From Physicians Practice: 6 Ways Physicians Are Using Mobile Devices

Lea Chatham June 25th, 2014

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The 2014 Technology Survey, conducted by Physicians Practice and sponsored by Kareo, asked physicians if they are using mobile devices and how. Turns out that smartphones and tablets are becoming as ubiquitous as stethoscopes. More than 50% of physicians are using applications on an iPhone, Android device, or other smartphone. And, what are they using those applications for? Find out in this new infographic from Physicians Practice.

Physicians Practice Infographic

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Your Top 4 Questions about Working with a Medical Billing Service Answered

Lea Chatham June 24th, 2014

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View Webinar RecordingsAccording to the recent Black Book 2014 User Survey, the majority of small and solo medical practices are looking to outsource some or all of their billing in the next two years. At a recent webinar, practice management expert, Laurie Morgan discussed best practices for choosing and working with a medical billing service. Her overview provided simple strategies to get the most from the relationship. There were many questions about what to expect if you want to move your billing to a service.

Here are answers to four of the most common questions that were asked:

  1. How long does it usually take to get up and running on a billing service to start submitting claims?
    There is no one answer to this question—it depends on many factors, one important one being whether you’ll be switching from a different platform, and how difficult it is to move data from it to your new one. While in many cases it won’t make sense to try to move claims data for work-in-progress, it is always a good idea to move basic patient data if you can—especially if you will be seeing patients on an ongoing basis. Even if you can’t move data easily from your current practice management (PM) system to your new one, you may be able to capture and move some data from your electronic health record (EHR).Your account rep at your new billing service (and perhaps tech team, if there is one) should be able to estimate the time and effort required to make the transition. They should work with you to spell out the steps required to move from your old system to your new service (whether these steps involve exporting and importing data, manually entering data into the new system, setting up electronic interfaces with your payers, etc.).

    Be wary if you are told that, in effect, “it’s a piece of cake” without details on what steps you’ll need to take, and steps the billing service will need to take, to complete the process. If you are starting a new practice from scratch, that simplifies the process somewhat—but in that case, of course, you will need to establish relationships with your payers (including determining whether you or your billing service will handle credentialing).In all cases, you’ll need to allow sufficient time for testing the electronic connections between your service and your payers. Ask your potential billing service partner how long this typically takes.
    And for reassurance about the process, ask for current client references who can comment on the experience of getting started with the billing service.Tweet this Kareo story

  2. If you change to a billing service, what is the best way to handle existing A/R?
    Generally speaking, it’s most efficient to make a plan to manage your existing A/R before switching to a new billing service. Tweet this Kareo story
    Starting fresh with new claims that can be managed from start to finish by your new service will minimize the risk of previously submitted but not paid or completed claims slipping through the cracks. This is especially true if you’re switching technology platforms, but it’s helpful to have a clean break even if you’re staying on the same system.If you are currently using an in-house biller or a different third-party service, this means you’ll have two different billing processes running in parallel for a period of time. If switching to a billing service will mean that your in-house biller will be out of a job once the task is complete, you may find it useful to offer an incentive for managing your current A/R to completion (e.g., a bonus based on a percentage of the revenue collected).Of course, if your current in-house biller is being discharged for poor performance, you may need to find another solution. Your new service may be able to take on existing A/R under a separate agreement from your main contract, or they may be able to recommend a local contractor who can help your practice work through its current receivables backlog.
  3. What kind of reporting should we ask for or expect from a billing service?
    We’ve reached a point in 2014 where billing technology has advanced so much it doesn’t make sense to settle for anything less than real-time reporting. Your service should use a modern platform that allows you to log in and research key metrics like your denial rate and accounts receivable aging. You should also be able to see notes from your billers on missing information you need to provide like clinical documentation, pre-authorizations, etc.If you are already working with a billing service, be sure you know what reporting is available. Occasionally, we have worked with practices that have not been briefed on the full complement of reporting resources their service offers, and have concluded that they either need to rely solely on what the service chooses to provide or that they just don’t have access. (Sometimes the service might assume that you don’t want to be bothered with reports, or that you just expect them to provide them periodically.)If you are working with a service that is using an older platform that really does not permit remote reporting, it’s time to discuss a transition with your service. Sometimes, a smaller, local service with just a few local clients may be reluctant to make such a switch—but by pushing them to do so, you’ll be helping all of their clients get access to a better system. And if they’re ultimately unpersuadable, then it’s probably time to think about switching to a new service.
  4. Who owns our data? Can we take it with us?
    This is determined by your contract, and, before signing with a billing service, it’s important to be sure your contract clearly indicates that you own your own data and can take it with you. If you are shopping for a billing service, be sure your agreement will make your ownership of your data clear.You might also ask about the process of exporting data, the format(s) it will be available in, and what kind of timetable would be required to receive your data in the event you decide to terminate.

