Tag: Healthcare

The 4 Most Common Reasons Your Practice’s Claims Are Bouncing

Posted on by VettersEnt

Billing can be time-consuming, tedious and frustrating to say the least. It can be even more frustrating when the medical claims that you worked so hard to submit are bounced right back. What are the most common reasons that a medical practice’s claims are bouncing back after submission?

Minor Errors

Just like it’s easy to miss a comma in an email or mistype a word, it’s also very easy to make minor errors in medical claims. Reimbursements are often denied or delayed due to seemingly-small mistakes, like forgetting to include a plan ID number or mixing up a letter. Because front desks are already so busy and overwhelmed, mistakes can fall through the cracks. One winning solution to this is using a professional outsourced claims processing service that will review claims before submission and look just for errors. The time saved from going through a resubmission is much less than time spent reviewing claims.

Missing Information

Another common reason that claims are bouncing is insufficient information. You always need to submit documentation to back up claims, and you should always supply each insurance provider the information that is requested to process payment in an expedient manner. Again, it is much easier to put the effort into properly gathering everything beforehand instead of needing to go back in the future to find the right documentation.

Skipping Authorization

If you needed authorization before a procedure was performed and it was not secured, you shouldn’t be too surprised that a claim bounced back your way. You should verify whether or not prior authorization is needed before you schedule the procedure. When it is time to bill, ensure that you also include the prior authorization number on the submitted claim. While prior authorizations can seem like an annoying extra step, they are vital to ensuring that claims receive approval in a prompt manner.

Changes on the Patient End

One of the most common reasons for claim denial isn’t necessarily your practice’s fault at all. Claims are often denied because a patient’s coverage has changed, the plan or payer has been changed or coverage has been terminated altogether. Even if you think everything is the same as the last time you spoke with a patient, you should always ask to confirm insurance information and see an insurance card at each appointment.

Trust the Experts at Vetters Enterprises for your Billing Needs

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

When You Should Call Your Patients Instead of Emailing

Posted on by VettersEnt

Technology has changed the entire healthcare landscape, and for many doctors, it has also transformed the way that they speak with their patients. Instead of communicating by telephone and letter being the only options, emailing and texting are now on the table. Do you know when you should call your patients instead of emailing or texting?

Why Do Doctors Email?

A growing number of doctors use email for most regular communications, as it can increase practice efficiency and prevent playing phone tag. Doctors also like being able to make themselves available for patient questions and concerns around the clock through email. Email communication can also be perfectly sufficient for quick messages requesting appointments, rescheduling or requesting prescription refills. However, there are HIPAA violations that can come to play over email that aren’t as possible elsewhere.

When Emailing Is Inappropriate

As with any other technology product, there are both upsides and downsides to emailing instead of calling your patients. Beyond potential murky water with HIPAA guidelines, there are many situations where emailing can lead to unnecessary stress and confusion:

  • Discussing issues before completing a physical examination of the patient could lead to misdiagnosis.
  • Email messages can be misinterpreted by the patient receiving them. If the misinterpretation leads to damage, you could be held liable.
  • Anyone who is not the patient could open the email and read sensitive information.

If there is a chance that any of the above scenarios could occur, you should call your patients instead. Remember that the tone of your voice can have a huge effect on the message that a patient receives, and written words are not ideal for conveying tone.

If You Do Email

When it is appropriate to email instead of calling your patients, use the following best practices:

  • Use email messages to supplement your existing patient relationship, send reminders and offer general health tips.
  • Only use email if you have a firewall-protected server and both you and the patient are using encryption technology. Most standard email does not meet HIPAA requirements.
  • Educate your patients about when it is appropriate to email the office instead of calling.

Learn When to Call Your Patients with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Ending the Revolving Door of Patients at Your Practice

Posted on by VettersEnt

A general practice with a revolving door of patients is one that always seems to be losing patients at the same rate that they are attracting them. New patients are showing up for appointments, but most of them vanish off to never be seen again. While it’s tempting to invest most of your marketing efforts towards attracting new patients, without making an attempt to keep the old ones, you’ll end up with a revolving door of patients.

Why Are Patients Leaving?

