So, what are you waiting for?

Part one of a three part series.

Over the past six months we have regularly written about the changes about to take place in healthcare. Now, 2012 is here and the first of those changes, 5010 should be implemented by all medical practices. This is a mandatory first step in what will be the transition from ICD-9 to ICD-10.  It is also a step that will greatly impact your cash flow everyday that implementation is delayed.

And now speaking of delays, ICD-10 has been delayed.

Thank your lucky stars right? That is an emphatic “Wrong”.

Now that you have a bit more time you can create a stress free transitional environment for your practice. Don’t get caught behind the eight ball like 35% of practices did while implementing 5010. Those 35% hadn’t even addressed implementation until late in the third quarter of 2011. Four months is not conducive to stress-free transition, implementation and testing on the scale of 5010 much less ICD-10.

This series will launch a step-by-step process that will help your practice and staff ease into ICD-10 in a more stress-free and confident manner saving everyone the anxieties of last minute implementation.

We will also be launching an ICD-10 portal soon to make information available and easily accessible.

So let’s get right to it, stress-free ICD-10.

To foster a better understanding of ICD – 10, I have included a number of frequently asked questions (courtesy of the AMA) that range from basic to TMI (too much information),  simply in an effort to paint a clear picture of the who, what, where and why of ICD – 10.

ICD-10 FAQs

What is “ICD-10”? “ICD-10” is the abbreviated way to refer to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS).

Explain the difference between ICD-10-CM and ICD-10-PCS. 
ICD-10-CM is the diagnosis code set that will be replacing ICD-9-CM Volumes 1 and 2. ICD-10-CM will be used to report diagnoses in all clinical settings. ICD-10-PCS is the procedure code set that will be replacing ICD-9-CM Volume 3. ICD-10-PCS will be used to report hospital inpatient procedures only.

Will ICD-10-PCS replace CPT®? 
No. ICD-10-PCS will be used to report hospital inpatient procedures only. The Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) will continue to be used to report services and procedures in outpatient and office settings.

Do I have to upgrade to ICD-10? 
Yes. The conversion to ICD-10 is a HIPAA code set requirement. Providers, including physicians, are HIPAA “covered entities”, which means that you must comply with the HIPAA requirements.

Who else has to upgrade to ICD-10? 
Health care clearinghouses and payers are also HIPAA covered entities, so they are required to convert to ICD-10 as well.

I thought HIPAA code set standards only applied to the HIPAA electronic transactions. What if I don’t use the HIPAA electronic transactions? 
It is correct that HIPAA code set requirements apply only to the HIPAA electronic transactions. But, it would be much too burdensome on the industry to use ICD-10 in electronic transactions and ICD-9 in manual transactions. Payers are expected to require ICD-10 codes be used in other transactions, such as on paper, through a dedicated fax machine, or via the phone.

Why is ICD-9 being replaced? 
The ICD-9 code set is over 30 years old and has become outdated. It is no longer considered usable for today’s treatment, reporting, and payment processes. It does not reflect advances in medical technology and knowledge. In addition, the format limits the ability to expand the code set and add new codes.

The ICD-10 code set reflects advances in medicine and uses current medical terminology. The code format is expanded, which means that it has the ability to include greater detail within the code. The greater detail means that the code can provide more specific information about the diagnosis. The ICD-10 code set is also more flexible for expansion and including new technologies and diagnoses. The change, however, is expected to be disruptive for physicians during the transition and you are urged to begin preparing now.

When do I have to convert to ICD-10? 
The delay instituted on February 16, 2012 is indefinite. That said, doctors are still encouraged to work toward compliance with system and workflow changes enabling transition and reception of ICD-10 codes.

What if I’m not ready by the compliance deadline? 
Any ICD-9 codes used in transactions for services or discharges after the established deadline will be rejected as non-compliant and the transactions will not be processed. You will have disruptions in your transactions being processed and receipt of your payments. Physicians are urged to set up a line of credit to mitigate any cash flow interruptions that may occur.

There you have it, a pretty thorough foundation to begin our next conversation, Part 2 on ICD – 10.

In the interim, if you have any questions or would like to talk to someone directly about help with the transition to ICD – 10 CRT Medical Systems would like to be the people you speak with. CRT has been in business for over 30 years and there isn’t much we haven’t seen in technological developments, healthcare legislation and insurance carrier evasion tactics. With over 400 years of combined medical billing experience there isn’t much we haven’t seen. That also means that we know what to look for in every aspect of effective medical billing.

If you would like to know more please call me, CRT president, David Doyle @ 248-789-1700 or visit www.crtmedical.com/billingbusiness

Even doctors need help. It’s a fact of life, and one that applies to the financial wellbeing of your practice. That’s why practices seek the services of medical billing partners. Medical billing partners can make cash flow more consistent, a practice more profitable and life a little easier.

