Manage My Practice

Join me on Tuesday, February 1 at 7:00 p.m. EST as I host “Making Sense of Social Media in Healthcare” for HITECH Answers. In this sessionI will discuss my “big three” in social media: Twitter, Facebook and YouTube, as well as integrating the big three with your website and the impact of HIPAA on social media.

All HITECH Answers webinars are free to the managers and staff of eligible providers.

If you cannot attend the webinar live, it will be available to view on the HITECHAnswerssite on demand.

There are a number of different audits that are carried out by Medicare-contracted auditors. It’s important to know the differences and have a plan for responding.

CERT stands for Comprehensive Error Rate Testing and CERT audits were initiated in 2000. The program is responsible for measuring improperly paid claims. The CERT Program uses the following OIG-approved methodology:

1. A sample of approximately 120,000 submitted claims is randomly selected;
2. medical records from providers who submitted the claims are requested; and
3. the claims and medical records are reviewed for compliance with Medicare coverage, coding and billing rules.

RAC stands for Recovery Audit Contractor and began in early 2009. The RACs detect and correct past improper payments so that CMS and Carriers, FIs, and MACs can implement actions to stop future improper payments. RAC is currently focusing on inpatient services and physical therapy services. As of the date this post was published RAC was not focusing on physician services.

ZPIC (Zone Program Integrity Contractors) replaces the Medicare Program Safeguard Contractors (PSCs) and Medicare Drug Integrity Contractors (MEDICs) that are currently in use by CMS. ZPICs are be responsible for detection and deterrence of fraud, waste and abuse across all claim types. ZPICs have access to CMS National Claims History data, which can be used to look at the entire history of a patients treatment no matter where claims were processed. Being able to look at the overall picture will enable them to more readily spot over billing and fraudulent claims. Among other things, ZPICs will look for billing trends or patterns that make a particular provider stand out from the other providers in that community. Once a ZPIC identifies a case of suspected fraud and abuse, the issue is referred to the Office of Inspector General (OIG) for consideration and possible initiation of criminal or civil prosecution. ZPIC is widely considered to be the greatest threat to physician practices.

Seven ZPIC zones have been identified. The zones include the following states and/or territories and most have been assigned contractors:

How should you respond to a Medicare audit?

1. Log all requests for records from all payers. Time and date all communications received and all communications sent.
2. Scan all records sent and include a cover letter itemizing contents of response.
3. Send records via certified mail.
4. If you get a request for a large amount of records at one time, consider getting advice from a consultant or attorney who specializes in Medicare audits as a large scale record request may cripple the practice operations.

How can you be proactive before you get an audit letter?

1. Check the audit sites monthly to see if your specialty or any services you provide are being targeted for an audit.
   • CERT – www.cms.hhs.gov/cert
   • Check the ZPIC site for your zone above
   • OIG – www.oig.hhs.gov/reports.html
   • Check your RAC site in my post here
2. Conduct an internal assessment to identify if you are in compliance with Medicare rules or hire a third-party to conduct an audit for you.
3. Identify corrective actions to promote compliance.
4. Appeal when necessary

Excellent resource site http://www.willyancey.com/sampling-claims.html

Many thanks to the MMP readers who responded to my application to the board of the newly formed Mayo Clinic Center for Social Media by sending messages of support to the Center. I am humbled that I was chosen and am excited to serve with such distinguished members!

The Mayo Clinic’s announcement can be found here.

Many managers find it difficult to begin performance evaluations in a way that puts the employee at ease and opens the door to dialogue.

Do you make small talk or start reading from whatever form you’re using?

Do you preface the actual evaluation by setting the mood giving visual or tonal clues that it’s going to be a good evaluation or a bad evaluation?

