John Lynn Answers Your Questions about Medical Practice Websites

Lea Chatham May 21st, 2015

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Watch NowAs a follow up to his recent webinar, 5 Marketing Tips to Get New Patients Now, speaker John Lynn has answered the questions posed by participants about medical practice websites.

Q: Do you recommend asking/surveying current patients about what they would want to see on an updated website?
A: While it is always nice to get direct feedback from patients, it can be hard to get that input. I recommend asking your staff what questions they get most often and trying to address those issues and items on your website. Those are probably the things patients are looking for most. However, if you do want to also get direct feedback from your patients, I suggest doing it face to face as opposed to through some electronic survey.

Q: Do pictures of practice staff on the website have more impact than stock images? Tweet this Kareo story
A: I think it is great to use pictures of your practice staff on your blog and social channels since they’ll show the human element of your practice, but I’d use some caution on your website. This is often the first impression a potential patient gets of your practice so you want it to impress. Stock photography may be a better fit. However, if you can get professional high quality images of your practice employees, that can be a good option, but be sure the quality is there if you go that direction.

Q: Do you think practices should add a personal number for referring providers and patients on the website to increase accessibility?
A: Sharing a personal number like a cell phone with referring providers is fine and great way to strengthen those relationships but it may not be something you want to share across the board with patients. Use some discretion there. Provide it on more of a case by case basis as you are comfortable but don’t publish it for all to see. Also, keep in mind that when patients call you in off hours you may not have your EHR handy. So have a plan in place for documenting anything that needs to be documented to protect yourself against liability.

Q: Do you recommend reposting blogs from other sources? What about guest blogging?
A: There is some risk with reposting an entire post that your website will get a penalty from Google for what they call “duplicate content” that could do you more harm than good. To avoid this, consider just picking some key highlights from the other source to share on your blog. A paragraph or two is good and you can weave some text around it to introduce and close it out. Getting guest posts is a good strategy as long as they are high quality posts and relevant.

Q: How do you know if a website or SEO vendor is any good?
A: Always look at rating and references. Consider asking another person whose website and online marketing you like who they used. Ask a lot of questions and request that specific key metrics be set out in the contract as a requirement for full payment. If someone isn’t willing to provide references or work towards some specific objectives then look elsewhere.

About the Speaker

John Lynn is the Editor and Founder of the nationally renowned blog network John also co-founded two companies: and 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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The First PQRS Deadline of 2015 is Fast Approaching

Lea Chatham May 19th, 2015

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By Joy Rios, MBA

We’re well into the 2015 reporting year and from changes to the Meaningful Use program to ICD-10 implementation, there’s plenty to keep track of. Well, don’t forget about PQRS.

Providers have several reporting options to choose from, with criteria that vary depending on the choice. However, the decision, particularly for groups, must be made soon.

*cc = At least one Cross-Cutting measure must be reported

Groups must register as a group and commit to a reporting method for PQRS no later than June 30, 2015. Tweet this Kareo story

During registration, group practices must elect and commit to their reporting method for the 12-month period. Once a group has registered for 2015 as a PQRS GPRO, the group will not be able to withdraw its registration.

Remember, a group practice is defined as two or more eligible professionals (EPs), as identified by their NPIs, who have reassigned their Medicare billing rights to the organization’s Tax ID Number.

How do you know if you should use the group practice reporting option (GPRO)? If your organization is multi-specialty and has 25 or more EPs, the GPRO Web Interface is a possible candidate. But so is registry reporting and EHR-based reporting. Also, will you have the option to include patient satisfaction surveys in your report.

There are instances where a group may be eligible to report using the GPRO, but decides not to. These circumstances may sway a group to have EPs report individually rather than with the group practice:

  • If an EP’s best performance rates are with quality measures included in a Measures Group
  • If collecting data is particularly burdensome, reporting a Measures Group (which relies on a 20-patient sample) might be a better option
  • If only non-PQRS measures are applicable to the provider, an individual EP may consider reporting through a Qualified Clinical Data Registry (QCDR)

If a group decides not to report PQRS as a group, CMS will still calculate a group quality score for the purposes of determining the Value-based Modifier, but only if at least 50% of the EPs within the group report measures individually and avoid the 2017 PQRS payment adjustment.

The consequences for non-action are steeper than ever. EPs and groups who decide not to participate this year will see an automatic -2% payment adjustment for PQRS in 2017 and CMS will tack on an additional -2% or -4% payment adjustment for the VBM, depending on the size of the organization.

