SEO Basics for Doctors: Inbound Links

Lea Chatham July 26th, 2016

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Have you heard the term inbound links? Wondering what that means for your website SEO? Find out how to use inbound links to improve SEO from online marketing expert John Sung Kim in this short video. Tweet this Kareo story

 

Get more tips on how to create an effective and engaging website in this simple guide.

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A Frugal EHR Implementation: Is There Such a Thing?

Lea Chatham July 21st, 2016

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By: Lisa Eramo

Money isn’t everything … or is it?

Seventy-three percent of office-based physicians who haven’t yet adopted an electronic health record (EHR) say the cost of purchasing an electronic system is the biggest barrier, according to a 2014 report published by the Office of the National Coordinator (ONC). Other barriers include the following:

  • Loss of productivity (59%)
  • Annual maintenance costs (46%)
  • Finding an EHR to meet the practice’s needs (46%)
  • Adequacy of training (40%)

Here’s a closer look at the costs associated with purchasing an EHR and some tips on how to stay on budget during implementation. Tweet this Kareo story

Open your wallet … and your mind
The average up-front cost for an in-office EHR is $33,000, according to HealthIT.gov. Up-front costs for a web-based EHR are reported as slightly less at $26,000. However, these estimates don’t indicate what is included, and there can be a wide variation in expenses related to training, implementation, staffing, and patient load. Even with reduced patient load and some added staff costs, there are some EHR vendors that provide solutions at a far lower cost.

Still, there are both upfront and ongoing expenses when implementing an EHR. And many physicians are concerned about that impact and whether or not there is enough return to warrant the investment.

The good news is that with a little strategizing, physicians can make frugal decisions that won’t make or break their EHR implementation. Consider these five cost categories and tips for how to save money:

1. Hardware
Examples include costs associated with database servers, desktop computers, tablets/laptops, printers, and scanners.

Tips to save time and money:

  • Look for a cloud-based EHR vendor. These vendors manage all record creation, sharing, and storage over the Internet, thereby minimizing the costs associated with hardware and licenses while still providing many robust features. Cloud-based computing means there are also no costs associated with expensive in-house servers. Many cloud-based solutions are also mobile and can be used on less expensive devices, such as tablets and laptops.
  • Take advantage of tax write-offs. The federal tax code (section 179) includes provisions that allow practices to purchase up to $500,000 worth of hardware and write it off during the first year.
  • Don’t have a sizeable amount of money saved for an EHR? Consider options such as leasing, a low-interest bank loan, or a low-interest line of credit.

2. Software
Examples include costs associated with EHR applications and upgrades as well as interface modules (e.g. lab interface module).

Tips to save time and money:

  • Look for an EHR vendor that provides automatic upgrades at no cost—or low cost—to the practice. Also remember that month-to-month subscription-based services can be more affordable because there are no up-front costs, and it’s easier for practices to budget a reasonable monthly fee.
  • Contact your medical association to inquire about additional vendor discounts.
  • Ensure that your EHR vendor is capable of sending diagnostic orders to the lab information system and receiving results for review and inclusion in the patient record. Without these capabilities, practices may face significant costs associated with interface design.

3. Implementation assistance
Examples include costs associated with hiring an IT contractor, attorney, electrician, and/or consultant support; chart conversion; hardware/network installation; and workflow redesign support.

Tips to save time and money:

  • Reach out to your nearest Regional Extension Center (REC). RECs are funded by the ONC specifically to help primary care physicians adopt and use EHRs. Center services include outreach, education, change management support, workflow redesign, and other types of technical assistance.
  • Network with other practices. Can you pool resources to fund a full-time IT position that can be split among each setting, for example?
  • Look for an EHR vendor that will provide free or low-cost implementation assistance with tasks such as data migration.

4. Training.
Examples include costs associated with hardware and workflow training for physicians, nurses, office staff members, coders, and others.

