach, namely the cumbersome way Google verifies your business address. If this can be overcome, this does indeed have the highest search engine impact, as seen below:

kevin-pho LinkedIn

But any friction whatsoever prevents the majority of physicians from defining themselves online. From talking to doctors across the country, many are petrified of taking even minimal steps to be visible online.

Which brings us back to LinkedIn.

While it isn’t perfect for the reasons Howard mentioned, LinkedIn is a low-threat, low-resource, high-yield action.

I acknowledge that there are tradeoffs involved, and after considering those, continue to recommend it as a reasonable first step to establish a physician’s online reputation.

This piece originally appeared on KevinMD.com. For more tips an strategies from Kevin Pho, register now for his upcoming free webinar, Defining Your Online Reputation: A Social Media Approach.

About the Author

Kevin Pho for Health LeadersKevin Pho is an internal medicine physician and co-author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. He is on the editorial board of contributors, USA Today, and is founder and editor, KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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6 Tips for Creating Work Life Balance

Lea Chatham October 8th, 2014

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Tweet This Kareo StoryBy Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

Balancing work and family can seem like an impossible task. According to the Physicians Practice Great American Physician Survey, sponsored by Kareo, many physicians struggle with creating work life balance and they want to improve this area. As a mother of two young children, figuring out how to juggle everything has become a personal quest of mine. A recent article in The Atlantic looks at some of the numbers in recent studies on work-life balance in the U.S., and it makes an interesting read. Why do so many struggle with this balancing act? Is there ever a happy medium?

The reality is that the process of balancing is dynamic, and it changes as the situations change. Here are some tips to help put this seemingly impossible task into perspective:

  1. Recognize that family life has seasons. The demands on your time and energy will change as new members are added to the family and as kids get older. Homework becomes more independent for kids as they get older, meaning less homework for mom and dad to help with.
  2. Schedule family times, just as you schedule your appointments. It might sound cold, or not spontaneous, but it works–especially if you are like me and live by your calendar. Plan some vacation time now and block it on your calendar. It doesn’t have to be two weeks at the shore, but you do need to have fun together as a family. A weekend at a cabin, a walk through town or your neighborhood, or an evening at an ice cream store works, too.
  3. If the traditional family dinner hour doesnt work for you, set a 8:30 meetup in your family room with a snack. The idea is to connect at least once a day for a short time because it is cumulative: all those short times build on one another to maintain relationships.
  4. Turn off the electronics during that connection time! Think face-time instead of screen-time. You can’t give your full attention to anyone if you’re getting texts.
  5. Say “no” to a few things. Choose not to “do it all” and just do one extra-curricular activity per family member.
  6. Delegate and get help when you are overwhelmed. You can’t do everything. Sometimes you need to break down and ask for help. I finally did just that. After years of taking care of children, keeping a clean house, and managing a growing business, I finally had to break down and admit I needed some help–in one area in particular–my landscaping. Now, I must add that my husband is a huge help in keeping the house organized and picked up, and is a great with the kids and their schedules, but does he know the difference between a weed from a Spring bud? NO. To him they all get pulled out. So, I hired Joanna, Master Gardener and Savior of Pitiful Landscaping. She came in, took one look at what I was attempting to do with the yard, talked with me for awhile about what I wanted to see, and went to work. Just a few hours from her took such a load off my mind. What a difference a professional makes! I never knew my landscaping could look so good. Finally, curb appeal! Delegating that task was the best thing I ever did.

There will be times when family has to be the priority over work: sudden illnesses, crisis situations, school activities, etc. There will also be times when work has to have priority over family because of call schedules or a patient crisis. Balance is that shifting of resources to adapt to changing needs and keeping your focus on the priorities you’ve set.Tweet this Kareo story

Most of us would say that we work to provide for our family and that our families are also a priority. Deliberately investing your energy into connecting with your loved ones on a daily basis with occasional longer times together helps you maintain that critical balance between work and family. Delegating, limiting commitments, and asking for help allows you to focus on what is important.