About the Author

Joy RiosJoy Rios, MBA, is a Certified Healthcare Technology Specialist and a subject matter expert in both Meaningful Use and EHRs. She has a unique talent for distilling forbidding materials down to the information providers need to succeed. Joy develops EHR training programs, authors Meaningful Use and PQRS coursework, and is a regular contributor to the HITECH Answers publications. You can learn more about her work at or follow Joy on Twitter @askjoyrios. If need help navigating the PQRS maze, pick up a copy of ABC’s of PQRS: Your 2015 Guide to Successfully Participating in the Physician Quality Reporting System, and save 20% off the list price with the code: RIOSPQRS.

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New ICD-10 Guide Now Available for OB/GYNs

Lea Chatham May 14th, 2015

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Download NowThe new eBook, ICD-10: How to Transition Your OB/GYN Practice is now available for download.

While all HIPAA-covered entities need to make the change to ICD-10, the changes to coding and documentation are not the same for every specialty. Each specialty has it’s own unique new codes and documentation requirements for those codes.

For example,for OB/GYNs, the requirement to provide anatomical site or location plays out differently than it might for a pediatrician. If a patient presents with endometriosis, physicians must document precisely where the endometriosis has occurred (i.e., the uterus, ovary, fallopian tube, pelvic peritoneum, rectovaginal septum and vagina, intestine, in cutaneous scar, other endometriosis). Without this specificity the encounter must be coded as unspecified.

Some other changes that specifically impact OB/GYNs include:

  1. Documenting the specific trimester
  2. Providing more specificity for annual exams
  3. Documenting the causes of pelvic pan
  4. Increased detail is required when documenting migraines
  5. Reason for fetus viability scans is required

These are just some of the changes OB/GYNs should be preparing for now. To find out more about these and other ICD-10 changes coming for OB/GYNS, download the eBook, ICD-10: How to Transition Your OB/GYN Practice.

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Free Webinar: Learn More about Kareo Medical Billing

Lea Chatham May 14th, 2015

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Register NowConsidering Outsourcing Your Billing: Check Out Kareo Medical Billing
Thursday, May 21, 2015
10:00 AM PT, 1:00 PM ET

If you are considering outsourcing your billing, don’t miss this webinar on how Kareo Medical Billing can help. Tweet this Kareo story

Many medical practices consider outsourcing their billing at some point. There are a lot of good reasons to look at this option, including staff changes, lack of qualified billers in your area, a complex specialty, and reimbursement changes like ICD-10. When opting to outsource choosing the right partner is critical.  

We’ll cover:

  1. What you should look for when choosing a billing service
  2. How your ICD-10 preparedness plays into the outsourcing decision
  3. The comprehensive solution available with Kareo Medical Billing Services
  4. The latest enhancements to Kareo’s cloud-based web and mobile software
  5. Kareo’s offering if you want to continue to do it yourself

Register now to learn new ways to use your website and social media to reach new patients.

Register Now

About the Speakers
Rossana Fernandez, Kareo Product Marketing Manager and Rachael Ibbetson, Kareo Sales Engineer both have a deep knowledge of Kareo Medical Billing and will walk attendees through the features and benefits and answer questions.

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Read Latest Tips & News in Kareo May Getting Paid Newsletter

Lea Chatham May 12th, 2015

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The May edition of the Kareo Getting Paid Newsletter has great tips on patient retention, ICD-10 success, and improving your medical billing. The newsletter also provides a chance to discover upcoming events, news, and resources from Kareo. Plus, learn about how to register for upcoming webinarsRead all this and more now! Tweet this Kareo story


Read Kareo Getting Paid Newsletter Now

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Free Assessment: What Is the State of Your Medical Billing?

Lea Chatham May 11th, 2015

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The quality of your medical billing can make or break your practice. An inexperienced biller, poor processes, or the wrong technology can all impact your bottom line. As a small business you can’t afford to have problems with your medical billing. Take this free assessment to get a detailed analysis of some of the key areas that impact your billing success. You’ll quickly be able to see if you need to make changes to processes, staff, or technology and even whether or not to consider outsourcing to improve billing quality.

