5 Tips for Successful Patient Payment Plans

Lea Chatham March 27th, 2013

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By Rico Lopez, Senior Market Advisor at Kareo

Rico Lopez

During my consultant days, I gave my clients five tips for successful patient payment plans. Here they are:

  1. Always have a signed agreement. Have the patient sign an agreement with clear expectations that defines all the components laid out below.
  2. Choose a realistic payment amount and reasonable timeline. The patient can always pay more than the scheduled amount or pay earlier. Set the amount so the patient can realistically make the payment and it meets the practice’s minimum payment amount. The minimum payment amount is something the practice should set in advance for their staff to enforce. The timeline has to be acceptable to the practice as well.  The payment plan cannot be $1 a month for the next 100 months to pay a $100 balance. Along with defining the minimum monthly payment amount, the practice should also set a minimum balance to qualify for payment plans. Exceptions to these rules should only be approved by the office manager or the provider. If you find that you are getting too many requests for exceptions, then maybe you should revisit your minimum balance and/or payment amounts.
  3. Define consequences for failure to pay on schedule. There has to be a consequence if the patient doesn’t follow through with the agreement. For example, the total amount becomes due unless patient gets back on schedule or if you offered a discount, they lose the discount. The consequences should be clearly spelled out in the payment plan agreement in writing. This agreement is signed by the practice representative and the patient.
  4. Offer incentives to pay off total balance early. Offering incentives and discounts to pay can help you collect outstanding balances earlier in the payment plan. Always check your payer contracts to be sure you are in compliance with any discounts you offer. Each practice has to decide how much they are comfortable discounting, but determining the costs to collect outstanding balances over time (or in some cases, the risk of never collecting the full amount) is a good basis for determining an appropriate discount amount. Consider this, a balance that you fail to collect that is later referred and recovered by a collection agency may cost you 30-40% of the collected amount. The amount could be more when you factor in your staff time and printing and mail costs over time as well. You could lose as much as 50% of the original amount by the time you get paid. So would you rather dictate your discounts early on or have them decided for you down the line?
  5. Offer the discount at the end of the payment plan. If you do offer a discount, discount the last payment (not on total amount or first payment). If you discounted the whole balance up front and then they failed to comply, it is harder to add back the discounted amount. It is much easier to waive their last payment or give them 50% off the last payment. This also gives them more of an incentive to stay on schedule so they can get the discount at the end.

More and more patients are paying a larger amount out of pocket for their medical care. Being prepared with clear guidelines for patient payment plans, a template for an agreement, and strategies to motivate patients to pay their bills can help you collect those patient due amounts.

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Your Top 5 Medical Practice Marketing Questions Answered

Lea Chatham March 26th, 2013

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Laurie Morgan & Judy Capko

At the recent webinar, Medical Practice Marketing for Profitability, Laurie Morgan and Judy Capko of Capko and Company discussed many strategies for effectively marketing your medical practice. If you missed Medical Practice Marketing for Profitability, watch the recorded webinar to find out about Laurie and Judy’s great suggestions. They received many good questions and were unable to answer them all. Here are answers to five of the most common questions that were asked by attendees.

Q: I read in an article that Social Media use for medical patient communications is going to be the highest law suit for HIPAA Violations, since they are not well secure developed. What do you think?
A:  HIPAA applies to social media in the same way it applies to all aspects of your business. You need to follow the same rules. If you use social media, it is important to remember this and be careful not to divulge any information that identifies a patient or provides information about a patient. If a patient says something to you on Facebook for example, you will need to be ready to reply in a way that redirects the conversation to a secure location. You can say something like, I would like to discuss this with you please call my office.

