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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3 Easy Ways to Hire the Right People at Your Medical Practice

Lea Chatham March 7th, 2013

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3 Easy Ways

You want to hire the right staff the first time, right? Of course you do. It takes time and money to recruit new staff and if they aren’t a good fit then before long you have to do it again. In a medical practice this can really affect your bottom line! There are things that you can do to help improve the odds of getting that qualified person who is also a good fit for your practice. Use these three simple strategies as part of your hiring process.

  1. Easiest: Test their skills. Just because a resume says someone is an expert at Excel, doesn’t mean it’s true. If running reports and managing spreadsheets is a key part of the job, test those skills. If the job is in billing, ask detailed questions about their billing skills and billing scenarios. If phone skills are critical, roleplay with the candidates and see how they would interact with people. There are many tools and resources, paid and free, that you can use to help you test candidates on specific skills.
  2. Easier: Check references! We all know references are revealing and critical, but we get busy and begin to believe we got a good sense of the person from the interview. So, we offer them the position. References are important because they have direct experience working with the person and can provide information about the candidate’s strengths, work style, and experience. To take some of the burden off of you, get the candidate involved in helping obtain the references. For instance, ask them to send to you the names, phone numbers and email addresses of 1-2 previous managers and peers. You may also ask that the candidate to send an email to their identified references with a request to contact you.
  3. Easy: Find out if the candidate’s personality is a good fit for your practice. You know the staff at your practice and what kind of person would be a good fit. If you need someone who is independent and quiet or someone who is outgoing and collaborative, ask questions such as; “Tell me about the best place you have worked and why it was the best,” or “Tell me about what tasks you enjoy the most and why.” These types of questions can help you identify the preferences and style of the candidate. Skills can be taught, experience can be obtained, but fit is unchanging. Just like shoes, when they don’t fit, they can still do the job of covering your feet, but you can’t stop thinking if the pain is worth it.

Finally, take your time. This is hard, especially when you need someone now. But remember, a bad hire today, can mean damage that lasts long after that person has left the practice. And a great hire can be a catalyst for positive impacts beyond the scope of the person’s position.

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3 Easy Ways to Keep Your Medical Practice on Schedule

Lea Chatham January 22nd, 2013

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3 Easy Ways

It may be one of the biggest challenges in a medical practice management—staying on schedule. Physicians get sidetracked with refill requests, reviewing labs, returning calls to patients. Patients take up more time than they are allotted. A registration person calls in sick and your front desk gets a little behind. There are a hundred reasons why you might get off track. But once it happens, it’s hard to get that time back. You may find that your practice is slightly behind for the rest of the day. Here are a few simple strategies that might help avoid bottlenecks or turn things around when they start to go south.

  1. Easiest: Set clear guidelines for staff about not interrupting the physician with calls or questions between appointments unless it is a true emergency.  Establish a process for the physician to receive messages and manage tasks as specific times of the day—first thing each morning, at the end of the day, perhaps a break at midday. He or she can take care of refills or return calls during those appointed times.
  2. Easier: Prioritize tasks for staff. Make sure your staff know what their top priorities are so that if they get busy they know what to let go of for the time being. Sometimes people are trying to do too much when they should just be focused on moving patients swiftly through their appointment.
  3. Easy: Do an analysis of your time management, including your scheduling process and task management. You may need to look at your days from nuts to bolts. Is your schedule inefficient? Maybe the problem is that your longest patient visits are at the wrong time of day and they are causing backups everywhere else. Perhaps you providers just aren’t managing their tasks well. For more on scheduling, see our blog post on using your schedule to increase revenue. Many practice management and electronic health record systems offer task management tools. If everyone isn’t using them to stay on top of tasks and priorities, now might be a good time to start.

In the end the most important things to remember when trying to keep things on track are making sure that everyone knows exactly what their role is, what their priorities are, and what they should do if things get busy.  Sometimes the problem is simply that people don’t know what to do next to keep things on track and they flounder.