Take this free medical billing assessment now to get a detailed billing report and see how you are doing! Tweet this Kareo story


Take the assessment now

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Hack Patient Retention with These 4 Tips

Lea Chatham May 11th, 2015

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Tweet this Kareo storyBy Molly Maloof, MD

Is your practice plagued with no shows, cancellations, and a schedule filled with blanks? Are your waiting rooms only half-filled? Well, let me ask you this question, do you have the contact information for all of your patients in a place that is easily accessible? I’m guessing it’s somewhere in your medical record going unused. In this article I’m going to teach you how to hack one of the most important things to a successful practice: patient retention.

I promise if you follow these instructions, you will be well on your way to marketing automation and this will keep your patients in your practice long-term. Tweet this Kareo story

Okay, so let’s get started.

  1. Make a list of the four most important data points you need for every patient:

    • Your patient’s name: If you don’t have a list of every single patient that has ever walked into your practice, you’re losing patients. Every single piece of communication needs to be personalized to them. Period. Look for a marketing solution that can do this automatically.
    • Your patient’s cell phone number: Patient’s don’t actually want to be called. Most of them would prefer to get a text message than a phone call from their doctor.
    • Your patient’s email address: Did you know patients check their emails on their phones an average of 34 times every day?
    • Your patient’s birthday: Who doesn’t love getting a reminder they are getting older? Just kidding. But, seriously, getting a happy birthday shout out from you is really sweet and says how much you care.

    It’s astonishing the number of doctors who do not have this information handy, and it doesn’t surprise me that their retention rates are so low. Task one of your staff to see if your EHR provides the ability to easily export this data. If it doesn’t, you can make an Excel spreadsheet, but it might be better to change your EHR!

  2. Automate Your Patient Appointment Reminders Via Email & Text: Now that you have your patient list, it is time to consider a solution that can automate your communications. This solution should allow you to quickly upload your patient data so you can send automatic reminder emails or texts and follow up requests to review your practice. Most patients don’t miss appointments because they don’t want to see you, they miss them because their lives are busy and they forget. Reminders can cut no shows in half.
  3. Schedule Their Next Visit Before They Leave the Office: Take a tip from the dentists who are GREAT at this: At every preventive visit, make a habit of scheduling the patient’s next annual visit before they leave the office. You save the time and hassle of follow up calls for recalls, keep your schedule filled, and with automated reminders, you can also make sure the patients show up.
  4. Send Out A Monthly Newsletter With Health Education & Practice Updates: If you don’t have a way to securely communicate via email to your entire patient panel, you are missing out on one of the easiest ways to reactivate patients–the monthly newsletter. In this newsletter you can explain all of the interactions a patient should be having with your practice including all services and touch points. This newsletter can be your conduit for teaching patients how to engage with your practice online through social media, making appointment requests, and receiving text and email reminders.

Automating patient communications and marketing is really very easy. I set up my own DoctorBase account in less than an hour. To see for yourself, schedule a DoctorBase demo.

About the Author

Dr. Molly Maloof is passionate about using technology to improve the lives of patients and health care providers. She graduated from the University of Illinois College of Medicine and was a pediatric resident in the Kaiser Permanente Oakland/Berkeley MPH program before making a career shift into digital health. She advises and directs early stage health technology startups with her carefully honed skills in communication, strategy, research, and product development. She is a licensed California physician and runs a boutique medical practice in San Francisco specializing in health optimization.

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ICD-10 Success Step 2: Financial Planning

Lea Chatham May 11th, 2015

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Kareo ICD-10 Resource CenterThe ICD-10 deadline is now only five months away. There is no time to lose in your preparations. As we continue our recap on the steps to ICD-10 success, we’re looking at the importance of financial planning to ensure your business can weather anything ICD-10 brings your way.

ICD-10 will impact your revenue—both now and after the transition. To make a successful transition requires thoughtful financial planning.

There are four basic steps to your ICD-10 financial planning: Tweet this Kareo story

