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.

Malpractice and Negligence Defined

Malpractice and Negligence Defined

Nitin Chhoda explains the definition of malpractice and negligence and its implications for a private practice. He also shares tips to avoid malpractice and negligence lawsuits.

malpractice and negligenceEvery healthcare practice management professionals fear the words malpractice and negligence, and rightly so.

A lawsuit alleging either will cost the practice in terms of financial payouts, increased insurance costs and lost patients.

A lawsuit can even lead to the closure of a clinic. To avoid malpractice and negligence lawsuits, therapists must first understand exactly what the terms malpractice and negligence mean.

Malpractice results if a healthcare professional provides treatment that falls below commonly accepted standards and results in injury, death or direct damage to the patient.

Failure to provide appropriate treatment is also fodder for a malpractice suit and can include mental and emotional damage.

Negligence

A therapist would be considered negligent if they failed to provide care that’s considered reasonable for the circumstances, or if they missed or overlooked information that led to a worsening of the client’s condition.

To avoid potential malpractice and negligence lawsuits, it’s imperative that healthcare professionals take sufficient time to collect as much medical information as possible on their patients utilizing all available resources.

An EMR is one tool therapists are using to protect themselves.

An EMR can be accessed by multiple providers and is updated instantly for the most current information possible on all aspects of the patient’s medical history. Being fully informed is the first step to avoiding malpractice and negligence suits.

Therapists must be vigilant to head off potential problems before they occur. While some litigation is legitimate, clinicians must also be aware that there are unscrupulous individuals with one goal in mind – score a huge payday.

Steps

There are steps therapists can take to protect themselves and their practice from a damaging malpractice and negligence lawsuit.

  • Maintain complete and precise documentation. It can make the difference between winning and losing a malpractice suit.
  • Double-check all available information. This is especially true if the client’s condition hasn’t been assessed or is unclear.
  • Advise patients of all their options, risks and potential outcomes and have clients sign documentation to that effect.
  • Always have a second party present if the client is required to display sensitive body parts for examination and ensure documentation clearly shows the assistant was present.malpractice and negligence
  • Take extra time if needed to explain medications, why they’re being prescribed and possible side effects.
  • Ensure patients understand the difference between the facts of their care and any opinions that may be stated.
  • Never leave a reported problem or complaint unresolved, and always conduct follow-ups.
  • Seek consultations or provide referrals if indicated.
  • Don’t rush through exams. It’s imperative that therapists fully understand the client’s complaint, treatments that have been tried, and the results of that care to provide patients with the level of care needed.
  • Cultivate a good patient-therapist relationship.

Some healthcare providers never encounter the devastating effects of a malpractice and negligence suit. Those clinicians are constantly aware of the potential dangers and take appropriate precautions.

There will always be patients who are willing to sue for any imagined problem and the high cost of malpractice insurance is a clear indicator of the trend. Clinicians must practice defensive therapy and take steps to avoid problems before they have a change to arise.

Practice Management: Integrating Scheduling, Documentation, Billing and Marketing

Practice Management: Integrating Scheduling, Documentation, Billing and Marketing

Improving the four key areas of scheduling, billing, documentation and marketing allow a private practice to grow in a progressive manner.

This is now possible with the help of electronic medical records systems. Nitin Chhoda shares the advantages of an end-to-end integrated system for your private practice.

practice managementAn EMR represents a major change in the practice management workflow and the way business is conducted.

It will integrate freely into every facet and department, offering clinicians a more productive and efficient means of managing their practice and patient care.

EMR as a Tool

An EMR offers business and marketing tools to easily track and monitor a wide range of variables that used to take hours or days to assemble.

Scheduling, documentation, billing and marketing are the four key areas in any healthcare practice management and EMRs facilitate the process, allowing therapists to expand their clientele and obtain quicker returns on reimbursements.

Documentation is available in precise detail and from multiple providers for a more accurate picture of the patient’s condition. EMRs offer advanced tools for marketing, allowing practitioners to develop, execute and monitor advertising efforts and their success.

A Complete Solution

A completely integrated practice management solution provides a multi-pronged approach to scheduling. An EMR allows therapists to schedule patient appointments complete with the date, time and client information, rather than a simple notation that includes a name and date.

Other events can be scheduled in the calendar, including meetings, times when other providers are unavailable, and personal appointments, along with vacations and sick days. Calendars can be set up for each provider within the clinic.

A scheduler provides therapists with multiple resources to coordinate services with other healthcare professionals in multiple locations. Patients of practice management can be scheduled for x-rays, surgeries, lab tests and a wide variety of ancillary services. A web-based EMR allows therapists to view a real-time calendar from anywhere in the world where an Internet connection is available.

The Old Way

Few patients have just one healthcare provider. Under a paper system, therapists often had to wait days or even weeks for medical records to make their way to the clinic, leading to delays in treatment. EMRs can be accessed by multiple providers and instantly updated when information is entered for the most current and up-to-date medical history available.