Tips to save time and money:

  • Look for an EHR vendor that provides a whole host of online help and teaching materials that staff members can access anytime and from anywhere. Ask to see examples of these training materials before signing the dotted line.
  • Ask for references. Ask other practices about their experience with each vendor. How easy was it to adapt workflows and learn the system? How accessible was the vendor before, during, and after the transition?
  • Look into tax credits for retraining. For example, Georgia offers a retraining tax credit of 50% of direct training expenses (up to $500 per full-time employee, per training program). The annual maximum of the credit amounts to $1,250 per employee. Other states may offer similar incentives.

5. Ongoing network fees and maintenance.
Examples include costs associated with hardware and software license maintenance agreements, ongoing staff education, telecom fees, and IT support fees.

Tips to save time and money:

  • Look for an EHR vendor that automatically includes a service package for ongoing support. What does this support entail, and how is it offered (e.g., via onsite, telephone, or email)?
  • Shop around. Take your time before choosing an IT consultant and network provider. You should feel confident that you’re getting a good deal.
  • Identify a super-user. This is someone in the practice who can attend ongoing trainings and then share that information internally. He or she can also troubleshoot as questions or problems arise.

For more tips on how to effectively implement your EHR to get the most of our it, download this helpful guide.

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal and AHIMA Advantage. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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8 Steps to Set Up Your Medical Practice Facebook Page

Lea Chatham July 19th, 2016

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By: Adria Schmedthorst

Social media has become a vital marketing channel in the healthcare world and your independent practice cannot afford to ignore it. While jumping into social media to promote your business may seem intimidating at first, it doesn’t have to be. Setting up social media accounts for your practice can be a simple, step-by-step process and a great place to start is Facebook.

Think of Facebook as a channel to connect with your existing patients and even bring in new ones by offering helpful tips and insights into what it is like to be part of your practice. It is also a good starting point for practice owners, since many people are already familiar with Facebook for their personal connections.

Don’t wait any longer to put this marketing mega-tool to use. Follow these simple steps and you will have your medical practice Facebook page up and running and reap the rewards. Tweet this Kareo story

Step #1 – Your Personal Account
If you don’t already have a personal account on Facebook, it is time to set one up because your business account will be connected to it.  By Facebook rules, you cannot have separate business and personal accounts or you risk having them both shut down. And, while you can set up a business-only page, without have a personal account, there are many limitations to these pages that make them far less attractive for use in marketing your practice. Just make sure that as the practice owner, your Facebook business page is connected to your own personal page. You don’t want to have it connected to the page of even a trusted employee because if they leave your practice, you risk losing access to your business page. To set up your personal account, just go to www.facebook.com and follow the instructions.

Step # 2 – Creating the Page
Once you have created and are logged into your personal profile, go to www.facebook.com/pages/create.php and choose the option “Local Business or Place”. It will then ask you to choose the category of your business from a drop-down menu. You will also choose a sub-category to further refine your niche, making it easier for patients to find you. Make sure to choose the categories that best fit your practice so that if, for example, a patient is searching for an urologist in San Francisco, they can easily find you.

Step # 3 – Choosing Your Facebook Page Name
Under the Category menu, you will be asked to enter the name of your page. This should be the name of your practice. However, if another practice with the same name already has that page it is time to get a little more creative. You might choose your practice name followed by the city you are in. Facebook gives you 70 characters to work with in choosing your page name, so you may have to tweak it a little. Just remember that once you have more than 200 fans or likes, you won’t be allowed to change your page name, so including the name of a provider, who might not be a permanent fixture in your practice, would not be a good choice. Select the box next to “I agree to Facebook Pages Terms” and click “Get Started” to move to the next step.

Step # 4 – Your Profile Picture
Your profile picture could be a photo of yourself, your staff, or your office. Choose what you feel your patients will connect with best because this picture will appear next to every post that goes into the news feed from your page. Facebook recommends a photo size of 180 pixels by 180 pixels. If you choose a picture that is larger, you can adjust the viewable portion by placing your pointer on the picture and clicking “Edit Profile Picture” and then “Edit Thumbnail”. Once you have your profile picture set, click “Next” to move on.