  1. Planning for added expenses related to training and preparing for the transition. Because ICD-10 requires training, updates to forms, changes to workflow, and the purchase of new resources, it needs a budget. It doesn’t have to be fancy, but take some time to create a spreadsheet and list out all the potential expenses. The sooner you do this, the more time you have to spread out the costs.
  2. Identifying what you will need for cash reserves to protect your practice in the event of a reduction in revenue and productivity. Industry experts have suggested that denials could increase by as much as 200% after October 1. As a result, many believe that practices should have reserves to cover as much as 50% reduction in revenue for up to three months. You’ll need to set aside cash reserves or apply for a line of credit. You can’t predict how quickly or accurately claims will be paid. With money set aside you can be sure you can pay the bills no matter what happens.
  3. Looking at ways to contain costs and reduce expenses in case you do see a revenue shortfall. One way to set aside some savings or cover extra costs for ICD-10 is to reduce costs in other areas. It is always good to review expenses and look for opportunities to reduce them. You might be inclined to look at ways to reduce staffing costs–your biggest expense– but now is not the time for that. You’ll need all the staff and resources you can get. However, now is not the time to for bonuses or raises. Wait until after the transition. January 2016 is probably a better time to evaluate raises.
  4. Monitor claims closely after October 1. After the transition, one of the most important tasks will be monitoring your claims, watching for denials, and addressing them quickly. If your medical billing software has denial tracking or no response claim tracking, be sure to use it. Put in place a process now to monitor claims so it becomes a habit before October 1. Ideally, denials should be followed up on within a set window of time like 48 hours.

Recent studies have suggested the cost for small practices to transition to ICD-10 will be around $2000 – $6000. While this isn’t a huge amount, for a small business it isn’t a drop in the bucket either. Planning adequately will really help make this cost easier to manage. More importantly, ensuring that you have adequate savings will help your practice survive the transition. Get started now to ensure your financial security through October 1 and beyond.

For more tools and resources to help survive ICD-10 visits the Kareo ICD-10 Resource Center.

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5 EHR Benefits We Seem to Have Forgotten About

Lea Chatham May 7th, 2015

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Kareo EHRBy John Lynn

In the wake of $36 billion of government EHR incentive money, it’s been easy to focus solely on the “free” government MONEY and not all of the other benefits an EHR provides. Now that the government stimulus program has matured, it is worth taking a minute to look at some of the non-government benefits an EHR provides a practice.

In many cases you’ve likely even forgotten how much nicer something is in the EHR world as compared to the previous paper chart world. Tweet this Kareo story

I’m about to list off a number of EHR benefits. When you look through these benefits you’re going to tell yourself “These benefits are all so obvious!” In fact, that’s exactly the point of this post. Once you’ve adopted an EHR, you start taking these EHR benefits for granted. The benefits just become part of the status quo, and we forget to give the EHR credit for these efficiencies. That’s why it’s important to remember them.

Here are a few of the guaranteed EHR benefits:

  1. Legibility of Notes: Physicians’ handwriting has been the topic of many jokes. While it’s funny to joke about, it’s not funny if you’re the physician receiving one of those illegible notes or the billing office trying to get paid based on some illegible chart note. The beauty of an EHR is that the notes are all typed in a font that can easily be read. The whole issue of physician handwriting goes out the window.
  2. Accessibility of Charts: Charts are more accessible in an EHR in two distinct ways. First, the concept of a lost chart basically disappears in the EHR world. When you want the chart, you search by the patient’s name or other identifier and instantly have access to the patient chart. No more searching through the chart room, the lab box, the nurses’ box, the box on the exam room door, etc. for the lost chart. Second, the chart can be accessed from anywhere in the world. Gone are the late night phone calls which require you to drive to the office to view the chart. An EHR can be accessed anywhere you have Internet.
  3. Multiple Users Accessing the Chart: How quickly we forget the fact that only one person could use the paper chart at a time. In fact, entire workflows were created around the fact that two people couldn’t work on the paper chart at the same time. In an EHR, the nurse, doctor, front desk, HIM, and billing staff can all work on the chart at the same time.
  4. Disaster Recovery: Many people are afraid of disaster situations with their EHR. While this is an important topic, an EHR can be so much better in a disaster than a paper chart. If your chart room goes up in flames, what could you do? Not much. Your charts were lost. In the EHR world, you can easily create multiple backups and store them in multiple secure locations including secure offsite storage. This takes some thoughtful planning to do it right, but EHR makes it possible to store multiple copies of your data which minimizes your risk of lost data. This is so much better than a paper chart in a disaster. With a cloud-based EHR this redundancy is often built in, and there is little or nothing you need to do.
  5. Drug to Drug and Allergy Interaction Checking: Yes, we’ve had Epocrates in our pocket for a long time. That was a huge improvement over those stacks of books on the shelf. However, EHR takes that one step further. Your EHR knows about your patients’ list of allergies and the drugs they’re taking. These extra pieces of information can provide a much deeper analysis of any drug you’re looking to prescribe. I don’t remember a prescription pad ever alerting you to an issue with an allergy when you were writing the script.

