Ways To Prevent A Lawsuit

Many physicians if not all can attest to the fact that patients will complain.  It is one thing if a patient only complains about the office staff or the physician themselves; but how do you prevent a complaint into becoming a lawsuit? 

During a busy day in your practice, you may encounter patient complaints.  Sometimes the patient leaves without an answer to their problem or a remedy for their concerns, in turn they tell others about their poor treatment.  They may even report it to their insurance carrier and occasionally file a malpractice claim.

The office should have a written grievance process that provides an opportunity for the patient to reveal their problem and allow the physician the chance to remedy the grievance.  It is important for the office to post notifications for the patients to see, or you may want to give a copy to all patients that come in for a visit.  Make sure that it clearly states that the physician will review these grievances.   Another suggestion would be to have a suggestion box that is in view of patients so that they could make suggestions or complaints without having to identify themselves.  It is also important to post signage that gives patients a way to contact an office staff member, either by phone extension, email or phone if they have any complaints or concerns.  This helps to prevent these problems from escalating into something bigger.

The most common complaints are (1) prolonged wait time (2) rudeness (3) failure to communicate (4) failure to fulfill expectations from the exam (5) billing issues.

The top complaints are wait time and rudeness.  Physicians need to make sure their staff members are treating patients with respect and dignity.  The physician should also take the responsibility of how they manage their schedule as well as the office staff.  If the physician is behind in their schedule, this should be told to the patients as they arrive.  Also giving them an update on the wait time would help to ease patients and it gives them the feeling of being cared for and shows them that the office values their time as well. 

In a complaint regarding rudeness, an office manager or physician should address this issue immediately and not let it go on for a period of time hoping it will stop, it won’t, this needs to be addressed as soon as it is apparent.  Rudeness is something that is unacceptable and should never be tolerated by a physician.  Proper corrective actions towards the staff member need to be taken.

Good communication between staff members and patients along with the physician is key to a good working environment, not only for the staff but patients as well.

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 http://www.inscoding.com/aboutus.php

Click here to read testimonies regarding MariAnn Medical Billing Service http://www.inscoding.com/testimonials.php

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Financial Mistakes Doctor’s Make

With all the day-to-day activity that goes on every day in your practice, sometimes you may lose sight of the things that can jeopardize your finances.  These are four things that can affect your practice financially. 

1.  Trusting your money with your employees

The front office is an opportunity for someone to take advantage of payments being made.  Usually there are one or two people, which are in charge of collecting payments from patients.  It is very easy for someone to accept $75.00 in cash and only claim the patient paid $30.00.  It is always good to assign two people to handle all payments, one to accept the payment and one to double-check the payment once it has been received.  One way to also help with this problem is to hire an outside billing service.  This is a good way to have a good check and balance system.  Let the employees know that there will be periodic checking on the books that is done randomly.

2.  Investing in a product

Plenty of doctor’s have been tempted to invest in a colleague’s “great” idea. This could lead to a lot of problems. Even if the idea does go well, it usually takes over 20 years to see a profit.   One notable case was when a physician invested $400,000 and lost it all.  Too many doctors fail to do any research on the product or finding out what the company’s financial status is prior to making the investment.

3.  Not having enough Malpractice insurance

It may be very tempting to take the policy with the lowest coverage and premiums to save money but in the long run it is not a good idea.  Buying a policy that has good coverage that you can afford can save you from losing your life savings if ever you are found liable in a lawsuit against you.  “Occurrence” coverage is more comprehensive than a “claims-made” policy, but that blanket protection costs a lot more.

4.  Investing in high-tech equipment

The medical community is always on the fast track for developing new and better equipment for physicians.  Some doctor’s fall into the trap of buying some of these new products without testing them, researching them or even asking other colleague’s their opinion.  Some products are very helpful and end up being worth the investment; some though can be costly and not much different from the old product.  This leaves you left with a very expensive product and not much use for it.  It is best to do your homework and decide if it is worth the money and if it will truly make a difference to your practice.

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 http://www.inscoding.com/aboutus.php

Click here to read testimonies regarding MariAnn Medical Billing Service http://www.inscoding.com/testimonials.php

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Secrets to Boost Your Practice Profits

Secrets to Boost Your Practice Profits

Some key steps to make your practice a success are simpler than you think.  There are a few easy ways to cut costs and boost your profits.

1. Pay as little rent as possible

Besides payroll, paying rent is the biggest expense in your practice.  You don’t necessarily need a medical office building for your practice or the most luxurious location.  Consider sites such as a residential unit.  One physician bought a fourplex and he turned one of the apartments into his office and rented out the other 3 units to other medical practices.  By owning your property you don’t have to answer to anyone as to how you want to manage your space.

2.  Hire only a few employees

It’s always good to have a few good core employees.  Assign positions to each employee along with having them multitask and share responsibilities.  Have them all work as a team and back each other up when needed.  Treat these employees well because they set the tone of the office and you want them to be satisfied in their job which makes for a better work environment for everyone.

3.  Send ALL claims electronically

This should be the ONLY way to send a claim for processing.  Sending claims on a “claim form” is the old way and not efficient.  You can receive payment from some insurers within 5 working days, and few take no longer than 2 weeks.  This keeps a good flow of payments coming in.

4.  Good Service

Make sure you offer good care and service to your patients.  This keeps your patients coming back and recommending you to their friends and family.  Don’t make your patients wait.  If they do have to wait, apologize to them.  Call the next day and see how they are doing.  Also report back to them with any test results promptly.  In addition leave room for same day appointments to accommodate patients that need to be seen right away.