To learn more from Laurie, check out the recorded webinar. Or if you are wondering if outsourcing is right for you, download the helpful guide, To Hire or Not to Hire a Medical Billing Service.

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5 Steps to Become a Non-VA Community Provider

Lea Chatham June 19th, 2014

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Small Practice Guide to Serving VeteransThe Department of Veterans Affairs (VA) provides a nationwide system of healthcare services for America’s 5 million veterans. Despite having more than 1,400 facilities across the country, the VA is seeking ways to provide more timely care to veterans.

Currently, there is a program that allows you to become a Non-VA Community Provider and offer services to veterans in certain circumstances.Tweet this Kareo story

The VA is seeking to expand this program through the Accelerating Care Initiative, which addresses the problem of access to care by authorizing a two-year trial program that would allow veterans to seek private healthcare if they reside more than 40 miles from a VA facility or have been waiting more than 30 days for treatment. This program is still pending Congress, but it is likely to pass and ultimately expand care to veterans.

In the meantime, practices can sign up now to participate in the existing program for Non-VA Community Providers. While it takes a little time and effort, joining this program enables your practice to support veterans by providing timely access to quality healthcare services. In addition, it promotes long-term relationships between veterans and local providers.

Once your practice is registered and set up to provide services as a Non-VA Community Provider, the process of submitting claims and getting paid is similar to working with Medicare. Claims are submitted and funds are deposited electronically, and reimbursement is made at Medicare rates.

The process of registering has several steps, which are laid out in detail in this helpful checklist. Essentially, you need to:

  1. Contact your local VA Medical Center to sign up as a local Non-VA Community Provider. You can find your local VA in this directory. It’s your local VA Medical Center that will refer patients to you. They have a list of local Non-VA Community Providers that they use to refer patients.
  2. Register for the VA payment system. Kareo customers can get help with this registration process by emailing Otherwise, download these forms and return them to your local VA Medical Center: Standard Form 3881 and W-9.
  3. Register for the Central Contractor Registration Database. Visit the database to register for and receive your DUNS number to become government contractor.
  4. Setup electronic funds transfer. Fax your Standard Form 3881 and W-9 to the VA Financial Services Center at 512-460-5221.

For more details on how to successfully accept patients and submit claims, download this Small Practice Guide to Serving Veterans, which provides all the information you need to ensure that you can see veterans and get paid.

There is a growing need for medical services for veterans—your practice can help to fill this gap. Becoming a Non-VA Community Provider is a way to both grow your practice and play an essential role for the nation.

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5 Reasons to Consider Outsourced Medical Billing

Lea Chatham June 17th, 2014

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Black_Book_Rankings_2014According to the recent Black Book Rankings 2014 User Survey, 42% of small physician practices with employed billing staff hope to move billing out of house in the next 12 months.Tweet this Kareo story

This statistic highlights a trend that shows up repeatedly throughout the survey. Practices are looking to upgrade and outsource to reduce costs, improve revenue, and stay independent in these challenging times in healthcare.

