Free Webinar: Healthcare Business Trends for 2016

Lea Chatham November 25th, 2015

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Getting Paid in 2016: Business Trends
Wednesday, December 2, 2015
10:00 AM PT, 1:00 PM ET





Learn about key business changes impacting private practices in 2016 in this free webinar with John Lynn Tweet this Kareo story

The business of medicine is changing quickly. Government and commercial payers know that we’re paying more for healthcare and we’re getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.

In this webinar we’ll talk about some of these changes, how they’re impacting independent physicians, and what’s coming in the future.

Join renowned blogger John Lynn to hear about coming changes in the business of healthcare, including:

  1. Accountable Care Organizations (ACOs)
  2. Value Based Reimbursement from Government and Insurance Payers
  3. The Increase in High Deductible Plans
  4. The Wave of Government Penalties for Non-EHR Use

Register now to to join John. We’re sure you’ll be enlightened!

Register Now

About the Speaker

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


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The Business of Medicine in 2016: Where Are We Headed?

Lea Chatham November 24th, 2015

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By John Lynn

Healthcare is going through a massive transformation to the business of medicine as we know it. This shouldn’t come as a surprise to anyone. We’ve all seen charts like the one below which show how the US is paying more for healthcare than any other country in the world and we’re actually getting worse results.

While we all know that US healthcare costs are out of control, many people don’t recognize that these increasing costs translate to an increase in revenue for small practices. As the healthcare system works to reduce costs, that translates to a decrease in revenue for small practices. That’s right. In 2016, doctors are going to be expected to do more with less.

As part of this effort to reduce healthcare costs, we are seeing a massive change in reimbursement models across the following areas: Tweet this Kareo story

  • Accountable Care Organizations (ACOs)
  • Value Based Reimbursement
  • Increase in High Deductible Plans
  • Government Penalties

What do all of these changes mean for you and your practice? How quickly are these changes happening? How will these shifts impact your small practice in 2016? What technologies can help you make the most of these changes and turn them from challenges into opportunities? Learn the answers to these questions and more at my webinar on December 2, 2105 at 9:00 AM PT (Noon ET).

Until then, think about the 420 Medicare ACOs that exist already and cover 7.8 million Americans. Look at CMS’ stated goal to tie 50% of payments to ACO or bundled payments by 2018. Consider a group of the major payers called the Health Care Transformation Task Force which has stated their goal to have 75% of their business under-valued based payments by 2020.

Consider that 36.9% of patients are now on high-deductible insurance plans and that number continues to rise. Are you ready for this change, which is already starting to happen? How much of the potential 9% penalty will you incur in 2017 from programs like Meaningful Use, PQRS, and the value-based modifier?

While many of these changes are incredibly challenging, they also present a great opportunity for organizations to maximize their participation in the changes as they happen. Every small practice should take the time to learn about these changes and evaluate how their practice can make the most of the changes.

Plus, many of these programs are still evolving as we speak. By participating in these programs early, you can use your voice to ensure that new reimbursement models are fashioned in a way that benefits you and your small practice in both the short and long term.

2016 is going to bring to a head a whirlwind of changes to the business of medicine as we know it.  Those that sit back will get blown away by the changes when they come. However, the proactive small practices will ride the winds of change to higher heights and new opportunities for their practice and their patients.

Register now for my webinar, Getting Paid in 2016: Business Trends, on December 2.

About the Author

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

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Video: Get Serious About Patient Collections

Lea Chatham November 23rd, 2015

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Patient collections is a growing concern for many practices as patient due amounts now make up 30% or more of A/R.

Learn simple techniques to improve patient collections in this short video. Tweet this Kareo story

For more tips, download this helpful guide, 5 Steps to Perfect Patient Collections.

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3 Steps to Continue to Manage ICD-10

Lea Chatham November 19th, 2015

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Kareo ICD-10 Resource Center

By Lisa A. Eramo

Although many experts in the healthcare industry predicted that chaos would occur once we flipped the switch to ICD-10 on October 1, just the opposite seems to be true.