Medical professionals don’t have to rely on their client’s memory to recall tests that were administered, medications they’re taking or surgeries they’ve had. Integrated documentation allows practice management clinicians to create custom forms that reflect the clinic’s special needs, import provider notes, prescribe medications and refills, and make referrals when needed.

A physical therapy practice runs on its reimbursements. Integrated billing and coding virtually eliminates errors, the need for clarifications and rejection rates.

practice management integrationIt includes complete diagnosis and CPT codes, and claims are submitted electronically so information reaches insurance companies and clearinghouses in record time, while maintaining HIPPA requirements for privacy and security.

Supporting Material

A variety of supporting practice management material can be attached to expedite the reimbursement process.

Marketing is an essential part of operating a successful physical therapy clinic and an EMR provides tools that allow practice owners to develop strategies that target specific demographic groups.

Practice management owners can monitor the success of those campaigns and ascertain where referrals are originating to create more advantageous alliances.

Integrating scheduling, documentation, billing and marketing under a single system streamlines all facets within a practice management for increased efficiency, better patient care and timely reimbursements. EMRs provide clinicians with the high-tech tools they need to succeed in a highly competitive field without sacrificing the well-being of clients or the clinic.

Physical Therapy Marketing to Patients — Before, During and After Visits

Physical Therapy Marketing to Patients — Before, During and After Visits

Effective physical therapy marketing begins even before the patients starts his / her treatment. Nitin Chhoda shares some important strategies about effective marketing to patients before, during and even after their treatment.

physical therapy marketingOwners of a physical therapy practice will soon learn that marketing takes up a significant portion of their clinic time. The business of physical therapy marketing never stops.

Clinicians must market their business to attract patients, find ways to promote themselves to clients in the office, and develop follow up methods to keep the clinic in the forefront of clients’ minds.

Patients can pick and choose the therapist they see and practice owners must market to ensure those clients are selecting them. Physical therapy marketing can be viewed as a dating game where therapists court new patients, woo them from other sources and keep the romance alive with ongoing strategies.

Good Physical Therapy Marketing

Building a good patient-therapist relationship takes time and effort, but if clinicians are giving clients what they want, or perceive they want, it can be the beginning of a long and profitable relationship.

Successful physical therapy marketing strategies begin with a clinic standing out from its competitors. Practice owners can utilize a variety of techniques that take advantage of referrals, word-of-mouth advertising and free information.

Social media, search engine marketing, patient newsletters and discounts for patients that pay cash can all be utilized to build a reputation as the preferred go-to therapist. Physical therapy patients want to feel better or mitigate their pain and practice owners need to demonstrate to prospective clients how they can accomplish those goals.

Clients want to feel cared for and clinicians that make each patient feel as if they’re the clinic’s only priority are guaranteed return business, an effective physical therapy marketing technique. Clinicians who achieve that are building a team of cheerleaders for the practice that will have far-reaching effects.

Promoting a physical therapy practice doesn’t have to be expensive. Some of the best strategies utilize simple but low-cost methods. The most effective physical therapy marketing strategies use a combination of techniques and can include any of the following.

  • Patient newsletter (a very effective physical therapy marketing strategy);
  • Hold a customer appreciation day;
  • Establish a VIP club with discounts for those who pay cash or pay their balance by a specific time and give away free trial memberships;
  • Write a column for the local newspaper, do regular radio spots and make the clinic’s expertise available to TV stations;
  • Submit press releases online to announce new products, methods, techniques and services;
  • Network with other healthcare professionals for referrals;
  • Send patients a note, email, voice mail or text message thanking them for their visit, inquire about their health or offer an incentive for discharged patients to return;
  • Give a community presentation on injury prevention or the benefits of exercise;

  • Create and distribute an audio CD or short DVD about the practice, its services or the benefits of physical therapy;
  • Develop a product or treatment method specific to the clinic;
  • Provide free information on the business website;
  • Utilize social media to connect with clients;
  • Offer a core service and two or three specialized services such as massage or acupuncture;
  • Create a blog;physical therapy marketing to patients
  • Write a book;
  • Seek staff input.

The best therapists,with the help of above physical therapy marketing techniques, are with the most patients. They are clinicians that are warm, sincere and provide a superior patient experience.

They are not afraid to display a sense of humor if appropriate. A good bedside manner is essential and humanizes therapists to their clients.

In the office, even little niceties like free coffee and juice creates a friendly ambiance that makes patients feel welcome, cared for and promotes a practice they eagerly return to for all their physical therapy marketing needs.

Healthcare Insurance and its Effects in the New Economy

Healthcare Insurance and its Effects in the New Economy

Nitin Chhoda discusses the current status of healthcare insurance in the country and how practice management, patients, as well as the insurance companies deal with the situation.

healthcare

Healthcare is a complicated and convoluted process in the U.S. that involves patients, practitioners, insurance providers and a multitude of clearinghouses established specifically for processing, verifying and paying claims.

Each entity has its own set of rules, regulations and protocols governing covered expenses and how reimbursement claims must be submitted. The system has patients confused and healthcare providers fighting for revenues.

