Healthcare Management Defined

Healthcare Management Defined

In this article, Nitin Chhoda defines the healthcare management process and how in past years it had been very complicated.

He will share how electronic medical records can help make the physical therapy management and documentation process easier and simpler to understand.

healthcare managementWhen patients think of healthcare management, they’re referring to their ailments, medications, tests and procedures.

A physical therapist views healthcare management as a total package of client care, practice management, administration, insurers and reimbursements.

Healthcare practice management is a rapidly changing landscape filled with new technology, coding upgrades, innovative treatments and a better understanding of existing conditions.

Healthcare Management

Healthcare management in the 21st century means having the tools, knowledge and methods to provide the best possible care for clients. Therapists must invest in ongoing training, create liaisons with other healthcare providers, market their clinics successfully and educate the public.

It’s an enormous responsibility and one that requires extensive time and effort. The scope of the tasks can seem overwhelming at times, but an EMR facilitates office processes, expedites revenues and enhances the quality of client care.

Healthcare management in the practice setting encompasses working with multiple insurance companies and providers, interacting with patients in a variety of ways in and out of the office, and remaining in compliance with state and federal laws.

It’s a lot to place on anyone’s plate, and smart therapists know that an EMR makes everyday tasks easier, increases productivity and creates a higher level of efficiency throughout the entire practice.

The healthcare management process begins the moment a patient makes an appointment. There are health forms to complete, visits to schedule, and insurance information to verify.

The Process

A client’s insurance eligibility and coverage is an essential part of the healthcare management process. It allows clinicians to provide the best treatments for the client within the boundaries and limitations of their insurance coverage, while ensuring the practice is compensated appropriately.

healthcare management definedIn the electronic age, therapists need the tools to communicate with clients in a variety of ways. In days past, a mailing or a call to a landline will suffice.

Today’s patients live busy, mobile lives and office technology must evolve to reflect those changes.

Superior healthcare management allows therapists to connect conveniently with clients by email, voice mail and text messaging with patient portals. Reminders can be sent about upcoming appointments, balances due, and test results can be posted online for patients to view.

The digital age also allows practice owners to interact with pharmacies, labs, hospitals and other healthcare providers quickly and efficiently. Tests and prescriptions can be ordered using the power of the Internet and consultations with other healthcare professionals is just a click away with an EMR.

The Turnaround

The success of any practice rides on its available cash flow. A great deal of time will be devoted to obtaining and verifying insurance eligibility, ensuring correct coding, and follow ups to ensure funds reach the clinic’s account in a timely manner.

Submitting that information electronically allows claims to reach insurers and clearinghouses almost instantly for a much faster turnaround on reimbursements. A steady cash flow allows clinicians to plan for the future in terms of equipment, training, staffing and expansions.

Today’s patient may have numerous healthcare professionals overseeing their conditions and ailments.

EMRs represent state-of-the-art technology to obtain a clear, concise and complete picture of a client’s medical history that’s updated instantly with an EMR. Therapists can manage their clients’ healthcare more efficiently, without spending valuable time simply waiting for paper records from another facility.

Healthcare management encompasses a wide variety of tasks, from monitoring the efficacy of a patient’s care to ensuring reimbursements reach the clinic in the quickest way possible. Technology provides the means for better patient outcomes and enhanced cash flow. It’s also an environmentally sound solution that will save clinics thousands of dollars each year.

Healthcare Practice Management and Its State (Before, Present and Future)

Healthcare Practice Management and Its State (Before, Present and Future)

Nitin Chhoda shares how the healthcare practice management has evolved from a manual documentation process to an electronic medical records system.

A few more years, and the medical industry will be using a push-button technology that will greatly increase the cash flow of any private practice.

healthcare practice managementHealthcare practice management has changed enormously as technology has evolved throughout the centuries.

A Blast from the Past

Management of a healthcare operation used to involve little more than an exchange of goods for services rendered.

The days of patients bartering a chicken or garden produce for treatments really isn’t that far removed, relatively speaking. Practices were smaller and served a greater geographical area. Patients had few choices in the treatments they received or their provider.