“It has been the calm before the storm, and we’re not even really sure whether the storm is going to hit,” says Anita Archer, CPC, director of regulatory and compliance services at Hayes Management Consulting. “Everyone has been holding their breath for the expected impact.”

Archer, who works mostly with large multi-specialty and academic practices, says she has heard very little in terms of major technical or operational glitches during the first few weeks of the transition. A few physicians experienced problems when using automated cross-walks for encounter forms and problem lists; however, those problems were mostly resolved within 24 hours. Even one of her largest clients—an 1,800 physician academic practice—reported virtually no issues. In a recent survey of customer data, Kareo found that 99% of claims submitted in the first month of ICD-10 were successful.

“We haven’t seen the spikes that we were expecting, but it’s still early,” she says.

Where could potential ICD-10 payment problems and/or denials still occur once payers adjudicate more claims? Tweet this Kareo story

Archer suspects that practices could encounter problems related to the following:

  • Denials due to a lack of medical necessity. Many payers are still in the process of updating LCDs to reflect specific ICD-10 codes, making it difficult for practices to prepare.
  • Referrals with ICD-9 codes. Practices may struggle with referrals that include ICD-9 codes or even non-specific ICD-10 codes. These referrals may cause operational headaches for staff members who must then follow-up with the referring physician for more information. Payers will not accept ICD-9 codes for services rendered on or after October 1, 2015. Archer says one way to alleviate this is to ensure that patients have the proper code before presenting for their appointment. Educate patients about their responsibility to obtain this information from their referring physician.
  • Episode of care. Archer says some urgent care clinics and orthopedic practices have struggled with assigning a seventh character to denote the episode of care, making this an area ripe for denials. The seventh character denotes the episode as initial (A), subsequent (D), or a sequela (S) for injuries, poisonings, and certain other conditions. Specifically for fractures, the seventh character also includes information about whether the fracture is open or closed and, during the healing phase, whether the fracture’s healing is routine or occurring with complications such as delays, nonunion or malunion. Seventh-character extensions for some open fractures also capture the Gustilo open fracture classification.

Steps to take now

Consider these steps to mitigate any revenue loss in ICD-10:

1. Set up a process for denial management. “You need to look at your denials more closely than you probably would have done historically,” says Archer. As part of your denial management strategy, categorize your denials as follows:

  • Denials by payer
  • Diagnosis-related denials
  • LCD/NCD-related denials
  • Denial percentage by payer and/or clearinghouse
  • Volume of denials by reason

Once your denials are categorized, ask this question: What is the root cause of these denials?

Denial management also includes a plan for timely responses. Ask these questions: Who will be charged with monitoring denials as they come in? Who will respond to the denials and when? Will coders be responsible for reviewing and re-submitting claims?

“Don’t store up denials, put them on a shelf, and try to get them done later because that may never happen,” says Archer. Look at your payer guidelines to determine the timeframe in which you need to respond.

2. Identify a few key performance indicators (KPIs)—and monitor them frequently. Archer says KPIs don’t need to be burdensome or overwhelming for the practice. Start with a few basic ones such as:

  • Total days in A/R
  • Aged accounts receivable
  • Percentage or number of unbilled claims
  • Number of encounters billed

How do these numbers compare in the six month pre- and post-ICD-10? This will give you a high-level of practice performance and any payer problems.

In terms of frequency, the larger the practice, the more frequently you should monitor these metrics; however, a good rule of thumb is to monitor them weekly or daily, if possible. Monitor the aged accounts receivable monthly. If your 60-day buckets are growing, that’s an indication of a problem.

3. Make ongoing ICD-10 education a priority. Archer says to find time in your day for ICD-10 education. Everyone in the practice should receive ongoing or remedial ICD-10 education, as necessary. Again, this doesn’t need to be burdensome. A 30-minute “lunch and learn” once a month or every few months could suffice.

For more resources to help you manage ICD-10, visit the Kareo ICD-10 Resource Center.

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She also works as a healthcare content specialist for Agency Ten22. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal and AHIMA Advantage. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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Video: Is Mobile EHR Right for You?

Lea Chatham November 18th, 2015

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Many providers are interested in a mobile EHR but are hesitant to adopt a new solution.