The multi-tiered healthcare system in the U.S. is a slow and ponderous process, but one that’s essential for the financial stability of practices and to ease the pain and suffering of patients. Due to the many facets of the industry, it can leave even insured patients with insufficient coverage or none when they need it most, while clinicians are buried in a mountain of paperwork and rejected claims.

Reactive healthcare is the new normal

Until recently, healthcare was a reactive system focused on treating ailments and illnesses as they appeared.  The beginning of the 21st century saw a shift in the thinking of insurance company executives toward preventative measures and ways for clients to avoid becoming ill or developing conditions such as diabetes and heart disease.

It’s a high goal that can mitigate a wide range of expensive healthcare problems, but doesn’t factor in variables such as genetic predispositions, or work and environmental elements. It’s a system that penalizes the elderly, infirm and those experiencing ongoing health issues or who require extensive treatment.

Insurance creates conundrums for the insured

When the Affordable Health Care Act is fully implemented, millions of previously uninsured individuals will have access to a core group of services through insurance policies obtained through their employment or a healthcare practice management insurance exchange.

Unfortunately, as insurance companies increase deductibles, co-pays and other costs, patients are delaying or failing to seek treatment and practitioners are experiencing distinct drops in revenues.

Today’s healthcare insurance may not cover specific services patients need or may require thousands in out-of-pocket costs clients can’t afford.

Healthcare insurance providers are forcing patients to shoulder more of the cost burden and setting limitations on costs and treatments. The result is that many clients that have insurance are no better off than those without.

Creating revenue strategies is a multi-pronged process

To ensure sufficient cash flow, clinicians must develop and implement strategic plans to contract with the best paying providers and examine client insurance coverage closely before beginning treatment. In some instances, clinicians may need to refer patients to other facilities or resources to obtain whatever treatment is available.healthcare insurance

The technology embodied in an electronic medical record (EMR) system is a clinician’s best friend for verifying insurance, providing enhanced documentation and submitting reimbursement claims.

EMRs empower practitioners, providing them with the tools to manage client treatment needs against their insurance coverage.

EMRs can identify claims that may pose potential problems, while offering electronic reimbursement submissions to facilitate payment turnaround times.

The structure of the healthcare system in the U.S. is difficult to navigate for patients and practitioners and the new direction being taken by insurance companies is actually narrowing options for the insured and creating financial hardships for practice owners. To remain solvent, clinicians will be required to make hard decisions about the patients they treat, the insurance they accept and the providers with which they contract.

Healthcare Practice Management: The 4-Prong Approach

Healthcare Practice Management: The 4-Prong Approach

To manage a practice, it’s important to adopt a multi-faceted approach that consists of four ‘pillars’. This allows for a more efficient, streamlined and successful practice, according to Nitin Chhoda.

healthcare practice management approachManaging a healthcare practice management is a lot like running other small businesses, except for a few glaring differences.

In general, a small business can predict how often and how well they will be compensated for products or services.

This is because the client or customer who received the products or services is the same as the payer. In healthcare practice management, the payer is often a third party, in the form of a health insurance company or a governmental program.

To ensure that a medical practice is financially secure, healthcare practice management must take a 4-pronged approached; everything within the practice needs to be integrated with the rest of the practice. Most importantly, scheduling, documentation, billing, and marketing must all be integrated to get the most efficiency and productivity from the staff.

Start with Scheduling

Making your scheduling of healthcare practice management efficient is fairly obvious; for every open appointment slot of each day, there should be a patient coming in to the clinic. The problems arise when there are either not enough patients or patients cancel appointments and the slots are never filled.

Historically, medical practices haven’t had much of a choice when it came to making the scheduling process more efficient or precise. But with technological advances, scheduling has evolved so that filling slots is easier and tracking patient visits becomes automated.

Scheduling and Marketing

To get the most from your schedule, it turns out that the healthcare practice management will have to do some marketing. Usually this means projecting a certain image to the general public and attempting to entice patients to come to your practice rather than alternatives.

Marketing is also important as patients move through the system, and encouraging referrals from current patients should be part of the healthcare practice management plan. Without good marketing, it will be hard to keep your schedule full.

Scheduling and Documentation

Of course, usually it is the receptionist who handles both scheduling and the pulling and re-filing of medical records. The responsible healthcare practice management staff member must take the time to look over the schedule and pull the correct records each day.

They must also know when to schedule the next visit based on the clinician’s notes from the current visit. This entire process can be automated and streamlined with current technology.

healthcare practice management 4-prongDocumentation and Billing

And the bottom line for any healthcare practice management will be collection of payments from the payer, whether that is the patient or their health insurance company.

Medical billers and coders need access to those medical files, too, and they need to know what the clinician has been doing to help the patient get better.

Integration

By realizing that there are important connections between the four major parts of a practice, healthcare practice management can look for the ways that communication and transfer of information has become inefficient within the practice. Efficiency can only be improved when management is seeing the connections and assessing the performance of each aspect of the practice as it relates to the rest.