Q: Can the Google programs be set up without activating the “reviews” portion?
A:  Unfortunately, no. A lot of people are concerned about this, but we really see it as an opportunity. First, it can give you a chance address legitimate concerns that will affect other patients’ perceptions of your practice—for example, if the scheduling process is causing complaints because it’s too difficult, or if wait times in your reception area are more of an annoyance than you realized. Studies also show that the majority of reviews posted about physicians are positive—and the negative ones are mostly related to fixable administrative issues—so, some of the fears that people have are misplaced. Finally, if there is a truly illegitimate review that has been posted maliciously, most sites provide a means to get those removed.

Q: What is the best way to connect with potential referring physicians? Lunch? Stopping by to drop off lunch? Phone calls?
A: This may depend on your practice (location, specialty, etc.) and who your referring providers are. Your goal is to build lasting relationships. Ideally, the communication should be between the providers (not staff). This could be a phone call or scheduling an in-person visit. If you are a new practice or you are adding new providers or services, you may want to host an open house lunch or other event to try to meet your potential referral network. Also, ongoing follow up through thank you cards, a small annual gift, birthday cards, communications about changes at the practice, etc. is important.

Q: How does your recommendation about gifts relate to Federal Anti-Kickback and Stark Laws which prohibits solicitation (including gifts) of referrals?
A: These regulations are designed to prevent you from “buying” referrals. They do allow you to provide nominal gifts. We generally say nothing valued at more than $50. We also suggest gifts that can be enjoyed by the entire practice staff and not just the provider. For example, a fruit or candy basket or a cheese cake from a great local bakery.

Q. When do we know we should cut off new patient intake?
A. This is a big decision. You need to be cautious because once you say you are not taking patients, this can backfire and cause your patient load to decrease. So be sure this is the right choice. Do a thorough evaluation of your schedule and make sure you can’t make changes to accommodate additional appointments. Be sure you are meeting all of your revenue and growth goals. And determine if this may be a time to consider building the practice by adding another provider as opposed to limiting additional patients. If after all this, you decide that in fact you are not taking more patients, then go forward.

If you found this information helpful, then you might also enjoy our next webinar, What You Need to Know about Meaningful Use Now.

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When Patients Won’t Pay…

Lea Chatham March 21st, 2013

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By Rochelle Glassman

In my recent webinar, 3 Innovative Strategies to Improve Collections, an attendee asked, “Can a physician refuse to see a patient if they have an outstanding balance and won’t pay or make arrangements to pay?” This is a patient collections question that required a longer answer than I could provide on the webinar. So here are my detailed recommendations.

In all patient challenges, the most important goal is to avoid a claim of patient abandonment and assure that patient care is not neglected. [1]Regardless of the reason for your issues with a patient, whether it’s unpaid bills, failure to follow advice, or mistreatment of staff, the same advice applies:

  1. Document any issues you are having with the patient. Make sure not to terminate a patient until there is evidence in the record of the problem(s). Patients should be provided with notice of such problem(s) and an opportunity to modify their behavior. If the particular patient’s issue is an unpaid balance, meet with the patient privately and discuss the issue. Can a payment plan be established? Can the patient demonstrate financial hardship that you are able to document? Document your meeting with the patient, the issues discussed, and the patient’s response.
  2. If no agreement can be reached regarding payment of amounts due, follow up in writing and let the patient know that unless a payment plan is established by a certain date, the practice will provide notice of termination.
  3. If efforts to establish a payment arrangement are still unsuccessful, you may need to terminate the patient. Always remember that the patient must be provided with sufficient time to find alternative care before termination from the practice. Reasonable notice can vary depending on the patient’s medical condition and the difficulty which a patient may have in finding alternate care. For example, I recommend that an oncologist not terminate a patient for nonpayment of medical bills until the patient has completed the current course of chemotherapy. Alternatively, a patient of an internist who simply comes in when he or she has a cold or other minor issue may require only 30 days notice. There may be state-specific laws regarding minimum notice periods and these must also be observed. It’s not your responsibility to make sure the patient has found a new physician, only to provide sufficient time for the
    patient to do so. However, in certain circumstances, there may certainly be ethical obligations to provide additional assistance to extremely ill patients to secure continued care.
  4. Termination of a patient from the practice should not interfere with your ability to turn over the patient’s bills for collection. However, at all times through the termination process and thereafter, it should be the goal of the practice to attempt to establish a payment arrangement with the patient and to determine if there is a documented financial hardship.
  5. In any notice provided to patients, make sure you clearly note the date on which they will no longer receive care and how they can obtain copies of their medical records. You should also offer assistance in locating a new physician, such as providing contact information for a state medical association or similar organization. The patient should understand that in the event of an emergency or urgent situation (which may depend upon specialty), the practice should take the necessary steps to assure the patient is properly cared for.
  6. Like any other business, physicians should not be required to continue to offer services without payment. However, in medicine it’s not all about the bottom line. Take the time to properly handle each patient and to assure their understanding and continued medical care in order to best protect your medical practice.