Office management consisted of copious amounts of hand-written records that had to be transcribed and rewritten by the office scribe into a document that could be read by anyone. Records were often lost due to fire, floods and natural disasters, with no way to put them back together into a coherent whole.

The advent of the typewriter improved the overall readability of medical documents, but it was difficult to coordinate care with other healthcare practice management providers. Unless the professional was just across town, it could take weeks or even months for documentation to travel through the postal system, leading to significant delays in treatment.

Cash flow within the practice was unsteady at best. Healthcare providers had to submit reimbursement claims to individual insurers, without the benefit of clearinghouses, and few patients even had insurance.

EMRs Era

healthcare practice management stateToday, EMRs are eliminating the need for paper records with electronic documents. They’re stored in the cloud, can be accessed instantly by multiple medical professionals, and are updated immediately.

Therapists no longer have to endure long waits for reimbursements. Push-button electronic submissions arrive almost instantly and funds are deposited directly into a clinic’s account.

Healthcare practice management can accept one-time and recurring payments online. The clientele of the 21st century is highly mobile, often relocating multiple times to take advantage of employment and educational opportunities.

New healthcare practice management providers can access a patient’s records simply by utilizing the power of the Internet and their EMR, with no interruption or delay in treatment.

The New Technology

Instead of charts, folders and paper records, EMRs of a healthcare practice management can be implemented on laptops and tablets for the ultimate in portability. The systems also allow clinicians to expand into additional therapy-related markets.

Communication is a key aspect of the therapist-patient relationship and patient portals have arisen as the result of technological advances. Clients can schedule appointments, request medication refills, provide insurance information, and view test results, all online. Practices now have multiple ways of interacting with patients via email, texts and voice messages.

Many have speculated about what the future of healthcare practice management holds. While no one knows for sure, it promises to be an interesting journey.

Healthcare providers in all fields could easily find themselves using software programs that assist in the diagnostic and treatment process based on information provided in a patient’s health record.

EMRs in healthcare practice management will continue to evolve and may contain voice recognition capabilities that allow therapists to record their notes and documentation entirely by voice. Technological strides may eliminate the need for certain types of treatments, while opening new vistas in alternative services.

It may be that healthcare delivery will become more uniform across the board. Clients will become more educated about their ailments and conditions, and more time will be expended on preventative measures.

Healthcare practice management professionals in all fields may find themselves engaged in more patient forums to educate clients, while finding new ways to communicate effectively with those they serve. An ever-increasing population in need of services guarantees innovation, with new treatments and means of delivery that will astound even the learned professionals of today.

Healthcare Management and Medical Billing Relationship

Healthcare Management and Medical Billing Relationship

Medical billing and healthcare management are interconnected. The success of the practice relies on these two factors having a good relationship.

Nitin Chhoda explains the correlation between billing and management, and the role it plays in a successful healthcare practice so that the owner will value its importance and avoid recklessness.

healthcare managementTherapists walk a thin line when reconciling the healthcare management of their patients and medical billing.

The process of accurately coding and billing of healthcare practice management can sometimes be at odds with the client’s welfare and their insurance coverage.

Therapists are often dealing with a narrow description of a complicated problem and it’s essential to provide the exact billing codes that describe the diagnosis, symptoms and corrective measures that were taken.

Patients can differ widely in their responses to treatment, making it imperative that therapists provide in-depth documentation to support their actions and conclusions.

Accurate physical therapy billing ensures clients to receive the best possible care and the clinic to reimburse at the highest available level for the services provided.

Healthcare Management and Billing

Billing and healthcare management is a closely interwoven process and it’s the responsibility of clinicians to educate themselves on the intricacies of the two. The result is better billing and coding, expedited reimbursement claims, and staff members that aren’t overwhelmed.

