Disclosure: We use and believe in Box at Manage My Practice and we are Certified Box Resellers. More information here.

Box, a California cloud file sharing and content management service has announced new partners and investments in the healthcare industry. Makers of software for clinical documentation, care coordination, interoperability and access to care will integrate tightly with Box’s existing platform to make sharing data from their software even easier. The platform partners announced were: EHR DrChrono, dental PM systemUmbie Dentalcare, secure messaging apps TigerText and Medigram, provider social network Doximity, telehealth platform Healthtap, image viewers iMedViewer and iPaxera, record release app Medi-Copy and finally posture analysis app Posture Screen Mobile. In addition to announcing the new platform partners, Box also announced an early-seed investment in DrChrono to help the software make medical data viewable in Box. Box also added former Google Health director Missy Krasner to help their push into healthcare. Krasner sees her work with Box as “picking up where Google Health left off“.

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Register Now!

Our next Credit Card on File Webinar will be Thursday, May 9th at 1 p.m. EST. If you want to improve your practice’s cash flow in just one hour, sign up now as seats are going fast!

We’ve had such a great response to our Credit Card on File Webinars that we are running another session.We hope you will join us!Click here to register!

How to Cut Your Medical Practice’s A/R and Collection Costs in Just 60 Minutes.

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Update: We have moved the session up one week! Please note the new date!

With registrations piling up we are moving the Credit Card on File Webinar up to Tuesday, March 5th at 1 p.m. EST. If you want to improve your practice’s cashflow in just one hour sign up now as seats are going fast!

We had such a great response to our Credit Card on File Webinars that we are running another session, in addition to the Revenue Cycle Management Series that will start next month. We hope you will join us!Click here to register!

How to Cut Your Medical Practice’s A/R and Collection Costs in Just 60 Minutes.

We know patients are bearing more of the financial burden for healthcare, particularly in the form of High Deductible Health Plans (HDHPs), so it falls to the provider to collect the deductibles. How can you collect deductibles, co-pays and co-insurance, as well as electronically manage patient payment plans while reducing the associated labor and resource expense? Register for the Manage My Practice webinar that teaches you everything you need to know to spend less and collect more at time of service by implementing a Credit Card on File Program in your practice.

What is a Credit Card on File Program?

A Credit Card on File (CCOF) Program facilitates the collection of a credit or debit card from each patient and requires this card to be used for co-pays, co-insurance and deductibles. You have the option of collecting an estimate of what is due at time of service, and/or charging the credit card when the payer pays the claim.

What are the benefits of a Credit Card on File Program?

• Reduced days in accounts receivable.
• Improved cash flow.
• Elimination of statements.
• Electronic management of payment plans.
• Elimination of bounced checks.
• Elimination of the manual refund process and refund check expense.
• Reduced labor in daily reconciliation process.
• Elimination of cash drawers and change issues.
• Reduction or elimination of deposits.
• Facilitate faster check-in and check-out.
• Elimination of paper receipts.
• Elimination of collections expense.

This one-hour webcourse with accompanying materials is an incredible value at $59.95

What will I learn if I take this webinar?

1. Understand how a credit card on file program differs from traditional payment options offered by practices.
2. Learn the terminology and protocols of credit card processing its not as mysterious as it seems!
3. Compare credit card processing fees and choose a vendor based on an informed analysis.
4. Utilize handouts to train staff and educate patients on the credit card on file program.
5. Successfully implement a credit card on file program.

What does the program include?

Purchase of this program for only $59.95 includes the live webinar, slide handouts, and a complete Action Pack of forms and templates in Word, including:
1. Worksheet for Credit Card on File Program Return on Investment (ROI)
2. Staff Script & Role Playing Suggestions for Staff Training
3. Sample Security Policy to Comply With PCI Guidelines
4. Credit Card on File Program Timeline Worksheet
5. Credit Card Program Comparison Worksheet
6. Patient Handout #1: Information About Our Credit Card on File Program & Discontinuation of Statements
7. Patient Handout #2: What is a Deductible and How Does It Affect Me?
8. Sample Patient Agreement for the Credit Card on File Program

Register Now!

• March 5, 2013 at 1:00 p.m. Eastern/ 12:00 p.m. Central/
  11:00 a.m. Mountain/ 10:00 a.m. Pacific Click here to register!

