Nitin Chhoda shares the state of health care practice management from the past and how it will affect the future. He shows how the role of management and its staff are evolving as technology enters the physical therapy business.
Even though the tasks assigned to health care practice management staff have been around for as long as hospitals have existed, the job of health care administrators is relatively new and is constantly changing.
Handling medical records and medical billing is a big job. For very small practices, these jobs used to be the tasks of the health care practice management, usually in the form of an office manager.
But today, health care practice management involves so much more, and tasks like medical billing and coding are handled by specialists.
The current role of the health care practice management staff involves a lot more analysis and efficiency management than ever before, largely due to changes and improvements in technology.
The role of electronic medical records (EMR) in this change cannot be emphasized enough. Electronic health care practice management technology has allowed health care management to take advantage of data that was previously too time consuming to extract.
Health Care Management Focuses on Patients
Of course, all these technological improvements might lead health care practice management consulting professionals to spend more time with charts and graphs than dealing with patient concerns. But that is not entirely the case. In fact, analyzing performance of the clinic will serve two purposes.
Firstly, identifying problems with efficiency will provide many advantages to the doctors, nurses, clinicians, and entire staff of a hospital or practice. Many health care practice management professionals will be quick to look for ways to save money, which is another advantage of EMRs and using the technology that is available today. But most of the changes that help the practice’s bottom line have other benefits, too.
The second purpose of looking for inefficiencies by using data on outcomes, re-scheduling rates, and visits per patient is to identify where patients can be better served. This is the tangible benefit that technology can bring when used the right way.
Number of Patient Visits
As an example, imagine that some clinicians only see a patient three times before the patient can go back to life as usual but other clinicians spend at least five visits with each patient.
Usually, in a busy office, you would never even notice a pattern of health care practice management like that.
Clinicians tend to know just how often they need to see patients, based on past experiences and what they were taught.
But if you could see that patients with the same complaint were given a more effective treatment or series of treatments, you could find out what it is that efficient clinician is doing.
Health Care Practice Management, a Delicate Balance
It’s easy enough to see how this kind of information could be misused. And it is likely that we’ll see plenty of cases of disgruntled staff members who are frustrated by statistical analysis and being treated as if they aren’t doing a good job.
Health care practice management in the future is going to be more and more a job focused on efficiency. But there are important human elements that must always be kept in mind so a practice is really running the best it can. Unhappy staff are not the way to make things better.
The relationships between the healthcare management and medical billers are important. It involves the whole process of physical therapy billing.
Nitin Chhoda reveals certain areas where healthcare management and medical billers should support each other for the success of the practice.
Depending on your first hand experience with medical billing, it may be completely obvious that health care management and medical billing are very closely integrated.
However, manyhealth care practice management professionals who have no experience in medical billing can cause problems for medical billers if they do not educate themselves on the relationship between the two.
Small Practice Medical Billing
In a small practice, it’s very likely that the medical billing will either be hired out to a separate company, or that it will be handled by the health care management staff.
These days it is easier to both hire out as well as accomplish medical billing jobs in-house as part of a position with other responsibilities. But this can cause a lot of problems when that single staff member starts to get overwhelmed.
Medical billing is the most important part of running a medical practice, besides actually treating patients. Health care management involves being able to detect the signs of an overwhelmed medical biller before it causes serious problems. Everyone in the office relies on the medical biller to bring in the payments that keep the practice running.
Health Care Management Indicators
There are a number of indicators which may tell health care management that the medical biller needs more support or more time to do their job correctly. Sometimes changes in workflow can bring efficiency up, but often it is more a problem of being overworked than anything else.
Health care managers who don’t realize how much time it takes to complete the medical billing in the way it should be handled are likely to overwhelm their staff unknowingly.
One way that health care management can identify a problem is by looking at rejections and denials from insurance companies.
This is a tough indicator, because the average rejection and denial rate is about 50% of claims. However, with an advanced EMR you can get more detailed information.
Why has a claim been rejected? How often are rejections and denials due to clerical error, time restriction problems, or incorrect medical coding and health care management? These are the kinds of errors that occur when the medical biller doesn’t have the time to review their work before submitting claims.
Another indicator are accounts receivable aging reports. Aging reports will tell you how long it takes for claims to be paid. It can also tell you whether or not medical billing and health care management staff is taking the time to review the accounts receivable aging reports regularly enough.
Sometimes payments are delayed or even overlooked because the claim has been sent, but was never received by the insurance company.
Sometimes the rejection or denial is sent incorrectly and the practice will have no way of knowing that this is what happened. Unless someone runs an aging report and checks with the insurance company to determine the status of the claim.
Medical billing involves a lot of duplicate work and communication. Health care management principles can ensure that this work is done correctly by giving medical billers the time to do their job.