Next to treating patients, billing is the most important position in a practice. A clinic’s profitability rides on the billing professional submitting claims in a timely manner, conducting follow-ups and ensuring payments are received.

healthcare management relationshipPhysical therapy billing is complicated and time consuming, and smaller practices often have a designated biller that has a variety of additional tasks.

The day-to-day workflow doesn’t remain the same and it’s easy for billers to get behind without the appropriate healthcare management support and sufficient time to perform their responsibilities.

An EMR facilitates the process, allowing billers to submit claims quickly, efficiently, and with a lower denial rate.

Billing With EMR

EMRs provide clinic owners with the tools to track reimbursement claims, monitor denials, and identify potential and existing problems. On average, claims are denied approximately 50 percent of the time.

This is due to a variety of factors, from incorrect coding to improperly submitted claims. The burgeoning number of healthcare claims and limitations on services has been the impetus for insurers to scrutinize reimbursements more closely than ever.

Therapists with an EMR for healthcare management can utilize its many capabilities to identify denial rates, ascertain why claims was rejected and discover any patterns that might exist.

Problems may lie with incorrect coding, inefficient healthcare management or time restrictions placed on the biller. Once the cause has been determined, clinicians can work toward a solution that better utilizes the biller’s time.

Revenue Loss Factors

Another factor in revenue loss is the number of old and unpaid accounts the practice is carrying. One of a biller’s priorities is to track payments and ensure they’re deposited in the clinic’s account. Billers must review accounts on a regular basis to ensure payments have been made and make inquiries into their status if needed. Billing and healthcare management requires an individual who is detail oriented, with an agile mind and specialized knowledge.

The financial health of a physical therapy practice hinges on the efforts of its coding and billing expert. A large part of effective healthcare management is ensuring the biller has the time and support needed to maintain a steady cash to the clinic.

Ensuring the individual has superior training and sufficient time to perform the necessary and sometimes redundant tasks of billing will boost the clinic’s revenues and allow clinicians to pursue additional streams of revenue.

Practice Management and Its Fundamentals

Practice Management and Its Fundamentals

Some practitioners forget that regular monitoring of activities plays a vital role in determining the success of the practice. They feel that continuous cash flow is enough to determine that the business is thriving.

Nitin Chhoda reiterates the importance of the practice fundamentals and how reviewing of detailed information on the practice is valuable.

practice managementOne of the fundamentals of health care practice management is working smart, not hard. For many therapists, practice management is one of life’s great mysteries.

Some clinicians hire expensive firms to manage their clinics, while others prefer a hands-on approach.

What EMR Has to Offer?

EMRs offer the tools to manage a practice as efficiently as any high-price practice management firm, while allowing clinic owners to keep a finger on the pulse of their business.

Information is knowledge and EMRs provide a wide array of data, facts and statistics to market any practice successfully.

The goal of any physical therapy practice is to be a financially sound enterprise with growth potential. Practice management and business owners have been taught to offer patients the best treatments possible, but they don’t receive training in how to manage a clinic.

They spend endless nights trying to decipher an array of disjointed information, arrange it into a coherent whole, and decide how to best use it for the clinic’s benefit.

What many don’t want to acknowledge is that their practice is a business and it must be operated as one.

Reimbursement claims have to be submitted in a timely manner, delinquent accounts must be addressed and payments collected from patients.

Even asking for money that’s legitimately owed can be an extremely unpalatable task of therapists of a practice management.

An EMR offers the tools to accomplish all those tasks and provides a whole office solution that will place practices on a pathway to profitability and efficiency.

Lessons to Learn

The first lesson to be learned through practice management is that a clinic may appear to be solvent on paper, even as it’s experiencing an exhausted cash flow. Therapists should view every encounter and opportunity as a marketing tool. Networking with other medical professionals is an important source of referrals and increased revenue streams.

In a well-managed practice, therapists know exactly how much it costs to provide a specific service, attract new patents, and pay the bills each month. EMRs provide the tools to track and monitor the best payers, clients who are most likely to self-terminate treatment, and referral and retention rates.

practice management fundamentalsA practice management and physical therapy documentation systems ensure billing and coding is being conducted that provides clinics with the highest level of reimbursement.