Despite this high number of small practices seeking to outsource billing, using a billing service isn’t for everyone. It’s a change that impacts your bottom line so it requires a thoughtful approach. If you currently have a great in-house biller and efficient billing, you may want to keep doing what works. However, there are five scenarios that definitely lend themselves to an outsourcing solution:

  1. New Practice: If you’re just getting started in practice, outsourcing can help you keep your costs low while providing a solution that can scale with you as you grow. You also get the benefits of an experienced biller and billing best practices without the need to go through the hiring process or manage staff.
  2. Your Specialty Is Complex: Some specialties have more complex or unusual billing. For example, mental health billing to commercial payers often requires submission to a different department than medical claims and some surgical specialties with very high cost procedures require more complicated authorization and documentation processes. Outsourcing can enable your practice to access a biller who is an expert in your specialty area.
  3. You’re Struggling to Find and Retain Staff: The truth is that sometimes it is hard to find the qualified, well-trained staff you need to ensure quality medical billing for your practice. Luckily, a great medical billing service can be right next door or on the other side of the country and still do the same high-quality work for you. Outsourcing can dramatically improve the prospects for finding qualified billing staff who specialize in your field.
  4. You Just Found Out Your Billing Metrics Aren’t Very Good: Often, practices that choose to outsource do so because at some point someone saw dropping revenue or inconsistent cash flow. Perhaps, after a couple months of bad numbers, the manager or provider asked to see more detailed numbers and found that denials were high, A/R was high, patient collections were terrible, etc. This is the time to make the switch and get professional help. The longer you wait, the worse the problem will be. A billing service can often go back and collect outstanding balances for you. They can also resubmit claims, but it needs to be done before the timely filing deadline passes.
  5. It’s Time to Put the Focus Back on Patients: Times have changed, and patient expectations have changed with them. Two-thirds of patients would consider switching doctors to see someone who uses and EHR and patient portal. Patients want more access to their own medical information and more opportunities to engagement with their provider. It’s hard to do this with cumbersome manual systems. You need to join the digital age, offload administrative and billing tasks where you can, and get the focus back on patients.

If you think now might be the right time to consider outsourcing your medical billing, download To Hire or Not To Hire a Billing Service. This guide will walk you through the process of how to decide if outsourcing is right for you and help you choose the right service for your needs.

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Webinar: Easy Steps to Choose and Manage a Medical Billing Service

Lea Chatham June 12th, 2014

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Register NowGet the Best from Outsourced Medical Billing
Wednesday, June 18, 2014
10:00 AM PT, 1:00 PM ET

Are you overwhelmed with the challenge of keeping up with all the changes in medical billing? Frustrated by the difficulty of attracting and retaining billing staff? Worried about falling behind in technology? And wondering if there’s a better way to manage your revenue cycle.

Outsourcing to a medical billing service COULD be the answer—if you choose the right partner and work well together. In this free webinar, learn the secrets of choosing and managing a billing company to simplify your revenue cycle management.Tweet this Kareo story

Practice management expert Laurie Morgan will talk about how to select a billing service and manage the relationship for maximum benefit. You’ll learn:

  • Key considerations in choosing the best billing partner for your practice
  • Why technology is an important part of the choice—and what to look for
  • How to manage the relationship to ensure peak productivity
  • Red flags to watch for when evaluating billing service contracts

Who should attend? Practice managers, healthcare providers, and anyone else who is interested in finding the best and easiest way to manage your practices revenue cycle.

Register now to learn easy steps to choose and manage a medical billing service

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June Newsletter Offers Tips for Medical Billing, Social Media and More

Lea Chatham June 10th, 2014

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The June edition of the Kareo Getting Paid Newsletter is packed with great tips for improving your revenue cycle management, getting involved with social media, and managing ICD-10 and Meaningful Use. The newsletter also provides a chance to discover upcoming events, news, and resources from Kareo. Plus, you’ll learn about how to register for our upcoming free educational webinar, Get the Best from Outsourced Medical Billing, presented by Laurie Morgan. Read all this and more now!

Kareo Getting Paid Newsletter

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4 Simple Steps to Take Control of Your Online Reputation

Lea Chatham June 7th, 2014

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4 Steps to Building and Managing Your Practices Online Reputation


Whether you know it or not, you have an online presence.Tweet this Kareo story

And it may be growing without any input from you. It’s time to take control of your Internet presence, engage patients online, and manage your online reputation.