Choosing a medical billing partner is a big decision, there are many factors and criteria involved in the decision making process. The essential characteristics identifying a great medical billing partner are similar to those you’ll find in a good accountant or financial advisor.

The first thing people will say about a great financial advisor is that they act like your money is their money. They are stingy with the personal allowances, and always looking for areas to eliminate extraneous expenses so more money can be invested for the future.

Medical billing partners make their first impressions with strong statistics on claims recovery (typically over 96% success rate) and reduced patient account receivables. Their reputation is shaped by successes they have in processing claims, submitting the paperwork or digital data, and payment collection. In short it all amounts to how stingy they are with the money people owe you.

Stinginess isn’t the end all, as a matter of fact, in an odd way it is regulated by the government on many fronts. All potential medical billing partners must employ certified, medical billing specialists. These specialists need to pass a series of tests to receive certification. Some medical practices even have their own in house, certified, medical billers. So all certified medical billers are the same then right?

Not so fast.

Certification is just the first step in what is a very tedious and intricate profession. A certified medical biller ensures a minimal industry standard. Once a specialist has been certified the learning really begins. The current medical billing environment requires an understanding of 17,000 billing codes and the restrictions of insurance carriers. The job is made even more difficult by the ever-changing insurance carrier requirements. And all of that is about to change. By now you know the details of ICD-10 – consisting of no less than 120,000 additional new, detailed billing codes for implementation by 2014. ICD-10 will add on average, 700 hours of education time, for each practice management team.

Saying that life just became much more complex for every medical practice in existence is an understatement. The variables have increased 8-fold, which means that you will likely be seeing fewer patients on an already maxed-out schedule. How in the world will you achieve positive cash flow and profitability in an environment of decreasing doctor production?

The answer is simple, experience tempered with stinginess. Not yours, but that of your medical billing partner. Experience is always a great asset, but a long track record is not worth much if it isn’t a good one. Make sure your prospective medical billing partner has references to validate their track record. You can look into the billing partner’s track record by asking references about claims recovery percentages, the average number of days for patient A/R and by the total annual write-offs.

Once you are satisfied with the answers it’s time to interview your potential partners. Remember, your goals are both short and long term. Also remember that stinginess doesn’t equate to mean or aggressive behavior but rather an iron fist in a silk glove. As a matter of fact, if you understand that honey attracts more than vinegar you’re way ahead of the game.

Considerations for your practice’s immediate future include processes by which your new partner will:

                    1 – Provide a cost benefit analysis

                    2 – Stay current with carrier policies

                    3 – Schedule insurance claims rejection follow-ups

                    4 – Develop Patient Account Receivables recovery strategies

                    5 – Prioritize carrier follow-up and project potential case write offs

Considerations for your practice’s long-term future include processes by which your new partner will:

                    1 – Review technology applications and efforts to meet meaningful use

                    2 – Establish clear and enforceable “time of treatment” financial policies

                    3 – Establish Patient Account Receivables due date milestones

                    4 – Develop Patient Account Receivables recovery strategies

                    5 – Provide an account of patient interactions in the collections process

                    6 – Provide numerous indicators of practice performance

Ultimately, the biggest question for both short and long term considerations is: Does the potential medical billing partner act like they are trying to recover their own money? If they do not exhibit the ingenuity and stubborn resolve to outlast the carriers, and outsmart patient stall tactics – keep looking.

CRT Medical Systems would like to be among those potential medical billing partners that you speak with. CRT has been in business for over 30 years and there isn’t much we haven’t seen in technological developments, health care legislation and insurance carrier evasion tactics. If you would like to hear more please call me, CRT president, David Doyle @ 248-789-1700 or visit www.crtmedical.com/billingbusiness

There are many so-called “health care experts” out there who are willing to tell you how to ensure positive cash flow even in tough times. The trouble with the expert advice is that it always involves the doctor’s paycheck, assets, or credit, in one form or other.

I decided to take a quick look at what the experts were again advising doctors to do in order to maintain cash flow.

No surprise, the list in amednews.com is comprised of all of the above, and more:

1 – Using a doctor’s personal funds.

2 – Accessing a line of credit secured by practice assets.

3 – Accessing a line of credit secured by a doctor’s personal assets.

4 – Accessing unsecured credit.

5 – Deferring doctor compensation.

6 – Leaving some money in the practice from year to year.

7 – Maintaining a three- to six-month cash cushion.

While well meaning, the list seems to put all the burden on the doctor’s shoulders, from taking a pay cut or no pay at all, to putting hard earned assets up in exchange for credit or, if you’re lucky, paying additional points for scarce, unsecured credit.

What I don’t hear are strategies for doctors to get paid!