One survey of patients who chose to leave their medical practice of choice found that patients have 4 core reasons for putting their medical care in someone else’s hands:

  1. Feeling neglected
  2. Poor communication or misinformation
  3. Feeling rushed
  4. Lack of detail or description for procedures, tests and results

At the heart of all 4 of those things is that sometimes, doctors do not have enough time to satisfy patient needs fully. What does that mean? You should go above and beyond to provide patients with additional resources and also distribute the patient retention responsibility throughout your practice. It isn’t just the doctor who is responsible for keeping patients. Instead, it’s also the receptionists, nurses, technicians and more.

Educate

Invest in resources that can educate your patients. While you might not have time to explain a procedure to a patient in one visit thoroughly, you could show a video, offer them literature or direct them to a page on your website. When patients know where to find the information that they need, they will be much more likely to seek it out and sate their curiosity.

Ask and Reassess

Regular patient surveys are another great way to see how you’re doing and make changes to suit the needs of your patients better. In some cases, patients value the opportunity to express themselves more than actual changes taking place! Make it clear that you care about your patients, their health and their experience at your practice and you will be much closer to retaining them.

Follow Up

When a patient leaves that means that they’re gone forever, right? No! If a patient leaves your practice, despite your efforts to retain them, you should place a follow-up call to see why they chose to do so. Many patients are willing to give you valuable insight on why they left, which could help you pull more patients out of the revolving door of patients.

Additional Retention Tips

  • Ensure that patients are informed of when their next appointment is.
  • Reward patient loyalty.
  • Send appointment reminders.
  • Make scheduling as easy as possible.
  • Keep track of important patient information, like birthdays and contact information.

Practice Guidance for Your Practice from Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

What PCPs Should Know About Asking for a Hospice Consult as a PCP

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Once you’ve determined that hospice care might be the best course of treatment for one of your patients, it’s time to formulate a plan to discuss hospice care and arrange for a hospice consult. Making that recommendation can be easier said than done, especially since hospice care has many connotations that go along with it. What do you need to know about hospice care for your patients?

What Is Hospice Care?

Whenever someone is facing a life-limiting illness, the goal of their medical care should be a team-oriented approach to care, pain management, emotional support and spiritual support that is customized to the patient. In surveys, many caregivers and families of terminally ill patients indicate that they would have liked information about hospice care when the diagnosis was labeled as terminal, not later in the process. While communicating this might not be comfortable, you should keep this in mind.

Delivering Bad News

One of the best methods for delivering bad news in the medical field is SPIKES. SPIKES represents a 6-stage process: set up, perception, invitation, knowledge, emotion and summary.

  • Set Up: Choose the right environment for the discussion and ensure medical consensus beforehand.
  • Perception: Ask the patient what they know about the illness and any information they already know. Ask the patient what matters most to them and what their wishes are. You should also ask if the patient has heard of hospice care and what they know about it.
  • Invitation: Ask the patient if it’s okay if you share information about hospice care with them.
  • Knowledge: Provide the patient with information before the hospice consult. Let the patient know that hospice can help them meet their goals of staying at home instead of going to the hospital, pain management and emotional support. Also, let the patient know what hospice care provides.
  • Emotion: Express sympathy for the patient. For example, “I know this isn’t good news to hear,” or “I’m sorry that I have to be the one to tell you this.”
  • Summary: When patients get a lot of information at once, it can be hard for them to process things. At the end of the conversation, ask the patient what they understood. You should also state clearly your recommendation that the patient have a hospice consult so they understand what the next step should be.

Recommending a Hospice Consult

You should determine whether or not a patient is eligible for hospice care. Medicare mandates that patients have a life expectancy of 6 months or less if the illness runs the expected course. You must be able to certify the terminal diagnosis and prognosis or re-certify them. To obtain a hospice consult, you must request it from a hospice service provider. The provider will evaluate the patient, determine eligibility and establish a care plan.

Practice Guidance for Your Practice from Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Breaking Down GDPR and What It Could Mean for US Physicians

Posted on by VettersEnt

There’s a high chance that if you subscribe to 200 mailing lists, you’ve received what feels like 1,000 emails informing you about privacy policy changes. All of these emails are coming in the wake of the European privacy laws called the General Data Protection Regulations (GDPR). What do you need to know about these laws, even if you’re only treating patients in the United States?