In my last blog post, I provided my 8 Best Practices for Patient Collections, which I also discussed in the webinar. For more great information about improving collections and shortening your revenue cycle, check out the recorded webinar.

About the Author:

Rochelle Glassman

Rochelle Glassman Our guest speaker is Rochelle Glassman, a passionate advocate for physicians and medical practices who has devoted her career to helping doctors get paid. Rochelle is the President & CEO of United Physician Services, and is a nationally recognized healthcare consultant known for her candor, tenacity, and vision.


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3 Easy Ways to Reduce Phone Calls into Your Medical Practice

Lea Chatham March 19th, 2013

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3 Easy Ways

Answering and fielding phone calls at your medical practice can take up a lot of time, especially in a small practice with limited staff. You may even be letting calls pile up on voicemail because you don’t have the resources to check in patients at the front desk and answer the phone every time it rings. Finding a way to more effectively manage phone calls is important from a time management perspective, but it is also a valuable piece of providing quality customer service. Most calls into the practice are related to follow up questions, scheduling, and prescription refills. So how can you both reduce the number of calls and increase your ability to be responsive to patients? Here are three easy ways to get started:

  1. Easiest: Provide patients with printed materials to take home. Give patients their educational materials, instructions, and/or visit summary before they leave. Ideally, the physician has reviewed this information and even highlighted some key areas for the patient. This allows the patient to review it at their convenience and get many of the answers to questions without calling back to talk to the nurse or provider.
  2. Easier: Tell patients what to expect. Let patients know when they should expect someone to contact them about tests results or other follow up and when they should return to the office for another visit. Then, have patients schedule their next appointments while they are still in the office.
  3. Easy: Get patients to call the pharmacy for refill requests. Many calls are related to prescription refills and a portion of those are refills that are already approved. Begin telling patients to always contact the pharmacy for refill requests. If there is a refill on the prescription it gets refilled right away and if not, the pharmacy can fax a request. Consider adding this request to your voicemail (i.e., if this call is about a prescription refills, please call
    your pharmacy directly). As patients get used to this process, call volume will begin to decrease.

One more thing to consider is implementing a patient portal. Many practices will be looking at this as part of attesting to Meaningful Use Stage 2, but there are other good reasons to get a portal in place. It allows you to provide patients with access to certain information and it enables patients to send secure messages to providers about their care. This can also help reduce phone calls while increasing patient satisfaction.

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8 Best Practices for Patient Collections

Lea Chatham March 14th, 2013

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By Rochelle Glassman

In my recent webinar, 3 Innovative Strategies to Improve Collections, I discussed collecting patient due amounts at the time of service as part of your medical billing strategy. I touched on patient collections and many attendees had questions about collections best practices for past due accounts. Here is my detailed guide for best practices on turning patients over to collections.

Whatever collections efforts you make, one rule always applies: Get busy as soon as possible and stay on the account until you’re paid. Send bills promptly and re-bill monthly. There’s no need to wait for the end of the month. Send past due notices promptly once an account is overdue.