I’ve been in the medical billing business for over thirty years and I can tell you that you don’t survive by standing still. Innovation and shrewd insight carry you through tough times. That’s why, over these past few months, we have developed a number of new tactics to help doctors get paid. These new tactics dovetail completely with doctors’ practice payment policies. As doctors become more stringent with regard to payment at time of service and mandatory co-pay policies, CRT Medical Systems becomes the enforcer. Diplomatic, helpful, and firm.

• We use a comprehensive electronic review system that enables us to help prevent and eliminate first time rejections on claim submissions. Statistically speaking it can improve claims payment by over 30% (based on the industry average 37% first time claims rejection).

• CRT’s PAR We employ a highly educated, locally based, special department that contacts patients with overdue balances and process payments immediately or via a patient portal.

In addition, all phone calls are recorded and tracked for quality control and client review.

• CRT deploys a sophisticated Internet-based communication system that enables our team to be an extension of your practice. It is an extremely efficient, paperless way to communicate – nothing can fall through the cracks! It’s like having a billing department in house but without the expense.

• You will work directly with an account leader who has you and your practice in mind, all day every day.

This is an actionable and verifiable road map to profitability without the huge up-front personal sacrifice.

All of these services take a doctor’s assets off the bargaining table. Doctors get to keep their money and make money at the same time. We can even help you increase staff productivity by assigning the billing challenges to the most capable resources, CRT, and allowing your staff to tend to patients and practice policies.

When a patient walks out your practice door with a balance due, they’re ours!

When you decided to be a doctor, you didn’t anticipate that you would be in the lending business or working for nothing. CRT Medical Systems’ sole purpose is to help you be the doctor you want to be.

Please start by visiting www.crtmedical.com or calling me, David Doyle @ 248.679.1700.

“Success is a peace of mind which is a direct result of self-satisfaction in knowing you made the effort to become the best of which you are capable.”

                                                                                      – John Wooden

 Our lives are an evolving, never-ending work in progress.

Every day we get up, look in the mirror and hope that we have the wisdom and intelligence that will enable our contributions to make a difference. If we’re serious, it dawns on us that these aspirations can’t happen in a vacuum. We need a community, a team (whether we call it that or not), and a common point of reference to help us understand the basis for the difference we hope to make – in a word a “benchmark.”

How do we stack up when compared to others in our realm?

Do we understand our performance year over year?

Do we know how to improve our community and ourselves?

If you’re a doctor overseeing a practice, you may know where this is heading.

You need to ask difficult questions in order to make the right decisions. Coach John Wooden was relentless where initiative was concerned, as this quote would indicate:

         “Make a decision! Failure to act is often the biggest failure of all.” 

This is incredibly relevant when it comes to your practice. There are resources (MGMA, HBMA or a number of others) available to help you understand the quantitative decisions, but what about the qualitative decisions?

While productivity, revenue and efficiency are normally categories associated with quantitative data, there is a deeper qualitative aspect to them as well. The qualitative decisions are directly related to the capabilities of the individuals or partners you assign and entrust your day-to-day tasks to. It is the basis for building a great team, or less metaphorically, optimizing staff.

An optimized staff has the most appropriately skilled individuals at each position. Once these individuals are in place, operational costs decline and practice overhead decreases. The key is finding those gifted individuals.

Wooden’s criterion for success is one way to identify an effective and skilled individual. Here are just a few of the qualities to look for:

Competitive Greatness: Perform at your best when your best is required. Your best is required each day.

Alertness: Constantly be aware and observing. Always seek to improve yourself and the team.

Industriousness: Success travels in the company of hard work. There is no trick, no easy way.

Cooperation: Have the utmost concern for what’s right rather than who’s right.

Enthusiasm: Your energy, enjoyment, drive and dedication will stimulate and inspire others.

For over thirty years I’ve held these virtues in high esteem and built the CRT staff around them. If I don’t see these qualities when I look in the mirror every morning, it’s likely I won’t recognize them in any candidates. As I said, it is an evolving, never ending process.

If you need a medical billing and EMR partner, you can be sure that CRT is the best. In turn, if you choose to work with us, we will help you dedicate the time you need to do what you do best, and ultimately look in the mirror and see a great doctor.

Please start by visiting www.crtmedical.com or by calling me, David Doyle @ 248.679.1700.

CRT Medical is the largest medical billing company in Michigan. It has also flourished in the industry for over 30 years.

For more of John Wooden’s pyramid for Success please visit:http://www.coachwooden.com

Benchmarking is a great way to evaluate how your practice is performing. Various methodologies range from singular internal practice benchmarking (such as one physician to another’s collections year over year) to external benchmarking (comparing one practice to the best performing practices in a specific region).

The key to actionable, effective benchmarking is to ask the right questions of your practice in the benchmarking process. It is a bit more challenging than it might seem and requires an astute understanding of the care-providing business (not simply care providing!).