Obviously this is just a small list of the guaranteed benefits. We could create an even longer list of the possible, probable, and future benefits of an EHR as well.  I’ll just cap it off with one simple example. How are you going to handle pharmacogenomic medicine on paper? It’s coming. The simple answer is that you’re not doing pharmacogenomics on paper. You’re going to need technology, and it will likely be connected to your EHR.

While I still don’t think we’ve realized all of the benefits that we could have (and many might say should have) from an EHR, we shouldn’t forget the many benefits an EHR has already provided. Far too often we evaluate our current EHR implementation against the perfect EHR as opposed to the alternative. EHR software has already provided a lot of benefits, but the most exciting thing is that we’re really just getting started. The future benefits will be even more impactful than the benefits we’re receiving today.

About the Author

John Lynn is the Editor and Founder of the nationally renowned blog network John also co-founded two companies: and 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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Radiology Coding in ICD-10: A Primer

Lea Chatham May 5th, 2015

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Kareo ICD-10 Resource CenterBy Lisa A. Eramo

When it comes to ICD-10, radiologists may be particularly vulnerable to denials if they don’t take the time to prepare. Tweet this Kareo story

Why? These practices often depend on documentation from referring physicians who may or may not include the specificity necessary to justify medical necessity for a particular test, says Betty Hovey, CPC, COC, CPB, CPMA, CPC-I, CPCD, director of ICD-10 development and training at the American Academy of Professional Coders (AAPC). This is problematic today in ICD-9, and it will become even more troublesome in ICD-10 when the code set demands more specific information. Hovey says radiology practices should focus on obtaining more specific documentation for the following diagnoses:

1. Bone fractures. Referring physicians must document the following (Note: Some fractures don’t require all of this documentation, but many of them do):

  • Whether the fracture is pathological (include the underlying cause, if applicable) vs. traumatic
  • Specific anatomical site at which the fracture occurred
  • Type of encounter (i.e., initial, subsequent, or sequela)
  • Laterality (i.e., right vs. left)
  • Alignment of the fractured bone (i.e., displaced vs. non-displaced)
  • Open vs. closed fracture
  • Type of fracture
  • Healing (i.e., malunion or nonunion, or delayed or routine healing)

For example, the following diagnostic statement is appropriate for an x-ray performed for a patella fracture: Displaced longitudinal fracture of right patella, subsequent encounter for closed fracture with nonunion. For more information about fracture coding and documentation in ICD-10, visit the American Academy of Orthopaedic Surgeons’ Website.

2. Limb pain. In ICD-9, limb pain maps to code 729.5. However, in ICD-10, referring physicians must specify the specific limb, where the pain occurs on that limb, and whether it is the right or left limb. For example, ICD-10 code M79.632 denotes pain in the left forearm.

3. Abdominal pain. Referring physicians must document the specific location of that pain (i.e., right upper quadrant, left upper quadrant, epigastric, right lower quadrant, left lower quadrant, periumbilic, or generalized abdominal pain). Ask physicians to distinguish between acute abdominal pain, abdominal tenderness, rebound abdominal tenderness, colic, and pelvic pain.

4. Congestive heart failure (CHF). Referring physicians must document the type of heart failure (i.e., systolic, diastolic, or combined) and whether it’s acute, chronic, or acute on chronic. For example, ICD-10 code I50.32 denotes chronic diastolic congestive heart failure.

5. Osteoarthritis. Referring physicians must document the specific anatomical location as well as laterality. The American Academy of Orthopaedic Surgeons provides more information on how to code and document this diagnosis properly in ICD-10.

Ensuring compliance
To prepare for ICD-10, consider the following tips:

  • Know the practices from which referrals are obtained. Compile a list of all physician practices that refer patients to your radiology center. Contact each practice to explain the importance of documentation specificity in light of ICD-10. Payers will likely deny unspecified codes. Physician orders for tests should reflect the same level of clinical detail that’s included in the physician’s own chart at the practice.
  • Ask for the information you need. Consider designing an order template that prompts physicians to document specificity necessary for ICD-10. Share this template with all referring physicians, and require them to use it when completing orders.
  • Track and trend your data. Does a particular referring provider constantly demonstrate non-compliance, resulting in time-consuming follow-up and resubmission of claims? Reiterate to these providers that eventually, the radiology center may refuse their patients simply because the center is unable to get paid for the services it performs.

For more ICD-10 news, updates, and tools, visit the Kareo ICD-10 Resource Center.

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She also works as a healthcare content specialist for Agency Ten22. 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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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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