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Reduce Absenteeism at Your Medical Practice

Lea Chatham November 29th, 2012

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3 Easy Ways to Manage Employee Absenteeism

3 Easy Ways

It is the bane of many medical practices: employees who frequently call in sick or don’t show up for work. Employee absenteeism is a huge problem for American businesses. According to the global management company Kronos International, absenteeism costs employers more than 8 percent of their payroll[1]. It also takes its toll on employee morale, not to mention productivity and workflow. While sometimes the employee may actually be sick, more often there are family illnesses or other pressures that make employees miss work. Here are some practical ways to manage employee absenteeism.

  1. Easiest: Be sure you have an absenteeism policy that states how many absences are acceptable in a defined period of time, and for what reason they are allowed. You should also address any personal reasons for which employees may be absent, such as a family member’s illness or home emergency. Delineate the consequences for not complying with the policy.  Every new employee who is hired should receive a copy of the policy and acknowledge in writing that they have received it.
  2. Easier: If absenteeism becomes an issue with one individual, address it directly. Talk with the employee to determine if ongoing adverse circumstances are affecting her ability to meet her work schedule and if so, discuss possible solutions. Of course, if calling in sick continues, be prepared to give a verbal warning and document it in the personnel file. This provides a paper trail should you need to terminate the employee.
  3. Easy:  If absenteeism occurs routinely in your office with more than one employee, there may be other issues at work—literally. According to an article published in the January 2009 “Journal of Organizational Behavior,” increased job demands and decreases in job resources are directly related to absenteeism. Consider meeting with employees, with a promise of non-retaliation, to ask if there are workflow or resource issues that prevent them from doing their jobs effectively.  Or consider bringing in a practice management expert to review your office staffing and workflow. If workplace dynamics make it difficult for employees to do their jobs, you will have a much larger problem: keeping competent qualified employees.

This is the third in an ongoing series of blog posts aimed at helping you manage the day-to-day realities of running a medical practice. Check out our last post on keeping patient information up to date, and be sure to watch Kareo’s Getting Paid blog for more in our “3 Easy Ways…” series.


[1] http://smallbusiness.chron.com/deal-employee-absenteeism-16074.html

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Complimentary Webinar: Become a High Performing Primary Care Practice

Lea Chatham October 24th, 2012

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Tuesday, October 30, 2012
1:00 PM EDT/10:00 AM PDT

Join this panel of great thinkers and doers who will lead a discussion about how to build high performing primary care practices.

  • Dr. Sreedhar Potarazu, renowned physician, author of widely acclaimed book “Get off the Dime, The Secret to Changing Who Pays for Health Care”, Fox Business News contributor, and CEO of Vital Spring Technologies.
  • Dr. Jean-Luc Neptune, a licensed Internal Medicine physician, entrepreneur, and national leader of Health 2.0 developer challenge and Doctors 2.0 initiatives.
  • Terry Douglas, advocate for small medical practices and healthcare marketing leader at Kareo, Inc.

Are you ready for change?
On this webinar, you’ll learn:

  • Secrets that helped 7 primary care practices improve the patient experience, staff satisfaction, positive clinical quality metrics, and practice profitability.
  • How primary care physician practices could play a key role in forming a more nimble health care system.
  • Insights into a new approach for “reliable care” – where innovations, quality, and outcomes meet patient service.

Who Should Attend
Private practice owners, physicians, office managers, billing managers, billers, billing service owners and others who want to improve the performance at their primary care practice or the practices of their clients.

Register now to learn how to improve the performace of your primary care practice

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Stop Denials in Their Tracks: Get Paid the First Time by Health Care Insurers, #2

Kathy McCoy, MBA August 23rd, 2012

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Expert Betsy Nicoletti advised in this complimentary Kareo webinar that by setting up a process to measure, quantify and fix the reasons for denials, practices can significantly improve their collections and cash flow—and their bottom line.