Step # 5 – The About Section
Be as thorough as you can in filling out this section. Here you will put your website address, your physical address, and describe your practice. Don’t skimp on your description here. Tell patients about yourself and your practice, and be sure to use keywords here to make your page as easy to find as possible. At this point, you will click on the button that says you are a real business and then click “Save Info”. You now have your own Facebook business page.

Step # 6 – Choose Administrators
Your page is up but you still have a few housekeeping tasks to take care of before you are ready to begin posting. First, you need to choose who will be responsible for adding content to your page. You can designate a Page Manager. Just remember that this person will have the right to send messages, create posts and ads, and review the reports generated by Facebook on your page. If you choose to keep the role of Manager for yourself, you can designate other functions such as Moderator or Content Creator for employees to limit access while still allowing your staff to handle some of the basic necessities.

Step # 7 – Review Your Permissions
To review your permission settings, click “Edit Page” then “Manage Permissions”. You will find these in the admin panel. Two key areas to check are the Profanity Blocklist, which should be set to medium or high, and the Message button. If you leave your message button on the default setting, patients can send you messages through your page. This is fine if you make sure to monitor your page. However, if you don’t plan to check your page regularly, change your default messaging so that patients will be able to reach you through your office email. You never want patients to message you and not receive a reply.

Step # 8 – Your Cover Photo
The final step before you are ready to begin posting is to add a cover photo to your business page. To do this, just click “Add a Cover” and upload a photo from your computer. You can position it the way you like and then click “Save Changes”. Facebook requires your cover photo be a minimum of 399 pixels wide. Most standard photos work well but sometimes the top or bottom of the picture may be cut off so you might have to try a few shots to find the one that looks best on your page. Facebook does have a rule that cover photos cannot contain more than 20% text, so just be aware of that and you can choose a picture that best shows off your practice to both new and current patients.

Now that you have your medical practice Facebook page up and running, you can “Like” your own page, start posting content, and send out emails to your patient community letting them know where to find your page. Remember that by its nature, social media is “social”. That means that once your page is up, it is vital that your practice is active, posting regularly, and providing timely, useful content, tips, and glimpses into your practice itself. Adding this personal touch can greatly improve how connected patients feel to you, your staff, and your practice.

For more tips on managing your online reputation, download this helpful guide.

About the Author

Adria Schmedthorst is a writer focusing on the medical device, technology, software, and healthcare industries. Adria is the founder of AMS Copy and a healthcare professional herself with more than 10 years in practice. She now uses her knowledge of the industry to help companies achieve their goals of writing content that speaks to the hearts and minds of medical professionals. She has been featured in blogs, written articles, and other publications for the industry, and ghostwritten books for doctors in both the United States and Australia.

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Get Updates on MACRA in July Getting Paid Newsletter

Lea Chatham July 13th, 2016

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The July Getting Paid Newsletter has updates on the impact of MACRA on independent practice along with some great medical billing tips. You can also check out recent events you may have missed as well as upcoming events you might want to add to your calendar. Plus, learn about other recent Kareo news. Read all this and more now! Tweet this Kareo story

 

 

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Video: Tips to Reduce No-Shows and Cancellations

Lea Chatham July 11th, 2016

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Are you plagued by no-shows like many practices? You can reduce no-shows and late cancellations with the simple tips in this short video. Tweet this Kareo story

 

Looking for more tips to keep your practice schedule full? Download this helpful guide.

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3 Tips to Use ERAs to Ensure You Get Paid Correctly

Lea Chatham July 11th, 2016

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By Lisa A. Eramo

In most practices, the billing cycle goes something like this: You code and submit the claim, receive and post the payment, and move on to the next task at hand. But how do you know whether each payer has actually paid the claim accurately and according to your contracted amounts?

 

The answer to this question requires practices to take a holistic approach to revenue cycle management that includes these three basic steps:

1. Use an updated fee schedule for all payers. This ensures that the practice has valid points of reference when assessing payment accuracy.

