Optimize Your Practice Appointment Schedule with Virtual Visits

Lea Chatham August 26th, 2015

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By Teresa Iafolla

Maintaining an efficient appointment schedule for your medical practice can be tough. How do you fit in as many patients as you can, but also keep wait times low? How do you reserve enough room for urgent patient requests and walk-ins? How can you stop late cancellations and no-shows that leave you with unused time?

There are countless recommendations on how to organize the best possible appointment schedule—and some of them are likely to work better for your practice than others. One of the options is offering a way to do virtual appointments with your patients.

This might seem like an out-of-the-box strategy to planning a better appointment schedule, but it can have some key effects. Here’s how a telemedicine solution could improve your patient flow and help you build a better schedule. Tweet this Kareo story

Reduce late appointments and no-shows
While creating an efficient practice schedule can be a challenge, getting patients to show up on-time for their appointments is another battle entirely. Even with a strict cancellation or late-arrival policy, patients who travel a long way or who are traveling during peak traffic times can get delayed by unforeseen circumstances. Sometimes, this can throw your entire schedule off for the day and create a bottleneck.

If you’re able to do a virtual telemedicine visit with some patients, especially those who only need a quick five-minute follow-up appointment for instance, it cuts down on the possibility of late or no-show appointments. If patients can simply do the appointment from wherever they are, they’re less likely to skip it or get stuck in traffic. The more convenient the appointment is, the less likely it is that patients will cancel.

Improve availability of walk-ins and urgent appointments
One of the biggest reasons retail health clinics have exploded in recent years is their ability to handle walk-in patients who need same-day care. That kind of service can be a huge challenge for medical practices. When your schedule is booked for the day and a patient calls in or walks in wanting a same-day appointment, you might not be able to accommodate them—especially without a long wait.

Offering virtual patient visits can help here too. If you don’t have an open timeslot to simply schedule the patient, you can offer to do a five-minute virtual consult whenever you have a spare five minutes open up in your day. Since you can simply connect with the patient online whenever you’re ready, the patient doesn’t need to wait hours at the office until you’re ready; they can simply go about their day until you have an opening. This gives you the flexibility to offer valuable same-day care, and could even keep that patient from going to an urgent care or ER for a minor issue.

Offer after-hours virtually
While most practices opt out of providing after-hours care, it can give your practice a huge competitive advantage. And either way, you’re likely to already get some urgent after-hours calls from patients. Offering after-hours virtual visits can help you serve those patients who often can’t get in during the business day, or are likely to be rushing to your office at the end of the day and extending your end-time. With virtual visits, you have the flexibility to do appointments from home, and head off any bottlenecks in the beginning and end of your workday. Plus, you can turn those late-night urgent phone calls into documented patient visits.

There’s an art to organizing an efficient appointment schedule, and the best strategies can vary widely by practice. Consider adding virtual patient visits to the mix and check out other tips for keeping your office wait times down.

About the Author 

Teresa Iafolla is Director of Content Marketing at eVisit, a physician-first telemedicine solution connecting providers to their patients via secure, video chat. Teresa manages and writes for the eVisit Blog, a resource for physicians and practice managers trying to improve their practices and boost revenue. To contact Teresa with questions or comments, email tiafolla@evisit.com.

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Membership Medicine on the Rise in Post-ACA Environment

Lea Chatham August 25th, 2015

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group of docsBy Lisa A. Eramo

Today’s physicians face many challenges: The costly transition to ICD-10, the complex attestation process for Meaningful Use, the adoption of e-prescribing and portal technologies, the challenges of collecting from patients with high-deductible insurance plans, the barriers of costly overhead, and more.

Enter the world of private pay or membership medicine also referred to as concierge and direct primary care.

Concierge and direct pay models continue to grow in popularity among physicians who are frustrated by today’s complicated regulatory-driven healthcare environment. Tweet this Kareo story

According to the 2015 Great American Physician Survey, sponsored by Kareo, the number of physicians participating in a concierge practice stayed relatively the same at just over four percent, but the number in direct pay jumped more than two percent from 2014 to 2015. Overall interest in these models remained strong over the past two years with more than one-third of respondents saying they are considering a concierge or direct pay model.

“Concierge medicine allows me to practice a model of medicine that is currently not widespread called P4 Medicine: Personalized, Predictive, Preventive, and Participatory,” says Dr. Molly Maloof, a practicing physician and Medical Advisor at Kareo. “I wanted an old-fashioned doctor patient relationship with a futuristic technological orientation of care. P4 medicine allows me to do this and concierge medicine allows me to be paid for it.”