To start you‘ll need to understand a few of the integral categories for consideration (as outlined by MGMA) including Leadership, governance and equity, Productivity, Compensation, Clinic/Practice operations, Facilities and capital improvement, Staffing, Accounts receivable management, Coding and compliance, Information systems, and Utilization management. This is the basis for a holistic perspective that will shed insights on opportunities for practice improvement.

While all of the categories named above play a role in the vitality of your practice, we will focus on two primary areas that seem to give practices the most challenges:

1 – Accounts receivable management
2 – Coding and compliance

Analysis of these two areas will clearly indicate the practice’s financial health and help you forecast the impact of patient A/R and coding variables in the future.

Accounts Receivable Management
These days we are seeing a trend of practices gravitating to affiliations with hospitals to help ensure stability. While this may seem like a great alternative to the current business climate and its challenges, it does have some underlying drawbacks. When independent practices are immersed in a new health system, there are generally a number of billing and collection systems performing at a range of different levels, all required to interface and coexist with the larger health systems’ infrastructures. It can be a laborious and costly transition. The tedious nature of the transition is impacted even more substantially by virtue of payers’ increasingly rigid claims management.

Here are a few questions to ask yourself that will provide a strong basis for actionable learning:

• Have sufficient staff and a realistic time line been dedicated to standardizing billing practices and minimizing operational redundancy?
• Have systems been implemented to minimize patient A/R delinquencies (days and amount owed)?
• Has one person been designated to provide insights and guidance on individual payer requirements for co-pays, deductibles, pre-authorizations and referrals?
• Is there a system in place to deal effectively with delinquent accounts after they have been written off by the hospital or health system?

These astute questions will help you become keenly aware of your practice’s financial potential. These are also questions you may not know the answers to. That’s where CRT Medical Systems’ 30 years of experience can help get you on the right track. We can answer these questions because we have over 30 years of aggregated data from practices of all sizes. We know the best processes to improve practice performance at any size.

Coding and Compliance.

A famous architect once said, “God is in the details.” When it comes to coding and compliance he was wise beyond his drawing board. Consider coding and compliance the superhighway infrastructure of the healthcare system. Now think of that superhighway being regulated by signals that change at random intervals at new locations on a daily basis. It requires a sharp and nimble intellect that can identify change, react to it quickly and implement new information seamlessly in order to be reimbursed in a timely manner and to maintain compliance. Detailed documentation is critical to reimbursement and to maintaining compliance.

Is your head spinning yet?

We know that physicians generally make minimal investments in practice management systems, typically only to handle billing.¹  As government scrutiny of integrated systems and compliance increases, it’s paramount that a practice understand changes in regulation (such as meaningful use and transition to 5010). Physicians and staff are solely responsible for optimizing reimbursement and minimizing denials and compliance risks. As payers pay less and patients pay more, practices are moving to a threshold of greater risk.

Is your practice prepared for this increased risk?

Here are some questions to help you determine how well prepared you are:

• Does your practice maintain up-to-date and proper coding procedures?
• Does this training account for individual specialties within your practice?
• Have all of your practice’s providers been audited annually?
• Is your practice (organization and process) in compliance with relevant rules and regulations?
• Does your practice perpetually implement and observe compliance throughout the system?

While these questions will give you a solid foundation to begin implementing the best processes for your practice, we humbly believe the best question is “Have you called CRT Medical Systems yet?”

If the answer to this question is yes, then an affirmative domino effect is in place for any remaining questions. CRT handles it all.

Process and performance benchmarking help practice leaders understand their organization’s performance year to year and how it compares to similar medical practices in their region. Please call me, David Doyle, CRT CEO @ 248-679-1700 or visit www.crtmedical.com. We can answer these questions and many more, freeing your mind, helping you be a better doctor.

 CRT Medical is the largest medical billing company in Michigan. It has also flourished in the industry for over 30 years.

^{1 – 2011 Q2 HBMA Survey}

I’m sure you remember when you were 10 years old and your friend forgot his lunch money. You trustingly lent him money expecting to be repaid promptly only to realize that you had to ask him for repayment. In fact, sometimes you had to pester the borrower until you downright embarrassed him before you were repaid. You were eventually repaid, but realized the relationship would never be the same.

Fast-forward a few decades and that lesson is as relevant as ever.

Human nature hasn’t changed. Add an uncertain economy and stress to the equation and it is simply easier for a lot of people to ignore challenging situations, particularly those involving financial stress. It is definitely something we can all relate to. We all want to do the right thing, and sometimes a small nudge is all we need to help us – this is particularly true when it comes to patient A/R.

Your patients really want to do the right thing, but the right thing can be very confusing. Patients are mystified by HMOs, PPOs or other insurance carrier decisions and constant coverage changes.