 About the Author
erin-photo-200X300Erin 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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6 Steps to Hiring the Right Medical Practice Staff

Lea Chatham August 5th, 2014

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Tweet This Kareo StorySo, you’ve read the recent blog post on having the right medical practice staff mix at your practice. Now, you’re looking at your staffing, processes, and technology.

You may have discovered you are actually understaffed or incorrectly staffed. Perhaps someone has recently left the practice. Whatever the reason, you have determined you need to fill a position. Now what?

  1. Create a job description: Each position should have a clear job description that includes title, department, date the job description was developed and a revision date, who the employee reports to, and if the position is exempt or none exempt. The body of the job description should describe the general purpose of the position and responsibilities. This is where the job tasks are listed (i.e., knowledge, skills, and abilities). Describe the skills that are required to perform the job function and the experience needed. Include educational experience, physical requirements, and typical working conditions. Once the job description is complete you have the tools to identify the right candidate for the position. You can find sample descriptions online through a simple search or check with associations you belong to.
  2. Test the candidates: Test candidate knowledge and skills first so you don’t waste your time—or theirs. For example, if the position is for billing, have them complete a billing test before you interview. The test complexity should be based on the position. If the candidate does not pass the test, don’t interview. Tests should be conducted in the office so that you can be sure that the actual candidate is the one that took the test and not one of their friends.
  3. Identify the top applicants: Once you’ve tested skills, then you can interview the most qualified applicants. Depending on the size of your practice you may do more than one interview. In a smaller practice, the practice manager might be the only one who needs to speak with the candidates. In a larger practice, there could be an initial interview with the practice manager for the top candidates, followed by an interview of the top two with the department as a group or with the practice owner/provider.
  4. Conduct a working interview: Once you are down to the top two, schedule a working interview where the candidates get to work side-by-side with coworkers. Tweet this Kareo story
    This gives the practice a “test drive” to observe actual skills and how they interact with the patients and staff. A working interview should last no less than four hours and up to a week. Remember to have the candidates sign a confidentiality agreement before they are exposed to patient and business information. They should also have a clear understanding of HIPPA regulations.
  5. Conduct a background check: Once you have decided that the candidate is a good fit, make sure you complete a thorough professional reference and background check. Too often we are called in to practices for theft only to find out that the “perfect” candidate has a criminal background. It is important to remember that if the candidate has a criminal background that is not relevant to the position they are being hired for you cannot refuse them the position.
  6. Make an offer: When you have selected the ideal candidate, prepare a written offer letter. It should include the position they are being offered, rate of pay, who they report to on their first day, date and time they start, and if you are in a right to work state, a paragraph should be included to clarify what that means. Including a copy of the full job description is a good idea too. The offer letter and job description should be signed before the employee’s first day.

There is one last important thing to keep in mind. Often, employees leave without notice. When you hire in a right to work state no notice of termination is required by either party. You could find yourself short staffed with a full schedule of patients. Obviously, this puts pressure on you to fill the position quickly. Do not fill the position out of desperation. It is better to hire a temp to help out while you look for the right person. It may also be less expensive in the short term to pay a little overtime or reallocate staff to provide the appropriate coverage. It can cost up to $9,400.00 according to eHow to replace a wrong hire so don’t rush it.

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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What’s Your Ideal Medical Practice Staffing Mix?

Lea Chatham July 22nd, 2014

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By Rochelle Glassman

Tweet this Kareo storyThere is no hard and fast rule on how many staff you require for your practice because each specialty and situation may require something different. It is important to understand your medical practice staffing needs based on the job functions required to efficiently operate and manage your practice. Understaffing can cause breakdown in operations that could result in errors, reduction in revenue, and patient dissatisfaction. Overstaffing may cause a loss of productivity and an unnecessary financial overhead burden.