Here are eight ways to start a performance evaluation and get things started on the right foot:

1. Review the agenda for the performance evaluation. This is especially important if you’re new to the organization and the employees are not sure what to expect. Tell the employee what information you’ll review and encourage them to ask questions so it’s an interactive evaluation, not just you telling them your thoughts.
2. Review the job description to see what changes, if any, need to be made based on duties added or removed during the year.
3. Review last year’s evaluation. Amazingly, many managers don’t look back at last year’s evaluation. How can improvement or goals be assessed if you’re not making a measurement between last year and this year?
4. Discuss big events at the group that impacted the staff. Providers coming or going. Installing EMR. The installation of other software. A move. Merging with other groups. Discuss it.
5. Discuss the employee’s significant events in the past year. A baby? A marriage? A divorce? A move? A Family Medical Leave Act (FMLA) leave? A new position? Discuss it.
6. Review the self-evaluation if you’ve asked the employee to complete one, and I hope you have. Read the employee’s answers aloud and ask questions about what they meant. Here’s my favorite simple self-evaluation.
7. If the evaluation is related to a raise or bonus, start by telling them if you’re giving them a raise or a bonus. This is an unusual way to start an evaluation, but I’ve used it in the past if the employee is unable to relax and really participate in the evaluation because they’re so worried about the raise. By the way, it’s usually the really good employees who are worried – the so-so employees tend to expect the raise and don’t worry about it. Do not start an evaluation by telling an employee you are NOT giving them a raise or a bonus.
8. Review continuing education that the employee completed and ask what they learned and how they implemented what they learned.

All of these suggestions give the manager the opportunity to start the evaluation on a relaxed note and engage the employee in meaningful discussion.

Note: I am excited to announce a new book from Manage My Practice coming in July 2011: “The Smart Manager’s Guide to Mastering Performance Evaluations.” Stay tuned for more details.

Image provided by Wikipedia.

Most medical facilities have refrigerators, but do you know the guidelines surrounding refrigerators and freezers? Laboratory Consultant Libby Knollmeyer debuts on Manage My Practice with answers to your most-asked questions.

What kind of refrigerator do I need?

If you need to COOL only…

In most cases, a good quality household refrigerator will suffice if the cubic footage is adequate for what needs to be stored and nothing has to be frozen.

If you need to FREEZE and COOL…

If frozen storage is required, either a NON self-defrosting freezer or a freezer designed to maintain constant temperatures will be required. Household refrigerator-freezer combinations are generally not suitable for critical frozen storage since they must get above the freezing point temperature to self-defrost. While most freezer compartments of refrigerator-freezers will maintain -15C (except for the self-defrost cycle), many vaccines and quality control materials require frozen storage at -20C or colder, which a household refrigerator-freezer will NOT maintain reliably.

When frozen storage is required at -20C or below, a freezer designed to maintain extra-cold temperatures will be required. There are some under-counter models which are relatively inexpensive and require much less floor space than upright freezers or chest freezers. If a household freezer is purchased for reagent, quality control, or vaccine storage, a chest freezer is recommended because the cold air does not fall out of the unit when the door is opened and thus the temperature is more stable.

What about small dormitory refrigerators?

Small dorm refrigerators may be used when temperature stability is not a critical issue, but be aware that they do not maintain constant temperatures nearly as reliably as larger refrigerators or refrigerator/freezer units. These are great for any beverages you keep specifically for patients or for cold packs for injuries or injections.

How should I monitor the temperature of the refrigerator or freezer?

If refrigerated or frozen storage is required by a manufacturer, staff members should monitor and document the temperature of the refrigerator and/or freezer on a daily basis. If the monitored temperature is outside the range provided by the manufacturer, corrective action must be taken and documented to remedy the problem.

For refrigerators and freezers, thermometers suspended in a liquid solution are preferable to one that measures the temperature through the air in the unit since they do not react immediately to the opening of the door or temporary removal of the thermometer to be read. The thermometer used should be either National Institutes of Science and Technology (NIST) certified or NIST traceable. The laboratory or med-surg vendor can assist with selection of a reliable and acceptable thermometer.

Remember that state-supplied vaccine programs as well as accreditation agencies such as Commission on Office Laboratory Accreditation (COLA), Clinical Laboratory Improvement Amendment (CLIA) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) require cooling/freezing documentation. Many vaccines and medications are also extremely expensive, so it behooves the practice to protect that investment. A sample form to document temperatures is available here.