In 2010 alone providers wrote off over $65 billion in bad patient debt.*
This is a result of healthcare reform, rising patient responsibility and the increase of consumer directed health care (CDH). On the other hand claims processing costs payers an estimated $15-20 billion annually.† These two dynamics account for a substantial portion of the total revenues flowing through the US healthcare system every year.

The bottom line:
Practices need to adopt a patient friendly process and with fewer payment processing delays. Practices will also have to implement more patient-friendly information than ever before. Even so, at best, practices should be prepared to devote at least twice the amount of time with patient A/R as they are currently spending on claims with insurance payers.

While this may sound like a daunting task with the looming mandatory requirements for meaningful use and transitions to 5010 by 2012, CRT Medical Systems can help ease the pressure you’re feeling. We have helped practices like yours succeed for over 30 years.

CRT developed PAR to help you manage patient confusion and delinquent accounts. It’s a new service that employs expert patient management. CRT is capable of dealing with delinquent patients in an intimate and caring manner. Our experts have the personal skills to empathize with the patient as well as intimate knowledge of their medical file. There are no gray areas regarding patient responsibility and no hard feelings because the patient felt pressured into paying.

Our experts know the medical billing industry inside-out, so they can definitely eliminate the confusion and mystery your patients experience by constant changes in their insurance coverage. You could say that these patients have been waiting for the right answers so they could do the right thing. Some have even been waiting as long as five years. As a matter of fact, since CRT has implemented the PAR program we have settled receivables from over 5 years ago and have a success rate of over 90%.

PAR has been a homerun for practices that have signed on with CRT Medical Systems.
Give us a call @ 248.679.1700 to see what we can do to minimize your patient A/R.
We guarantee the days of patients eating your lunch are over. 

 CRT Medical is the largest medical billing company in Michigan. It is also one of the oldest, having flourished in the industry for over 30 years.

* – Mckinsey Quarterly (2010)
† – Mckinsey Quarterly (2007)

As long as we seem to be on the best-in-class business band wagon, I thought it might be interesting to take a look at how Apple does business. I’m not talking about the cool products or the seamless software (which makes people wonder how they did it) but rather a more fundamental aspect, the brand/customer interface.

Apple has become synonymous with easy when it comes to technology. Their first question in product development or customer service seems to be, How can we make (insert buying music, making movies, etc.) easier than it has ever been? That philosophy starts from the top down with its chairman and leader.

 Wait a minute, isn’t that what all consumer based products or services should do, make things easier for their customers? So why does Apple seem to get all of the credit for such an “easy” business premise?

What did Apple do so effectively that no one else has?

It created a desire through transparency.

Apple made the help desk a destination and an incredibly positive experience. Not only can a customer come in and be enlightened by one of the geniuses behind the Genius Bar, but other customers with the same question can be similarly enlightened and engaged. The bottom line is that people accept and understand that everyone has techie problems and they aren’t alone (…so lose the self-consciousness!). Better yet, they feel good about being a part of this group of newly empowered Apple users.

A convenient byproduct for Apple retail stores is that they always seem to be busy. Beyond that, with every new product there seems to be a line of enthusiastic zealots starting 24-48 hours prior to the product even being released at the store. They happily pay a super premium to be the first to own the newest “Apple.” And all while the country has been wallowing in the great recession, and as numerous other electronics and computer stores have fallen by the wayside. (Does Apple know how to do business or what?)

All of this activity and positive energy accomplishes two very important objectives:

1 – It strips away the “behind the curtain” mystique of technology and makes it a user-friendly encounter.

2 – These educated customers comprise the crowds in the store casting the pebbles creating the ripple effect Apple sends throughout society. They create buzz.

The first objective is met by virtue of operations, and the other forms an undeniable marketing tool.

While Apple does make it look easy, make no mistake it is a consistently evolving and tedious task of refinement. It is a philosophy that permeates every aspect of the company.

Apple has empowered the once hapless computer neophyte and made them feel like they can take on the world. Apple has given them hope and better yet, a reasonable understanding of what they might achieve.

That very same mystique exists now in Healthcare (and it is a huge opportunity). How can we bring the primary patient issues out from “behind the curtain”? How can you empower your patients to become confident and trusting, singing your praises, returning again and again while minimizing patient A/R?

Start by asking how can we make everything easy – a simple black and white proposition?

Apple does this very elegantly when it comes to in-store service and support. The make it all available online with a sophisticated scheduling system broken down geographically. They offer you the closest location, at the most convenient date and time. They even do a little recon, or pre-op, so they can have a basis from which to explore the challenges the customer is facing. Again, it is all about the customer.

How can this be literally parlayed to your practice?