How Many Staff Should You Have?
Many of the medical associations such as Professional Association of Healthcare Office Management (PAHCOM) and Medical Group Management Association (MGMA) benchmark how many full-time employees you need per full-time provider. A full-time employee (FTE) is an employee who works between 35 and 40 hours per week. A practice’s FTEs may include front desk, billing, office management, medical assistants, nurses, and even scribes.

There are many factors that can influence your staffing like patient volume, specialty, and the use of technology.Tweet this Kareo story

Here are some recommendations from MGMA to use as a guide for your practice.

Tweet this Kareo story

Calculating Your Staffing Ratio
Before you calculate your practice’s staff-to-provider ratio, however, it’s essential to know how to do it correctly. It seems simple enough: Count up the doctors in your practice and divide by the number of billing staff, right? Well, not quite.

Rather than count each physician individually—a common mistake—practices must make sure to count physician FTEs. To properly calculate the number of physician FTEs within your practice, divide the total number of patient encounters performed during the past year for your entire practice by the average number of yearly physician encounters, (This number will be between 3,600 and 4,800 depending on your specialty. Primary care tends to be on the high end at 4,800 and single surgical specialists, like orthopedics tend to be on the low side at 3,600). The reason that you want to perform your FTE calculation in this manner is to accurately account for physicians who work part-time, job share, work any other less-than-full-time schedule, or manage their time efficiently and therefore are able to treat more patients.

To calculate the number of billing staff FTEs, you’ll want to define an FTE as an employee who has been compensated for 2,080 hours of work (40 hours/week X 52 weeks/year) during the last year. Like the physician FTE calculation, this will take into account any employees who work any schedules more or less than 40 hours per week. Hours to include in this calculation should be related to any personnel who participate in the physician revenue cycle, including insurance verification, data entry, coding, payment posting, accounts receivable follow-up, patient statement processing, customer service, etc.

Once you know your medical practice staffing ratio, compare it to the chart provided above. If you are much higher, it’s probably time to look at your staffing, processes, and technology. The next blog in this series will review areas where you may find inefficiencies and ways that process changes or technology can help.

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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7 Ways to Erase Workplace Stress

Lea Chatham February 4th, 2014

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Medical practices are fast-paced places. On top of that there are so many things that you have to do and remember—HIPAA, billing changes and updates, and other regulatory changes. Then tack on the fact that you are often dealing with people who are sick or injured and may be tense or short tempered. Anyone in that situation is bound to get a little stressed out every now and again.

The thing about stress is that it is bad for you. It takes a toll on your body in many ways from raising your blood pressure to causing anxiety attacks and weight gain and it reduces your productivity.

Luckily, there are lots of ways to beat stress in the workplace. In honor of healthy heart month (less stress is good for your ticker!), here are 7 ways to manage and reduce workplace stress:

  1. Stay alert for the warning signs. There are many signs of stress and recognizing them is an important part of getting it under control. Watch for feelings of anxiety, irritability, depression, and fatigue. Other signs include problems sleeping and concentrating as well as stomach issues, headache,s and muscle tension. Everyone is different and these are not all the possible signals of stress. Get to know your own responses to stress so you can see it coming.
  2. Take care of yourself. When you start to feel those signs of stress creeping in, do something about it. Take care of your mental and physical health first. Even small things can help you stay on track. Hydrate, get a little more rest, eat a healthy meal, etc. If you need to take some time away from the office, make arrangements for that. A short walk or lunch with a friend can work wonders to relieve tension.
  3. Remove stress triggers. Seeing the stress coming is one thing. Preventing it all together is another. Take some time to think about what triggers stress for you. For some people it is conflict with others, for another person it might be a messy desk. Identifying your triggers is the first step to addressing them.
  4. Build up your emotional intelligence. You’ve heard the phrase “Know thyself.” That is really what emotional intelligence is all about. Tweet This
    Beyond identifying your triggers, work on having self-awareness, awareness of others, and the ability to develop effective coping skills. You may be able to do these things on your own or you might need some help. There is nothing wrong with reaching out for professional help if you need it.
  5. Learn to resolve conflict. Conflict with others in the workplace can cause a lot of stress. And most of us don’t deal well with interpersonal tension. Learning to resolve these issues can be a huge stress buster. Read our recent post on reducing workplace tension for good strategies.
  6. Talk it out. This suggestion comes from the Mayo Clinic. An article from the Mayo Clinic suggests trying to get some perspective by getting other points of view or taking a break. Talking to a friend or colleague about what’s bothering you is a great way to help resolve the stress.
  7. Get some help. It was mentioned above, but it’s worth saying it again. Sometimes you need some help to resolve a problem. Seeing a professional can help you with all of the steps above if you just can’t seem to do them on your own. The best part is that due to changes in healthcare reimbursement, many insurance companies now cover mental health services with a co-pay, making it more accessible and affordable for many people.