What if the power goes out?

Transfer the materials to a refrigerator that is operable, if possible, or keep everything in coolers with ice packs. For frozen materials, especially medications, it is imperative that the frozen state be maintained to preserve the integrity of the materials. Long term power outages (e.g. hurricanes or major winter storms) are a real problem. If that is common in the practices area, it would be worth the money to purchase a generator.

Could the power go out without me knowing it and the contents be compromised?

Yes, the penny method is to sit a penny on top of an ice cube or small container that youve frozen water in. If the power is out long enough for the contents of your freezer to thaw, the ice cube will melt. This will cause the penny to drop to the bottom of the ice cube tray – so check the position of the penny daily. If everything has refrozen but the penny is at the bottom of the ice cube, then everything probably thawed to an extent where it is now unsafe to use.

What is the rule about storing medical supplies, medication or vaccines in a refrigerator or freezer with drinks or food?

Dont do it. Ever.

Consultant Elizabeth Knollmeyer, B.S., MT (ASCP) has over 40 years experience in the laboratory industry. She specializes in financial, operational management and compliance issues for both hospital and physician office laboratories. Libby has a wide variety of experience with her areas of special expertise including financial review and management, Quality Management protocols, Outreach development, compliance and regulatory assistance, lab design and up fitting, lab remodeling, and market research for IVD manufacturers. She works independently and with large consulting groups to provide interim management for hospitals, and serves as adviser to lab equipment and supply distributors. She can be reached at (336) 288-5823 or at eknollmeyer@triad.rr.com.

Elimination of Deductible and Coinsurance for Most Preventive Services

Effective January 1, 2011, the Affordable Care Act waives the Part B deductible and the 20 percent coinsurance that would otherwise apply to most preventive services.

Note: I covered this in my post here and it’s pretty straightforward.

Coverage of Annual Wellness Visit (AWV) Providing a Personalized Prevention Plan

The Affordable Care Act extends the preventive focus of Medicare coverage, which currently pays for a one-time initial preventive physical examination (IPPE or the Welcome to Medicare Visit), to provide coverage for annual wellness visits in which beneficiaries will receive personalized prevention plan services (PPPS). The law states that the AWV will include at least the following six elements, as determined by the Secretary of Health and Human Services:

• Establish or update the individuals medical and family history;
• List the individuals current medical providers and suppliers and all prescribed medications;
• Record measurements of height, weight, body mass index, blood pressure and other routine measurements;
• Detect any cognitive impairment
• Establish or update a screening schedule for the next 5 to 10 years including screenings appropriate for the general population, and any additional screenings that may be appropriate because of the individual patients risk factors; and
• Furnish personalized health advice and appropriate referrals to health education or education or preventive services.

CMS has developed two separate Level II HCPCS codes for the first annual wellness visit (G0438 – Annual wellness visit, including personalized prevention plan services, first visit), to be paid at the rate of a level 4 office visit for a new patient (similar to the IPPE), and for subsequent annual wellness visits (G0439 – Annual wellness visit, including personalized prevention plan services, subsequent visit), to be paid at the rate of a level 4 office visit for an established patient.

Note: Payment for annual wellness visits (AWV) is now covered by Medicare and the payment will be equivalent to a established level 4 visit. I’ve received a lot of questions about who can perform the PPPS and CMS says “A medical professional (including a health educator, registered dietitian, or nutrition professional or other licensed practitioner) or a team of such medical professionals, working under the direct supervision of a physician.”

An evaluation and management code (EM) may be billed with the annual wellness visit if the EM service is medically necessary. If so, a modifier 25 must be appended to the EM service and the documentation for the EM service must have no components of the annual wellness visit used in determining the level of service for the EM visit. A separate note containing the history, exam and medical decision making, relative to the presenting problem, must be separately documented.