2. Review each and every electronic remittance advice (ERA) report that the practice receives. (Note: An explanation of benefits (EOB) is the paper version of the ERA). These reports provide helpful insight into how and why claims are paid or denied, such as:

  • Amount billed by the practice
  • Amount paid by the payer
  • Reasons for any differences between the billed and paid amounts
  • Recoupments related to claim re-adjudication or adjustments unrelated to a particular claim, such as interest or capitation payments

Providers must request an ERA through an enrollment process with each payer. The good news is that HIPAA requires all health plans to comply with these requests using the 835 transaction standard. Physicians can receive ERA reports for a variety of government and commercial insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield, Aetna, Cigna, Humana, United Healthcare, and many more.

Aside from monitoring the accuracy of payments, ERAs also help practices:

  • Automate payment posting within practice management systems
  • Reduce manual tasks associated with opening and filing mail
  • Automate secondary claims reporting
  • Facilitate a faster revenue cycle
  • Avoid the need to decipher proprietary payer remittance codes

3. Take action. Simply reviewing the ERA is not sufficient. Use the information gleaned to drive process improvement and ensure payment accuracy.

Three tips to use the ERA most effectively

How can practices use ERAs to monitor payment accuracy? Consider the following tips: Tweet this Kareo story

1. Give your practice a basic billing check-up. In particular, pay attention to these two types of codes listed on the ERA:

Claim adjustment reason codes (CARC). These codes identify the reason for a reduction or increase in payment from the original submitted charges. Some examples include:

  • The procedure code is inconsistent with the modifier used or a required modifier is missing
  • The time limit for filing has expired
  • Dispensing fee adjustment

Remittance advice remark codes (RARC). These codes provide additional insight into the specific reduction or increase in payment. Some examples include:

  • Equipment purchases are limited to the first or the tenth month of medical necessity
  • Only one initial visit is covered per specialty per medical group
  • Missing/incomplete/invalid other diagnosis

Monitor CARCs and RARCs as you receive them. Over time, categorize these codes to look for trends and to better understand of areas of vulnerability. For example, consider grouping codes into the following basic categories:

  • Additional information required—missing/invalid/incomplete documentation
  • Missing/invalid/incomplete data from submitted claim
  • Billed service not covered by health plan
  • Benefit for billed service not separately payable

2. Don’t assume that all payments are accurate. Ask the following questions when reviewing the ERA for paid claims:

  • Is there a contractual reduction? If so, is the amount consistent with the related fee schedule?
  • Does the patient responsibility amount account for the difference between the payment and the allowed amount?
  • Is there a remaining balance? If so, can you bill a secondary/tertiary health plan or the patient?

3. Work with your practice management vendor to enable automation. According to the AMA, 80% of ERA processing can—and should—be handled without human intervention. Ideally, practices would only need to review ERAs that their practice management system cannot automatically process. Can your vendor handle all ERA scenarios, including denials, underpayments, overpayments, multiple adjustments, automatic cross-over, secondary remittance, and reversals? Also ensure that your vendor can help your practice save electronic remittance reports to your computer in ANSI-835 format and export your ERA reports for use with other programs, such as Medicare’s Remit Easy Print software.

The ERA provides invaluable insight into payment adjustments, denials, and more. Is your practice taking full advantage of this resource? If not, what are you waiting for?

If you are looking for more places where you can look to improve your medical billing, use this Billing Best Practice Checklist to see industry standards and establish goals.

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal and AHIMA Advantage. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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MACRA Will Impact Small Practices

Lea Chatham July 11th, 2016

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By John Lynn

The MACRA (Medicare Access and CHIP Reauthorization Act) legislation is upon us and regardless of whether you love or hate government regulation of healthcare, MACRA is here to stay and is going to impact small practices in a big way. While Meaningful Use caused a pandemonium around EHR adoption, MACRA is going to have a much bigger long-term impact on the healthcare business as we know it.