Don’t let stress get in the way of workplace satisfaction. You spend 40 hours (or more) a week at your job. You should enjoy it.

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5 Steps to Improving Your Sense of Wellbeing

Lea Chatham January 7th, 2014

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By Jerry Bridge

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photo courtesy of Ruud Janssen

“If healthcare is about well being, then why am I so stressed out?” Tweet This

Over the past two decades I have had the privilege of working with hundreds of medical practices on a number of issues, ranging from collections to customer service, and now, ICD-10. I have come to understand, firsthand, the unique nature of healthcare as a business, along with the stresses and anxieties that so often seem to go with it!

Medical office managers and providers face extraordinary challenges for managing their limited time, staff, and projects. The time management models, first formed in the 1950’s, are simply insufficient for managing the speed, volume, and complexity of information coming at you. Now, add in industry changes like the Affordable Care Act, ICD-10, and Meaningful Use. No wonder your feeling overwhelmed and stressed out!

How can you learn to live and work in a time in which there’s simply more to do than time to do it! I believe you need to learn and implement principles and practices for managing productivity and reducing stress!

Here are my 5 suggestions to help get you there:

  1. Commit yourself to a new possibility! This may sound easy or obvious but until and unless you are committed to a new possibility for yourself — the possibility of living and working with less stress  it may not ever show up for you!
  2. Manage Your ‘Techno Addictions’: Recognize and release your addiction to technology, to being constantly busy, and always on. Turn off your device(s). Here’s one idea: at lunch, have everyone put their smartphones in the middle of the table. First person to text or check email pays!
  3. Stop multitasking! It doesn’t work; we wind up doing more things but less effectively. Our brains love to focus on one thing at a time. It feels good as we become more mindful and present. For example, don’t eat lunch at your desk. Eat when you eat, work when you work, sleep when you sleep.
  4. Clean and organize! Clutter negatively impacts your productivity and well being. Think about what it feels like when you clean the garage or the closet that’s been nagging at you. Feels great, right? Get rid of all those trade magazines you’re going to read ‘someday’. Clean off your desk. Schedule time to do this in stages; don’t try to do it all at once.
  5. Breath, Conciously: Practice taking long slow deep breaths, which will naturally help to alleviate stress. Meditation works! (More than 600 scientific studies verifying the wide-ranging benefits of the Transcendental Meditation technique, conducted at 250 independent universities and medical schools in 33 countries during the past 40 years.)

The more you practice any one of these suggestions the better you will feel. Feeling less anxiety and stress naturally enhances productivity and extends to excellent customer service. Of course there will be times when this is ‘easier said than done’. But it doesn’t matter because if healthcare is truly about well being, that includes you! It is up to each one of us to do whatever we can to take care of ourselves and be well.

About the Author

Jerry Bridge

Jerry Bridge is a nationally recognized motivational speaker and educator for the healthcare industry. Over the past 25 years Jerry has worked with thousands of providers, practice managers and staff nationwide on a variety of practice management issues ranging from billing and collections to customer service and communication. Jerry has written several articles and books on these subjects, including The ICD-10 Transition Planning Guide; Making a Successful timely Transition. To learn more, please visit www.healthcarecollections.net.