To find out if a mobile EHR is the right fit for you, watch this short video with EHR expert Dr. Tom Giannulli. Tweet this Kareo story

Ready to try a truly mobile EHR? You can sign up for the free Kareo EHR today and try it out.

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What DCs Need to Know about Chiropractic Software and Meaningful Use

Lea Chatham November 17th, 2015

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By Zach Watson

On October 6, the Centers of Medicare and Medicaid Services (CMS) released the final rules for Stage 3, as well as modifications for Stage 2 of Meaningful Use. Even though the term “final” is in front of the Stage 3 rules, CMS has left a 60-day comment period open, which indicates there could be further modifications and possibly even further delays—though these are hypotheticals.

Based on what we know now, there are some items of particular note about Meaningful Use for chiropractors. Tweet this Kareo story

Reporting Periods and Deadlines
First and foremost, it’s important to point out that there’s been a restructuring of objectives and measures. In its current form, Stage 3 requires eight overall objectives with multiple measures assigned for each respective objective. This was done in an attempt to simplify the Meaningful Use framework.

DCs have been slow to buy-in to Meaningful Use, so many practitioners will likely benefit from the revised 90-day reporting period in 2015 as well as the 90-day reporting period for new providers in 2016 and 2017. The shorter reporting periods are meant to speed along attestation and propel laggards to Stage 3 as quickly as possible. It’s also important to note that the deadline for Stage 3 is January, 2018.

Health Information Exchange
When we examine the new Stage 3 objectives, it quickly becomes obvious that interoperability is a major focus. Of particular prominence is the Health Information Exchange objective. It requires eligible professionals to attest for three measures, though the threshold would only need to be met for two. While the first measure relates to referring EPs, measure two of this objective requires providers to incorporate an electronic summary of care document from a source outside of the provider’s EHR system into the patient’s record. Measure two specifies that this must be done for more than 40% of referrals and patient encounters that involve previously unseen patients. Measure three requires the same thing, but for 80% of transitions or referrals. Again, interoperability is huge for Stage 3, and it’s especially relevant as DCs begin to play a larger role in the care team.

Computerized Physician Order Entry
Another important objective for Chiropractors will be the Computerized Physician Order Entry (CPOE) requirement. The first two measures for this objective establish thresholds for medication orders and laboratory orders created by the EP during the reporting period. Measure three, likely of most importance to DCs, requires that more than 60% of diagnostic imaging orders created by the EP during the reporting period be recorded using CPOE functionality within the EHR. Whether DCs are performing diagnostic imaging in-house or shipping it out to an imaging lab, the CPOE rule will be an important objective for the specialty.

These are only two of the eight of objectives, but upon initial inspection, they appear to be the two that relate most to DCs. Like all Meaningful Use objectives, they will require the best chiropractic software to make the recording align with provider’s workflow.

For more tips on how to streamline your chiropractic practices and get the most from technology, watch this recent free webinar, Chiropractors, Discover the Secrets to Increasing Profitability.

About the Author

Zach Watson is marketing operations analyst at TechnologyAdvice. He covers marketing automation, healthcare IT, business intelligence, HR, and other emerging technology. Connect with him on LinkedIn.

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You Can Tie Medical Practice Social Media to ROI

Lea Chatham November 16th, 2015

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Register now to learn more about the ROI of patient engagementBy John Sung Kim

Patient engagement has become an industry buzzword defined differently by different constituents. While “engagement,” as defined by policy wonks and technology pundits may be some years away, providers have implemented both IT and service programs in attempts to monetize this term.


Much has been said about the “consumerization of healthcare” putting increasing pressures on providers, but the emerging data shows that patient engagement can indeed be profitable if operational and financial goals are clearly set from the beginning, and key performance indicators (KPI) are measured carefully.

While there are numerous patient engagement KPI metrics one can measure, one of the hardest to measure has been social media. Tweet this Kareo story

There is a huge amount of interest in social media both from patients and providers. While patients are using social media more and more to find a physician, the physicians aren’t entirely sure there is a return on the effort. But recent studies show that there is a return and it is valuable.

