Rosemarie Nelson

It doesn't matter how busy the other guy tells you he is; you know you are even busier. While you can fit more in a day than the average person and usually accomplish this before they even wake up, that doesn't mean you can't use a little help. Here are 10 time-saving apps and technology tips that can make your personal and professional life easier.

Want to meet Rosemarie Nelson and get tips on boosting your medical practice revenue, tips on productivity and compensation and more? Join us May 2 & 3 in Newport Beach, Calif., for 

, a new conference for physicians and office administrators.

 It's likely that you know about this mobile drug-reference resource. It's free and as many as 50 percent of U.S. physicians rely on Epocrates to help improve patient safety and increase practice efficiency. For an annual subscription fee, you can also have access to ICD-9 and CPT billing codes, lab tests and panels with reference ranges, and more.

By scanning a QR code (similar to a bar code) using a smartphone camera, you can access data that links your phone directly to a webpage. For example, if you add QR codes to patient statements, patients can easily link to your payment page online. There are multiple, free QR code generation websites: 

. Create the code, print it, and you're ready to go.

There are plenty of apps to help patients keep track of and understand their health, but two that are particularly useful are:

 (free in Apple app store) - physicians can sketch, stamp, or type on detailed anatomic images and then save them to the EHR and/or share images with patients.

(free in Apple app store) - patients can share information such as weight, blood pressure, and pedometer results with physicians, who can then send the information to their EHR.

 for your transcriptionist - think coding and billing staff and even phone operations. 

 Not just your practice management system, but your entire PC network so that all those documents and forms and accounts payable records are all safely stored and retrievable if a problem occurs. Investigate Internet-based services for data backup such as HP Live Vault or OffSite Backup.

 This app provides access to a social network for physicians and healthcare professionals across the United States - similar to "LinkedIn." Features include a free digital fax, ability to upload your CV, and earn honoraria. 

Passwords, while they can be troublesome, are a necessity. Be sure that you force a password change for all users on your network at least once per quarter. Do not allow staff to post their passwords 

 for all staff and providers whenever an employee resigns or is terminated. Check out RoboForm. It provides a master password and inserts a toolbar into your browser to auto-logon for up to 10 applications for free ($29.95 for more).

, a free app in Apple's online store, allows you to gather instant feedback on your practice with custom surveys; see compiled survey results in your account and get software alerts when a patient rates your service as poor.

Let your patients check-in and make their copayment at a kiosk in your reception area. Some kiosks will even verify insurance eligibility! A few of the vendors you might consider are: OTech Group, ClearWave, SeePoint, and Phreesia.

 Feeling great can help you be even more productive. Try these two apps for your smartphone:

Get your daily workout with how-to details, including video. Each workout will provide the benchmark for you and feedback from others attempting these serious exercises. 

Enter your daily calorie budget and throughout the day you can add the food you take in and the exercise you complete. Voila! Are you under (weight loss) or over (weight gain) your budget? The app is easy to use, allowing you to create "My Foods" lists, custom recipes, and brand name food lists. 

The approach to effective use of technology tools is incremental. If you wait until the next version comes out, or the next upgrade, or the complete interface, or … you will miss many opportunities to reap incremental benefits. "All or nothing" is a losing proposition. Take small steps down the path of technology and you will gain big returns for yourself and for your practice.

is a principal with the MGMA healthcare consulting group. She conducts educational seminars and provides keynote speeches on a variety of healthcare-technology and operational topics. Drawing upon her diverse experience, Nelson provides practical solutions to help medical groups succeed in their practices. She may be reached at 

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Here are 10 time-saving apps and technology tips that can make your personal and professional life easier.

Top Ten Tech Tools for Your Medical Practice

Front-office staff are the face of your practice - an expression of your practice's philosophy, attitude, and values. Therefore, it should be a top priority to hire and retain quality staff members for this position. In order to keep turnover and dissatisfaction down for administrative positions such as receptionists, phone operators, medical secretaries, and transcriptionists, you need to keep morale high.

This is a challenge because these positions can include high stress and low pay. Try something different - pay more for the right candidate. If you pay someone more than they think they're worth, they'll work up to that level. If you pay people less, they'll work down to that level.

One of the stressors for front-office staff is that many of the patients they interact with are unhappy simply because they're not feeling well. Although it can be difficult, this fact makes it even more important that front-office staff smile, make patients feel welcome, and convey a happy attitude. To lessen the likelihood of burning out the person at the front desk, rotate these staff members throughout the practice. As a result, you can enjoy the benefits of cross-trained staff as well as increased loyalty.