Nitin Chhoda shares the basic fundamentals of having an effective practice management that will help increase productivity and efficiency within a practice.
Healthcare practice management is often a delicate balance between the human side of an efficiency equation and the problems or benefits related to technology.
For some practices, the introduction of the latest EMR technology is a difficult and frustrating experience.
For other practices, implementation can go smoothly and an EMR will start to improve efficiency right from the beginning. How can you determine that technology will actually benefit your practice? Good practice management will find out what the goals of the practice are before considering any new technology.
Common Reasons for Technology Improvements
Most practice management professionals know that technology is the way to greater efficiency. Communication via email is considerably more efficient than mailing a letter.
You would never consider going back to paper communication when email is an option, right? That is how most practice management professionals feel about using EMRs and practice management technology once they have implemented and adjusted to the changes.
However, at the start of the process, there will always be pushback. There are high start-up costs, and to answer the questions about whether or not EMRs are worthwhile, you will certainly need to ascertain that there are efficiency problems in the practice that an EMR can solve.
But think about investing in email. Email requires significant start-up investments, including computers, high speed internet, and software. Implementing an EMR may sound expensive, but the benefits almost always outweigh those initial costs.
What are the benefits? Most clinics find that the reduction in paper and the improved speed and quality of communication is the first thing they notice.
Additionally, for medical billing and accurate medical coding, an EMR can represent higher efficiency and better rates of accepted claims. In fact, the number one reason for implementing better technology, from a practice management perspective, is to reduce rejected or denied claims.
Ensuring That Technology Works for Staff
Of course, anyone in practice management will also want to think about how these changes will affect the staff. The idea behind technology improvements is to improve efficiency. But if the staff is not well enough prepared or if they do not find the EMR to be useful or intuitive to use, the outcome will not be improved efficiency.
Similarly, technology improvements can allow for incredible benefits for practice management reporting. Good practice management should include a reporting and review system so that you can focus on changing the things that are not working.
But if the staff doesn’t understand why they are adding more tasks to their day, they may not enter information correctly, leading to useless or even harmful report results.
Additionally, there should be an integration of staff needs and goals into the overall goals of the practice management solutions.
Effective practice management will include human resources principles into the overall strategy of improved efficiency.
Rather than assuming staff will figure it out eventually, make sure they are an integral part of the EMR or practice management technology implementation process.
Before deciding what type of physical therapy software to use in your practice, you first need to determine where your practice needs help. Nitin Chhoda shares the different healthcare practice management tools, and the ways it help to increase productivity and efficiency.
Improvements seem to be made from day to day, so should you invest now or is it too early?
Should you spend a lot of money up front for the best solution, or find something more reasonably priced and add features as you benefit from the change?
What are the risks of choosing the wrong health care practice management tool? Rather than focus on which are the best tools, first it is important to distinguish between the different kinds of health care practice management tools and what they can do for your practice.
Electronic Medical Records
At their simplest, EMRs are systems that allow you to keep detailed records of each patient without using a lot of papers and pens. There are plenty of other benefits, such as the fact that information is faster to enter, review, and communicate with others.
This can improve efficiency within the office as well as the health care practice management, and when communicating with other clinics or hospitals.
Medical Billing Software and Medical Accounting Software
For big steps toward improved efficiency, most health care practice management consulting teams will look for an integrated EMR and medical billing software solution. Medical billing software will improve the speed and accuracy of claim submissions, reviews of rejected or denied claims, and re-submittal of claims.
A well designed medical billing software system will incorporate medical coding, as well, increasing the opportunities for staff to catch their own errors before claims are sent to insurance companies.
With an incorporated system, EMRs can be shared with medical billing staff instantly. Filing and sharing of files will no longer hold up the important processes that health care practice management want the staff to focus on.
Staff may also find that their jobs become more streamlined and flexible as a result of a good EMR and medical billing system.
Staff are often thrown off balance by cancellations or re-scheduled appointments at the last minute. An improvement in scheduling can also result in improved billing and collections.
And naturally, if patient scheduling software is included in the health care practice management tool you purchase, the results can be pretty exciting. For example, if a clinician needs to be informed of a change in schedule, they can get a notification instantly.
Reminders can be set for scheduling tasks and priorities so open appointments can be filled rather than overlooked. And each patient visit can be channeled through the system via their electronic medical record, triggering the medical billing cycle, and new appointment scheduling.
There are many other perks that some EMR and health care practice management solutions provide, including radiology information systems and picture archiving systems. To determine which health care practice management tool is best for any practice, the first step should be the detection of inefficiencies that exist and goals that the practice has.
Healthcare practice management tools already exist in the market today, but you must choose wisely. Nitin Chhoda points out that the tools you selected should meet the needs and requirements of your physical therapy practice.