Marketing is an essential part of practice management if a clinician is to grow the business, retain current clients, and persuade new patients who need services only in a specific clinic can provide.

Physical therapists know about the best treatments for their patients, but often feel lost and adrift when contemplating marketing strategies. Practices differ widely and there’s no one-size-fits-all magic formula, but the key ingredient is to stand out above the dozens of clinics vying for the same customers.

Therapists Must Always Keep in Mind

Perhaps the most important rule of practice management is never become complacent. It’s the difference between practices that are simply surviving and those that are expanding and regularly adding new patients.

Complacency has killed more practices than any other factor. Therapists must constantly strive to reach new clients, improve their range of services and become the clinic that others heartily recommend.

Practice management encompasses an extensive number of tasks, from scheduling staff and submitting timely reimbursement claims to communicating with patients and providing treatments. EMRs provide the tools to accomplish all those jobs efficiently and with an increased level of productivity, allowing therapists to work smart, not hard.

Healthcare Practice Management Best Tools

Healthcare Practice Management Best Tools

Nitin Chhoda shares the best tools that can help the healthcare practice management succeed. He emphasizes that the tools should cover the four areas of the practice; Marketing, Scheduling, Documentation and Billing.

healthcare practice managementHealthcare practice management is no easy task, but the right tools will make it considerably easier.

Integrated EMR

An integrated EMR provides the resources to address customer service, finances, human resources, patient care and risk management for a whole practice solution.

Healthcare reform and the mandatory implementation of an EMR are changing the way therapists conduct business and practice owners must have the appropriate tools to meet the challenges of operating a 21st century practice.

There are dozens of EMRs available, with more than 150 healthcare practice management tool options that encompasses everything from patient portals and billing, to disease management and disaster preparedness.

From Scheduling to Billing

It’s essential for an electronic system to integrate within the office infrastructure. At the very least, therapists require healthcare practice management tools in four areas that address billing, marketing, scheduling and documentation.

Those four areas serve to increase revenues and offer a higher level of customer satisfaction, both key facets of a successful practice. Those tools allow therapists to cater to a clientele that’s mobile and assists in attaining the highest level of efficiency and staff productivity.

The technology exists through EMRs to automate tasks, interact with patients and assign staff where they will be most effective.

healthcare practice management toolsThe process begins with scheduling when a client contacts the practice. There are only so many hours in the workday and each available appointment should be filled.

Efficiency of Technology

Modern technology provides the means to fill openings more efficiently, based on whether the client’s visit is their first or a follow-up, the reason for the patient’s visit, and the clinician’s notes.

EMRs for healthcare practice management can be automated and streamline the entire process.

Documentation is an essential part of every practice, affecting treatments, ongoing care and payments to the clinic. EMRs are compatible with tablets for optimum portability and offer the ability to create custom documents specific to individual practices.

Documentation is the key ingredient for correct coding and billing of health care practice management. The financial stability and profitability of practices relies on submitting the right codes for reimbursement and EMR systems keep errors and rejections to a bare minimum.

Whether funds are collected from self-pay patients or insurance companies, it’s a time consuming process. It’s much easier with an EMR and provides coding and billing experts with access to therapists’ notes and medical information to assist in the billing process.

EMRs Provide Complete Information

Payers want to know the full story behind a client’s complaints, treatments and the steps taken to return them to health. Electronic documentation of healthcare practice management provides that information, speeds the billing process, and ensures quicker reimbursements.

Integrated electronic systems capture a wide range of information that can be used to devise more effective marketing campaigns. Advertising and marketing a physical therapy business or other healthcare practice management is more complicated than in decades past when a clinician would simply run an ad in the local newspaper.

Today’s therapists must be able to reach patients using multiple modes of communication that includes email, voice and text messaging. EMRs provide the information needed to target specific groups utilizing a variety of demographics.