  1. Don’t harass. Don’t harass people who owe you money, but let them know that you follow these matters closely. Don’t leave more than one phone message per day for the debtor (person responsible for payment), and never leave messages that threaten the debtor or contain statements that put the debtor in a bad light.
  2. Be direct, listen, and don’t get personal. Keep your calls short and be specific. Your goal should be to prevent the debtor from taking the call personally—that is, from associating the failure to pay as meaning a failure in life. Always stay calm but maintain a sense of urgency about getting paid.
  3. Get creative. If the customer has genuine financial problems, ask what amount they can realistically afford to pay. Consider extending the time for payment if the customer agrees in writing to a new payment schedule. Call the day before the next scheduled payment is due to be sure the customer plans to respect the agreement.
  4. Write demand letters. Along with phone calls, send a series of letters that escalate in intensity. Save copies of all correspondence with the customer and keep notes of all telephone conversations. You may need these if you hand the matter over to a collections agency or take the customer to court.
  5. Use a collections agency to send letters. You can pay a collection agency a fixed fee to write a series of letters on your behalf. This is different than turning over the debt to an agency. For example, Dun & Bradstreet Small Business Solutions (http://smallbusiness.dnb.com) will write a series of three letters for under $30. They will also make telephone collection calls on your behalf. Other companies such as Transworld Systems (www.transworldsystems.com) and
    I.C. System (www.icsystem.com) offer similar services.
  6. Offer a one-time deep discount. If an account is fairly large and remains unpaid for an extended period (say six months) and you’re doubtful about ever collecting on the debt, consider offering in writing a time-limited, deep discount to resolve the matter. You can finalize this with a mutual release and settlement, a legal document that terminates the debt.
  7. Have the Patient/Guarantor sign. Have a clause on the patient/new patient forms that states that any charges not covered by insurance are the responsibility of the patient/guarantor, including any collections fees incurred if turned over to collections.
    Example: In the event that your insurance is not valid or your coverage was terminated at the time the services are rendered, you will be solely responsible for the full amount of your office visit and/or any procedures rendered. In addition, if your insurance plan determines a service or procedure to be “not covered”, you will be responsible for the complete charge of such services. I agree to be responsible for the payment of all unpaid services rendered on my behalf or my dependents, including any fees for collection service needed.
  8. Turn the account over to a collection agency. Turning a debt over to collections is your last resort. A collection agency will usually pay you 50% of what it recovers. Of course, in some cases, half is better than nothing. Dun and Bradstreet Small Business Solutions, and the similar business services Transworld Systems and I.C. System, all offer debt collection services. The Commercial Collection Agency Association (www.ccascollect.com) provides more information on debt collection agencies.

In my last blog post, I answered the Top 5 Questions from attendees at the webinar. You can also check out the recorded webinar to get all of the great information provided there.

About the Author:

Rochelle Glassman

Rochelle Glassman Our guest speaker is Rochelle Glassman, a passionate advocate for physicians and medical practices who has devoted her career to helping doctors get paid. Rochelle is the President & CEO of United Physician Services, and is a nationally recognized healthcare consultant known for her candor, tenacity, and vision.

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Complimentary Webinar: Medical Practice Marketing for Profitability

Lea Chatham March 13th, 2013

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Wednesday, March 20, 2013
1:00 PM EDT/10:00 AM PDT
Speakers: Judy Capko & Laurie Morgan

Is your practice facing increasing competition? You’re not alone! Consolidation, higher health plan premiums, and big changes from the Affordable Care Act mean most practices are facing more challenges than ever in attracting, retaining, and satisfying patients. It’s not easy … but, with great challenges come great opportunities. By learning how medical practice marketing can positively impact your practice – and how every aspect of your practice can help you market better – you’ll be ready to take advantage the flux in the market to grow your practice and be more profitable. Join Judy Capko and Laurie Morgan of Capko & Company, as they help you:

  • Expand your understanding of marketing: it’s much more than promotion and selling!
  • Understand the lifetime value principle
  • Identify and serve your different customer bases – online and off
  • Build a marketing plan that blends the best of old-school and new-school techniques
  • And more

Register today!  You don’t want to miss this.