1. Start by offering patients their choice of appointment schedules online

A. be transparent – allow them to see your schedule openings

B. allow them to have a second choice if their first may not be available

2. Offer your patients numerous payment options

A. most practices now accept credit cards – be sure your practice accepts the major three (Visa, MasterCard, Amex)

3. Offer your patients individualized payment plans

4. Offer your patients informed help

A. designate one of your staff to become a Patient Service expert

B. offer a help line staffed by people familiar with the patient records as well as insurance procedures and approvals

C. you might even offer a public forum for your patients to help one another out – many of your patients already trust you with their lives and they would be happy to help out a confused or uncertain patient

5. Above all find a way to let your patients know what to expect with all of the known variables

A. get pre-approvals on any expected procedures

B. follow up on those approvals to ensure the percentage of payment  expected

C. let your patient know what their responsibility is as soon as possible

Finally you can visit www.crtmedical.com or call me, John O’Green, directly @ 248-679-1606. We have some new ideas for healthcare that will improve your practice performance and help make your life being a Doctor as easy as being a Doctor again!

CRT Medical is the largest medical billing company in Michigan. It is also one of the oldest, having flourished in the industry for over 30 years.

Apple logo is a registered trade mark of Apple Computer.

What can your practice learn from Starbucks?

You’ve got to be thinking, “How does he get to Starbucks from medical billing?” – He’s out of his mind!

Please hang with me here for a moment, I promise it will be worth your while.

Starbucks recently launched an application that lets customers purchase goods with their Android smartphones. The company already has similar applications for BlackBerry, iPhone and iPod touch.

These applications allow customers to load their Starbucks loyalty card accounts, check card balances and find stores nearby, and it also notifies customers of promotions and other discounts.

In addition to these conveniences, they are also launching mobile payment options for customers frequenting over 1,000 Starbucks within Safeway Supermarkets nationwide.
They already offer similar programs in over 1,000 Target store locations as well as 6,800 of their own locations.

Wow, talk about giving the customer some easy payment options.

“The expansion of our mobile payment footprint has been driven by customer interest and input. With the addition of Starbucks for Android to the Starbucks app line-up, a Starbucks mobile payment app may now be used on approximately 90 percent of smartphones currently in use,” said Adam Brotman, VP, general manager, digital ventures at Starbucks Coffee Co.*

To think all of this started over 25 years ago, when a cup of coffee generally cost $.75 and Starbucks was charging $1.50! Suffice it to say they had to change “product” expectations.
They did it by providing an effortless and unique experience.

Granted buying a latte is a bit different from buying medical services – one is a leisure purchase and one could be termed a “maintenance” purchase. The purchase mind set is very different.

Surprisingly, the payment experience doesn’t have to be.

As we have considered the practice payment “logjams” over the past 30 years we see definite patterns that, in this day and age of increased patient responsibility, can adversely affect patient A/R.

Patient responsibility is increasing at a rate of 10% annually meaning that insurance payer responsibility is decreasing by 10% annually. It would seem that the simple solution is to notify patients that they are responsible for payment and everything will continue “business as usual”.

Not so fast. Statistics show that collecting from patients is two and a half times more work intensive than collecting from payers! I’ll repeat that one more time as it appears on your staffs’ timesheets, for every hour your practice spends collecting from insurance or health plan networks they will spend on average 2.5 hours collecting from patients. (Something you may have already experienced.)

Now just think what that additional time against does to your practice overhead not to mention how the interim patient A/R is affected. The cost is a double hit before any money is even in the door. It becomes painfully clear that this is not a singular issue but rather a domino effect, zero-sum game.

Enter the Starbucks customer convenience model. It is the pivotal point of any successful business – getting the money in the door!

When we adjust our business perspective and think of practices as retailers (from a financial aspect) we can begin to manage customer (patient) expectation in a very different way.

As Adam Brotman, Starbucks VP, General Manager, cited earlier their actions were taken directly as a result of customer interest and input. Intel! It’s a great place for every practice to get a clear picture of its strong points as well as areas it can improve.

I would recommend that every practice develop a financial survey for every patient to fill out at the office or on-line at the practice website. From patient answers you will be able to develop actionable and empathetic payment options for your patients. You will likely receive an answer for every conceivable payment option possible. The great thing about these options is that they are easily sorted and categorized into finite actionable solutions.

Actionable solutions are where CRT Medical Systems excels. We are launching comprehensive services ranging from new patient payment options for your practice, to reducing denials and improving claims efficiencies, to increasing collections rates. While all of these services are available a la carte they are most effective when employed in concert. This is another area that CRT Medical Systems provides your practice with many great options. We have three models to offer your practice:

• First and most comprehensive is our Full Management solution, CRT Medical Systems becomes your complete billing department solution.
Please click here for more information.

• Second is our Hybrid Management solution is a combination of our Full Management solution services and giving our clients access to the system so they can perform certain billing functions themselves.
Please click here for more information.