When you do, you’ll be able to:

  • Improve your online reputation
  • Ensure that new patients can find you online
  • Grow your practice through referrals

Your current and future patients are online, and they are listening to what others have to say.

One in five Internet users has consulted online reviews and rankings of healthcare service providers and treatments.Tweet this Kareo story

Staying competitive means being online, listening to what people are saying, and engaging in the conversation.

Follow these four steps to successfully build and manage your online presence and reputation:

  1. Create a website for your practice
  2. Engage with patients on social media
  3. Own your online listings, rankings, and reviews
  4. Be responsive to comments and reviews

Patients are increasingly looking for healthcare services online, and they expect you to be there and to be actively engaged. More than two-thirds of patients used online search prior to booking an appointment and over 40% of consumers say that information found via social media affects the way they deal with their health. If you’re not there, then you are missing an opportunity to build your business.

Download 4 Steps to Building and Managing Your Online Reputation to get started and get a handle on your online presence and reputation to grow your practice.

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To Your Patients, Your Medical Billing Service Is Your Practice

Lea Chatham June 7th, 2014

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By Laurie Morgan, Capko & Morgan

Register now to learn how to maximize your outsourced billing

Have you ever called about a problem with a bill or a service from a local company, only to find yourself connected to a support person from a third-party company who doesn’t understand or isn’t sympathetic? If you’ve experienced this frustration—and perhaps even responded by taking your dollars to another company—you know that you don’t want your patients to experience this. But if you outsource your billing to a service without understanding how they’ll handle your patients’ calls, how can you be sure your patients will experience the same type of service you provide inside your practice?

Details like these can mean the difference between a medical billing outsourcing relationship that elevates your practice to new heights and one that could make your practice worse off than before. After all, to a patient who calls with a billing question—much like when you call a customer service line for your cable company or ISP—the person who answers the phone is your practice. If your billing service represents you poorly, it’s no different than if any other staff member disappoints a patient: it can cost you in lost patients, missed referrals, and negative online reviews.

There are many options to choose from when shopping for a billing service. Choose wisely, and you’ll have a team working for you who will handle your patients with all the care and attention your own staff would provide. And, you’ll potentially see lots of other important benefits, too, like better technology and broader expertise.

But choosing wisely is just the beginning. For peak performance, you’ll need to work hand-in-hand with this external billing team to maximize the benefits of the relationship. Tweet this Kareo story

Build a great partnership and you’re on your way to reaching the goals you had for outsourcing in the first place—fewer hassles and more financial stability.

To learn more about how to choose and manage a third-party billing service for maximum patient service, claims processing efficiency, and billing profitability, join me for my upcoming free webinar, Get the Best from Outsourced Medical Billing on Wednesday on June 18.

About the Author
Laurie MorganLaurie Morgan is a senior consultant and partner at Capko & Morgan. 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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3 Ways to Contain Costs before ICD-10

Lea Chatham June 5th, 2014

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ICD ebook_Primary Care

Setting aside reserves or getting a line of credit for ICD-10 may not be enough. When you combine additional expenses for several months with loss of revenue for up to three months or more, you might want to look at how you can cut expenses in your business. Managing expenses and containing costs is actually something you should do on a regular basis as part of your annual budgeting.Tweet this Kareo story

Here are several areas to review and consider:
1. Reduce Utilities: You should always be looking at ways to minimize costs for electricity, Internet, phones, etc. Watch for competitive rates and special offers that may reduce these expenses.

2. Review Contracts & Leases: Review all your vendor contracts and leases each year and get competitive quotes from at least two or three other vendors. Also, look for ways to reduce usage for printers, copiers, and other equipment. With more automated solutions, some of these items may become obsolete.

3. Automate or Outsource Processes: If you are still doing many practice management, billing, and clinical tasks manually, now is the time to automate or outsource. For example, manually processing paper statements can easily cost two or three times what it costs to use a statement service. Using a medical billing service is often a less expensive alternative to having full time billing staff and can improve your overall collections. According to the Medical Group Management Society, using an integrated practice management and EHR solution can increase your revenue by almost 10% while also reducing expenses for many supplies and time spent on previously manual tasks.