With concierge medicine, insurers may pay for certain covered services; however, patients generally pay a monthly or annual fee/retainer in exchange for certain non-covered clinical services and improved access. In direct primary care, patients pay for services out of pocket and receive more personalized care and access. Patients often get benefits such as same-day access to the physician (including the ability to reach his or her cell phone as well as engage in text messaging), unlimited office visits with no co-payment, online consultations, fast prescription refills, convenient appointment scheduling, and more.

The idea is to establish a direct financial relationship with patients, thereby removing or reducing the time- and resource-intensive process of billing insurance companies. This is particularly true for direct primary care, where practices bypass insurance companies entirely when providing comprehensive preventive care. The appeal for physicians is that they’re often able to earn more money while seeing fewer patients with whom they spend more quality time. “Concierge also allows me to add additional wellness programs to my practice offerings and my maintain independence,” adds Dr. Maloof.

Although joining an Accountable Care Organization, merging one’s practice with others, or working in a hospital setting are options, these membership medicine models seem to be the best of all worlds. “I think that with declining reimbursements, primary care providers are starting to realize that they have an opportunity to either join hospital groups or maintain autonomy through adding an extra fee to their practice,” explains Dr. Maloof. “Most doctors don’t want to just receive cash for their practice. They want to enable patients to get some value from their insurance.”

Interest appears stronger among younger providers who are looking at the long term. According to a 2014 survey conducted by the physician staffing firm Merritt Hawkins, 17 percent of physicians ages 45 or younger indicate they will transition to a direct-pay or concierge practice. The survey also supports an overall increase in the interest in these models with 13 percent of all physicians saying they plan to transition in whole or in part to this type of practice. This is a substantial increase from the 2012 study where only 7 percent were considering this as a future move.

There are definite benefits for patients, too. Say goodbye to long wait times in the office or having to wait for weeks or months to make an appointment. “Patients can expect longer visits with their doctor and usually better access to their physician when they need it,” Dr. Maloof says. “Patients can purchase high deductible plans and use their HSAs to pay for the additional costs of joining a concierge practice.” Using HSAs does have some restrictions though so it’s important to know the rules in your state and help patients understand what is and what is not covered with an HSA. States are slowly changing their rules to support these options for patients.

The upward trend of these models will likely continue as physicians—and patients—search for alternatives in this complex and increasingly costly healthcare marketplace.

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Do You Have An SEO Strategy for Your Practice?

Lea Chatham August 20th, 2015

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By Molly Maloof, MD

Some people love their privacy, but for those of us in public-facing professions (e.g. doctors, dentists, politicians, etc…) we need visibility and our careers depend on it. In the last week, two different people complimented me on my online presence and SEO (Search Engine Optimization). Both of them asked me how they could enhance their Internet presence. I thought about what I learned over the last two years working in technology and came up with the following list of my favorite SEO strategy tips.

  • Take advantage of social network SEO: If you didn’t know this by now, social networks optimize their search engine visibility on purpose to gain more users. For this reason, it’s valuable for you to realize which networks matter to your industry and to create profile pages. Here are my favorite social networks:
    • Facebook
    • Linkedin
    • Twitter
    • Google+
    • Doximity
    • Angelist
    • Clarity.fm
  • Update your social media pages regularly. The more you check and update your pages, the more they will show up on search. Also, it may be common sense, but what is the point of being visible online if the content of the page is out of date? It’s a bit of a pain, but it does pay off in the end to set up pages with accurate and up-to-date content.
  • Take advantage of video website SEO. When people search Google for videos under your name, you definitely want to be the person who shows up. Youtube and Vimeo are two great places to syndicate your knowledge to the world, and both have great SEO. If you don’t have any videos online, now is the time to consider making one that showcases your knowledge and expertise. If you speak at a conference, make sure to get the video online. It takes persistence, but you want your online visibility to be more than just text.
  • Develop your namesake website. This seems pretty self explanatory, but if you want to be visible online, create a website such as mollymaloofmd.com. Tweet this Kareo story
    This way you will have control over your own domain and the content you put in it. For a short-cut you can always create an www.about.me page. One of the nice things about having your own site is that you can develop inbound and outbound links to and from your social media and video pages. This will increase your SEO rankings for both.
  • Blog on your website and SEO your blog posts. To write effective blog posts, you should make sure to include outbound links with title tags (the phrase a persons sees when they hover over a link). You can set this up by
    • Creating a hyperlink by highlighting the text and clicking the paper clip icon.
    • The first box allows you to insert the link and the second the title tag.
    • It’s also important to take advantage of innate wordpress SEO. Make sure your focus keyword is found in the article heading, page title, page URL, article content, and meta description.
  • Optimize your images for better search rankings. This article provides plenty of explanation on how to optimize the images you post online for better SEO and includes where to look for photos. Other sites that may show up in a search under your name are Instagram and Pinterest. Most professionals use these for personal use. It’s in your best interest to reduce SEO for these by disabling their public visibility in the website settings.
  • Regularly request reviews from your patients. It’s important for you to have ratings online that reflect your actual performance. Right now, websites like HealthGrades and Vitals.com are making it way too easy for random people to evaluate your practice. And, these sites can easily be manipulated. And, unfortunately, these sites have great SEO. Worst of all, anyone can sign into these websites with different email addresses and rate you multiple times. Practice marketing platforms help you get more reviews from your actual patients and post them to your website or syndicate to sites like Google and Yelp.