Who Is Affected by GDPR?

Any business that is established in the European Union and any business that handles the personal information of “data subjects” in the European Union, regardless of where they live and their citizenship, is subject. If a doctor works or is based in the EU and has a website that collects any personal data, like a name, email address, phone number of IP address (even through Google Analytics), they are required to comply. Doctors in the UK must follow these new regulations, but US doctors are exempt…for now. There’s a good chance that over the course of the next few years, the United States will put similar regulations into place.

What Happens if Doctors Don’t Comply?

Anyone who doesn’t comply with these new laws can be subject to fines up to 20 million pounds or 4% of the worldwide turnover for the past 12 months depending on which is greater. These steep fines probably won’t be levied against small practices, but instead against any businesses that receive the most complaints. It’s a good idea to practice keeping patient data safe now, instead of running into nasty surprises in the future.

What Should You Do for GDPR?

If GDPR-type regulations go into place in the United States, here’s what you need to know!

  • Personal data includes names, phone numbers, emails, questions, comments, IP addresses and digital data. Even if you do nothing with personal data but store it, you must still comply.
  • You should audit the personal data that you’ve already collected and note where it is from and who it is shared with. Once you do that, you should document the legal basis for the processing of data and send an email to all existing list members to notify them of your privacy policy.
  • When collecting personal data in the future, you must add opt-in wording to all of your forms. It should include the affirmation of “explicit, affirmative and granular consent.” Patients should have no doubt that they are granting their consent and not simply have an automatically-selected box. You should also make your privacy policy so that it is written in plain, easy-to-understand English.
  • Update your cookie policy or add one.
  • Make sure that all of your data processors are GDPR-compliant.

Protect Patient Information with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

The Effect of Social Media on Patient Health

Posted on by VettersEnt

From late nights spent staring at Instagram feeds to thumb injuries from scrolling too much (seriously), social media has a serious effect on patient health. While the impact on physical health might not be as prevalent, the effects on mental and emotional health can be very serious.

The Power of Social Media for Public Health

One of the most beneficial effects of social media and mobile connectivity on public health has been the opportunity for more healthcare providers to meet patients where they are. The Suicide Hotline expanded to add chat and text messaging options, allowing people of any age to receive crisis mental health consultations anywhere in the country at any time. Facebook has also added a feature where friends can anonymously report a post that another friend makes as concerning, and the platform will provide the friend with mental health resources. These are just two examples of how social media can provide people with health resources when they are at their most vulnerable.

Social media also makes health information more accessible, which can be a good or bad thing. While it makes it easier for people in food deserts to learn creative ways to prepare healthy food on a budget without access to a great deal of produce, it can also make it easy to disseminate false medical information.

Social media can also be an excellent place for vulnerable patients to connect with one another. It can be especially empowering for patients with rare conditions to meet people, across the country or the world, who are experiencing the exact same thing. While some patients would have suffered their entire lives with loneliness, social media can provide them with a place to connect.

The Negative Effects on Patient Health

Social media addiction is a growing problem, especially in young adults and teenagers who are used to spending the majority of their time on digital devices. An estimated 210 million people are suffering from addiction to social media. Young, single females are the most likely to deal with an addiction. Don’t think you’re a compulsive social media user? 50% of people driving while using a smartphone are checking social media apps. Over 70% of adults sleep with or next to their cellphone. Finally, almost 75% of Americans check Facebook on a daily basis.

As providers, it’s important to realize that patients might be using social media as a stand-in for other healthy parts of life, like spending time with friends and family. Or, they might be using social media to distract themselves from mental health difficulties.

What are the potential negative effects of social media on physical patient health?

  • Carpal Tunnel Syndrome from typing and swiping on a mobile phone too frequently
  • Eye problems can occur from staring at screens for long periods of time
  • Chronic fatigue is common in teenagers who stay up late to check social media networks instead of getting enough sleep
  • Lack of exercise or an increased risk of leading a sedentary lifestyle
  • Distraction while walking or driving, which can lead to accidents or injuries

Improve your Practice Health with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

How to Empower Patients Throughout the Diagnostic Process

Posted on by VettersEnt

When asked what they would improve about their patients, many doctors will indicate the desire for patients to take more control over their health, whether that means putting recommendations into practice or making an effort to build relationships with their doctors. How can you empower your practice’s patients throughout the diagnostic process?