For those not familiar with the MACRA legislation it’s broken down into two quality programs: MIPS (Merit-based Incentive Payment System) and APMs (Alternative Payment Models). The MIPS program rolls up PQRS, the Value-Based Modifier, and Meaningful Use (Medicare EHR Incentive Program) into one streamlined program. Plus, it adds a new program called Clinical Practice Improvement Activities (CPIA). The APM program rolls together a number of value-based healthcare programs including ACOs (Accountable Care Organizations) and PCMH (Patient Centered Medical Homes).

The MACRA legislation is the backbone of the efforts CMS is making to move healthcare to a value-based healthcare system. CMS has stated their goal is to have 30% of Medicare payment tied to quality or value through alternative payment models by the end of 2016 (already achieved) and 50% by the end of 2018. MACRA is the legislation they will use to reach this goal.

If you’re in a small practice and thinking this will pass, you are likely in for a rude awakening. Tweet this Kareo story

Not only will MACRA not just “pass”, but it will serve as the foundation for future value-based reimbursement efforts that CMS employs. Yes, this is just the start of the movement towards doctors spending time keeping patients healthy as opposed to doctors time being spent treating the chief complaint.

Plus, we’re likely to see other commercial payers follow suit soon. Each of them has stated similar goals to CMS. In fact, many payers are watching the MACRA legislation to know which elements they should consider implementing. Plus, CMS is even looking at ways to reward providers who are taking part in value-based programs from commercial insurers.

Once you break down the MACRA legislation, you’ll see that CMS has made real attempts to simplify and consolidate the previous legislation. One of the best examples of this was their decision to do away with the “all or nothing” feature of the previous programs. The MACRA program rewards organizations for their efforts even if they don’t comply 100% with every requirement. This is a big change that will make a lot of organizations very happy.

The other thing small practices should know about MACRA is that if they’ve been participating in PQRS, Meaningful Use, and the Value-Based Modifier, then MACRA will not be a huge leap to achieve. There will be some hoop jumping (welcome to government), but it won’t be that much harder than what you’re already doing.

The exciting thing about the movement to value-based care is that it’s the way most doctors really want to practice medicine. Most doctors I know would love to get off the fee-for-service treadmill. They dream of being able to spend time with patients really focused on their health. There will no doubt be a lot of bumps in the road on this journey, but MACRA is going to be CMS’s first step down that road.

If all of this makes your head spin, join me on Wednesday, July 13, 2016 at 1 PM ET (10 AM PT) for a free webinar where I’ll be discussing the MACRA program in detail along with what it means for small practices. Register now.

About the Author

John Lynn is the Editor and Founder of the nationally renowned blog network HealthcareScene.com. John also co-founded two companies: InfluentialNetworks.com and Physia.com. Plus, John is the Founder of 10 other blogs including the Pure TV Network and Vegas Startups. John’s 25+ blogs have published over 15,000 blog posts, garnered over 30 million views and had over 122,000 comments. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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Learn How MACRA Might Impact Your Independent Practice

Lea Chatham July 7th, 2016

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MACRA: What’s In Store for Independent Practices
Wednesday, July 13
10:00 AM PT, 1:00 PM ET

Get the scoop from John Lynn about the impact of MACRA on independent practices in this free webinar Tweet this Kareo story

 

MACRA has been the hot topic since the proposed rule was announced in May. Feedback is still being collected, but we have seen the proposal and many responses from leading industry organizations. Find out what we know now and what we expect see in the coming months.

In this free webinar, renowned blogger John Lynn will look at:

  1. Some of the components of MACRA, including MIPS
  2. What they mean by Alternative Practice Models
  3. The change from Meaningful Use to Advancing Care Information
  4. How these changes may impact smaller practices

Don’t miss this chance to get the latest update on MACRA to understand how it may impact you starting in 2017.