A Manage My Practice Webinar:

Starting a Credit Card on File Program

in Your Practice

We know patients are bearing more of the financial burden for healthcare, particularly in the form of High Deductible Health Plans (HDHPs), so it falls to the provider to collect the deductibles. How can you collect deductibles, co-pays and co-insurance, as well as electronically manage patient payment plans while reducing the associated labor and resource expense? Register for the Manage My Practice webinar that teaches you everything you need to know to spend less and collect more at time of service by implementing a Credit Card on File Program in your practice.

What is a Credit Card on File Program?

A Credit Card on File (CCOF) Program facilitates the collection of a credit or debit card from each patient and requires this card to be used for co-pays, co-insurance and deductibles. You have the option of collecting an estimate of what is due at time of service, and/or charging the credit card when the payer pays the claim.

What are the benefits of a Credit Card on File Program?

• Reduced days in accounts receivable.
• Improved cash flow.
• Elimination of statements.
• Electronic management of payment plans.
• Elimination of bounced checks.
• Elimination of the manual refund process and refund check expense.
• Reduced labor in daily reconciliation process.
• Elimination of cash drawers and change issues.
• Reduction or elimination of deposits.
• Facilitate faster check-in and check-out.
• Elimination of paper receipts.
• Elimination of collections expense.

This one-hour webcourse with accompanying materials is an incredible value at $59.95

What will I learn if I take this webinar?

1. Understand how a credit card on file program differs from traditional payment options offered by practices.
2. Learn the terminology and protocols of credit card processing its not as mysterious as it seems!
3. Compare credit card processing fees and choose a vendor based on an informed analysis.
4. Utilize handouts to train staff and educate patients on the credit card on file program.
5. Successfully implement a credit card on file program.

What does the program include?

Purchase of this program for only $59.95 includes the live webinar, slide handouts, and a complete Action Pack of forms and templates in Word, including:
1. Worksheet for Credit Card on File Program Return on Investment (ROI)
2. Staff Script & Role Playing Suggestions for Staff Training
3. Sample Security Policy to Comply With PCI Guidelines
4. Credit Card on File Program Timeline Worksheet
5. Credit Card Program Comparison Worksheet
6. Patient Handout #1: Information About Our Credit Card on File Program & Discontinuation of Statements
7. Patient Handout #2: What is a Deductible and How Does It Affect Me?
8. Sample Patient Agreement for the Credit Card on File Program

The Webinar will be offered live at three different sessions for your convenience.

• February 5, 2013 at 10:00 a.m. Eastern/ 9:00 a.m. Central/
  8:00 a.m. Mountain/ 7:00 a.m. Pacific Click here to register!
• February 6, 2013 at 1:00 p.m. Eastern/ 12N Central/ 11:00
  a.m. Mountain/ 10:00 a.m. Pacific Click here to register!
• February 7, 2013 at 4:00 p.m. Eastern/ 3:00 p.m. Central/ 2:00 p.m. Mountain/ 1:00 a.m. Pacific Click here to register!

Medicare has so many programs that have the potential to increase or decrease your payments that practices need a list to keep them straight.

Here’s your list with information on which programs are mutually exclusive and which can be combined.

1. Electronic Health Records (EHR) Incentive Program

• You must be an eligible provider to participate.
• You must be the owner of the EHR, although you do not need to have paid for the EHR.
• The EHR must be certified.
• You can choose to participate in Medicare (federally administered) or Medicaid (state administered) program.
• You must register for the programs.
• You must attest or document that you have adopted, implemented, upgraded or demonstrate meaningful use.
• Eligible professionals choosing to participate the Medicare program can each earn up to $44K over 5 years, and eligible professionals choosing to participate in the Medicaid program can each earn up to $63,750 over 6 years.

2. ePrescribing Incentive Program

• Eligible professionals do not need to register for the program.
• You can participate in one of three ways: via submitting codes on claim forms, via an EHR or via a registry
• Each professional needs to report 10 eRx events for Medicare patients for dates of service before June 30, 2012 OR apply for one of five exclusions or four exemptions.
• EPs who are successful e-prescribers can qualify to earn an incentive payment based on a percentage of their total estimated Medicare PFS allowed charges processed not later than 2 months after the end of the reporting period. For reporting year 2012, EPs who are successful e-prescribers can qualify to earn an incentive payment equal to 1.0 percent of allowed charges. For reporting year 2013, EPs can qualify to earn an incentive payment of 0.5 percent of allowed charges. Beginning in 2012, EPs who are not successful e-prescribers in 2011 and do not qualify for a hardship exception will be subject to a payment adjustment equal to 1.0 percent of their Medicare PFS allowed charges. The payment adjustment increases to 1.5 percent in 2013 and 2.0 percent in 2014.