By the end of this article you might be feeling two things. Either your relieved that SEO isn’t actually that hard or you are totally overwhelmed at the amount of work that this appears to be. Rest assured, you don’t need to do all of these things overnight. It took me two years of plugging away at this to figure it out. Slow and steady wins the race.

For more tips on how to manage your online reputation, download this helpful guide.

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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How Well Are You Managing Patient Collections?

Lea Chatham August 19th, 2015

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Patient due amounts now make up 30% or more of your practice’s A/R. Have you changed and improved your internal processes to ensure that you are collecting every dollar you are owned by patients? There are many best practices you an can now use to improve the way you management patient collections. Take this simple assessment to find out what you are doing well and what processes might need improvements. Tweet this Kareo story

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EHR Critical for ICD-10 Success

Lea Chatham August 17th, 2015

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Kareo EHRBy Michelle Cavanaugh, RN, CPC

There are a core set of steps to ICD-10 success. Probably the two most important are improving documentation and learning to complete accurate ICD-10 coding. Nearly every other step is really about supporting these two efforts from mapping codes to training.



A practice that uses a paper-based clinical documentation system is at a disadvantage in preparing for ICD-10.Tweet this Kareo story

While many providers feel comfortable with their paper superbill now, it will not be the same after October 1. And here is why.

The actual number of codes is increasing significantly. While your practice doesn’t need to learn all of the additional codes, you do need to get familiar with the ones for your specialty. This is where the code mapping process comes in. You could have 20 common ICD-9 codes or 100 or more depending on your unique practice. You need to map those codes to their ICD-10 equivalents. The number of equivalent ICD-10 codes for each ICD-9 code could be just one or it could be 10.

To provide a sense of what this looks like for different specialties, here are few examples of how many additional codes a variety of different specialties will see with ICD-10:

  • Endocrinology: 340
  • Gastroenterology: 110
  • Mental Health: 300 (this is an estimate)
  • Neurology: 132
  • Pediatrics: 111 (this is over 500 if you include infant and pediatric codes)
  • Pulmonology: 81
  • Urology: 202

So, as an example, if you currently have a two page superbill with 100 common codes on it, that could easily become 500-1000 common codes. As a result the superbill goes from being two pages to 10 pages or more. In addition, the documentation must support the codes. Based on reviewing the ICD-10 Code Manual, it appears that for every 100 or so additional codes there are about a dozen documentation changes that providers need to be aware of as well. An EHR can help ease the documentation process.

This is why use of an EHR for clinical documentation and charge capture is so important for ICD-10 success. An effective EHR gives providers additional tools to ensure the most comprehensive documentation along with features to assist with accurate coding. Here’s how:

  1. Templates help ensure specificity and accuracy.
  2. Export and print features enable the practice to easily provide backup to support medical necessity.
  3. Coding crosswalks and dual coding tools make it easier to ensure that the right ICD-10 code is selected.
  4. Using an electronic superbill eliminates the need for manual entry to a billing system or additional work scanning the paper superbill.
  5. A fully electronic charge capture and claims process reduces entry errors.
  6. Using an EHR for charge capture increases coding accuracy as well as charges.

If your practice is still using paper based charts and charge capture, now is the time to change. It will not only make the transition to the ICD-10 easier, it can also improve your bottom line.


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Free Webinar: Get the Best from Outsourced Medical Billing

Lea Chatham August 13th, 2015

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Get the Best from Outsourced Medical Billing
Wednesday, August 19, 2015
10:00 AM PT, 1:00 PM ET

Learn how to choose the right billing company and get the most from outsourced billing for your practice! Tweet this Kareo story

Is your practice 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 billing technology? Or just concerned that you might be doing it all wrong and losing money—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 a billing company to give you peace of mind and maximize your profitability. In this interactive webinar, practice management expert Laurie Morgan will talk about how to select a billing service and manage the relationship for maximum benefit.

You’ll learn: 

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

Register now to learn new ways to become a new best practice!

