Tips to Improve Your Medical Practice

Many physicians when seeing a patient often refer their patients to a specialists in a variety of different fields.  Some doctors can refer up to 40 different specialists to their patients.  Most offices keep a binder with all the names, phone numbers and addresses of the physicians they often refer to.  This can be time consuming due to the fact the staff would have to go through the binder and either write down the info or make a copy of the information to give them.  Repeating this process over and over throughout the whole day takes up a lot of time and energy.

 Create a Database

Online is a perfect place to research finding a free address-book tool.  There are many that can be useful to the practice.  Most of these programs let you pull up the specialist by name, type of specialty or area of medicine they practice and the types of insurance they accept.  Just one click and all of their info pops up, tax ID number, address, phone number, fax numbers and even other providers in their practice.  There’s even a field to where the office can make notes.  Another click and the information is ready to go to give to the patient.

 Most of the programs do require that you enter the specialist information into the system, which is well worth the time considering how much time the office will save by having this easy referral system as opposed to the time it takes to find the information and hand write it for the patient.  With this tool it will free up more time to be able to accomplish more things throughout the day.

 Another tip on your practice to save time and improve efficiency is to establish a secure patient portal on your practice’s website.

 Web-based Tools

 Patients can use this tool to request prescription refills, referrals, make appointments and to get test results.  Some even have a application for e-mailed appointment reminders that sends the office back a confirmation notice so you know the patient received your messages.  This feature also helps to let patients know when their due for their annual visits and screening tests.  This can eliminate and cut back on the number of incoming calls and outgoing calls which can often be very time consuming.

 In some medical practices nurse practitioners handle all the prescriptions and prescription refills but with these web portals they are able to have a better handle on refill requests and they are able to spend more quality time with the patients.

 These tips have proven to save time, keep the office running smoothly and efficiently but most importantly, improved communication with patients.


Ways to Improve Patient Relations

Despite your practice’s best efforts, at some point in time, someone such as a patient, other physicians or carrier is going to complain.  This is the perfect opportunity to take this feedback and evaluate what changes can be made to help your practice become even better.

 Target Areas for Improvement

 Turning negatives into positives.

 *  Create spread sheets for the three most likely sources of complaints.  Patient/family member, carriers and other physicians.  Each one will typically be handled differently.

 *  Record the date, time and type of complaint that was being made, (e.g. billing issue, staff behavior, quality of care, wait times, etc. )

 *  Log what was done or what needs to be done to resolve the complaint.

 *  Log the date and time the issue was resolved.

 *  Have the office do this for at least two weeks or up to one month to get a good feel for all aspects of problem areas.  Example – Patient portion’s of what they owe on their end usually is sent out once a month, so this could be included in evaluating any billing issues.

 Now analyze the data, looking for patterns.

 For quality-of-care issues, is there an upward trend in post-procedure infections or are staff being accused of improper hand washing or any other practices?  Ideally, complaints should be received by one person with authority to address most of them without seeking approval.

 Staff not in a position to resolve the issue themselves could say “This sounds important.  May I transfer you to my supervisor so this can be addressed right away?”  If there’s no immediate resolution, inform the person there’ll be a delay and explain why.  This shows that the practice does care about the matter and is not just sweeping it under the rug.  It’s important that from wherever the complaint is coming from that it be handled with tact and the person with the complaint is being heard.

 At the end of the two weeks or up to one month period that your practice has been tracking complaints and issues, it’s good to go over with the entire staff the results of what was recorded.  This is a good time for the entire staff to work together as a team and find ways to resolve issues and also to help the office to run smoother and have it be everyone’s goal to have less complaints.

 Also a practice that is thriving is usually an office that has a high referral rate.  It’s very important that other physicians that call the office or refer a patient be treated with the up most respect and dignity because they will be more likely to  refer patients.  Some practices even have a separate phone line just for physicians.  This is so that they will not be on hold for a long period of time.

 Remember, more carriers are implementing pay-for-performance programs, and patient satisfaction is a heavily weighted element.

How to Handle Patient’s That Haggle Over Their Bills

With patient’s having a harder time than ever affording health care, news media and consumer publications are running stories and articles on how to haggle with doctors over their bills.  So what does a physician do to respond to patient’s who have read the articles and watched the news media?

 The solutions will vary depending on the practice, but generally, if a patient expressed financial concerns before care is provided, physicians can consider whether lower-cost options are available without actually discounting their services.

 Some patient’s have even made it clear up front that cost is an important factor in medical care decision-making.  Some of these articles have advised patient’s to ask for discounts if the bills are beyond what they can afford.  Experts say practice’s should be prepared to negotiate by following well established procedures.  It’s very important to consider any practice that may violate government regulations and third-party contracts.