Incentive Payments to Primary Care Practitioners for Primary Care Services

The Affordable Care Act provides for incentive payments equal to 10 percent of a primary care practitioner’s allowed charges for primary care services under Part B, furnished on or after January 1, 2011, and before January 1, 2016. Under the final policy, primary care practitioners are: (1) physicians who have a primary specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine; as well as nurse practitioners, clinical nurse specialists, and physician assistants; and (2) for whom primary care services accounted for at least 60 percent of the practitioners Medicare Physician Fee Schedule (MPFS) allowed charges for a prior period as determined by the Secretary of Health and Human Services.

The law also defines primary care services as limited to new and established patient office or other outpatient visits (CPT codes 99201 through 99215); nursing facility care visits, and domiciliary, rest home, or home care plan oversight services (CPT codes 99304 through 99340); and patient home visits (CPT codes 99341 through 99350).

In the final rule with comment period, CMS excluded consideration of allowed charges for hospital inpatient care and emergency department visits in determining whether the 60 percent primary care threshold is met. These exclusions will make it easier for practitioners of eligible specialties to become eligible for the payment incentive program. The incentive payments will be made quarterly based on the primary care services furnished in CY 2011 by the primary care practitioner, in addition to any physician bonus payments for services furnished in Health Professional Shortage Areas (HPSAs). CMS will determine a practitioners eligibility for incentive payments in CY 2011 using claims data and the providers specialty designation from CY 2009 for practitioners enrolled in CY 2009. For newly enrolled practitioners, CMS will use claims data from CY 2010 to make an eligibility determination regarding CY 2011 incentive payments. For subsequent years, CMS will revise the list of primary care practitioners on a yearly basis, based on updated data regarding an individual’s specialty designation and percentage of allowed charges for primary care
services.

Note: There is nothing to count or report: the bonuses arrive quarterly. Providers in HPSAs will receive two bonuses. Want to know if you’re in a HPSA? Click here.

Incentive Payments for Major Surgical Procedures in Health Professional Shortage Areas

The Affordable Care Act also calls for a payment incentive program to improve access to major surgical procedures defined as those with a 10-day or 90-day global period under the MPFS that are furnished by physicians in HPSAs on or after January 1, 2011, and before January 1, 2016. To be eligible for the incentive payment, the physician must be enrolled in Medicare as a general surgeon. The amount of the incentive payment is equal to 10 percent of the MPFS payment for the surgical services furnished by the general surgeon. The incentive payments will be made quarterly to the general surgeon when the major surgical procedure is furnished in a zip code that is located in a HPSA. CMS will use the same list of HPSAs that it has used under the existing HPSA bonus program.

Note: 10% bonus for general surgeons in HPSAs. Want to know if you’re in a HPSA? Click here.

Revisions to the Practice Expense Geographic Adjustment

As required by the Medicare law, CMS adjusts payments under the MPFS to reflect local differences in practice costs. CMS assigns separate geographic practice cost indices (GPCIs) to the work, practice expenses (PE), and malpractice insurance cost components of each of more than 7,000 types of physicians’ services. The final rule with comment period discusses CMS analysis of PE GPCI data and methods, and incorporates new data as part of the sixth GPCI update, while maintaining the current GPCI cost share weights pending the results of further CMS and Institute of Medicine studies.

The Affordable Care Act establishes a permanent 1.0 floor for the PE GPCI for frontier states (currently, Montana, Wyoming, Nevada, North Dakota, and South Dakota). The Affordable Care Act limits recognition of local differences in employee wages and office rents in the PE GPCIs for CYs 2011 and 2012 as compared to the national average. Localities are held harmless for any decrease in CYs 2011 and 2012 in their PE GPCIs that would result from the limited recognition of cost differences. CMS will continue to review the GPCIs in CY 2011, in accordance with the Affordable Care Act provision that requires the Secretary of Health and Human Services to analyze current methods of establishing PE GPCIs in order to make adjustments that fairly and reliably distinguish the costs of operating a medical practice in the different fee schedule areas.

Note: Check your GPCI (pronounced “gypsy”) for changes this year and every year. The GPCI changes the RVU values so they are specific to your location.

Where do I find my GPCI? Click here, click on Physician Fee Schedule Search at the top, click to accept the AMA terms, click on Geographic Practice Cost Index, enter your locality and click submit.

