Practice Management Partner

Missed Copays Have a Big Impact on the Bottom Line!

2009-01-24T16:14:00.000-08:00

In 1999 patient cash payments represented 10% of the gross income in physicians’ practices. In response to rising insurance premiums, many of today’s employers are choosing plans with higher copays and deductibles, meaning patients must assume a larger share of healthcare costs. With today’s higher copays and deductibles cash payments can represent 30-50% of the gross income depending on the type of practice.

Today copays routinely range from $20 to $60. This can sometimes represent at least 50% and up to 100% of the total allowed amount for a visit. Even smaller copays can really add up. For example, 15 patients a day who each owe $15 for a copay represent $58,500 in annual revenue. Increase that to a $20 copay and the annual revenue increases to $78,000. Missing just 2-3 copays a day can be costly.

With the higher percentage of revenue represented by patient payments, it is more important than ever to make sure that every copay is collected at the time of service. According to the Yale Practice published by the Yale School of Medicine, the cost to collect a copay that was not collected at the time of service can average $10. It is important that staff collect every copay possible when the patient is in the office to receive services.

One way to assist in the goal of collecting copays is to make sure that you know what the patient’s copay is. This can be accomplished by verifying benefits prior to the patient’s first visit.

In addition to verifying benefits, it is important to communicate the request for payment in the most effective manner. By nature, many people are uncomfortable asking for payment and they tend to phrase the question as “Do you have your copay today?” or “Would you like to pay your copay? One simple thing you can do to increase collection copays at the time of service is to train your staff to ask “How would you like to pay your copay today?”

Now in a perfect world, you would collect every copay at the time of service; however the reality is that there are times when the occasional copay slips by uncollected. Keeping track of what was missed and following up in a timely manner can minimize the effort required to collect missed copays.

Tracking missed copays can be difficult but is critical to keeping tabs on the patient responsibility portion of your accounts receivable. One of the best new features in Medisoft Version 12 is the copay tracking feature which allows you to designate procedure codes that require copays, easily inform patients at the time of service what their current and past due copays are, and generate reports of delinquent copays to send out copay statements to assist in collecting those valuable dollars that might otherwise slip through the cracks.

Considerations for an Electronic Medical Record System

2008-12-07T11:09:00.000-08:00

With a call from the government for the majority of Americans to have access to an EMR (Electronic Medical Record) within a decade, EMRs are gaining momentum. Estimates are that 20% to 25% of physician practices have adopted an EMR system; however the majority of those practices are mid-sized or larger, typically with eight or more physicians. Some sole provider and small group practices feel that there isn’t enough benefit to them to justify the expenditure and have decided to sit back and wait until the government mandates some form of EMR for all medical providers. However, there are significant benefits gained from EMRs, even for small practices. These benefits include:

Reduction and possibly elimination of transcription costs.
Savings on cost of paper chart supplies such as stickers, dividers, etc…
Reallocation of chart room space, possibly to be used for revenue producing activities.
Reduction or elimination of off site storage for archived charts.
Elimination of chart pulls and down time because a chart is in a different location or in the possession of a physician or staff member when needed.
Elimination of illegible prescriptions resulting in improved patient safety.
Remote access to charts for satellite offices, or for physician access from home on weekends or call.
Potential for Payer incentives such as a Medicare pilot program that will give a bonus of 1.5% to practices that use EMR.

With all of the benefits that a successful EMR implementation can bring to a practice, why aren’t more providers jumping on the EMR bandwagon? While it’s true that there can be significant return on investment, the fact that the total investment can be $20,000 or more for a complete system makes the decision a very important one and sometimes the task can be daunting. It’s important to make a wise decision the first time around because the impact that a bad decision can have on a practice is significant.

So how can you be sure that you are ready to start down the road toward EMR implementation? The following questions can help you gauge your readiness and make adjustments that might be necessary to be prepared to implement an EMR.

Are all physicians committed to implementing and using an EMR?

Without buy in from the physicians who will be directly impacted by this new technology, your chances for smooth implementation and achieving the maximum ROI will be reduced significantly. Make sure everyone understands the benefits that an EMR will bring to your practice.

Are staff members in your practice “technologically savvy” or at least open to learning?

Implementation of an EMR will affect every member of your staff. If you have staff members who are resistant to technology, it would be wise to begin introducing tasks that require basic computer skills prior to attempting an EMR implementation.

Are current job duties clearly defined for each position in your practice?

Part of the implementation process for an EMR involves analysis of the current workflow and workload in the practice. Having clearly defined roles and responsibilities can significantly improve the ability to tailor the EMR to your practice.

Do physicians currently follow standard policies and procedures for common tasks?

Physicians and other clinical staff vary in personality and preference for the way they do similar tasks. If your practice has clearly defined protocols for common tasks associated with patient care the implementation of an EMR will be a much smoother road.

Is the practice currently functioning efficiently?

An EMR is not a “magic bullet” that will turn chaos into utopia. Practices that function efficiently and have systems in place to ensure minimal wait times for patients, quick turnover of medical records, and consistent documentation of patient encounters are good candidates for a successful EMR implementation.

So how did you do? If you were able to answer yes to most of the questions above, it is likely that your practice is a good candidate for a successful EMR implementation. If you answered no more often than yes, don’t despair. It doesn’t mean you’re doomed to a life of missing charts and paper inefficiencies. Use this guide to begin making changes in your practice that will not only prepare you for eventual implementation of an EMR, but can also improve your day to day operational efficiency in the mean time.