Two recent studies from Stanford and Harvard uncover the value of social media in healthcare. The Harvard study showed that a one star increase in social media led to a 9% increase in annual revenues. Moreover, the researchers that conducted this study found that in areas with a heavy penetration of social media reviews of restaurants, consumers tended to take their money to small businesses with better reviews over chain restaurants that spent considerably more on traditional branding and marketing.

The challenge for healthcare providers is that even the most popular of healthcare practices may not get more than a few reviews per year. This makes sense as most consumers tend to want to share their experiences of great restaurants, but less so of their excellent healthcare experiences. Yet this means that in order to have the most accurate reflection of consumer opinion of your practice, one must either routinely ask patients for reviews as they leave your office (an unsettling task for many providers and practice managers) or employ the use of an automated patient survey system.

Many of the leading appointment reminder systems are starting to employ a post appointment survey that integrates to the practice management system or EHR, and then sends patients an opportunity to review their latest experience.

The very best systems take negative reviews and alert your office so your practice manager can communicate with the disgruntled patients, while the positive reviews get automatically filled into your profiles on popular review sites.

So how can a practice track the ROI of social media? This is an important metric in the age of the “experience economy,” yet also the hardest to measure as far as patient engagement. An easy hack for this is to simply place an average monetary value on four and five star reviews. In my experience, placing a value of $1,500 for every 4 star review and $2,500 for every 5 star review is a good metric, albeit not totally accurate in every condition or every market

To find out more about looking at the ROI of patient engagement, join me for my upcoming free webinar, Uncover the ROI of Patient Engagement, on Wednesday, November 18. Register Now.

About the Author

John Sung Kim is the technology evangelist at Kareo. He was previously the CEO of DoctorBase, a practice marketing and patient engagement platform that was purchased by Kareo in 2015. He was also the founder and founding CEO of Five9 (NASDAQ: FIVN). He’s acted as a consultant to numerous startups and government organizations including RingCentral, Qualys, Odesk, the city of San Francisco and the California Public Utilities Commission. 

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Free Webinar: Uncover the ROI of Patient Engagement

Lea Chatham November 12th, 2015

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Uncover the ROI of Patient Engagement
Wednesday, November 18, 2015
10:00 AM PT, 1:00 PM ET





Learn ways to grow and succeed through patient engagement in this free webinar Tweet this Kareo story

Patient engagement isn’t just a buzz word, it is becoming one of the key factors in independent practice success. It can help you recruit new patients, retain existing patients, and access increased reimbursement as the industry shifts to value-based payment programs.

Patient engagement and practice marketing expert John Kim and practicing physician Molly Maloof will show you how you can improve patient engagement in your practice and see a return on your investment.

You’ll learn:

  • What patients are looking for from a practice
  • How to implement patient engagement programs
  • Where you’ll see a return on investment from patient engagement

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

Register Now

About the Speakers

John Sung Kim is the technology evangelist at Kareo. He was previously the CEO of DoctorBase, a practice marketing and patient engagement platform that was purchased by Kareo in 2015. He was also the founder and founding CEO of Five9 (NASDAQ: FIVN). He’s acted as a consultant to numerous startups and government organizations including RingCentral, Qualys, Odesk, the city of San Francisco and the California Public Utilities Commission.


Dr. Molly Maloof is passionate about using technology to improve the lives of patients and health care providers. She is a practicing physician and medical advisor at Kareo. Dr. Maloof 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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November Getting Paid Newsletter Looks at Patient Engagement Tools and Trends

Lea Chatham November 11th, 2015

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The November edition of the Kareo Getting Paid Newsletter offers a look at the value of patient reviews, how to create an awesome medical practice Facebook page, and more patient engagement tools and trends. 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




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Short Video Shows Steps to Manage ICD-10 Denials

Lea Chatham November 9th, 2015

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We’re a month into ICD-10, and so far so good. However, practices are seeing some denials for a variety of reasons, as expected. This short video offers some simple tips to help manage denials. Tweet this Kareo story

For more strategies on preventing and managing denials, download 5 Steps to Prevent and Manage Denials.

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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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