 The first step is to determine who should you go into negotiations with?  Would it just be patient’s who don’t have insurance, or for some, have insurance coverage but have a high deductible health plan.  Discounts on co-pays and deductibles for insured patient’s may be possible depending on the practice’s contract with the third-party payers.  Some patient’s need to understand that physicians are already taking a cut from what they receive from the insurance company.  Some patient’s either don’t know that or understand it, so it should tactfully be explained.

 Other questions to consider are:  Who will handle the negotiating process in the office?  Will a patient’s word be good enough?  Practice’s should decide what discount is possible if a patient needs to spread payments over several months.  A patient may be able to pay part of the balance on the spot.  A prompt-pay discount is common, because a medical practice saves money on billing if a patient takes care of a charge before leaving the office.

 The amount of a discount that allows a patient to pay his or her bill but keep the office financially secure needs to be determined.  Practice’s should not just look at their fee schedule but also determine how much it costs to provide certain services and you need to know what a reasonable discount is.  The practice also should have a collection policy in place that tells the staff under what circumstances they can negotiate.

 The next step is to decide how these policies will be implemented and communicated to the patient’s.  Possible ways are adding wording or signage or patient forms that says if a patient has difficulty paying a bill, he or she should bring the matter up with a staff member.  Advertising specific discounts is not recommended but the wording makes it the patient’s responsibility to start a conversation.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

Click here to read testimonies regarding MariAnn Medical Billing Service

Preventing the Spread of Germs Helps to Keep Your Employees on the Job

This time of year brings new business to many clinics, because it is flu season.  The front lobby is usually filled with sniffing kids, or coughing adults with aches and pains.  The only problem is that many of your employees may be missing work for the same reason.  Your employees may be getting sick from the patients they interact with on a daily basis.

It’s so hard when you have a lot of patients coming in and out of the office, some are ill, some not, but no matter what; there are germs in the air.  Especially when cold and flu season hits.  Not only are the employees exposed but other patients as well as the physician.  Most medical practices these days are short staffed as it is, so when one employee is out sick, it impacts the whole office.

Some offices offer a “play area” for children in their offices.  They can include, games, toys, books, even a small kids table with chairs.  This can be the perfect environment for germs to be spread from child to child but also for the employees who clean up the area at the end of the day.  There are little germs lurking around those toys and many areas that are not cleaned but missed.

One way to eliminate this problem would be to take away the “kids play area”.  Also by placing hand sanitizer dispensers in different parts of the office, especially the front desk.  Also signs can be posted reminding patients to cover their sneezes and coughs.  Some offices even have a designated area for patients that are ill and patients that are well.  Some offices have even tried to schedule patients that are ill in the morning and well patients in the afternoon during cold and flu season, with the patients consent to avoid any spreading of germs.

Areas where there is heavy contact such as phones, desks, computer keyboards, copy machines, it would be good to use a anti-bacterial solution to wipe these items down every day.  A sign on the back of a patient restroom also would help in reminding them to wash their hands after using the restroom facilities.

Many discount stores offer great deals on anti-bacterial products which the office can stock up on to keep germ free as much as possible.  These are small measures that can be taken to keep everyone healthy in your medical practice which keeps the office running smooth and efficient.


Releasing of Medical Records

Many medical practices receive on occasion a Subpoena from an Attorney requesting patient’s medical records.  Most likely it will be received via fax, email or mail.  Most often included is a signed release from the patient allowing the records to be released to the Attorney that is requesting them.  Should your practice take that as the O.K. to send the records?

One Medical Practice did, only to find out it had been duped by someone claiming to be an Attorney to get the patients information.  The practice went through a costly legal battle in connection with a HIPAA violation.

If the requestor is not the patient, there appears to be no clear authorization or legal basis for the request, or if the matter does not pertain to treatment or payment, then it is illegal to release the information.

Patients have every right to put restrictions on who can have access to their information.  For example, some employers require an employee to have a physical examination.  A double-check with the patient as to if the employer should have access to the records and always have a written consent from the patient.

It get’s even more serious when the medical information pertains to mental health, substance abuse, reproductive health or genetic issues and also patients that are minors.  Legal experts recommend that you should ALWAYS get the patients signed permission for any medical record request. 

Some suggestions as to how to streamline and protect your medical practice from any HIPAA violations.

(1)  Review your states law concerning medical record disclosures

(2)  Have staff members who are familiar with HIPPA guidelines handle all record requests and if they are not familiar, it would be advantageous for them to either be trained or attend a seminar to learn and implement the guidelines

(3)  Have EVERY patient, before being seen; sign a HIPAA privacy notice for their file

One recommendation from a medical practice was to have their own “Release of Records Form”.  Where the patient must come in and sign with a photo ID, then it’s witnessed by the person present and followed by the physician’s signature.  This covers all bases and helps to keep you within compliance of HIPAA guidelines.

Also a seperate filing system just for requests of medical records could be kept seperate from the medical file so it can easily be accessed.

Most medical practices would do well to implement these simple practices in order to avoid any HIPAA violations.


Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

Click here to read testimonies regarding MariAnn Medical Billing Service

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