The Smart Medical Practice

Brent Nielson of St. Cloud State on Challenges in Practice Management Today


Practice management

Dr. Brent Nielsen is the Medical Director at St. Cloud State University Health Services where he oversees the medical care of students at a campus of 15,000 students.

We recently asked for his insight on practice management. Here’s what Dr. Nielsen shared:

How has medical practice management evolved since you started your career?

The most dramatic changes are all of the regulations and work directed toward billing, coding, insurance and documentation necessary for patient care.

What are the major challenges of managing medical practices today?

Definitely having the necessary support staff to deal with all of the above mentioned issues, and managing those added costs.

What are you doing now to prepare for the future of healthcare?

Our practice is focused on customer service and patient care. That will never go out of style. In addition, we have a great patient portal and are looking at delivering more telemedicine options for our patients in the future.

What have you found are the biggest benefits of the transition to EHR?

It makes some components of care delivery much easier and efficient. Examples include e-prescribing, delivering results to patients through the portal and communicating with patients via our portal.

What would you love to change about EHR? What improvements would you like to see made?

I would like to see them be more affordable. In addition, we need to embed online care options for patients into our EHRs so their existing providers can supplement care with telemedicine.

How has EHR impacted practice management?

It’s good for collecting practice data on billing and coding and patient care.

What has been the reception of your patients to patient portals?

They love them. More than 50 percent of our patients schedule their appointments form the portal and we often communicate with patients after the visit via the portal.

What have you found are the most effective ways to get patients to use portals?

I think it’s a generational thing, and we serve the segment of the population that prefers to communicate and engage in our practice options via a portal.

How do you envision these portals being used in the future?

They will be essential and a huge part of customer satisfaction given the generational issue mentioned above.

What are some of the challenges you are facing with billing today?

Adequate reimbursement, delay in revenues and the complexity of ICD-10 (ICD-10 is not intuitive for medical providers).

What types of tools have you found to be the most useful when managing billing?

It’s important to have options to answer billing and coding questions.

In a perfect world, what features would your medical billing software include?

A very good search engine for the ICD-10 coding options – that takes a lot of provider time.

How do you manage your relationship with insurance companies?

We focus more on our patients to be honest. However, we have a professional, working relationship with insurance companies and try to be fair an honest with them, while expecting the same.

Where do you have the biggest struggles with reimbursement?

I think the biggest issues with reimbursement relate to insurance rules – meaning you can’t get paid for certain things based on a coding or insurance-related reason, when medically it would still be best for the patient.

What have you found improves your practice’s ability to be reimbursed?

An excellent billing office staff is the most important asset.

Give your billing staff the best tools to manage your practice. Sign up for the free edition of PracticeSuite.


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