If you are interested in more information on Electronic Medical Records and some of the success stories that we have personally encountered, please feel free to contact us.

Medisoft Tips & Tricks: Decrease Rejections Using Patient Quick Entry Templates

2008-11-23T17:36:00.000-08:00

Patient Quick Entry is a powerful feature that was introduced in Medisoft Version 14. PQE consolidates patient entry into one screen and allows you to define fields to be included, which fields are required, the order in which they are displayed and to provide hints that help make training staff easier.

By requiring fields that cause common claim rejections such as missing birth dates, addresses, and policy numbers, you can increase first time claim acceptance rates, which can improve your overall revenue cycle management process.

For more information on creating and using Patient Quick Entry templates, contact us today.

Legislators Pave the Way for E-Prescribing Incentives

2008-11-15T05:16:00.000-08:00

You are certainly familiar with a piece of legislation that was passed this summer which reversed a 10.6% proposed cut to physician Medicare reimbursement. What you may not be as familiar with is some additional good news that was included in that bill. The Medicare Improvements for Patients and Providers Act of 2008 (HR 6331) takes one of the first steps towards government incentives for the adoption of healthcare information technology by offering incentive payments for Medicare physicians who use e-prescribing technology in 2009 through 2013.

Physicians using e-prescribing will receive a 2 percent bonus in 2009 and 2010 and 1 percent in 2011 and 2012. E-prescribing will be required in 2011 and beyond and providers who fail to e-prescribe will see reductions in payments minus 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014 and beyond. There are very few exceptions to the law, however it does prohibit the application of financial incentives and penalties to those who write prescriptions infrequently, and permits the Secretary of Health and Human Services to establish a hardship exception to providers who are unable to use a qualified e-prescribing system.

The specifics of how the incentives will be paid and what portions of the physicians revenue will be used to determine the payment amount has not been published. The program may be implemented in a similar fashion to the Physician Scarcity Incentive program in which quarterly payments are issued for the incentive.

The potential positive impact of e-prescribing is tremendous because prescription drugs are such a common part of medical treatment. Today, four out of five Americans who visit a doctor leave with a prescription. In 2007, more than 3.5 billion prescriptions were written, and that number is expected to grow to more than 4 billion by 2010.

Aside from the financial incentives, there are numerous benefits of e-prescribing for both physicians and patients. E-prescribing can lead to a reduction in medication errors and injuries by providing drug interaction checking and reducing mistakes due to look alike/sound alike drugs. It provides greater convenience for patients including a more streamlined refill process and better management of medication costs by providing information on formularies at the time the prescription is written. Of course the government is banking on seeing benefits of increased e-prescribing such as reducing avoidable hospitalizations, complications, and fatalities, and ultimately saving Medicare dollars.

The good news is that you don’t need to invest a lot of money in an electronic medical record in order to take advantage of e-prescribing in your practice. There are stand alone solutions available and some even interface with your current practice management system to allow patient demographic information to be transferred to the e-prescribing system, streamlining the implementation process. We can assist you in determining the best solution for your practice so that you can take full advantage of the benefits, both financial and clinical. For more information, contact us today.

Percentage of Physicians Using Online Communication with Patients

2008 – 36%

2007 – 31%

2006 – 25%

2005 – 24%

Source: Manhattan Research

Checking the Pulse of Healthcare IT

2008-10-25T07:36:00.000-07:00

Is the healthcare industry really ready for "all things electronic"?

For the last decade, the healthcare industry has been buzzing with talk about Electronic Medical Records (EMR). You may have gotten the impression that if your medical practice didn't jump on the bandwagon immediately you were going to be left behind- and your patients would leave your practice. All of the statistics show that the EMR vendors put out in their physician marketing may have made you feel as if you were one of the last physician practices in the country to take the plunge and implement an EMR.

However, a recent New England Journal of Medicine survey, Electronic Health Records in Ambulatory Care -- A National Survey of Physicians shed light on the fact that the adoption rate of electronic medical records in the ambulatory care field isn't what of the healthcare industry had expected.

According to the survey, physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with them. However, as of early 2008, electronic systems had been adopted by only a small minority of United States physicians.

Of those physicians surveyed, 4% reported having an extensive, fully functional EMR and 13% reported having a basic EMR. The most common instances of EMR usage were reported in practices of primary care physicians, physicians practicing in large groups, hospitals or medical centers, and physicians in the western region of the United States.

So what is stopping approximately 83% of the ambulatory physicians in the United States from adopting an EMR? The number one reason cited was the cost. The total cost of software, training, implementation, hardware can vary and ranges from as little as a few thousand dollars to as much as a $30,000 or more per physician for some of the fully functional electronic medical record systems, although there are signs that some of these prices are coming down as the market consolidates.

Letter from the President

2008-10-19T19:22:00.000-07:00

It's hard to believe that another Autumn is upon us. What a Summer it was! The healthcare industry has been the focus of a lot of attention in Washington and around the country.

At Medworks, we have been monitoring the issues as we continue to look for products and services that will meet the ever-changing needs of our clients. We are excited about some great opportunities that we will be bringing to you in the coming months.

This blog, Practice Management Partner is dedicated to highlighting important healthcare and medical billing practice management issues. We feel as medical software industry solutions providers, we owe our unique perspective and expertise to the community at large . We are truly humbled by the insight and needs hundreds of physician practices from around the nation share with us.

We thank you and hope you'll contribute to this forum.

Sincerely,

Steve Ruhle
President
Medworks Management, Inc.