Improving Collections

The economy is reportedly beginning to turn around, albeit slowly, which is good news. But we’re not out of the woods yet and your practice may be feeling the pinch as patients struggle to pay you. Certainly, they value your services and want to keep their accounts current, but buying food and paying utility bills may be higher on their priority list right now. Here are a few things to keep in mind that will help keep cash flowing into your practice, even during this difficult economy.

Set an expectation. Create a written financial policy for your office, one that’s easy to understand and not too long. Consider an FAQ format for simplicity. Post the policy on your website and give a copy to each new patient who visits your office. Having a written policy sets the expectation in the minds of patients that you intend to be paid for the services you provide. It also gives staff a document to rely on when patients have questions about payment issues.

Collect at the time of service. This sounds obvious, but far too many offices allow patients to waltz in for care and out again with “bill me” as their parting words. Make it clear when you schedule appointments that co-pays and other balances due are payable at the time of service. Patients who “leave their checkbook at home” should leave the office with a return envelope and a request that they mail a check the following day. Follow up by phone if no check is received within five days. Yes, this is time consuming, but less costly in the long run than sending a statement (or multiple statements) or waiting weeks or months for payment, which sends a message that late payments are acceptable in your practice.

Accept credit cards. If you’re not already accepting major credit cards at the time of service and as an option for patients to use when paying bills by mail, now is the time to start. Check with the bank where you have your business accounts to find out how to get up and running with credit card processing, or Google “accept credit cards” to find vendors.

Offer payment plans. No, you’re not a bank or finance company, but offering patients a reasonable payment plan might be a good solution in certain cases. If, for example, someone owes a few hundred dollars and can’t put the balance on a credit card, better to accept $100 a month than write off the balance or send a long-standing patient to collections. There are some rules associated with payment plans, so check with your accountant and create a policy that you follow carefully.

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Investing in a Staff Retreat

Now that 2010 is in full swing, you’ve hopefully settled on several meaningful goals for your practice for this year. Perhaps you have plans to write and implement a new marketing plan, improve collections by a specific percentage, cross-train employees, or convert to an electronic medical records system. Now the question becomes how to engage the entire team in achieving your most important goals. One way to get everyone on board and excited about making good things happen is to hold a staff retreat. Here are three options to consider, depending on your available time and budget. A hybrid of these may turn out to be the best format for you.

Half day, on site, internally facilitated. The most basic staff retreat would be a half-day session when you close the office and hold the retreat on site. If you go this route, either forward your phones to the answering service or hire a temp to handle incoming calls so that everyone can participate in the retreat. Four hours is about the minimum investment of time if you plan to really dig into practice goals, map out a strategy, and begin assigning specific tasks. For this simple retreat format, you’ll need only a comfortable meeting space, a flip chart, refreshments, and someone who can volunteer to facilitate and keep the group on track in terms of the agenda and schedule.

Full day, off site, with or without a professional facilitator. When you decide on a full-day retreat, it’s probably best to take it off site. You may choose a local hotel or retreat center, or if the budget is tight and your staff is small enough, someone’s home might work if there is a space conducive to a day of brainstorming. If you’re not in a facility with food service, have morning and afternoon refreshments as well as lunch catered so that no one is distracted with playing hostess. If you go with the full-day format, consider hiring a professional facilitator (more on that in the next item).

Two days, off site, with a professional facilitator. If you invest in a longer retreat, it makes sense to also invest in a professional to run the meeting. A skilled facilitator (ideally one with medical practice knowledge) can walk your team through not only how to achieve your critical goals, but can also help you work on longer-term strategic planning, mission/vision/values statements, and assist in resolving any conflicts that might arise during your retreat.

No matter which retreat format you choose, follow-up is essential. Immediately after the retreat, someone should transcribe everything that was written on your brainstorming/planning flip charts into a document that everyone can access and reference. Follow-up should continue throughout the year during regular staff meetings or specially scheduled “mini retreats” to ensure that you are continually moving toward achieving your goals.

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Celebrate National Medical Group Practice Week™

National Medical Group Practice Week™ is January 18-22, 2010.  We understand the importance of this week and want to support all practice personnel who help provide quality care within their own communities. 

In recognition of this week, click here to take 10% off your next order!

For more information, visit http://www.mgma.com/gpw/

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Setting Practice Goals for 2010

Does anything else produce optimism like the sense of having a clean slate that accompanies a new year? Sure, it’s just a flip of the calendar, and you could choose to set annual goals every May 19^th  if you’d like, but most of us think of the beginning of the new year as a time to reflect and consider what’s important to accomplish over the next 12 months. If you’re in the process of mapping out your practice goals for 2010, here is a process to consider.