Who Should Attend
Private practice owners, physicians, practice managers, office managers and others concerned about improving medical practice revenue.

Register now to learn about the benefits of medical practice marketing

About Your Speakers:

Judy Capko & Laurie Morgan

Judy Capko and Laurie Morgan are practice management and healthcare industry consultants with Capko & Company. Judy is the author of Secrets of the Best-Run Practices, a best-seller in the healthcare market. Her consulting focus is on building patient-centered strategies, improving leadership and valuing staff’s contribution. Laurie Morgan managed both start-ups and large-scale operations in the media industry before turning her focus to medical practice management. Her consulting focus is on driving and capturing revenue and operating more efficiently. Laurie has an MBA from Stanford University.

Register now to learn about the benefits of medical practice marketing

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Kareo Newsletter Is a Medical Practice Management Must Read!

Lea Chatham March 12th, 2013

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The March edition of the Getting Paid Newsletter is out. This month’s issue is full of great medical practice management topics and tools from EHR implementation to patient flow tracking. Laurie Morgan, MBA, reviews some simple techniques to get started marketing your medical practice. Ron Sterling, an EHR expert, reviews the 6 Features Small Practices Need when selecting an EHR. And, Rico Lopez, Senior Market Advisor at Kareo, guides you through an analysis of your patient flow and how to know if it is hurting your medical practice. In addition, there is information about our upcoming free webinar, Marketing for Medical Practice Profitability, and a chance to win $150. So, if you haven’t already read it, check it out now!

March 2013 Getting Paid newsletter


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Focus Your Medical Practice Marketing on Profitability

Lea Chatham March 11th, 2013

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by Laurie Morgan, MBA, Capko & Company

Starting up—or changing up—your medical practice marketing program can be intimidating, especially in the current economic climate. With profitability under greater pressure, marketing your practice well is more necessary than ever, but the prospect of wasteful mistakes is even more nerve-wracking. What’s more, with a wider array of marketing options—and demands on staff—it’s a challenge to prioritize your activities.

One way to gain confidence in marketing your practice is to begin to prioritize your activities from the most basic and pressing (if you’re slow or just starting out, that’s getting patients in the door immediately!) to the most complex and strategic (protecting against longer-term threats from competition and changing payment structures). Understanding where you are in the process can give you a sense of how to respond.

For example, if you’re still under-booked, it’s quite possible you’re missing out on prospects who could have found you online passively—either via a Google query, a search of their health plan’s directory or a physician listing/rating site like Healthgrades. Tidying up your online information costs virtually nothing, ensures you’re not missing out on business that would have come your way organically, and is easy. It’s a great place to start if you’re new to marketing, and a habit that all successful practices should incorporate into their marketing routines.

Getting a grip on online information is just one quick, easy, and low-cost/high-impact way to improve your practice’s marketing, and build the confidence to expand your efforts. If improving your marketing —or starting marketing —was on your resolution list for 2013, it’s not too late to make good on your vow! For more actionable tips and ideas for how to market your practice cost-effectively, join Judy Capko and Laurie Morgan of Capko & Company for their lively webinar, Medical Practice Marketing for Profitability, on March 20. Register here.

About the Author
Laurie Morgan

Laurie Morgan is a practice management and healthcare industry consultant with Capko & Company. She managed both start-ups and large-scale operations in the media industry before turning her focus to medical practice management. Her consulting focus is on driving and capturing revenue and operating more efficiently. Laurie has an MBA from Stanford University.

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Top EHR Features Small Practices Need

Lea Chatham March 11th, 2013

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By Ron Sterling

The electronic health record (EHR) decision is one of the most important decisions that you will make for your practice. It will dramatically impact the way your practice operates and how you interact with patients and other healthcare providers. Although the selection and implementation of an EHR challenges any size practice, it is especially problematic for the small practice with few resources and no margin for error. Indeed, a failed EHR can strategically damage your practice.