• Third is our ASP (Application Service Provider) or Online Billing Solution CRT Medical Systems offers the Online Billing solution as the first line of improving productivity and profitability. While this is exactly like having your own computer billing system in-house, it offers many more advantages. Please click here for more information.

All of these options have an inherent 30 years of billing expertise and even offer a patient call center staffed by professionals who understand how to deal with financially stressed patients.
These professionals establish patient and practice dialogues that can specifically address any patient concerns when it comes to payment responsibility.

In the end the patient is educated and well informed and the doctor can minimize the affect of new patient financial responsibility on the practice. The net result is a happy patient and a happy doctor.

CRT also offers the InstaMed system allowing your practice to verify patient coverage prior to the visit. It also allows patients the opportunity to use customized payment plans eliminating the angst, and reluctance at the root of patient A/R issues. Taking steps to make the insurance coverage status transparent eliminates surprises and helps manage patient expectations. While patients in general may not like paying, making payment easier is a game-changing asset reducing the pain patients feel in their bank accounts.

At the same time CRT never rests when it comes to improving billing and claims efficiencies.
In this never ending evolution we are continually searching for the most expedient and informative method of filing or re-filing claims. We have seen dramatic reduction in denials with our newest process over the past 60 days and when there is a denial we immediately know why. It may not sound like big news but this intelligence eliminates generations of redundancy with the insurance claims maze of information technology.

Armed with the time sensitive denial intel we can then take action to correct the information and resubmit claims immediately – or we can contact the practice and advise accordingly.
Either way the processing time is dramatically reduced. The net learnings on each case are applied to the CRT/Practice relationship to further increase efficiency and increase payment.

The benefit is a much shorter payment cycle.

Finally we go even deeper when it comes to collections; CRT Medical Systems has a new service called PAR. Designed to help minimize rapidly accumulating patient A/R. With all of the intelligence aggregated from our initial steps in the process including insurance validation, payer contributions and claims rejections CRT can approach the patient in a manner that helps inform and educate them when it comes to their financial responsibilities. We all know that an educated and relaxed patient is easier to deal with than an uneducated and emotionally charged patient – particularly when it comes to financial operations.

What could be better for your practice than decreased payment cycles, happy patients and most important an incredibly improved collections rates? If we work together and continue to apply our learnings, we might all be able to afford more lattes!

Please start by visiting www.crtmedical.com or calling me, David Doyle @ 248.679.1700. We’ve been in this business for over 30 years and we can help you develop a great practice all while helping you do what you always wanted to do – be a great doctor.

CRT Medical Systems is the largest medical billing company in Michigan. It is also one of the oldest having flourished in the industry for over 30 years.

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Let’s face it no one likes surprises. Why then do most medical practices wait until the patient has been treated and left the practice before informing them that the insurance has rejected their claim and they (the patient) are now responsible for the financial obligation?

Nothing could be more backwards.

There is a recent practice that doctors have been employing to ensure that they are paid no matter what and frankly it is irritating to patients. It begins with the desk attendant asking the patient to update their file and at the same time to sign a form accepting full responsibility for complete payment. The doctor’s form states something like “Insurance coverage is a contract between the patient and the insurance company – not the insurance company and the doctor. We (the doctor) provide you (the patient) with the convenience of using your insurance”.

The patient doesn’t get an estimate – they are simply called in and for all they know it could cost hundreds or thousands of dollars. The patient is blindsided!

A patient has been given the impression that by joining a specific Healthcare or Insurance network their doctor belongs to, that they are covered with the exception of the deductible. Does your practice want to add to patient angst and an already tenuous patient/insurance relationship by saying “hey that’s your business, you figure it out”.

It is at this point that things can get real sideways. A patient shows up for an appointment made weeks in advance for a specific treatment or consultation. Between the time of the appointment and when the patient arrives for the appointment insurance coverage can change. Posting a sign on the wall mentioning that practice policy is to expect payment at the time of service may not be the best way to handle unexpected patient financial responsibilities.

Can you imagine if most service business/customer relationships were run this way?

Avoiding the pitfalls of such a situation is easy if you look at it from the patient’s perspective, deal them with respectfully, and with a full service approach. Make it easy for them and they will be your patient forever and better yet refer patients by the dozens.

Here are a few easy and immediate processes your practice can implement to improve patient satisfaction and practice profitability.

1 – Provide the patient with a document clearly explaining the process your practice employs to process a claim to insurance carriers. Detail how responsibility is determined, process time cycles, as well as the payment process for denials. Transparency helps the patient understand that your practice is looking out for their well-being eliminating frustration.

2 – Educate the practice personnel on the best ways to handle the “patient unknowns”. If you don’t know where to start, use customer surveys. This act alone conveys a sense of concern for the patient’s well being.

3 –Keep appointments on schedule. Nothing is more important than letting patients know that you value their time as much as they do. And if you are running behind keep patients informed by developing a calling and/or social media (text or tweet) plan to contact them in advance. Remember no one likes surprises.