Improved Access to Certified Nurse-Midwife Services

The Affordable Care Act increases the Medicare payment for certified nurse-midwife services from 65 percent of the PFS amount for the same service furnished by a physician to 100 percent of the PFS amount for the same service furnished by a physician (or 80 percent of the actual charge if that is less). The increased payment amount is effective for services furnished on or after Jan. 1, 2011.

Misvalued Codes under the Physician Fee Schedule

The Affordable Care Act requires CMS to periodically review and identify potentially misvalued codes and make appropriate adjustments to the relative values of the services that may be misvalued. CMS has been engaged in a vigorous effort over the past several years to identify and revise potentially misvalued codes. The final rule with comment period identifies additional categories of services that may be misvalued, including codes with low work RVUs commonly billed in multiple units per single encounter and codes with high volume and low work RVUs. The final rule also includes CMS response to recommendations from the American Medical Association (AMA) Relative Value Update Committee (RUC) for CY 2011 regarding the work or direct practice expense inputs for 325 CPT codes.

Note: People and organizations are always lobbying to change the work or practice expense component of RVUs and some portion of the codes change every year. Make sure your computer is updated with the correct RVU components and total so your productivity reports are spot on.

Multiple Procedure Payment Reduction Policy for Therapy Services

The Affordable Care Act requires CMS to identify and make adjustments to the relative values for multiple services that are frequently billed together when a comprehensive service is furnished. CMS is adopting a multiple procedure payment reduction (MPPR) policy for therapy services in order to more appropriately recognize the efficiencies when combinations of therapy services are furnished together. The policy, as described in the CY 2011 MPFS final rule with comment period, states that the MPPR for always therapy services will reduce by 25 percent the payment for the practice expense component of the second and subsequent therapy services furnished by a single provider to a beneficiary on a single date of service. This policy will apply to all outpatient therapy services paid under Part B, including those furnished in office and facility settings.

Since publication of the CY 2011 MPFS final rule with comment period, this policy has been modified by the Physician Payment and Therapy Relief Act of 2010. Per this Act, CMS will apply the CY 2011 MPFS final rule policy of a 25 percent MPPR to therapy services furnished in the hospital outpatient department and other facility settings that are paid under section 1834(k) of the Social Security Act (referring to durable medical equipment), and a 20 percent therapy MPPR will apply to therapy services furnished in clinicians offices and other settings that are paid under section 1848 (payments to physicians) of the Act.

Note: The reduction applies solely to the practice expense (PE) portion of the fee schedule payment for Always Therapy Services when more than one service is provided the same patient on the same day. “Always therapy” services are always considered to be therapy regardless who provides the service (qualified therapist, physician, non-physician practitioner (NPP)). This is the list of services being referred to:

• 92506Speech /hearing evaluation
• 92507Speech/hearing therapy
• 92508Speech/hearing therapy
• 92526Oral function therapy
• 92597Oral speech device evaluation
• 92604Exam for speech device
• 92609Use of speech device service
• 96125Standardized cognitive performance test
• 97001PT evaluation
• 97002PT re-evaluation
• 97003OT evaluation
• 97001OT re-evaluation
• 97012Mechanical traction
• 97016Vasopneumatic device
• 97018Paraffin bath
• 97022Whirlpool
• 97024Diathermy (microwave)
• 97026Infrared
• 97028Ultraviolet
• 97032Electrical stimulation
• 97033Electric current
• 97034Contrast bath
• 97035Ultrasound
• 97036Hydrotherapy
• 97110Therapeutic exercise
• 97112Neuromuscular reeducation
• 97113Aquatic therapy
• 97116Gait training
• 97124Massage
• 97140Manual therapy
• 97150Group therapeutic
• 97530Therapeutic activities
• 97533Sensory integration
• 97535Self-care management
• 97537Community work reintegration
• 97542Wheelchair management
• 97750Physical performance test
• 97755Assistive technology assessment
• 97760Orthotic management & training
• 97761Prosthetic training
• 97762Checkout for orthotic or prosthetic use
• G0281Electrical stimulation for ulcers (unattended)
• G0283Electrical stimulation other than wound (unattended)
• G0329Electromagnetic therapy for ulcers