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5 Ways to Nip Workplace Tension in the Bud

Lea Chatham November 14th, 2013

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medical practice management dealing with office tension

It happens to everyone. For some reason you had a conflict with a coworker. Someone was having a bad day or took offense. It was probably a small thing, but it got out of control, and now there is this workplace tension. Sometimes it resolves itself through a joke or light hearted comment from one or the other. Other times it just passes without further incident. But occasionally it gets worse—it takes on a life of its own. The next thing you know you can hardly work together. You spend at least 25% of your time at work so you need to nip this thing in the bud!

In his article 5 Keys of Dealing with Workplace Conflict, Mike Myatt writes, “While conflict is a normal part of any social and organizational setting, the challenge of conflict lies in how one chooses to deal with it. Concealed, avoided or otherwise ignored, conflict will likely fester only to grow into resentment, create withdrawal or cause factional infighting within an organization.”

You said it! So now what? We’ve compiled our own five strategies to guide you in the right direction towards resolving workplace tension.

  1. Keep an Open Mind: Take a deep breath and think about the other person. Was it just a bad day? Or do they have a different point of view? Can you see where he or she is coming from? If you understand the other person’s perspective then perhaps you can find some common ground.
  2. Make the First Move: Someone has to make the first move. It might as well be you. We are all uncomfortable with confrontation, but look at this as an opportunity to grow and hopefully build a stronger relationship with your coworker. Reach out and ask if the other person has time to chat, go for coffee, or have a drink after work. Just the act initiating forward movement can sometimes be enough to diffuse a tense relationship.
  3. Be Respectful: We all have differences and may not always agree, but we can treat each other with respect. Sometimes we just have to agree to disagree. Show your willingness to work things out and your respect for the other person. Being open to fixing the problem can go a long to helping the other person respond in kind.
  4. Own Your Stuff: There is nothing worse than someone who can’t admit when they are wrong, but we all do it now and again. Own it and admit your role in the problem. It will immediately help alleviate some tension and open the lines of communication because you aren’t putting the other person on the defensive.
  5. Use What You Learned: Once you’ve opened the lines of communications and worked through whatever happened, talk about how to avoid the same thing in the future. Use this as an opportunity to strengthen your relationship and build new skills to use in this and other relationships.

While conflict is a challenge, there is always an opportunity in there too. It is a chance for you to look at your role and learn more about yourself, and it is also a chance to learn more about the other person. With all the hours we spend at work, wouldn’t it be nice to have better relationships with our coworkers? The best part is that the more you work to address tension or conflicts quickly, the easier it gets!

If you’re interested in learning more about hiring the right staff for your practice, check out 3 Easy Ways to Hire the Right People at Your Medical Practice.

Discover more tools to make your independent practice a best practice.

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Work Smarter, Not Harder, Part 2

Lea Chatham May 21st, 2013

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By Thom Schildmeyer

In my last blog post, I introduced a practice that wanted to address its decreased income (lower reimbursement, higher costs) simply by seeing more patients.  The thought was that, by increasing its volume of service, the practice would automatically increase its revenue. To that end, they were exploring different marketing initiatives and staffing needs to meet this “strategic” goal of seeing more patients instead of looking at their medical billing processes.

While this works for some practices, it is often better to look within your practice and try to work smarter not harder. Ultimately, I encouraged the practice’s management team to focus on its current claims and collections (working smarter), rather than serving more patients (working harder—while at the same time adding strain on themselves and their staff).

The practice heeded my advice, focusing on its current accounts receivable (A/R), while also implementing a couple other strategies that immediately yielded better financial results.

In addressing its current A/R, the practice employed a straightforward approach. The management reviewed reports that identified the practice’s highest balances (money owed) by payer, then further analyzed the A/R to see what patients owed the most money (reviewing the list from largest balances to smallest).