Once you have settled on goals for the practice, you can start to explore your options for health care practice management tools.
Many of these tools will offer basic EMR and EHR systems, but there are also features to consider for the future, or that might make sense to implement right now to reach your goals.
No matter which health care practice management solution you select, remember to set your goals first. The wrong system may not improve efficiency as expected and can cause problems instead of offer solutions.
The final decision should also be determined by the size of the practice, your specific needs, and the flexibility of the system as balanced by your budget; if you don’t have the finances to purchase an all-encompassing, health care practice management system, find one that can be expanded upon with other features as you feel ready.
Top 10 Most Popular Health Care Practice Management Tools
While popularity isn’t necessarily the best measure of a good health care practice management tool, companies that have done more installations are going to have worked out more bugs and inefficiencies. You can at least count on them to have evolved to suit their clients. Below is a list of the top ten companies and their market share as of 2011. Data may change in the near future.
Epic Systems (8.7%)
Siemens Healthcare (8.4%)
Healthcare Management Systems (7.3%)
Self-developed systems (5.8%)
Eclipsys, now part of Allscripts (3.9%)
The first three in the list above account for over 50% of market share, but that may be because they are used in large hospitals; for that reason it makes sense to review the experiences of practices of a similar size to yours, that have actually installed a health care practice management system you are considering.
Meditech is generally used in large applications of health care practice management, such as in hospitals and medical facilities that see hundreds of patients and have specialists of all kinds on staff. The program is considered very stable and consistent, but users do have some trouble with the interface. The majority of applications are used for medical accounting and lab documentation, but less by physicians and clinicians.
Cerner also ranks fairly low with users for functionality and is used by large hospitals and clinics. But there are quite a large portion of users who find Cerner to be quite useful.
It may be that for the right practice, this is the right health care practice management solution.
Amazing Charts, SOAPware, and e-MDs Chart also rank highly with small practices, although Amazing Charts ranks fairly low for functionality.
Praxis EMR is also highest ranked for satisfaction with support and training, which may be the most important ranking.
For small practices, with between one and five physicians, there are other options which rank very highly with practices that currently use the system. The top user ranked health care practice management consulting tool for small practices is Praxis EMR.
Nitin Chhoda emphasizes that a physical therapy practice should be aware of all the regulations and laws that are connected within the practice. Not everyone can be an expert, but assigning a dedicated staff member to focus on regulations, laws and the changes that are made will be helpful to your practice.
For a large hospital or clinic to keep a lawyer on staff is not uncommon, and in many ways it makes sense to always have a legal specialist available to answer questions about the rights of the hospital and their patients.
However, for a small practice it is much harder to justify having legal representation on staff. There are many horror stories of legal problems causing bankruptcy for a medical practice.
Health care practice management should include some basics about the dangers of making legal decisions for which the outcome is unclear. However, because of the focus on patient lawsuits, health care practice management teams often forget to think about regulatory legal blunders.
Understanding HIPAA regulations is one of the most important jobs of health care practice management. While mistakes in following HIPAA regulations can be damaging, they are also some of the easiest mistakes to avoid, if the health care practice management team is aware of common mistakes that are made.
The most common problems that health care practice management run into focus around liability for fraud, mishandling overpayments, violations of privacy, and not responding to Medicare inquiries. Third-party payer audits and certificate-of-need process should also be comfortable topics for health care practice management consulting professionals.
HIPAA violations can be avoided if at least one member of the health care practice management within your practice understands HIPAA thoroughly. It may seem like a very big and ominous law, so expecting everyone to know everything will be challenging.
But at least one person should be or become a HIPAA specialist so the practice has someone to ask before procedures and standards are set that will violate HIPAA regulations.
Legal blunders relating to contracts are also very common. Naturally, health care practice management professionals are on high alert about any contracts, especially with staff, physicians, and clinicians.
You can also run into trouble with non-compete clauses if you work with physicians who are providing services for more than one practice, especially in-office ancillary services.
To avoid legal problems, it is best to negotiate all contracts in full, taking the time to review all aspects that may introduce conflicts within the practice.
At the first sign of a problem, make sure that communication is open and honest so that changes can be made before a problem becomes a legal issue.
The HITECH Act will also pose a lot of risk for health care practice management, as the punishments for not following HIPAA regulations are more severe as a result of the HITECH Act.
Additionally, funding through the HITECH Act is expected to increased oversight so that infractions are more likely to be discovered.
Regulatory oversight can be the least of your worries if you have focused on improving your knowledge of the regulations.
Managing a health care practice can include complex facets, and being aware of risks to the practice should be a high priority. The best way to avoid a risk is to understand what constitutes risky behavior.