Modification of Equipment Utilization Factor and Modification of Multiple Procedure Payment Policy for Advanced Imaging Services

The Affordable Care Act adjusts the equipment utilization rate assumption for expensive diagnostic imaging equipment. Effective January 1, 2011, CMS will assign a 75 percent equipment utilization rate assumption to expensive diagnostic imaging equipment used in diagnostic computed tomography (CT) and magnetic resonance imaging (MRI) services. In addition, beginning on July 1, 2010, the Affordable Care Act increased the established MPFS multiple procedure payment reduction for the technical component of certain single-session imaging services to consecutive body areas from 25 to 50 percent for the second and subsequent imaging procedures performed in the same session.

Note: These are the services that were added by this policy:

• 70496-CT angiography, head
• 70498-CT angiography, neck
• 70544-MR angiography head w/o dye
• 70545-MR angiography head w/dye
• 70546-MR angiography head w/o & w/dye
• 70547-MR angiography neck w/o dye
• 70548-MR angiography neck w/dye
• 70549-MR angiography neck w/o & w/dye
• 71275-CT angiography, chest
• 71555- MRI angiography chest w/ or w/o dye
• 72159-MRI angiography spine w/o & w/dye
• 72191-CT angiography, pelvis w/o & w/ dye
• 72198-MRI angiography pelvis w/ or w/o dye
• 73206-CT angio upper extremity w/o & w/dye
• 73225-MR angio upper extremity w/o & w/dye
• 73706-CT angiography lower ext w/o & w/dye
• 73725-MR angio lower extremity w or w/o dye
• 74175-CT angiography, abdomen w/o & w/ dye
• 74185-MRI angiography, abdomen w/ or w/o dye
• 75565-Cardiology MRI velocity flow map add-on
• 75574-CT angiography heart w/3d image
• 75635-CT angiography abdominal arteries
• 76380-CAT scan follow-up study
• 77079-CT bone density, peripheral

Image via Wikipedia

Please welcome MMP’s newest sponsor: SmartFund Medical Acceptance Company, LLC aka “SMAC”

When I first heard about SMAC I thought they were a collection agency. But SMAC is not a collection agency in the traditional sense and I interviewed President Samara Keaton to find out what exactly SMAC is.

Manage My Practice: SMAC’s ad on Manage My Practice features a mermaid alternately kissing and smacking a handsome young man. What’s going on there?

Samara: We thought the SMAC (kiss or slap) approach to patient balance recovery was very appropriate. You love your patients, but sometimes you have to bring them a dose of reality – that there is a balance due for a service they received.

Manage My Practice: If you’re not a collections agency, what are you?

Samara: SMAC is the solution to the ever-present anxiety in healthcare over sending patients to collections. No one wants to send patients to collections, so we work with and help patients who want to pay. SMAC is a patient balance recovery company, and we do what you would do if you had unlimited resources to manage your patient collections.

Manage My Practice: And what is that?

Samara: SMAC bridges the gap between in-house patient collections and a third party collection agency. SMAC increases patient collections with customized precision according to the needs of the practice. First, the practice or hospital exports the account detail to SMAC, then SMAC opens the communication with the patient. We focus on:

(1) Educating the patient on “why” they owe the money
(2) Resolving insurance and other issues
(3) Working with the patients on timing of payments relative to their budget

Manage My Practice: What is SMAC’s collection approach?

Samara: We believe that every account has a story. We want to hear that story and help patients who want to pay make the payment or set up a payment plan. We resolve every account every time, which means that either the account is paid or SMAC is making a recommendation for credit impairment or legal action. It is the practice’s decision at that point.

Manage My Practice: When are accounts transferred to SMAC?

Samara: Most clients end up transferring accounts to us at around 61 days, but this is totally flexible. We can take accounts as soon as insurance pays and the patient balance is established, or we can take them after your in-house collections program has worked them, or we can take them when you want to impair credit or take legal action. Regardless of when you give us the account, we pay the practice $.50 for each account, then the practice recoups 70-80% upon collection of the account.