Register Now

 

About the Speaker

John Lynn is the Editor and Founder of the nationally renowned blog network HealthcareScene.com. John also co-founded two companies: InfluentialNetworks.com and Physia.com. Plus, John is the Founder of 10 other blogs including the Pure TV Network and Vegas Startups. John’s 25+ blogs have published over 15,000 blog posts, garnered over 30 million views and had over 122,000 comments. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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Infographic: How Outpatient Clinics Leverage Telemedicine

Lea Chatham July 6th, 2016

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Find out how outpatient clinics are leveraging telemedicine software in this infographic from Chiron HealthTweet this Kareo story

Telemedicine Infographic: How Outpatient Clinics Leverage Telemedicine Software

 

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Collect More Upfront to Improve A/R

Lea Chatham July 5th, 2016

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By: Adria Schmedthorst

Patient due amounts now make up 35% or more of your practice A/R, but only one-third of patient dollars are being collected up front. Once a patient leaves your practice, your chances of collecting all that you’re owed goes down dramatically. After 90 days, you will only collect 50%.

Improving patient collections can have a big impact on your long-term success. By collecting more up front and automating your collection process, you can significantly increase payments and reduce time in A/R.

The ideal patient collections process should look something like this: Tweet this Kareo story

  1.  Create a patient financial policy and ask all patients to sign at their first visit and every year thereafter.
  2. Verify eligibility at least once for every patient before every appointment, and ideally more than once.
  3. Collect copays and any outstanding balances at check-in, if information is available to help collect deductibles, co-insurance, or estimated payment, collect that as well.
  4. Set up credit card on file to process payments up to an approved amount. For example, patients can sign an authorization for you to charge up to $150. Once the patient due amount is known, charge the card, and send an electronic receipt.
  5. When credit card on file isn’t an option, send an electronic statement as soon as the patient due amount is known with a link to pay online.

Automating patient collections, especially with credit card on file, can significantly reduce your cost of collections. Some experts estimate that just credit card on file can reduce collection expenses to under 5% and reduce average days in A/R to less than 35.

Other tips that can help you create an efficient patient collections process include:

  • Compress your statement cycle: Don’t wait for a monthly cycle because monthly billing lengthens your A/R and reduces your chances of getting paid.
  • Provide online bill pay: Over half of consumers pay their bills online and 21% of patients say that online bill pay is the top feature you should offer.
  • Consider deposits for high-dollar procedures: High-dollar procedures are often planned giving you the time to determine the patient portion. By collecting a deposit prior to the procedure, you reduce the risk of not getting paid.
  • Offer electronic as well as paper statements: An electronic statement sent by email gets to the patient immediately, no waiting. This allows them to view the statement and pay right there on screen, making it more likely that you will get paid.
  • Use professional statements: Whether they are printed in-house or through a service, professional statements are more likely to be paid.

Using all of these tools will greatly improve your patient collections, but they will never be optimal unless you have a staff that is empowered and effective at collecting point-of-service patient payments. Asking for larger amounts of money can be difficult for some of your staff, who traditionally only needed to ask for small copays. According to patient collections expert, Cheryl Bisera, there are three things you can do to help your staff succeed at point of service collections:

  1.  Show how the patients benefit: Yes, increased point-of-service collections protect your profits, but it helps patients too. Knowing their responsibility up-front reduces patient frustration and protects them from unexpected expenses.
  2. Show staff the numbers behind the methods: Sharing the hard numbers to demonstrate how patient portions affect the practice revenue helps staff to see how their job directly contributes to the success of the practice.
  3. Back your staff up with patient-friendly tools and communication. Scripts, workshops, webinars, role-playing, and shadowing are all great ways to equip staff for positive financial conversations with patients.

For more tips to independent practice success, download 8 Ways to Keep Your Name on the Door.

About the Author

Adria Schmedthorst is a writer focusing on the medical device, technology, software, and healthcare industries. Adria is the founder of AMS Copy and a healthcare professional herself with more than 10 years in practice. She now uses her knowledge of the industry to help companies achieve their goals of writing content that speaks to the hearts and minds of medical professionals. She has been featured in blogs, written articles, and other publications for the industry, and ghostwritten books for doctors in both the United States and Australia.

 

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Welcome to Getting Paid, a weblog by Kareo offering ideas, news and opinions about medical billing and practice management with the goal of making medical billing easier and yes, getting you paid. Visit the Product Blog for more information on our products.

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