This led to a “quick hit” or “low-hanging fruit” list of highest dollar amounts owed. At the same time, the practice targeted the oldest dates of services to help identify and avoid any timely filing issues that would result in loss of claim re-submission—and thus, payment collection.

These two activities—sorting A/R by amount and date of service—enabled the management team to focus its medical billing staff on the highest-priority claims that would yield the fastest results.

Over a 90-day period, the practice remained focused on this activity, leading to an average increase each month of 19% in collections, while at the same time significantly reducing overall A/R balances.

A secondary, yet important, benefit derived from this activity was the staff’s awareness of high-dollar balances and timely filing issues. Frankly, it was an “eye opener” as to the amount of money sitting out there and the risk of losing that revenue when claims are not worked properly.

The billing staff’s increased sense of urgency—and knowing that management is looking more closely at the claims and A/R balances—has created a new billing environment that is focused on maximizing the practice’s bottom line by more diligently and aggressively working outstanding claims. Not only has this resulted in a more motivating culture, it has enabled the billing staff to share in the practice’s rewards.

Beyond collecting on unpaid claims, with a targeted focused as described above, there are several other areas the practice chose to focus on, including:

  • Collecting co-payments at time of service
  • Collecting past due balances at time of service
  • Reviewing and adjusting its fee schedule
  • Transferring balances and sending statements
  • Checking eligibility

Want to learn more? Be sure to read my next blog post, where I will provide more explanation on the above areas.

 About the Author

Thom Schildmeyer shares tips to solve real world medical billing problems for Kareo

Thom Schildmeyer is President of Aesyntix Health, Inc, a leading provider of billing and purchasing solutions for dermatologists and cosmetic surgeons. He has more than 20 years experience consulting with practices in the areas of financial analysis, practice valuation, human resources, training and development, sales management, marketing, and patient relations.

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Take Control of Your Patient Flow (Part 3)

Lea Chatham May 6th, 2013

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by Rico Lopez, Senior Market Advisor at Kareo

Rico Lopez

In my first blog post, Take Control of Your Patient Flow (Part 1), we looked at a host of reasons why patient flow is important and how it can impact your practice. We looked at scheduling in Part 2, and now we are going to talk about your staff schedule and the value of cross training.

To fully maximize your staff time, you must first completed the previous section on analyzing your Appointment Schedule Template. Even if you feel confident that your appointment templates are solid, you will still need to perform the previous exercise to fully understand the prospective bottlenecks of your patient flow and how to appropriately allocate resources to minimize delays. You might be surprised what you find. I have worked with clients who realized after performing this exercise that they could actually see more patients with just some minor scheduling tweaks while eliminating major bottlenecks with simple staffing adjustments.

Maximizing the Value of Your Staff

  1. Create a table to identify your existing staff, their certification/training, experience within your practice, prior experience and roles they are currently trained and can competently perform today.
    cross training
  2. Analyze your current staffing strengths and identify cross training opportunities. In the sample in Figure 1 above, I noted which role(s) each employee can cover today and I then I shaded (in blue) the 29 cross training opportunities. I am not suggesting that each employee should be cross trained in all roles for the practice – but the more flexibility you create with your staff, the easier it becomes to overcome bottlenecks in the practice.
  3. Develop a cross training strategy. While it is not realistic to cross train all your staff within a few weeks, it is a good idea to schedule cross training of your staff during ideal times for the practice. Depending on the amount of cross training needed in your practice, it could take weeks or even months to get everyone fully trained. Prioritize the cross training based on the biggest impact to your practice.
  4. Manage your staff schedule. In Figure 1 above, is it necessary to bring multiple staff members at 7:30? When does the practice really need them to come in? Are they needed more in the early morning or late in the day? What I have found in many practices is that some employers will adjust their employees work schedule to accommodate the needs of their employees without understanding the impact to the practice. Knowing your staff’s abilities (by creating the staff table above) and implementing cross training will provide you the flexibility to accommodate scheduling requests.