Manage My Practice: My memory of working with a third-party collections agency is the confusion over the patient payments at the practice and who owes whom what. How do you handle payments?

Samara: Patients can make payments to the practice or to SMAC. All payments are logged to an online account which shows who owes money to whom. SMAC makes payments to the practice/hospital weekly.

Manage My Practice: Your site says “Doctor Directed, Administrator Approved, Patient Preferred.” What does that mean?

Samara: It means that the physicians set the course for collections activity they are comfortable with, administrators approve the work of the SMAC collectors, and the patients prefer speaking to someone who can interpret the account activity to explain the reason why the balance is owed.

Manage My Practice: Why have patient collections become so important in healthcare?

Samara: In the past, the patient balances relative to the overall A/R balance of a medical practice was a much smaller number than it is today. Medical practitioners were conditioned to live off of co-pays and whatever they could get from the insurance companies, and tended to ignore and/or write off the unpaid patient balances. Today, Physicians have come to realize that they can no longer simply write-off the unpaid patient balances and expect to stay in business. 80% of the physicians interviewed said the A/R portion of their overall receivables has gone up more than 12% in the last 5 years. We expect this trend to continue as patients are moving more and more to catastrophic plans with $5,000 to $10,000 deductibles. Therefore, there could be an even greater shift in the revenue stream in the near future.

Manage My Practice: How can readers get in touch with you?

Samara: We invite medical practices, hospitals, billing companies and consultants to a very short (10-minute) demo of what SMAC can do. Contact us at 1-888-531-6406 or schedule an online demo here.

Disclosure: SMAC has paid a sponsorship fee to advertise on Manage My Practice. Sponsors are chosen for this blog based on usefulness to readers, product quality and authenticity.

Note: I get great pleasure in finding resources for my readers, and today I have a showstopper! Carol Flagg is co-owner of HITECH Answers and is visiting Manage My Practice to announce a free resource for eligible providers and hospitals.

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For the past two years HITECH Answers has been a vendor neutral resource for education on details of the HITECH Act. In that time, weve amassed a significant library of recorded webinars for viewing, along with a body of exclusive white papers and research.

But the time for analyzing the HITECH Act has ended. Similar to the purpose served by the 62 Regional Extension Centers (RECs) , our goal is to support as much as we can the process of adoption of a certified EHR system that meets meaningful use criteria. Given the sheer number of health care providers needing significant help and guidance through this process, we have transitioned our existing web-based subscription model to function as a Virtual Extension Center.

This Virtual Extension Center, or VEC, supports health care providers and hospitals looking for education and analysis throughout the HITECH life cycle in a 100% virtual environment. In a nutshell, our VEC widens the education circle and opportunity for all Eligible Professionals and Eligible Hospitals. Weve also made membership to our VEC completely free for EPs and EHs for the entire life cycle of the HITECH Act.

So what, exactly, is the VEC? And how does it function?

First and foremost, this newly created VEC houses all of the existing recorded training material and research accumulated over the past two years. This information is readily accessible upon members logging on to HITECH Answers. Heres what has been added to round out VEC membership:

• Meaningful Use for EPs and EHs Live webinar events hosted twice a month that focus specifically on the details for achieving Stage 1 meaningful use for EPs and EHs.
• Upcoming live web casts on tax implications for incentives for EPs and EHs, workflow, ICD-10 migration, HIPAA security assessment, the pros and cons of SaaS, EHR contract negotiation and more.
• Live web cast for our VEC members who are vendors and HIT consultants that address pressing topics and needs in conducting business in this industry.
• Attendance to live webcast interviews and presentations from leading national experts.
• Access to exclusive white papers and research found only in our VEC.
• Direct access to independent experts to help answers your specific questions.

An obvious large part of the VEC will be our live events. We debut our event offerings with these two important topics Meaningful Use for Specialists andEHR Contract Negotiations.

