Abigail Beckel

7 reasons to be happy you’re in primary care

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Looking for the positive in the pandemic. 

 7 reasons to be happy you’re in primary care

Times are tight, and not just for your practice. At the same time you are looking for cost efficiencies at the office, you can tighten the belt at home, too, usually without sacrificing much quality of life. Here are seven tricks to make your money go further.

 It's amazing how quickly money makes its way out of your bank account if you don't track where it's going. Start with your household take-home pay and make a budget that accounts for all of your monthly expenses, then decide how you want to divvy up anything left over. Track all of your expenses and see where your money is actually going. You'll be surprised how this practice reigns in impulse buys and unnecessary expenses.

 Home interest rates are predicted to rise from their current historical lows - just below 5 percent for a 30-year loan and as low as 4 percent for a 15-year loan - so now is a good time for most folks to refinance. If your equity position in your house will allow it and you plan to keep your home for at least three years, common financial wisdom says that you will save money by refinancing if it cuts at least one percentage point off your current mortgage rate.

 In today's electronic world, this doesn't mean you have to spend Sunday morning with a newspaper and a pair of scissors (though those coupons still help too). Sign up for the e-newsletters of your favorite grocery stores, retailers, hotels, airlines, and restaurants. Many offer big weekly or monthly discounts (30 percent to 50 percent) off their products for subscribers or at least announce upcoming sales. And check out independent Web sites, like Groupon.com, where local businesses offer (sometimes steep) discounts on popular items.

4. Get rewards and cash back on purchases. 

There's no way to avoid buying the necessities, so get the most out of your purchases by using credit cards that offer cash back, or rewards that make sense for you. Some cash-back programs offer as much as 5 percent back. If you long to travel more, go with a card that offers airline miles. If your favorite retailer offers a card that earns you gift cards there, go with that. Just make sure you are earning something when you swipe, and paying the balance in full each month.

Smart meal planning and grocery shopping, as well as eating at home more often, can cut thousands of dollars from your yearly expenses. Plan and pack lunches for yourself and your kids to save even more. Eating at home helps you avoid the mark-ups charged by restaurants, for example the $3.50 single bowl of restaurant soup that costs $2.00 to make at home and easily feeds four people.

If you carry balances on your credit cards, interest rates are costing you big each month. It doesn't hurt to call your credit card company to ask if they will reduce your interest rate - really, they've been known to do it! If your credit card company won’t help you, move your balance to a low interest credit card or one of several zero percent APR credit cards. And if you're in this situation, consider skipping step four and make future purchases with cash or a debit card.

While stopping for a premium coffee may seem more like a routine than a luxury, consider that it likely carries a mark-up of more than 500 percent over home-brewed coffee. Cutting out extra expenses like a daily Starbucks run can help keep you in the black. Consider other places you could cut back - for example trading an expensive monthly gym membership for a home treadmill, or dropping premium channels from your cable bill.

 She can be reached at abigail.beckel@ubm.com.

Times are tight. While you are looking for cost efficiencies at the office, you can tighten the belt at home, too. Here are seven tricks to make your money go further.

7 Ways to Save Money in Tough Times

Practices that think technology is a magic bullet solution to fundamental work flow problems usually find themselves disappointed. So argued practice management expert Cindy Dunn at the MGMA 2010 annual conference Tuesday.

“Technology will help,” Dunn said, “but it’s not the answer. You have to fix your work flow and process issues before you can really make new technology work for your practice.”
Dunn, an RN and senior consultant for MGMA, suggested that to run a successful practice, physicians and administrators need to change their mindsets and shift from just managing results to managing process 

“If you find you or other staff are blaming people for problems, it is always actually a process problem,” advised Dunn. She suggested examining all of your processes carefully to improve quality and eliminate waste.

Dunn defined waste as any activities that do not add value to the practice. Some of the consequences of waste, she noted, are under-utilized employees, ineffective responses to errors, missing information, increased wait times for patients and employees, and inefficient transfer of information.

One common area of wasted time Dunn pointed out is poorly functioning equipment: “Employees need equipment that works. Period.” When employees have slow equipment, it wastes time. And you’re paying for their time. Would you rather pay a single time for a needed equipment upgrade, or pay staff to sit around waiting for their computers to respond?

