How has medical practice management evolved since you started your career?
Medical practice management has evolved significantly since I started my career. It has become a challenge to keep abreast of the developments in this ever-changing, fast-paced field. We are being challenged to provide superior, yet accountable care, in innovative ways, all the way ensuring that this is done in a collaborative manner.
What are the major challenges of managing medical practices today?
Some of the major challenges of managing medical practices are: To prepare the practice for upcoming reimbursement changes that seek to reward good outcomes while penalizing bad outcomes; managing financial matters with the uncertainty of reimbursements and at the same time dealing with rising overhead expenses; collection from high deductible or HSA patients, whilst ensuring their continued access to or utilization of care, etc.
What are you doing now to prepare for the future of healthcare?
We are in the process of identifying areas of weakness and growth. We are investing in technology with an eye on the future. We are actively seeking partnerships, including becoming part of an ACO, to stay ahead of the future reimbursement changes.
What healthcare trends interest you most today?
There are several exciting healthcare trends that interest me, in particular the development of ways in which micro-samples of blood can be used to run multiple tests, rather than have the patient give a substantial amount of blood for a few tests. Also, the use of Cloud technology for storage of records, communication and generation of appropriate referrals.
What have you found are the biggest benefits of the transition to EHR?
The biggest benefit of the transition to EHR has been the fact that a patient now has a more comprehensive, yet easily accessible record, enabling better care to be rendered. Documentation has become somewhat easier for those comfortable with the EHR. Coding and billing errors have minimized. Communication with Specialists has improved.
What would you love to change about EHR? What improvements would you like to see made?
It should be more user friendly and should save time, rather than consume time. Multiple ways of documentation should be incorporated. Preventative health maintenance should be stressed.
How has EHR impacted practice management?
EHR has improved care coordination, enabled efficient running of the practice, helped with cost savings overall and improved outcomes overall.
What has been the reception of your patients to patient portals?
It has been a mixed sort of a reception, with some patients welcoming these portals and actually utilizing them regularly, and some patients showing no interest in them at all.
What have you found are the most effective ways to get patients to use portals?
By educating the patients that this is a tool for them to understand and take better control of their health, and be a partner in this journey rather than a spectator.
How do you envision these portals being used in the future?
I envision the portals being more interactive in the future, with the patients being able to communicate better with the healthcare team.
What are some of the challenges you are facing with billing today?
Some of the major challenges faced in billing are collection of co-pays and clearance of a unpaid balance prior to the patient being seen, inability to electronically cross check insurance coverage, determination of procedures which are not covered, and approval of procedures which require prior authorization beforehand.
What types of tools have you found to be the most useful when managing billing?
EHR’s, while having their downside, have definitely helped in correct coding and in minimizing billing errors. Electronic submission of claims has led to more timely processing and reimbursement, thereby helping the practice significantly.
In a perfect world, what features would your medical billing software include?
Medical billing software should ideally include features which manage or ensure compliance, minimize or prevent coding and billing errors, result in expedited claim reimbursements and result in increased overall profitability.
How do you manage your relationship with insurance companies?
By designating a point person of contact on either side, or at least from our practice, to begin with, to improve communication and understanding. Also, by familiarizing myself or our organization well with the practices and policies of insurance companies and their impact on my practice.
Where do you have the biggest struggles with reimbursement?
Denial of claims citing inappropriate documentation or coding, or delayed submission of claims; poor reimbursement rates for services rendered; or delayed reimbursement effecting the financial health of the practice.
What have you found improves your practice’s ability to be reimbursed?
Submitting claims in a timely fashion, with appropriate documentation and coding. Improved communication.
What would you love to change about working with insurance companies?
I would love to have improved communication with the insurance companies. I would also like the insurance companies to understand my practice and it’s needs better, and to that end process claims in a timely and efficient manner.
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