Here are some other ways to empower your staff and give them the tools they need to excel at their jobs:

Treat your front-office staff with kindness and respect. Beyond a friendly hello in the morning, be sure your staff has the right equipment to do their jobs.  Keep equipment working and up to date.  Make sure staff knows how to use the equipment and make it convenient for them whenever possible. For example, if the receptionist needs to scan/copy patients' insurance cards, place the scanner/copier near her desk.

Even with the best intentions, front-office operations are prone to kinks. At times, phones may go unanswered, patients may reach the exam room already dissatisfied, and these bumps can lead to sinking front-office morale and even resentment among staff members. A staff fallout can then affect patient flow, feeding an ongoing negative cycle.

Hold all staff to the same standards - the mini-max performance rule: "The minimum you get from one employee is the maximum you can expect from another in that position, in terms of performance."

Periodically use a chart to track incoming calls. Create a matrix with hours of the day along the right, and the reasons for the calls across the top - to schedule an appointment, talk to a nurse, refill a prescription, or get a referral. For one week every quarter, you can track the number and types of calls coming in at certain times of day. If you find you get numerous appointment calls in the morning, you can then staff accordingly. By tracking what's coming in, you can proactively plan for peak demand, rather than reacting to long wait times and angry patients.

Your phone company can provide you with additional information, such as the number of incoming calls, hang-ups, and busy signals. So if you discover after a month that 10 percent of callers get a busy signal or that 5 percent hang up, you know you need to improve your phone service by adding more lines, more people, or both.

You might also consider adding or tweaking your existing automated phone system. Program your automated system to play the greeting first, and then identify your practice. The first option should ask callers whether they want to make an appointment, and if so, transfer them to the operator. You can also include an option to hear directions to the practice or to refill a prescription. Although people are used to such phone trees, make sure it's clear, available, and friendly - especially for new patients.  And, remember to direct patients to your website for access to online services.

There should be no backlog of phone calls at the end of the day. Voice mail should be checked every hour. If there are too many voice mails to keep up with, you need to get someone, such as a float nurse, to provide extra help.  Use technology for the routine requests, so that your staff can use their talents to serve the patients.

Be smart with staff resources - for instance, reducing phone-call volume by using a patient portal on your website. A portal is an interactive tool that can answer patients' questions, schedule appointments, deliver test results, process prescription refill requests, provide directions to the practice, and more to save staff a tremendous amount of time, while improving service to your patients.

One of the best ways to keep your front office streamlined is to ask staff for suggestions.  We think we know the answers as managers, but we're not doing it every day. You're also likely to get higher buy-in for staff to carry out their own ideas.

Your front office is the face of your practice, therefore, it should be a top priority to hire and retain quality staff members.

Staffing Your Medical Practice for Excellence 

Revenue cycle management (RCM) is the lifeblood of any practice - private or nonprofit. Effective patient registration, insurance and benefit verification, charge capture, and claims processing are essential to maintaining practice viability. Before you can improve any process, you need to assess where you are now. Here are some questions you should think about:

• Do you know if you are achieving best practice standards in accounts-receivable management?

• Does it take your practice too long to collect, and/or are your write-offs and adjustments too high?

• Do you know your claim-denial rate on first submission (4 percent of claims or fewer is best practice)?

• Have you determined that you are not leaving any money on the table with a reimbursement analysis?

• What are your days in A/R? What percentage of your accounts receivable is more than 120 days old (10 percent or less is best practice)?

The revenue cycle starts with patient registration. Patient registration begins with a phone call for an appointment request. Your front-desk staff should interview the patient on the phone to collect billing and insurance information;  invite the patient to go online to your website to complete their registration information; and follow up if registration isn't completed two days prior to the appointment - so that the patient's insurance coverage can be verified. You can use an in-office kiosk for patient check in and to collect demographic information. Some kiosks will automatically verify insurance eligibility too.

Transferring patient charges from the EHR to your practice management (PM) system should be seamless - electronically transmitting data is an example of efficient workflow. But, if you are forcing your providers to first complete a paper visit-encounter form, and then transfer that information to the EHR, it can lead to inconsistencies, lost data, and redundant work processes. Furthermore, asking your check-out station to compare electronic patient information against the paper encounter form is burdensome and creates even more work when discrepancies arise.

Automatic payment posting can significantly reduce staff work, so why don't more billing staff embrace and drive implementation of auto-post opportunities? Holding tight to the status quo - manual payment posting and reconciliation - is an inefficient use of our most costly resource: staff.

Routinely ask your payers, clearinghouses, and software vendors about new services coming online, and roll out every new payer as electronic remittance and auto-posting become available. Investigate a bank lockbox service that converts the paper explanation of benefits (EOBs) to electronic transactions (837s) for automatic posting to patient accounts.

