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 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 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.


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.

Automated Vs. Manual Patient Follow Up

Automated Vs. Manual Patient Follow Up

Clinicians put a lot of effort into patient reminders, but they still don’t know if clients are going to show up even after they’re reminded. That uncertainty points out the advantages of automated patient follow up. There’s no need to set aside blocks of time for patient reminder calls.

Manual follow up and patient reminders consume a significant amount of staff members’ time that could be better spent on dealing with patients in the office and conducting marketing activities. An automated system is more efficient and offers increased access to healthcare for those who really want it.

24 Hour Notice

Twenty-four hours before the patient has an appointment, an automated system sends the patient a text or voice message to confirm or reschedule. In Touch EMR™ provides practitioners with multiple means of contacting clients that allows them to confirm or reschedule appointments automatically with the touch of a button.

Depending upon the client’s choice, they can confirm their appointment on the spot or be transferred automatically to the appropriate staff to reschedule. In Touch EMR™ slashes patient no-shows. It also provides staff with opportunities to fill those empty appointments to maintain patient flow. Messages can be customized according to the clinician’s preferences.

It’s All About The Numbers

Some clinics are experiencing record no-show rates. The Affordable Health Care Act, changes in insurance and higher co-pays has led many clients to delay or suspend their care due to monetary considerations. Any practice that has more than an eight percent cancellation rate definitely needs an automated system to cut down the work and increase the number of patients that actually show up.

Breaking Down Barriers

While many practitioners have made the transition to an EMR, they continue to avoid contacting patients via email, text or voice message. The fear of violating HIPPA regulations is often cited. No confidential information is exchanged during a patient reminder.

Caring Attitudes

Patients want to feel that their clinician cares about them as more than a paycheck. One of the best ways to foster that perception is through automated contact. It takes little time with an automated system, it’s a good marketing strategy and wins patient loyalty.

Leveraging technology to stay in contact with patients has never been more important. It’s essential to gather all forms of contact information from patients, obtain their permission for that type of communication, and their preferences for messaging. Text and voice mails are typically answered within five minutes of their receipt, making them an ideal way to reduce no-shows.

How to Automate Patient Follow Up

How to Automate Patient Follow Up

One of the most important things a clinician can do is to keep his/her name in front of patients. That can be done with automated patient follow up. When patients provide their information, the practice should obtain the client’s mail, email, home phone and cellphone number, along with their permission to communicate with them in those ways.

An automated system should be able to contact patients by all four of those mechanisms. The In Touch EMR™ has the ability to accommodate those who utilize mobile devices and older patients who may not be comfortable with modern technology. Patient follow up encompasses more than appointment reminders.

Traditional Mail

In Touch EMR™ has the ability to generate personalized greeting cards with a variety of user defined messages. The feature is an effective means of connecting with new and established patients. Cards are computer generated, but have the look and feel of a personal note.

Cards are effective in welcoming new patients after their first visit or thank established patients for their continuing patronage. Cards can be sent on client birthday or on their anniversary with the practice. Cards tend to make a more lasting impression and are perceived as requiring more effort on the part of the practitioner.


An email message can be generated for the same purposes as a card and many individuals prefer being contacted by email rather than other means of communication. Messages can be used to notify clients about special deals, coupons and referral programs. When applicable and appropriate, congratulatory messages can be sent for an upcoming marriage, birth of a baby or workplace promotion.

Every practice should produce a newsletter and email is a convenient means of delivering it. In Touch EMR™ has the ability to generate newsletters with new, educational and engaging content that requires little effort on the part of the clinician.


In Touch EMR™ can send personalized voice messages to a variety of mobile devices. Studies have shown that individuals typically respond to a text or voice mail within five minutes of its receipt, making it ideal for patient communication. Clinicians can connect with a variety of messages, from appointment reminders to extending holiday greetings.

Home Phones

There are still some individuals who resist the use of smartphones and computers. These are typically older patients. They may not have a computer or mobile device, but they will most likely have an answering machine. In Touch EMR™ can generate any type of message desired to keep in touch with patients that may be resistant to newer types of technology.

Automated patient follow up is an essential part of operating a successful clinic. Automation simplifies the process for staff, while building goodwill with patients who are then more likely to refer the practice to others. It’s customer service at its best, facilitated through the automatic abilities of the In Touch EMR™.