Many practices also fail to value time when it comes to processes and their employees. One practice told Dunn that it didn’t use real-time claims adjudication because it cost 25 cents a patient and they had as many as 200 patients a week. They were having their billing staff submit claims the same old way to avoid that 25-cent charge. But when Dunn helped them do the math for the billing staff’s salaries, it turned out that each biller was paid between 32 and 41 cents a minute. So every minute they spent working on claims that could have been processed immediately at the front desk at the time of service for 25 cents, they were actually losing money.

The goal, Dunn suggested, is to figure out how to add technology tools to your practices that give you more time and more accuracy - which then leads to better patient care.

To be successful, work flow processes must change as your practice moves forward with technologies, and Dunn advises that this requires administrators to engage providers in improving office efficiencies and create team commitment to new technologies and work flows.

For more MGMA 2010 conference coverage, be sure to visit our 

Want to implement new technologies or maximize your current systems? According to expert Cindy Dunn, you need to fix your work flow inefficiencies first and use new technologies as tools to help solve underlying process issues. Here’s how to do it.

Technology Won’t Fix Inefficient Processes

Could your practice be making more money? According to healthcare consultants Deborah Holzmark and Doral Davis-Jacobsen, the answer is definitely yes. Holzmark and Davis-Jacobsen of the accounting and consulting firm Dixon Hughes, identified a list of “rocks to look under” - common oversights made by practices that could be costing them dearly - for attendees of the MGMA 2010 convention Tuesday.

Today’s physician practices are busier than ever, so it’s hard to find the time to review practice systems and processes. But with reimbursement deteriorating, managed care maturation, and less competition among payers, it’s also getting harder all the time to keep a practice in the black. Practices can’t afford to let money slip away due to inefficiencies and unexamined processes, Holzmark and Davis-Jacobsen said.

So where to look for missed financial opportunities?

Consider bad debt recovery; adjusted collections; time-of-service collections; managed care contracts; provider production and compensation; coding errors and processes; technology; and work flows.

Concerning bad debt, Davis-Jacobsen said, “It’s important to ask the question why are all these dollars being written off by each physician?” Though there are number of reasons she noted, including patient lack of insurance coverage, timely filing issues, lack of required prior authorization, and ER call cases, Davis-Jacobsen focused on uncollected copays as the most easily correctable problem.

Many people assume that the majority of write-offs are for uninsured patients, Davis-Jacobsen said. But in reality, a higher percentage of missed revenues are generated from unpaid copays of fully insured patients - money your practice could easily be collecting, and should be.

Davis-Jacobsen pointed out that for many patients medical bills fall to the bottom of the priority list for payment, after other bills are paid and groceries purchased. So it’s crucial to institute a good time-of-service collections policy and procedure.

“We enable this patient behavior,” Davis-Jacobsen suggested, by allowing patients to walk out of the practice without paying their copays and deductibles. She says practices need to change their mindset about time-of-service collections because when a patient walks out the door without paying his copay, there’s less than a 50 percent chance the practice will get that payment. Miss three $20 copays a day, and the practice would lose more than $15,000 a year.

Holzmark and Davis-Jacobsen said that 100 percent time-of-service copayment should be your goal. Start by getting the patient’s current insurance information at the time the appointment is scheduled, so coverage can be determined before the patient arrives.

Also, take advantage of the real-time claims adjudication that most payers are now offering. With real-time claims adjudication the patient’s claim can be submitted online while the patient is seeing the doctor, so an accurate EOB waiting for him at check-out. So the practice not only gets the copay at the time of the appointment, but any other deductible or money owed, which saves the practice the time and money spent sending multiple statements, making phone calls, and sending the patient to collections.

Holzmark and Davis-Jacobsen also suggested a technology growing in popularity among practices, but long-used in other industries, what they called “hotel-style payment.” The receptionist swipes the patient’s credit card at check-in. The front desk deducts the copay and gives the patient a note outlining any expected further charges. The patient’s credit card information is stored in a program built for this process, and when the EOB comes back, the card is charged and the practice sends a receipt to the patient. Just make sure the patient knows that this will happen. It’s easy for the patient and the practice collects efficiently and completely.

Holzmark and Davis-Jacobsen advised that as you examine your processes for lost revenues and implement new initiatives, you involve your staff. Track your efforts to improve areas like bad debt and time-of-service collections and make the results public among your staff as motivation. After all, your staffers are the ones actually collecting the money from patients and that can be a difficult job, so letting them know you appreciate their efforts goes a long way.

For all the latest from this year's MGMA conference, be sure to visit

Could your practice be making more money? The experts say yes. Here are some places to look to find revenue your practice is missing.

Author | Abigail Beckel

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