What Do Patients Want from the Healthcare Experience?

A 2016 study of patients examined what patients want the most from their providers. A whopping 75% of patients indicated the desire for a more personal relationship with their providers. The majority of patients also wanted greater convenience and access to digital tools. These desires especially come to a head when patients are experiencing an illness or ailment and going through the diagnostic process.

Embrace the Benefits of the Internet

Building a relationship with patients doesn’t mean spending hours in each appointment getting to know their favorite color. Instead, it means being open to a patient’s concerns and being accessible where and when they need you. The internet is an amazing tool for staying connected with patients and empowering them throughout the diagnostic process. When most patients have a concern, they will head straight to the internet to learn more and ask questions. If your practice offers a secure health portal where they can find out more and send messages, patients will be able to equip themselves with knowledge and feel more understood.

Communicate Clearly and Offer Actionable Plans

Empowering a patient does not start or stop in the exam room. Since so many patients feel comfortable seeking health information from other sources (that may or may not be reputable), it’s important for doctors to offer them clear, achievable and realistic action plans. Giving patients accurate information will soothe fears that inevitably occur during the diagnostic process and prevent patients from clinging to false ideas.

Encourage Wearables and Tracking Methods

If patients are concerned about their health or going through the diagnostic process, encourage them to track symptoms and activities that promote health. Whenever patients actually start to measure and pay attention to their health, they will be more empowered to make the changes necessary to improve the metrics. From keeping a food diary to tracking blood sugar, small changes can add up to lifestyle transformations.

Partner with Vetters Enterprises Help with Your Value-Based Care Reporting

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

How to Find Patient Data for Value-Based Care Report Requirements

Posted on by VettersEnt

The increased emphasis on value-based care requires doctors and practices to compile detailed patient data for reporting. However, that’s much easier than it sounds! The technology needed to track patient data is available, but also expensive and time-consuming to use. The data that you need isn’t always easily accessible, as patients move from provider to provider (and system to system). How can you find the patient data you need for value-based care report requirements?

What Caused the Change?

The biggest push behind value-based care comes from the Medicare Access and CHIP Reauthorization Act (MACRA), which requires doctors with over $90,000 in Medicare Part B charges or over 200 Part B beneficiaries to enroll in the Merit-based Incentive Payment System (MIPS) or an Advanced Alternative Payment Model. MIPS includes a whopping 271 quality measures, and every doctor enrolled has to select 6 of them to report on. Private payers might have different requirements, but most require data collection and value-based care reporting.

The Challenge of Value-Based Care Reporting

Electronic health records are being changed and reconfigured to ease the new burden of reporting, but that doesn’t mean the learning curve has been easy. Unfortunately, the current value-based care metrics are not always easy to find or track, and there are plenty of issues with the system itself. Some doctors feel that tracking puts the emphases on electronic health records (EHR) and not treating patients. Other doctors are concerned that clinical quality is measured on process metrics, like whether or not preventative screenings take place, instead of actual outcomes.

How to Find the Data You Need

One approach involves tying your measurement to overall strategic priorities. One successful healthcare network encouraged all physicians and specialists to focus on 40 total metrics. While most of those metrics were tied to primary care, specialists received alerts at appointments when the patient they were seeing was also overdue for a pap smear or colonoscopy. By encouraging a team effort to meet tracking requirements, this network found great success.

Another successful strategy is creating your own internal metric definitions. One of the most common reporting issues is payers asking providers to report on measures that seem to be identical. However, the difference is usually in the details. To create standard internal metrics, look at the best-practice suggestions from industry leaders and work with the appropriate staff members at your practice. For example, before arriving at a standard definition for diabetes metrics, consult with primary care doctors, diabetes educators and endocrinologists.

While there is no magic way to track and report patient data yet, your practice should be engaged in constantly refining the process to get the best results for your patients. 