You may wonder why the largest expense of all—staffing costs—is not included above. It’s because there are some special considerations around staffing with regard to ICD-10. On the one hand, this is probably not the time for overtime, raises, or bonuses. Wait until after January 2016 to look at that and explain to staff the reasons why. Conversely, this is also not the time to make staff cutbacks. Generally when looking at cost reductions, this would be the first place to consider. But you’ll probably need all your resources and then some to manage this transition. Even with the addition of new technology, any staff changes should also probably wait until 2016 when things have settled down.

For more strategies to plan and prepare for ICD-10, download the new eBook, ICD-10: How to Transition Your Primary Care Practice.

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HIPAA Compliance and Windows XP/IE8: What You Need to Know

Lea Chatham June 3rd, 2014

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By Ron Sterling

untitledOn April 8, 2014, Microsoft discontinued support of Windows XP and Internet Explorer Version 8 (IE8). Microsoft will no longer look for problems or issue new patches. Virus protection software may address some newly discovered issues, but others must be fixed by the software vendor. In the case of Windows XP, any newly discovered issues may provide an opportunity to compromise the confidentiality, disrupt accessibility, and/or undermine the integrity of electronically stored protected health information (ePHI). In the case of Internet Explorer, Internet sites may not work as intended.

What Is Your Obligation?
According to the HIPAA Security Rules, covered entities—like your practice—are responsible for maintaining the integrity, accessibility, and confidentiality of ePHI. Tweet this Kareo story

Although you have the right to adjust your procedures and security risk analysis to the complexity and size of your organization, you need to reasonably work to address the wide variety of procedural and technical risks that you face.

Outdated software and hardware is an issue that you will struggle with for as long as you have computers. The HIPAA Security Rules require that you address risks based on vulnerability and threat analysis. These recent changes are a vulnerability, but the level of threat and the resulting plan may address the problem without replacing the software or hardware. Whether it is Microsoft discontinuing support for Windows XP or the lack of maintenance support for equipment, your strategy should be validated through appropriate updates to your security risk analysis.

IE8 poses a different problem since the sites (especially a cloud-based EHR) you want to access over the Internet may require a more recent version of Internet Explorer. Your ability to continue use of the IE8 will be more affected by your web activity rather than your risk tolerance.

What Are the Next Steps?
When considering the Windows XP situation or any other change, remember to take a holistic approach. For example, keeping Windows XP systems in place may result in support problems when you contact your EHR vendor and disclose use of a workstation that does not meet their hardware standards. Many EHR vendors have removed Windows XP from their approved list of options. You may even face unexpected problems when you have a piece of diagnostic equipment that works fine, but is connected to a Windows XP computer. The equipment may not work on newer equipment or operating systems and your decision to dispose of the XP system may then require replacement of diagnostic devices.

The key issue is that you address unacceptable risks that Windows XP and IE8 may pose to your organization. Your Security Risk Analysis should be updated to reflect the change to support for XP and IE8. For example,

  • If a Windows XP-based system is used for a critical function, and you cannot work around the security issues, then you should replace the XP system to lower you HIPAA risk profile.
  • If the Windows XP system is used in a non-critical role, and access to the system is limited (e.g., no connection to the Internet and located in a low traffic area), then you may recognize the problem and change procedures (e.g., Lock the lab door after business hours) to lower the risk level.

If you have formally analyzed the risk associated with the Windows XP and IE8, and reasonably addressed the problems within your risk profile (such as planning to replace XP based systems), then you have met your HIPAA Security obligations.

In the final analysis, replacing Windows XP and/or IE8 just because Microsoft discontinued support is not an explicit HIPAA Security requirement. Maintaining vigilance over threats and vulnerabilities to your ePHI is.

About the Author
Ron Sterling Photo 2012Ronald Sterling, President of Sterling Solutions, Ltd., is a nationally recognized thought leader on the implementation and use of electronic health records (EHR). He authored the HIMSS Book of the Year, Keys to EMR/EHR Success: Selecting and Implementing an Electronic Medical Record. Ron has worked with a wide array of practices on EHR decisions and issues, and has reviewed products from over 150 vendors.



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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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