Meaningful Use for Specialists Qualifying for CMS EHR Incentives

January 18, 2011, 7 pm EST

Event summary: A first glance at the Stage 1 Core and Menu Set objectives makes sense for primary care, but what about specialists? How can Psychiatrists, Oncologists, Radiologists, Urologists, and other specialists meet the requirements and objectives outlined in CMS EHR Incentive Program? EPs that are specialists can still achieve the CMS incentives based on the flexibility that is incorporated into two primary areas: Menu Exclusions and Quality Measures.

EHR Contract Negotiations: Q & A with William OToole, OToole Law Group

January 25, 2011, 7 pm EST

Event summary: The HITECH Act of the American Recovery and Reinvestment Act of 2009 is driving new technology acquisitions unlike anything seen in the healthcare information technology (HIT) sector since Y2K. Specific terms and warranties in Electronic Health Record (EHR) agreements are absolutely essential for the protection of provider customers. Competent and experienced legal advice is extremely important. Get your questions answered in this special Q & A session.

You can visit our Events Page to learn more about these sessions.

And you can learn more about qualifying for a free membership at Become A Member or you can contact me at: carol@hitechanswers.com.

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Disclosure from Mary Pat: HITECH Answers sells my book on their site, and I am a Consulting Expert to HITECH Answers.

Healthcare is changing. It is changing to eliminate waste of money, time and resources. It is changing to make more care available with less providers. It is changing to empower patients to participate in their own care. How are you changing with the times in 2011? Here are 9 ideas.

1. Make your website interactive, clean-looking, interactive, friendly and interactive. Think of your website as your digital receptionist to your practice. If all your patients can do on your website is look up your phone number, you’re wasting everyone’s time. Patients want to register, make appointments, pay their bill, get their test results, chat online with a staff member, access their personal health record (PHR), watch videos and listen to podcasts you make or recommend. They do not want to wander around your phone tree or wait on hold.
2. Give your patients information, information, information. According to a MedTera study conducted in September 2010, 95% surveyed indicated that they are looking for more comprehensive information about disease management, and 77% said they hadn’t received any written information about their illness or medications directly from the physician. See more details about what patients want here.
3. Understand that people have different types of learning styles and offer your practice and medical information in different ways. Offer information via written and digital documents, videos, and podcasts. Offer support groups and group education for the newly diagnosed. Help patients build communities around your practice.
4. Take down all those signs asking people to turn off their cell phones. Cell phones are going to revolutionize healthcare so go ahead and bite the bullet and embrace them. For all you know the person on the cellphone when you walk in the exam room is texting “gr8 visit til now, wil i <3 doc?” (Great visit until now, will I love the doctor?)
5. Eliminate the Wait. Patients have much better things to do than wait in your practice. It doesn’t matter why the provider’s late – you’re cutting into the patient’s ability to make money and get things done. Text them to let them know the provider is running late. Text them to let them know an earlier appointment is available. Give patients an appointment range (between 10am and 12N), then text them when their appointment is 20 minutes away.
6. Use a patient portal to take credit cards, keeping them securely on file and stop sending patients statements. Use the portal to deliver results and chat and email patients.
7. Stop fighting the tide and let your staff use social media at work – for work. Involve everyone in Facebook, Twitter and your website and blog. Using social media for communication and marketing is not a one-person job.
8. Form a patient advisory board and listen to what specifics your patients want from you. If people don’t have time to attend a face-to-face meeting, Skype them in.
9. Think about alternate service delivery models, both in-person (group visits, home visits) and digitally (email, texting, Skyping, avatar coaches, home monitoring systems.) Emotional technology studies show that people can improve their health by accepting and utilizing technology in healthcare.

What do patients want in 2011? They want information, communication and a real connection with you. Use social media and technology innovations to make it happen.

Photo credit Image by gumption via Flickr

Amazingly, Ming-Zher Poh’s Cardiocam takes physiological measurements without physical contact with the patient of any kind! Click on the Cardiocam link below to see the video demonstrating the technology, which was introduced mid-2010.

Cardiocam

Thanks to Denise Silber’s eHealth Blog for featuring this technology on her blog.