Every aspect of a physical therapy practice is interconnected. Healthcare practice management tools that recognize that symbiosis provide an integrated solution that facilitates the tasks associated with each individual department, connecting them in a meaningful way for the overall efficiency, productivity and financial stability of the business.

Clinicians avail themselves of new breakthroughs in equipment and treatment methods, and electronic systems are another tool in a therapist’s arsenal of healthcare practice management.

Healthcare Practice Management: Top Legal Blunders to Avoid

Healthcare Practice Management: Top Legal Blunders to Avoid

Lawsuits in a healthcare practice are sometimes unavoidable, although they can be minimized.

Nitin Chhoda states that everyone in the health care practice must be knowledgeable enough to avoid ignorance and negligence of the practice which can affect its performance.

healthcare practice managementAny practice owner knows how quickly they can run afoul of the healthcare practice management system and require the services of an attorney.

Horror stories abound about clinics that have been forced into bankruptcy or completely out of business due to patient lawsuits or failure to comply with the many complicated state and federal regulations that must be met.

Good healthcare practice management takes into account the endless possibilities for legal issues that can crop up. At some point during every clinician’s career, they’re going to need expert legal counsel.

Legal Representative

Some clinics retain the services of legal representation on staff, but it can present a financial hardship for small practices with limited assets and budgets. Most therapists think in terms of patient lawsuits, while the specter of regulatory blunders usually doesn’t enter their field of vision.

Most practices encounter issues with HIPAA regulations concerning violations of privacy, failure to respond to inquiries by Medicaid, fraud and the handling of overpayments. There are specific procedures for dealing with each instance and healthcare practice management therapists often don’t even realize they’ve made a mistake or are in violation.

The most common way therapists encounter legal problems is through HIPAA regulations. It’s essential for at least one healthcare practice management staff member to have a thorough understanding of HIPAA rules as they represent the most common mistakes and are the easiest to avoid. It’s money well spent for the overall good of the clinic and will save countless headaches in the future.

HIPAA and HITECH Laws

In combination with adherence to HIPAA regulations, therapists face risks through the HITECH Act. The act provides funding for more vigorous oversight, allowing infractions and violations to be located quicker.

The HITECH Act also imposes stiffer fines and penalties for those healthcare practice management that is caught violating any part of HIPAA regulations.

Contracts are part and parcel of healthcare practice management. Therapists will enter into contracts with staff members, hospitals, physicians, labs and product vendors.

The list is virtually endless. One of the most frequently encountered problems is the non-competition clause. The term can take on endless meanings for a practice, depending on who the clinic owner is contracting with and if the other party is offering similar services to multiple providers.

The best way to avoid healthcare practice management potential problems is to ensure all communications are open, honest and every nuance is clearly spelled out in detail. That’s where legal representation becomes an invaluable resource for eliminating misunderstandings and conflicts.

healthcare practice management blundersContracts can be adjusted numerous times before they’re signed, but once legalized, neither party can use the excuse, “I didn’t understand.”

Lawsuits initiated by patients are always a possibility and they can be particularly devastating for small practices.

Even if the therapist wins the case, it can cost a practice dearly in terms of clients, reputation, lost revenue, and the funds to defend against the charges.

Everyone Must Be Knowledgeable

Everyone within the healthcare practice management clinic should be knowledgeable about the potential for lawsuits and how they can work to avoid them. Disgruntled employees are nothing new, but in a world of online videos and social networking sites, clinicians should be aware of the damage that can be wrought by an employee lawsuit.

They can cost a practice as dearly as a client’s litigation. When facing legal action by a healthcare practice management staff member, never say anything to incriminate the practice, stand by the clinic’s policies, and never underestimate the potential for disaster. Some situations will benefit from the services of a mediator and may even help therapists avoid a lawsuit entirely.

Legal blunders in healthcare practice management can be avoided if practice owners are vigilant and take definitive steps to keep staff informed about how lawsuits can arise and the part they play in the process. The same is true of HIPAA regulations. Enlisting the services of a single individual fully versed in HIPAA requirements will save clinics money and help them maintain a sterling reputation.