Small practices have limited, if any, technology support. Few small practices have in-house technical resources. Even if the doctor is technology savvy, you cannot depend on the doctor to support the rest of the practice when the doctor is seeing and serving patients. To avoid mistakes and problems, you should consider the following features in your EHR selection process:

  1. Certified EHR: If an EHR is not certified under the Meaningful Use Measures, then the marketability of the product is limited. Note that a small practice cannot buy a product on a certification promise, but a completed certification process. Be especially careful to ensure that the EHR vendor has a solid plan to meet the updated requirements of Meaningful Use Stage 2.
  2. Vendor Stability and Commitment: Small practices cannot afford the expense and disruption of switching EHR products every couple of years. Therefore, the stability and longevity of the EHR product and vendor are key criteria. Both of these factors are highly subjective, but even more important. Valuable indicators include:
    - Installed base of the EHR is growing. New users are attracted to more effective and improved products. If a vendor is not attracting new users, the small practice should not consider the product.
    - Verifying that the product is being enhanced and improved. For example, verify product improvements in recent release notes and the planned improvements for the next release. If the vendor is being evasive, or the release notes do not have substantive improvements, the vendor may not be making the investment in the EHR to remain competitive and viable.
  3. Usability: Smaller practices are particularly sensitive to usability and ease of use issues. The typical small practice lacks the staffing level and additional resources needed to assist users with complex products and obscure use issues. As important, the smaller practice cannot afford a drop in productivity or limitations for patient access that may result from a less user friendly EHR. The key problem is that user friendliness is in the eyes of the beholder. The doctors need to see the product in action and test the EHR to verify that the design and flow of the EHR works with the physician’s thinking and work habits. For example, some EHR systems are based on a library of clinical findings while other EHRs are based on formatted screens of information. Some doctors may be more attracted to one over the other.
  4. Clinical Content: Clinical content is the specific checklists, documents, and tools that support your area of medicine. The best way to check on the applicability of the EHR’s clinical content is to present sample notes from actual patient records to be documented in the EHR during your demonstration. Note that clinical content requirements can be very specific. For example, the clinical content needs of a spine surgeon are significantly different from the clinical content needs of a general orthopedic doctor.
  5. Technology Base: Small practices have the option of installing an EHR in their practice or using an EHR over the Internet also referred to as a cloud based or application service provider (ASP).  As a practical matter, ASP or cloud-based EHR products are an attractive option for the small practice for a number of reasons:
    - Cloud/ASP EHRs allow you to minimize the upfront costs of hardware and licenses.
    - Cloud/ASP EHRs manage and deal with electronic exchanges of information with labs, pharmacies and others for your practice. For example, the cloud/ASP vendor will maintain appropriate electronic links to send out lab orders and retrieve results. Practices with in-house EHRs must monitor such exchanges.
    - Cloud or ASP EHRs address a number of HIPAA Security issues to maintain the availability of records that are not economical for the small practice. For example, many cloud-based EHRs have redundant equipment and uninterruptible power for their data centers. Your practice does need to address communication with the cloud or ASP as well as workstations, tablets, printers and other equipment, but the heavy lifting is covered in your monthly fees.
  6. Online Help and Assistance: Small practices also need an EHR that has excellent online help and teaching materials. Due to the limited resources, small practices need training strategies that include online videos and materials that can be accessed at any time. As important, the online materials have to be complete and concise. Of course, you also need a vendor help desk that is staffed with people who can address your problem at the appropriate level of sophistication and target the problems of your type of practice.

EHRs have a wide range of features and capabilities to address the clinical and operational needs of your practice. Focusing on the key issues will help you select an appropriate product without getting distracted into areas that may confuse your process and, in the worst cases, lead to an inappropriate decision.