5.  Cultivate relationships to generate referrals

Making friends and relationships with your medical community is also a good way to generate referrals.  Consulting with them will result in more patient referrals.  As discussed before, offering good service will eventually get back to the physician that referred them and in turn this will make the physician more comfortable in referring more patients to you. 

6.  Create a Niche

Consider doing wellness medicine, which widens the scope of potential patients to include everyone. Develop a subspecialty such as geriatrics, thyroid disorders or diabetes.  Get into occupational health, offer driver’s physicals, and worker’s compensation for minor injuries, drug screening or pre-employment physicals.  Spend the money to advertise for these services and you will see your practice grow along with your profits.

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 http://www.inscoding.com/aboutus.php

Click here to read testimonies regarding MariAnn Medical Billing Service http://www.inscoding.com/testimonials.php

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Keys To Keeping Good Medical Records

Medical records are an important part of any medical practice.  Keeping good records is essential in avoiding an audit or possibly not getting payment from an insurance company.  Several auditing groups include, licensing boards, payers, litigants, accreditation organizations, each one is looking for specific things in the documentation.  Licensing boards want to find out if the doctor acted within his or her scope of practice or if they were grossly negligent.  Payers want to determine if a claim is justified for reimbursement.  Litigants want to know whether a breach happened during care.  Accreditation organizations want to determine if their standards and elements of performance have been met by the doctor.

These are some general requirements for documentation.

  1. Medical Records should be complete and are legible.
  2. Documentation of each patient that is being seen should include a reason for the visit and a history that is relevant to the complaint, physical examination findings and any prior diagnostic test results, a full assessment and clinical impression and diagnosis, a plan for care and date the record along with signature of attending physician, nurse etc.
  3. Reason for ordering tests.  If this is not recorded, it can be easily proved that it was not necessary.
  4. Past and present diagnoses whether it be from the patient or other past office visits from other physicians.
  5. Appropriate health risk factors should be identified and noted.
  6. Patient’s progress, response to changes in treatment, and a change of diagnosis should be clearly documented.
  7. The CPT and ICD-9 codes reported on the insurance claim form should always be supported by the documentation in the medical record.

Meeting the standard of care medical records must:

  1. Document any details regarding a patient’s history during the exam
  2. Document referrals
  3. Document refusals of treatment and the reason the patient has refused treatment
  4. Document that the physician has clearly reviewed the possible consequences of refusing a specified treatment to the patient
  5. Document encouragement of the physician of healthcare maintenance and risk reduction (example: weight loss or smoking)
  6. Document advice that has been given to the patient (example: pink eye can spread to others in the family)
  7. Document patient noncompliance with treatment regimen or referral, including the patient’s reason for not complying and advice to the patient about the risk of failing to take the advice given.

Good medical record keeping is an important part of good business.  The consequences of errors can result in a denial of payment, audit, loss of contracts, accreditation or possible lawsuit brought on by a patient.  It may take longer to do but in the end it benefits you, your practice and most important of all your patients.

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 http://www.inscoding.com/aboutus.php

Click here to read testimonies regarding MariAnn Medical Billing Service http://www.inscoding.com/testimonials.php

“Like” us on Facebook at http://www.facebook.com/pages/MariAnn-Medical-Billing-Service/224754564210246 

 

 

How Do You Know If Your Practice Is On Target?

Many physicians are overwhelmed with their day-to-day activities and are not aware if their practice is doing well or is in need of some fine tuning.  Below are five key areas of concern that should be looked into and followed up on to see how the practice is flowing.

1. Overhead

Calculate your overhead rate which includes staff and general operating costs by the total revenue the practice is bringing in.  Do some research on other practices similar to yours and see if they are comparable.  If your overhead rate is higher than the average for your specialty, consider reviewing all the cost that are involved within your practice and see if there are areas where you can reduce expenses.

2.  How productive is your practice

It’s a good idea from time to time to check the amount of referrals you are getting every month.  Make a spreadsheet of all referring doctors and see where possibly there is a drop in referrals or you are seeing an increase in referrals for a specific doctor.  By a physician taking 10 minutes out of their day to call a physician to remind them of your practice and also thank them for referring patients in the past, this could generate future referrals for the practice.

3.  Access the practices financial situation

Start by calculating a net collection rate.  When you enter into a contract with an insurance company, you agree to take a contractual adjustment from your submitted charges.  The net collection rate tells you whether you are collecting the remainder of your submitted charges once the adjustment has been made.  Calculate your net collection rate.  It should be 97% or greater to ensure a healthy bottom line.

4.  Avoid unnecessary hospital admissions or ER Visits

Evaluate a one month period and calculate the number of ER visits and admissions that were avoidable or potentially avoidable.  If your practice has a high level of preventable visits and admissions, create a quality plan to expand continuity of care, transition management, and care outreach.  Track this over time by checking it on a quarterly basis, with the goal of reducing your practice’s rate to zero.

5.  Survey referring physicians and patients

Many offices now use a patient survey or referring physician survey to evaluate their practice better.  This could be something that could be e-mailed or mailed with a return postage envelope to patients and referring doctors.  It can be done unanimously to protect their privacy as well.  This is an excellent tool to use to find out what’s really going on with the practice.  This data can be analyzed and put into good use to further make changes within the practice to help it run better.

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 http://www.inscoding.com/aboutus.php

Click here to read testimonies regarding MariAnn Medical Billing Service http://www.inscoding.com/testimonials.php

“Like” us on Facebook at http://www.facebook.com/pages/MariAnn-Medical-Billing-Service/224754564210246