3. PQRS (Physician Quality Reporting System)

• Originally called PQRI (Physician Quality Reporting Initiative) is the basis for pay-for-performance models.
• Physicians may report individually or practices may choose a set of three measures that relate to the type of patients they see. Measures are performed and modifiers are attached to claims.
• Bonuses are available until 2014; starting in 2015 practices not participating in PQRS will receive a negative payment adjustment.
• For reporting years 2012 through 2014, EPs who satisfactorily report Physician Quality Reporting System measures will earn an incentive payment equal to 0.5 percent of allowed charges. Additionally, for reporting years 2011 through 2014, EPs who satisfactorily report Physician Quality Reporting System measures can qualify to earn an additional 0.5 percent incentive payment by, more frequently than is required to qualify for or maintain board certification status, participating in a maintenance of certification program and successfully completing a qualified maintenance of certification program practice assessment. Beginning in 2015, EPs who do not satisfactorily report under the Physician Quality Reporting System will be subject to a payment adjustment equal to 1.5 percent of their Medicare PFS allowed charges. The payment adjustment increases to 2.0 percent in 2016 and beyond.

4. Medicare Wellness Visits

• Many practices are losing money due to the confusion over what Medicare pays for and what Medicare doesn’t pay for. Medicare introduced three new visits in 2010 and many providers continue to have trouble understanding and providing them correctly.
• The “Welcome to Medicare” visit is technically called the “Initial Patient Physical Examination” (IPPE), but to everyone’s dismay, it is not a physical examination at all, with the exception of basic visits such as height, weight, BMI, blood pressure and pulse, and the potential for an EKG and an Abdominal Aortic Aneurysm screening. The Annual Wellness Visit (AWV) and the Subsequent Annual Wellness Visit are not physical examinations either, yet almost ALL patients believe that Medicare now gives free annual physicals.
• Practices must train all staff and physicians to use the correct terminology first. I suggest everyone stop using the phrases “annual physical” or “complete physical” with Medicare patients. Patients can request and receive:
  • A Welcome to Medicare Visit with no exam (no deductible, no co-insurance)
  • A first annual Wellness Visit with no exam (no deductible, no co-insurance)
  • A Subsequent Annual Wellness Visit with no exam every year thereafter (no deductible, no co-insurance)
• What patients think they want is either a preventive visit, which Medicare will NOT pay for, or a standard Evaluation & Management (E/M) visit, which their deductible and co-insurance will apply to.
• The only way the practice can win is by driving home to patients what Medicare does pay for and doesn’t pay for and making sure your documentation matches the code you submit to Medicare.

5. The ABN (Advance Beneficiary Notice)

• Many practices miss revenue when they provide services to Medicare patients that are statutorily excluded from Medicare benefits.
• These may be services that do not meet the Medicare definition of medical necessity or are provided at more frequent intervals than Medicare approves.
• Identifying these non-covered services is the hard thing, however, unless your EMR can alert you to a service that will not be paid by Medicare, and if the patient requests the service and signs an ABN prior to the provision of the service In this case, the practice may collect the full fee from the patient.

6. Primary Care Incentive Payment Program (PCIP)

• Eligible Providers (Clinical Nurse Specialists, Nurse Practitioners, Physician Assistants, and Physicians who have their primary specialty designation in family medicine, internal medicine, geriatric medicine or pediatric medicine) can receive a 10% incentive payment for services under Part B.
• The PCIP program, which was created by the Patient Protection and Affordable Care Act, requires Medicare to pay primary care providers, whose primary care billings comprise at least 60 percent of their total Medicare allowed charges, a quarterly 10-percent bonus from Jan. 1, 2011, until the end of December 2015.
• Eligible primary care physicians furnishing a primary care service in a Health Professional Shortage Area (HPSA) area may receive both a HPSA and a PCIP payment.

7. HPSA (Health Professional Shortage Area)

• Medicare makes bonus payments annually of 10% to physicians who provide medical care services in geographic areas that lack sufficient health care providers to meet the needs of the population.
• Payments are automatic; there is no need to register or report anything on the claim for
• If services are provided in ZIP code areas that do not fall entirely within a full county HPSA or partial county HPSA, the AQ modifier must be entered on the claim to receive the bonus.

8. HPSA (Health Professional Shortage Area ) Surgical Incentive Payment (HSIP)

• The Affordable Care Act of 2010, Section 5501 (b)(4) expands bonus payments for general surgeons in HPSAs. Effective January 1, 2011 through December 31, 2015, physicians serving in designated HPSAs will receive an additional 10% bonus for major surgical procedures with a 10 or 90 day global period.
• Payments are automatic; there is no need to register or report anything on the claim form.
• If services are provided in ZIP code areas that do not fall entirely within a full county HPSA or partial county HPSA, the AQ modifier must be entered on the claim to receive the bonus.