Time Management for Private Practice Owners

Time Management for Private Practice Owners

Time management is essential for practices, yet many clinicians and practice owners find themselves wondering why their business isn’t more profitable. They’re seeing more patients but being less profitable, and there never seems to be enough hours in the day to accomplish everything. The problem could easily be that the clinician is spending too much time involved in negative-dollar or no-dollar tasks.

Many jobs can and should be handled by integrated EMR software. The In Touch EMR™ system provides clinicians with automated functions to save time and money, increase productivity and accelerate profitability.

Negative-Dollar Value

A negative-dollar task actually hurts the practice, whether it’s the clinician or staff engaging in the activity. These actions steal time from the practice and severely hinder productivity. Negative-value activities include checking Facebook, email and texts. Making or taking phone calls via landline or cellphone reduce the time spent with patients and directly affect the bottom line. Clinicians need to ensure that negative-dollar activities within the practice are kept to a bare minimum.

No-Dollar Value

A no-dollar value task is one that can be done by someone other than the clinician. Responding to email, calling patients and physician offices, and ordering supplies are all tasks that should be delegated to someone within the practice that is efficient and capable.

Other no-dollar value jobs that clinicians shouldn’t be doing include answering the phone, paying the bills and scheduling appointments. These are tasks that fall within the $10-$15 an hour range. It doesn’t mean they aren’t important, it just means they can be done by someone other than the clinician.

High-Dollar Value

Clinicians should strive to only perform high-dollar value tasks. These are things that only the therapist can do. All facets of patient treatment fall within the high-dollar value range, from examinations to documentation.


A medical practice is a business and there are some things that require the personal attention of the owner. These are tasks that provide lifetime value for the viability of the clinic. Owners should concentrate their time on conferences, business development, and managing and motivating staff. These are all jobs that will provide long-term dividends. Other jobs reserved for the practice owner include conferring with the accountant, working with a business coach and speaking with other professionals to learn what works for others in the profession.

Looking at reports is an essential part of business operations and among the lifetime-value tasks. They provide the clinic owner with information about the financial wellbeing of the practice. In Touch EMR™ provides business owners with a wide variety of sophisticated, in-depth reports to determine where referrals are originating, the most productive staff members, and which payers provide the best reimbursements.

Clinicians/business owners must manage efficiently to spend as much time as possible on lifetime value tasks. In Touch EMR™ helps practitioners staff with better people and choose better office systems to facilitate the clinic’s efficiency, productivity and overall earning power.

Should Your EMR Do Marketing?

Should Your EMR Do Marketing?

Should an EMR do marketing – the simple answer to that question is yes if it’s the In Touch EMR™. Marketing is an essential part of running a business and a clinician’s office software should have the functionality to do that without taking time from the practice’s normal processes.


The Information Is There

Clinicians are already using their EMR to document patient visits and it has all the information needed to perform marketing tasks.

It has a patient’s phone number and address, and it should also contain their email address and cell phone number.

That data allows practitioners to contact patients in multiple ways phone for appointment reminders and account balances, and it also offers marketing opportunities.

It’s just as easy to use that information to stay in touch with patients to inform them of special offers, to ask for referrals or send a simple holiday greeting.

It’s critical that clinicians keep their name in front of clients for when they require services and the In Touch EMR™ provides the tools to do that.

Ways To Stay In Touch

In Touch EMR™ allows clinicians to contact patients via phone, email, regular mail and text message.

It’s fully integrated with billing software and allows practitioners to communicate with patients automatically, freeing staff to do other tasks.

It also allows therapists to communicate with patients through newsletters and has built-in greeting card software.

Patients expect to be contacted about account balances and receive appointment reminders.

EMRIt’s a pleasant surprise when they receive a card or text message on their anniversary date with the practice, to check on their health, or receive a greeting on their birthday.

Clients can opt out at any time from receiving any of those communication methods.

An EMR that doesn’t market isn’t serving its full potential.

In Touch EMR™ is the only one that offers marketing capabilities and it performs those tasks automatically with information that’s already available.

The built-in automatic capabilities of In Touch EMR™ allow clinicians and staff to spend more time on the business of treating patients. Greater office efficiency is achieved and therapists can rest easy knowing that their EMR is working in the background to market their practice.