4 – Pre-certification follow-up is important. A pre-certification isn’t a guaranteed payment.

5 – Offer patients an on-line alternative to filling out forms in the office. Let them visit your website, download and print out forms to complete at home prior to an appointment.

6 – Use your web site to help educate patients. If a patient has access to information regarding their particular case and can read it in a relaxed friendly environment at home you’re killing two birds with one stone. Befriend the patient, propagate trust and at the same time educate them. You could even offer an option for patients to email pre- appointment questions!

7 – Pay attention to details. Understand the staffing and technology issues in your practice. Improving patient relations, patient flow and patient volumes translates into a predictable environment and practice stability. Ultimately, increased patient satisfaction and increase practice profitability.

8 – If you don’t know where to start or have the staff begin by visiting www.crtmedical.com or calling me, David Doyle @ 248.679.1700. We’ve been in this business for over 30 years and we can help you develop a great practice all while helping you do what you always wanted to do – be a great doctor. 

CRT Medical Systems is the largest medical billing company in Michigan. It is also one of the oldest having flourished in the industry for over 30 years.

For the past 5 years medicine has seen an attack on its business model from all fronts. From falling reimbursements, higher labor costs, higher patient deductibles, more non-covered services have brought many if not ALL practices to a cross road, that’s demanding their full attention as business owners. All of us in business have been subjected to relentless attack over the past 15 years. First it was the need to invest in technology, then it was the need to get on the internet or be a part of the internet in order to remain competitive, then it was the outsourcing of work to countries with lower cost metrics. Last but not least we faced the “Real Global Economy” whereby we truly were competing with businesses in Vietnam, China, Phillipines, Eastern Europe not to forget India and others who started 10 years ago.

All these changes have forced all business verticals to reexamine how they conduct business in order to stay profitable. Look at what is happening to Blockbuster, once the most dominant company in the pre-recorded video business has been forced into bankruptcy… by what? A new business model called NetFlix. But now there are signs that even Netflix are facing new threats to their business model.

So what needs to be done in the medical field to avoid those fates? Throw out the old rules and bring in the new. Take a moment to review the following which were published in a recent blog about the “status” of health care and the business side of it. They listed out the “old” and “New” rules for practices today. Do any of these apply to how you think about your practice?

• OLD RULE: Physicians could make a good living without having much business experience; just being a “good doctor” was enough for practice success.
• NEW RULE: Those days are gone. Change is the “new normal”. Physicians will need to be astute observers of healthcare and business economic conditions and determine how they need to respond to change from a business practice standpoint.

• OLD RULE: Enough healthcare dollars were available to allow physicians to make their fair share of the pie.
• NEW RULE: The per-patient healthcare dollar available will decline for the remainder of today’s physicians’ careers. Smart physicians will find ways to gain more control of the healthcare dollar they produce and in particular go after the patient portion of the health care dollar.

• OLD RULE: Managing a medical practice could be handled by administrative people with general administrative skills.
• NEW RULE: The complexity and risk of managing a medical practice has skyrocketed, requiring highly specialized expertise. 4,000 new regulations per year are created that affect physicians. Physicians cannot find the required level of expertise in one or two administrative persons. Outsourcing to specialized firms will become the norm.

• OLD RULE: Doctors could get away with being “low-tech”.
• NEW RULE: Patients, insurance carriers and the government will expect physicians to be high-tech. Physicians who are not high-tech will be limiting their income and value to patients AND become employees of systems that are.

• OLD RULE: The billing function of a medical practice could be performed by regular administrative staff.
• NEW RULE: With unintentional billing fraud* on the increase, identity theft running rampant and regulatory fines on the increase, physicians must ensure that their billing is done professionally by certified coders with multiple layers of protection in place.

• OLD RULE: A healthcare practice was not considered a “business”.
• NEW RULE: Structuring a practice around sound business principles and an understanding of healthcare economics will become increasingly important in order to survive. Those physicians who run their practice on business principles will survive. Those who don’t will be absorbed by those who do.

In summary, the administration of healthcare practices has become increasingly sophisticated. The post-healthcare reform system will increase in complexity. Success of physician practices will depend largely on the talent managing it. Embracing and deploying the right business process and technology will enable doctors to stay INDEPENDENT as oppose to becoming employees of a larger organization. Medical practices can MAKE money and can deliver world class health care. The paradigm needs to change in order to do that.

To see how we can improve your medical billing services please visit www.crtmedical.com or call me, David Doyle @ 248-679-1700

CRT Medical Systems is the largest medical billing company in Michigan. It is also one of the oldest having flourished in the industry for over 30 years.

* – The “New Rules” for Survival for Physicians in Private Practice Part 2 in a 4 part Series (December 07, 2010)