Investigate and incorporate automatic insurance eligibility verification into your work flows. You can use your clearinghouse service to upload the appointment schedule a couple of days in advance, in a batch process. For walk-in patients, use real-time verification through your PM system. An integrated verification solution creates a history within the patient's record that supports follow-up collection efforts, if there are later discrepancies with the payer.

Consider using a clearinghouse. Yes, clearinghouses have a cost. But, in-house personnel come with a cost as well. Do the math; it is unlikely that you can complete the same tasks (claims submission or eligibility verification direct to a variety of payer web sites, patient statement processing, automated appointment reminder calls, etc.,) more cost efficiently in-house than by outsourcing services and paying a monthly subscription cost or a per transaction fee.

You can improve your collections by billing closer to the date the patient received services. Do this by generating patient statements every week. Each patient will fall into a 28-day cycle, and a statement will be created during the week that they were seen, or the week that you received their insurance coverage. This way the incoming patient payments and questions will be distributed across the entire month, rather than overwhelming your billing department one week each month. Studies have shown that you collect faster too when the patient is presented with their bill closer to their care encounter.

Weekly statement generation is easy to accomplish when you outsource statement production. Does this mean that you can reduce staff members if you outsource? Maybe, maybe not. But it does mean that you will improve the results you get from your current staff because they will be attending to tasks that require personal follow up, instead of performing tasks that can be automated and/or outsourced more economically.

Have your staff focus on labor-intensive tasks like appealing denied claims; working claims that were underpaid; validating appropriate payments from payers; and uploading reimbursement schedules for your dominant payers.

Effective patient registration, insurance  verification,  and claims processing are essential to maintaining practice viability. Here's what you need to know.

Revenue Cycle Management Is More Than Billing Patients

Vendor relationship management, done with purpose and thoughtfulness, can deliver a successful partnership benefiting any medical group - small or large, multispecialty or single specialty. As the healthcare environment continues to increase in complexity, a true vendor-partner can serve as a consultant to your practice.

As a responsible buyer for your medical group, you need to know what solutions are available in the marketplace.  However, in this very complex and volatile market, it is a challenge to stay "in the know." Vendors perform a very necessary role by educating buyers about products and services. Consider how providers learn about the new solutions in the pharmaceutical world - isn't that type of introduction to a new product helpful to making an informed decision?

Vendors want to establish a relationship with you - they recognize that delivering quality information and proving to be a reliable resource for you will lead to long-term investment in future sales. You can start things off on the right foot by helping the vendor understand your medical group: explain your decision-making process and timeline, identify key stakeholders in your organization, and the process you envision. Lay out your needs and preferences for a solution to meet your objective. Be open to a dialogue that allows the vendor to ask probing questions and even challenge some of your assumptions. Transparency in decision-making can help develop successful relationships.

Vendors often lead the market with innovative solutions. Allow them to inform you about new products that may solve problems or create new efficiencies in your practice. If you're working closely with a vendor on a key part of your operation, invite representatives to sit in on strategic meetings.

Vendors employ experts that are well-versed in their products and solutions, so tap into that expertise in order to give your practice a competitive advantage. Take notes, recap action items, and follow up with the vendor when you need additional information or budgeting numbers. Let the vendor know what you expect from it, and don't forget to ask if your expectations mesh with the vendor's ability to deliver. Remember, your vendor expects a certain level of commitment from you too.

Once you have settled on a solution, make sure to set objectives well before contract discussions. Know what you want as an end result, and try to set aside preconceptions about how to get that result.

Be prepared: Collate all the information that will be helpful to the vendor in preparing a solution and a thorough quote for you; examine your past purchase history; invite the staff who will be most affected by the purchase to participate in the vendor exploration. If you don't manage the process, the vendor will and their timeframes may not mesh well with your timing.

Contracts are critical documents that are important to buyers and sellers. Be sure to take note of important items discussed throughout the sales process and include specifics in a contract addendum to establish the importance of each of those items. If you're using an RFP (request for proposal) in your purchase process, let the vendor know you plan to include their RFP response as a contract addendum - so it can prepare a specific response to your needs.

Healthcare may at first glance appear to be a very specialized market, but it is a business like all others when it comes to relationships and managing vendors. Get your game plan in place and be prepared to deliver honest and deliberate communications in your quest to obtain the right solution for your practice. Invest in your relationship with your vendor to develop a partnership that will reward your practice over and over.

Vendor relationship management, done with purpose and thoughtfulness, can benefit any medical practice - large or small.

Author | Rosemarie Nelson

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