Register Now

About the Speaker

Capko & 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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August Getting Paid Newsletter Looks at Outsourced Medical Billing

Lea Chatham August 12th, 2015

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The August edition of the Kareo Getting Paid Newsletter takes a look at when to outsource medical billing, the new mobile app from Kareo, and a few coming changes in healthcare billing and collections. The newsletter also provides a chance to discover upcoming events, news, and resources from Kareo. Plus, learn about how to register for upcoming webinars. Read all this and more now! Tweet this Kareo story

Read Kareo Newsletter Now

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Outsourcing Can Be the Solution to a Billing Talent Shortage

Lea Chatham August 10th, 2015

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by Laurie Morgan, Capko & Morgan

When we work with practices that are contemplating setting up a new medical billing department or evaluating whether to outsource to a billing service instead, they often ask us which is “better.” There really isn’t a single answer—but there are a few questions that are almost always worth asking!

One of the most important things to know is, how easy will it be for you to attract the talent you need if you decide you’d rather build an in-house team? In many markets, the availability of talent to lead a billing department—or even just to staff it—is a real constraint. Tweet this Kareo story

The challenge of attracting talent becomes even more difficult when you’re aiming for very specific skills, such as expertise in a particular specialty or coding certification.

When you’re in a tough market or looking for very narrow requirements, outsourcing to a billing service may be a better way to get the kind of help that you need. What’s more, practices often find they would love to have the help of a particular expert such as a certified coder, but don’t have need of a full-time person. Billing services can employ highly-trained and credentialed professionals like coders, and share their skills (and their expense) across many practice clients. This allows practices access to high-end skills they want just a little of, and allows the professionals to work full-time at the top of their capabilities.

Outsourcing can take away other staffing headaches, too. Sometimes small practices have had the excellent luck to have a Jack- or Jill-of-all-trades who is the perfect one-person billing department grow up in the practice—you know, the kind of miracle worker who will happily and competently handle all things billing, from chasing down denials to negotiating with payers. But what happens if your prized employee retires, or needs to move due to a spouse’s job transfer, or just wants to take an extended leave? Outsourcing may be the best way to respond if your practice has been lucky enough to benefit from one of these jewels for many years, and you already know there’s almost certainly no one else like her out on the market.

Moving forward, one of the best things a billing service will offer your practice is some protection from this scenario—since, in most cases, there will be redundancy in staff to provide coverage in case someone unexpectedly leaves.

If this is a challenge for your practice, or you are considering outsourcing for other reasons, join me in my upcoming webinar, Get the Best from outsourced Billing, on August 19. Register now!

About the Speaker

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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AAPP and Kareo Launch Private Practice Models Survey

Lea Chatham August 10th, 2015

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The American Academy or Private Physicians (AAPP) has partnered with Kareo to launch Private Practice Model Perspectives 2015, an annual survey around the perceptions and benefits of various practice models. This industry-first survey is intended to provide insight into the perceptions healthcare providers have of direct pay and concierge models in comparison to traditional payment models. It seeks to understand who is using these models, who is not, and why.

Share your opinions and experiences for a chance to win an Apple Watch, an iPad, or a one year AAPP membership. Take the survey now! Tweet this Kareo story



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Navigating Uncertain Times at Work (ICD-10 Anyone?)

Lea Chatham August 5th, 2015

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By Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

Healthcare is often uncertain, but some times are more challenging than others. ICD-10 is a perfect example of an uncertain time that goes beyond a small bump in the road. When there is an issue that has big impact on healthcare, it can impact your job. Tweet this Kareo story

You need to be prepared to navigate unknown waters. Here are a few basic points to keep in mind:

  • There will occasionally be uncertain times – look back in history and you can see that crises happen all the time, all over the world. But, if your job is uncertain, then you have every reason to be concerned enough to do something about it. Job-related stress has symptoms, but it also has resolutions.
  • It is always a good idea to prepare for uncertain times – work on paying off your debt load even if all you can do is pay a little more than the minimum every month. Put some money in savings every payday, and don’t use it unless it is a last resort. Work out your budget so you have a handle on what you are doing with your money. Talk with your family about how you will get through a crisis; it’s like a fire drill that prepares you for emergencies.
  • Don’t waste today’s energy on worrying — do something about what stresses you. Take a walk every day instead of eating a donut for breakfast (not that I object to donuts–believe me, I don’t–but a walk is de-stressing where sugary snacks backfire). Look at your worries and work on what you are in control of. If you can’t control the thing that worries you, how will worry help? Answer: it won’t.
  • Forget about drama and smile at the people in your life – we are in the boat together. It makes the journey so much easier when we treat one another with kindness. The people you work with, the people you live with, and the people you interact with as you go through your day are all on the same ocean, and we all do better when we are smiling.

About the Author

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

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