(1) Debrief 2009. What worked? What didn’t? What did you hope to accomplish that’s still on the “to do” list? What (or who) changed in your practice last year that might influence new goals for 2010? Don’t forget to include a thorough financial review. Did you meet your revenue targets? Did you stay within budget? Having a clear picture of the recent past will help you effectively manage the coming year.

(2) Poll office staff and providers. What does each person and the group as a whole consider to be top priorities for this year? You may be thinking that investing in a new phone system is number one on the list but find out that the staff is more than willing to limp along with the current system for another year if only they could please, please, please have a copier that doesn’t jam up every day.

(3) Set a limited number of clear, achievable goals. Resist the temptation to make a long list of goals. Instead, pick just a few very important ones and focus your attention there. What one, two, or three goals – if achieved – would have the most positive long-term impact on the health of your practice? Make sure your goals can be measured. Instead of “Do better with collections” say “Increase collections by 8% over 2009.” That you can measure.

(4) Create an action plan. Once you have your handful of goals written down (yes, put them in writing!) put together a step-by-step action plan that will help you stay accountable to continually working toward the goals. For example, you might review your current collections policies and hold a special staff meeting to discuss upgrading those policies in January as your first step toward that 8% increase.

Work toward getting everyone in the office on board to ensure that you achieve your goals this year. One way to do this is by holding a retreat for your practice. Watch for another post here soon on that topic. Good luck with your 2010 goals

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2010 Major Coding Change

Medicare will no longer recognize consultation codes starting January 1, 2010.
To avoid denials, it is imperative that your providers and coding/billing staff are aware of the changes and what your process will be to submit claims correctly. 

What is the change to consultation codes?
The consultation codes (99241-99245 for office/outpatient and 99251-99255 for inpatient) are still in the CPT manual for 2010, but will not be recognized by Medicare starting January 1, 2010.

Does that mean we can’t perform consultations for Medicare patients anymore?
No. Your providers will still be providing the same service, but it will need to be reported differently to Medicare.

Is there a crosswalk we can use to convert the consultation codes to other codes?
It depends on the code category.

The documentation requirements for office/outpatient consultation codes 99241-99245 mirror those of the new patient visit codes 99201-99205 and can be directly cross-walked.

The documentation requirements for office/outpatient consultation codes 99241-99245 are different from those of the established patient visit codes 99211-99215 and cannot be directly cross walked level by level.

The documentation requirements for the three highest levels of inpatient consultation codes 99253-99255 miror those of the three initial hospital care codes 99221-99223 and the three initial nursing facility care codes 99304-99306 respectively, and those levels can be directly cross walked.

If a provider is performing a service that would normally be reported with one of the two lower levels of inpatient consultation (99251-99252), there is no crosswalk available.

Note: The crosswalks noted above will not work for cases wehre the level of service is chosen based on time of counseling/coordination of care.

For more information, visit websites:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf

and

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf

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Five Steps to Take Now for a Successful 2010

In the midst of holiday shopping, parties, and visiting family and friends (or having houseguests descend upon you) it might seem out of the question to even think about planning for the new year. But plan you must if you have big practice goals for 2010. Here are a few things you can do now to establish the foundation for success in the new year. 

1.  Schedule weekly, bi-weekly, or monthly staff meetings now for the entire year and communicate the dates/times to all employees so they can put them on their calendars now.  

2.  Send out a brief questionnaire to all staff members and practitioners in your office asking what they feel should be the top 3-5 priorities for the practice in 2010. Share the results during a January staff meeting and use the information to solidify your business goals for the year. 

3.  Review your 2009 finances and draft a budget for 2010. Set goals for gross charges, collections, and operating expenses by category. Make a list of planned capital expenses. Set the bar high for keeping revenue up and spending down. If you agree with the philosophy of giving bonuses based on specific goals, build in incentives for employees to engage in helping make your practice highly profitable.   

4.  Set aside one day (or a half day if that’s all you can spare) between now and the end of the year to clean and organize your office. Purge old files, straighten up storage areas, have the windows washed, ask your janitorial service to do a “deep clean,” and throw away or donate anything not being used around the office. Sound daunting? Think it’s not worth the time? Consider for a moment how good it will feel to start the new year off in a state of complete order. 

5.  Begin thinking about how your practice can contribute to the community you serve in the coming year. What local charitable donations will you make? How much flexibility can you offer to employees who want to spend more time volunteering? In what ways can you educate residents of your community about how to stay healthy? Success is about much more than what we take in each year; it’s also measured by how we contribute.   

Bonus step: Come up with five of your own unique steps for success, in addition to the ideas in this post. Every practice is different and you probably have ideas about what you can do now to make 2010 a great year.

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