9. NEW! Comprehensive Primary Care Initiative (CPCi)

• Payment model per beneficiary per month (PBPM) for care management of Medicaid and Medicare patients
• Markets in Arkansas, Colorado, New jersey, New York, Ohio/Kentucky, Oklahoma and Oregon for Medicaid patients
• Arkansas, Colorado, Ohio and Oregon are the four states for Medicaid pilots.
• Multiple payers, including CMS, will be paying a monthly care management fee to support the 5 primary care functions of:
  • Risk-stratified care management
  • Access and continuity
  • Planned care for chronic care & preventive care
  • Patient & caregiver engagement
  • Coordination of care across the medical neighborhood
• Primary care practices in the states and markets can apply from June 15 to July 20, 2012 (application here.)

What Medicare Bonus or Incentive Programs Can Be Claimed Together?

• PQRS can claimed with eRx.
• PQRS can be claimed with EHR.
• HPSA and PCIP are automatic and are not affected by any other programs
• EHR and eRx can both be claimed but you cannot earn both an eRx incentive and an EHR incentive in the same year if you elect to receive the EHR incentive payment through Medicare. NOTE: Just because you cannot claim the eRx bonus in conjunction with EHR incentive, you must still continue to ePrescribe to avoid the eRx penalty!

What’s your website doing for your practice?

If your website is providing information to future and current patients, that’s a good thing.

More importantly, though, your website should be

1. Driving new patients to the practice.
2. Driving established patients to return to the practice.
3. Keeping patients attached to you as their provider.

Your website should be providing B2C (business to consumer) marketing for you. How does a website accomplish these things? In a web search, being the first or one of the first unpaid results that appears in the search is the way to ensure searchers find your practice. The way to get to page one, even number one on page one, is through SEO.

SEO stands for Search Engine Optimization.

Search Engine Optimization is the way you market your practice on the internet so that you show up in internet searches as high on page one of a search as possible. Wikipedia defines SEO as

the process of improving the visibility of a website or a web page in a search engine’s “natural,” or un-paid (“organic” or “algorithmic”), search results.

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Any time I ask a practice about their pain points, they invariably name “the phones” as one of their toughest problems to solve. Phone calls are escalating as many patients are trying to avoid going to the doctor. That means instead of making an appointment, patients are calling hoping to be given advice or a prescription over the phone.

Staffing up to answer the phones is rarely an option for most practices. In many cases, there is no compensation for healthcare via the phone, therefore adding more staff for no additional compensation is not tenable. This is just one example where the physician is feeling the bite of having to pay more for a practice that produces less income.

There is no best practice for number of phone receptionists to number of physicians and non-physician providers. Every practice is different based on the specialty, the practice culture and staffing structure.

When the problem is the phones, the issue is complex. Doing a poor job of answering the phones not only causes patient dissatisfaction, it snowballs as patients call back again looking for answers, causing confusion and inefficiency. Poor phone management also has the potential to compromise care if a patient’s question goes unanswered.

Where do you start to tackle the problem with the phones?

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Anyone who has read my writing for any period of time knows that I am a big proponent of No Statements!

Patient statements are a waste of time and resources. Think of what your life might be like without statements:

No monthly expense to generate or send statements via electronic service or printing and stuffing.

1. No need to sort them out of the mail, open them, post them, copy or scan them, and deposit them.
2. No returned checks.
3. When three or more statements don’t zero-balance the account, no need to prepare the accounts to be sent to third-party collections and write them off.
4. No need to dismiss the patient from the practice.
5. No need to post any collections payments and adjustment to the accounts.
6. No need to deal with the patient when they want to return to the practice and you have to deal with it.

But what takes the place of statements?

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Three technology trends are creating big opportunities for healthcare providers and managers to improve their bottom line, drive savings, and empower a mobile workforce with “The Cloud”:

1. Improved cellular and network access to the Internet at all times, from all devices.

1. More powerful, less expensive smartphones and mobile devices to harness this improved access.

1. The move to deliver computing services to these mobile devices, as well as traditional personal computers through these ubiquitous, powerful Internet connections, so that most of the work is actually done “In the Cloud”- saving a lot of resources.

The Cloud is more than just a fashionable concept – this is a real change in the way people work- and leading organizations are looking past the buzz into the substantive improvements that technology can offer in work flow and cash flow.

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