Identifying Bottlenecks

The last post where we created your patient flow worksheet and analyzed the downstream impact of your appointment schedule, should have given you some idea of the possible bottlenecks in your patient flow. The adjustments you made to your appointment templates as a result of your analysis will eventually provide relief.

There are other causes of delays in your practice other than those created by your appointment scheduling (we will discuss this in a future session). The key for now is recognizing when the practice begins to back up and determining the starting point of the bottleneck. Let me give you some sample scenarios that you will probably recognize:

  1. Staff are waiting for patients to be handed over from the front desk and the doctor is waiting for patients to be placed in exam rooms and lobby is full of patients.
  2. Patients charts are stacking up waiting for someone to call the patient, take them to vitals or the exam room for patient prep, half the exam rooms are empty and need to be cleaned/prepped for the next patient, provider and medical assistants are all preoccupied with patients in the other exam rooms, and the lobby is full of patients.
  3. Beginning of the day or right after the office lunch break, there is a line of patients at the front desk and there are already several patients sitting in the waiting room.
  4. Patients lining up at the check-out desk likely very frustrated and just want to leave but they still need to make follow up appointments and pick up additional paperwork.
  5. Lobby is full of patients, charts stacking up, all exam rooms are full and provider is jumping from room to room with no end in sight.

Now that you are more aware of bottlenecks and are able to quickly recognize the issue, its time to talk about what actions you can take to relieve these delays. The first four bottleneck scenarios above can all be quickly resolved by reassigning resources to the area causing the backup. In some cases, it would only take a few minutes to get the practice back on track. The fifth scenario might warrant hiring another provider, but we will talk about that in another post.

Anticipating & Planning for Challenges

There will always be events in your practice that will cause delays to your patient flow. For some practices, this is accepted as status quo and just the way the practice functions. I am here to tell you – NO IT IS NOT! There are three things you can do–Eliminate, Anticipate, and React.

  • Eliminate: If you already know about issues that causes delays in your practice, then what have you done to eliminate them? We will review this further in a future session and what you can do to identify and eliminate these issues.
  • Anticipate: No one knows your practice better than you and I am sure many of you can even predict when and where these delays will occur. The items that reoccur daily or on a very frequent basis are the ones you will need to address. Anticipating the problem will allow you to assign resources in the right location at the right time. Here is an example of one item that most practices experience. First thing in morning when multiple patients arrive at your office at the same time many practices find that they are already behind at the beginning of their day. If this happens in your practice, then anticipate the situation and assign an extra resource first thing in the morning just long enough (~30 minutes) to help overcome the initial wave of patients. Now think of other scenarios in your office where you can almost anticipate delays and implement a solution to avoid future recurrence.
  • React: Once you have addressed the anticipated delays, let us talk about the unpredictable. This is where recognition of the issue and full understanding of your staffs’ ability to cover other areas will come in handy. Don’t be afraid to move staff around throughout the day – making sure you that these adjustments will not cause a different delay for another area of the practice. Your staff will eventually begin to recognize these situations themselves and take the initiative to assist the other areas as soon as they occur without any instructions from you.

Changing the Culture

Just like any other business, one of your most important resources is your employees. Creating a working environment where their initiative and teamwork are recognized will promote an ideal scenario for any busy practice. Acknowledging employees who act on their own to back-up their struggling coworker will send a clear message to all of your employees.

Set goals and reward staff for meeting and/or exceeding them. One of the ones that my employees used to enjoy is the 5-Day Challenge. If the clinic finishes on time (you pre-define what “on time” means) for 5 days straight, then on the 6th day we have lunch brought in for everyone. Lunch is an inexpensive payment for reducing labor (or even overtime) and increasing patient satisfaction and employee satisfaction.

Watch for my next post when we will talk about overbooking and address various practice policies including no shows and patients arriving late for their appointments.

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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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