There’s no denying it: Denials are the bane of every practice’s profit-and-loss statement. But the good news is: By setting up a process to measure, quantify and fix the reasons for denials, practices can significantly improve their collections and cash flow—and their bottom line.

That was the message during Betsy Nicoletti’s recent Kareo-sponsored webinar entitled Stop Denials in Their Tracks: Get Paid the First Time by Health Care Insurers. Betsy is a well-respected practice management and medical billing expert, as well as founder of Codapedia.com. During her webinar, she provided a blueprint for minimizing the number of denials on the claims you submit, so you can take back the dollars you are leaving in payers’ coffers. Our first blog on her webinar offered ways to track denials and the reasons for them, along with some of the more common pitfalls that trigger denials. This last blog on the webinar will recap Betsy’s strategies for getting claims clean and complete enough to pass even the most exacting claims scrutiny.

Betsy acknowledges that sometimes, it takes some detective work to determine the reason for denials. That is certainly the case with coding errors. A modifier might be added to the wrong CPT code, or modifier 59 may be added to a procedure that cannot be unbundled. Diagnostic tests may be denied because the provider failed to establish medical necessity by linking it to the correct diagnosis code. Or just as common, the test was performed more frequently than the payor allows. The solutions to coding errors are often found hidden in plain sight, in editorial comments of the CPT book. Betsy suggests you start there and read complete descriptions of codes along with the editorial comments. For complex coding issues, specialty societies can often provide information and supporting documentation and some will even field a few coding questions for free for their members.

Other errors are more easily prevented and rectified, such as misspelling the patient’s name or entering wrong demographic information; failing to verify insurance and benefits prior to the appointment; or authorization errors, such as not obtaining  pre-authorization or having the referral for services. Not filing claims on a timely basis can automatically trigger a denial, too. For all of these errors, Betsy recommends a “zero tolerance” policy that holds staff accountable for fulfilling the basics of claims submission.

Expert Betsy Nicoletti advised how to measure, manage and reduce denials in this complimentary Kareo webinar

Betsy strongly advises that medical billers fix claims before they are denied by checking clearinghouse reports daily. The reports will flag pre-adjudication errors so that they can be corrected before they are sent.  If your practice management system supports it, use technology to help you manage claims preparation and submission. Many systems can perform batch verification of eligibility or benefits, including patients’ deductible amounts, patient due amounts by benefit type, and more. Coding programs can check for bundling or diagnosis code congruence, if modifiers are allowed and if so, which ones. Take advantage of functionality such as claims estimators and electronic remittance advice and payments. To learn more about how Kareo’s powerful suite of tools helps streamlinine your medical billing and collections, visit Kareo.com

Finally, establish policies and procedures that set clear expectations for staff. They should include full registration at the time of the appointment; verification of eligibility and benefits; and authorizations prior to the appointment. Coding policies may include double-checking denials by another set of eyes before re-submitting them.

By tracking, measuring, researching and fixing the reasons for denials, practices can give themselves a much needed raise. To hear more on other practice management or medical billing issues that impact or enhance profitability, view our archived webinars to find more topics of interest to you. If you would like to be put on our notification list for upcoming informative webinars such as this one, sign up now.

Learn additional ways to improve your practice revenue: Register now for our next informational webinar, Finish Strong: Make 2012 Your Most Profitable Year! with widely respected consultant Karen Zupko.

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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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Web–Based Software by Kareo

Practice Management

Simplify the daily essential tasks of your medical office from patient records, to scheduling and more.

Electronic Medical Records

Improve patient care with electronic charting, electronic prescribing and medical labs interfaces.

Medical Billing & Collections

Streamline your entire medical billing and collections process from charge entry to reporting.

Clearinghouse Services

Integrated electronic claims, electronic remittance advice and insurance eligibility services.

Analytics & Data

Store and access data with insightful reports, document management and faxing, and an integration