About the Author

Ron Sterling
Ron Sterling publishes the popular EHR Blog Avoid-EHR-Disasters.blogspot.com, and authored the HIMSS Book of the Year Award Winning Keys to EMR/EHR Success. He is an independent EHR consultant. Find out more at www.sterling-solutions.com.

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Take Control of Your Patient Flow! (Part 1)

Lea Chatham March 11th, 2013

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By Rico Lopez, Senior Market Advisor at Kareo

Rico Lopez

Is your practice a “well-oiled machine” where patients flow effortlessly through or is it a daily struggle just to get all your patients seen by your providers without any complaints (from patients and staff)?

Throughout my career, I have seen very few thriving practices operating efficiently enough that providers go from exam room to exam room with just enough down time at the right moments to catch up with their charting and at the same time, patient wait times are minimal and established patients are in and out of the office quickly.

Make no mistake; this did not happen by chance or by accident. These practices put in the time, effort, and commitment to run their booming practices as businesses by understanding the needs of their customers (patients) and maximizing their resources (providers, staff, and equipment) while delivering quality patient care.

How does inefficient patient flow affect a practice?
A practice having issues with patient flow is impacted in a few ways and all of them directly impact your bottom line:

  • Provider Time Not Maximized = Lost Revenue
  • Patient Dissatisfaction = Lost Revenue, Return Visits, and Future Referrals
  • Employee Dissatisfaction = Recruiting, Hiring, and Training Costs for Replacing Employees
  • Not Recognizing Growth Opportunities = A Stagnant Business

What are the telltale signs that your practice is having issues with patient flow?

  1. Provider Downtime: Are your providers actually waiting to see the next patient while the lobby is packed with patients waiting to see the provider? I used to ask my providers to keep a small notebook with them and record the times where they were actually waiting to see a patient. This may seem like just a few minutes here or there, but throughout the day, you may be shocked to find how much downtime your provider is really experiencing. How many more patients can be seen if you project this downtime for a week, a month, or a year?
  2. Patient Overload: Does it seem like you have too many patients and not enough exam rooms and providers cannot see patients fast enough to keep up?
  3. Patient Frustration: Do you find that patients are asking time and time again when they will be seen and complaining about their waiting time. Another sign is the practice is always way behind–seeing follow-up patients an hour or more past their scheduled appointments.
  4. High No-Show Rate: Do you have a high patient no-show rate? Or worse, are you glad patients don’t show up because it actually eases the burden on the practice if a few patients do not show up for their appointments.
  5. Patient Record Transfers: Are you getting a lot of requests for record transfers from other providers? Your patients may be migrating away. Another sign of this is patients not scheduling return and follow-up visits.
  6. Declining Referrals: Have you noticed that referring providers aren’t sending as many patients your way? Or are they primarily only referring financially risky or low paying patients to your practice?
  7. Employee Turnover: I had a doctor friend express to me one time her frustration that she was the training center for the medical assistants in her area. She would bring in new MA’s and train them only to have them leave a few months later. I happen to run into a couple of her ex-employees at another practice, so I asked them candidly to tell me why they left–they both gave the same answer–rude, abusive patients, and they never ever got out of the office in time.
  8. Long, Late Hours: Are your providers also working long hours? Are they staying late to catch up on their charting? I am not talking 20-30 minutes after patients are all gone, I am talking hours after patients are all gone. Some providers even take charts home (or log in to their system from home) to finish their charting.
  9. Social Media Bashing: Now that everyone is on some form of social media, it is not difficult to find patients sounding off about their frustrations with their healthcare providers. In addition, there are online rating sites for healthcare providers where patients can leave detailed reviews–good and bad!

If you answered yes to many of these questions, you probably need some help evaluating your patient flow tracking and tackling the many areas where things can go wrong. In this series of blog posts, I’ll address many of the problems and provide solutions, including changing your scheduling templates, cross-training your staff, appointment policies, and much more. So watch for my next post coming soon.

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