I work with medical practices all the time, and they don’t always seem to have all their bases covered.  This means they are spending their days fighting fires, while they provide patient care, but they are not able to spend their time proactively thinking about how to make things better.

Here are some questions you should ask yourself to see if your medical practice is performing at the top of your game:

1. Do you have command of your numbers?  And do you know what those numbers mean?  Between your accountant, and your practice management and billing systems, you should be able to know all kinds of metrics about your practice.
2. Do you know where your patients come from, and do you know which patients you’d like to have more of?  Less of?
3. What is your internet presence, and what do patients who are looking for your services, or looking into your practice, find when they do a search?
4. Are your contracts and fee schedules all up to date, and have you negotiated the highest reimbursement from your payors?
5. Are all your forms, superbills, EHR templates, billing reports up to date so you can maximize your capture of the most current documentation, coding, billing and remittance information?
6. Are you providing only those services you’ll get paid for, and referring patients to other specialty providers when their insurance plan won’t pay you?  For example, many insurance companies today don’t pay for imaging services in the office and require patients to go to specially contracted imaging centers.  Many providers have the equipment and figure it doesn’t really cost more to do it themselves, however, have you really done a return on investment analysis?
7. Are you documenting and coding and billing correctly for all the services you DO provide?  Many providers are so wary of being accused of over billing or over coding that they are cheating themselves.
8. Are you getting paid, and paid correctly, for all services you do provide?  If you use an outside billing service, how do you keep track of this?  What do you do when reimbursement falls short?
9. Do you perform regular internal audits of your entire revenue cycle to identify any areas in need of improvement?
10. And, this is a new one over the past couple years.  Are you KEEPING the payments you do get?  Every insurance company, especially the governmental payors like Medicare and Medicaid, have hired outside firms to work on a CONTINGENT FEE BASIS to identify ‘fraud and abuse’ and recover payments already made to providers, and many times these are for services provided YEARS AGO!  These companies cast a wide net looking for any potential discrepancies and many providers are so afraid of getting onto the radar of the government in any way that they may actually be doing themselves a disservice by not assertively responding to these refund requests.

I met with a practice yesterday that had met just about all these criteria, and it was so refreshing!  With so many practitioners being challenged by all the change going on in the healthcare arena, it is inspiring to see that it isn’t getting to everyone.

How about you?  If your practice needs a tune up, or if you’d like an assessment of the most cost effective improvements for your particular practice, contact us for a free consultation at info@HabaneroInc.com

A midsized consulting company created a proprietary product that had been around for several years.  There was a lot of “clutter”:

· staff members with slightly different unwritten processes and protocols

· documentation was dated and contained obsolete/incomplete:

o forms

o instructions

o processing descriptions

Analyze

The first part of the process was to identify and remove erroneous and dated materials from the shared repositories, archiving them for audit purposes.

The next step was to establish documentation standards for the shared repositories so all team members could find and create documents uniformly.  This included defining directory/file naming conventions and establishing templates for proprietary Lotus Notes database systems.

Areas of discrepant documentation were identified and a discovery process was performed to obtain team consensus on Best Practices.  Best Practices were then documented and incorporated into the system.

Document

The entire product lifecycle was then documented in an electronic document.  A key requirement was to ensure that when external documentation is modified, the most current version is available to the user.  To satisfy this requirement the document featured:

· clickable links within the document

· hyperlinks to the intranet and the world wide web

Train

The resulting Policy and Procedure manual was then presented to the entire team in two separate three day sessions.  A total of 44 people were trained.  The trainees included top level management (Vice Presidents of Sales, Operations and Programming), account executives, programmers, sales support staff and data entry/clerical staff.

The highly interactive presentation included:

· detailed examples from the current workload, which made the training particularly relevant to all participants

· live interaction with proprietary systems

· significant interaction among trainees as they learned from each other

· comprehensive question and answer sessions and the opportunity for follow up questions throughout the training period

· hard copy of manual for note taking and audience follow along

WHAT WE DO

Policy and Procedure Documentation and Training:

· Research, interview staff and document current formal and informal policies and procedures

· Identify and work to resolve current disparate processes

· Clarify vague areas in current processes and documentation

· Analyze suggestions for process improvement and implement enhancements where appropriate

· Update existing procedure manuals to incorporate new systems, regulations and requirements

· Train staff on updated documentation utilizing real examples from client’s processes

WHAT OUR CLIENTS SAY

The Senior Vice President of Operations, and project sponsor had this to say:

“I have had the opportunity to work with Habanero, Inc. over the past several years and have been pleased with the products and services they have provided.

In particular, Susan Montana of Habanero, Inc. has been able to quickly integrate information from a diverse group of my staff to develop a comprehensive Procedure Manual customized to our operation, which involves interpretation of government policies, and internal/external systems and processes.

She then developed and delivered multiple group training sessions to a wide range of participants, including directors, managers, programming and clerical staff, to introduce these Policies and Procedures.

I was particularly satisfied with her ability to work quickly under pressure, her excellent writing, presentation and communication skills, and the flexibility to travel to accommodate our very busy schedules. “

LET’S LINK UP

We look forward to helping your agency or business. To learn more, please contact:

Susan M. Montana

631-244-5661

SMontana@HabaneroInc.com

NYS IT Backdrop Contract CMT487A

Workflow Mgt Services~BPA & BP Re-Engineering~Data Conversion

NYS/NYC Certified WBE~Suffolk/Nassau/Rockland County Certified WBE