Partner with Vetters Enterprises Help with Your Value-Based Care Reporting

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

2018 Trends in Healthcare

Posted on by VettersEnt

It’s easy to get bogged down in the bustle of managing your practice—attracting new patients, keeping up with the latest in medical research and working hard to keep your current patients healthy. However, it’s essential to remain on top of the latest trends in healthcare and stay ahead of the curve. Here are the 2018 trends in healthcare your practice needs to know about.

Tackling the Opioid Epidemic

The leading cause of death for adults under 50 in the United States is now opioid overdoses. This epidemic is far too large for a single party to solve it, so everyone involved in the healthcare industry including prescribers, payers and the pharmaceutical industry, needs to band together to reverse this alarming trend.

A Focus on the Patient Experience

You’re probably sick of hearing about the importance of improving the patient experience, but this trend in healthcare isn’t going anywhere any time soon. As the healthcare market becomes more crowded and competitive, the efforts to improve the efficiency of the entire healthcare experience will dramatically increase.

Medicare Advantage on the Rise

Experts are projecting that Medicare Advantage will expand to cover a whopping 21 million people over the course of 2018, which is a 5% increase over the previous year. Your practice might see more patients with Medicare Advantage plans as a result.

Don’t Leave Mental Health Behind

As the social stigma around mental healthcare starts to dissipate, more and more patients will start to seek assistance for mental health struggles. Your practice should make a serious effort to understand the link between behavioral and mental health and tailor exams, including physicals, to address more than just the basics of patient health. Questions addressing technology use and the associated anxiety and depression, for example, are good screening tools for addressing the overall health of patients.

Using Wearables to Get the Bigger Picture

The wearable devices that many patients use, like Fitbits and other activity trackers, will start to be utilized by healthcare providers. Studies have shown that the most frequent users of wearable devices are less healthy than average and more likely to be hospitalized for health issues. These wearables can provide doctors with important information on patients and give a bigger picture of a patient’s health.

Partner with Vetters Enterprises for Information About the Latest Trends in Healthcare

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Preventing Physician Burnout in Your Practice

Posted on by VettersEnt

Physician burnout is a serious problem. A physician lifestyle survey in 2015 found that over 46% of physicians indicated that they were experiencing burnout. This issue does not just have an effect on the doctor experiencing it, but it also affects the quality of care that patients receive and, potentially, the future of the practice entirely.

The Consequences of Physician Burnout

Before we dive into how physician burnout can be prevented, we’re going to discuss why it is such a bad thing. Burnout leads to:

  • Low patient satisfaction rates
  • Poor patient care quality
  • An escalated number of medical error rates
  • High malpractice risk
  • Increased physician and staff turnover rates
  • Potential drug abuse and alcohol addiction

More worryingly, physician burnout can also be fatal. Suicide rates for male and female physicians are higher than the general population average and widely under-reported.

The Three Signs of Physician Burnout

The most commonly accepted standards for burnout were developed in the 1970s, and there are three core symptoms:

  1. Exhaustion: Low physical and emotional energy levels.
  2. Depersonalization: Cynicism, sarcasm and the need to vent about patients and work constantly.
  3. Lack of Efficacy: Doubting the quality and meaning of work.

The 7 Steps to Prevent Burnout in Your Practice

The American Medical Association lays out 7 key steps to stop your nurses and doctors from experiencing burnout.

  1. Use wellness as a quality indicator for your practice to see how your doctors and nurses are doing.
  2. Create a wellness group (if you have a large practice) or select a wellness coordinator (if you have a small practice) who can promote wellness resources available to physicians and model positive behaviors.
  3. Offer every employee an annual wellness survey that is a good indicator of whether or not an individual might be struggling with burnout.
  4. Meet regularly with other leaders in your practice to discuss potential interventions and survey results.
  5. Don’t be afraid to initiate selective interventions to address burnout as you identify parts of your practice that might aggravate it. Communication, workflow and facility improvements could all be completed during this step.
  6. After your interventions have been in place for some time, offer your survey again to see if stress and burnout levels have decreased.
  7. Using your data, continue to refine interventions and improve your practice.

Partner with Vetters Enterprises for Help Taking Your Practice to the Next Level

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.