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Don't work harder, work smarter. Technology can ease your most pressing revenue cycle and work flow concerns.
Physicians and their practices are becoming pretty comfortable using technology, according to the data from Physicians Practice's 2016 Technology Survey, which features 1,568 respondents from across the country. Apart from EHRs, which have made significant inroads into independent medical practice, there are a plethora of other technologies that can make a physician's life just a little bit easier and are increasingly being adopted into their practices.
Not surprising, a clear majority (78 percent) of practices say they use billing and coding software. Far more interesting, from our perspective, is that roughly a third of respondents say they use technology to conduct data analytics (33 percent) and manage their revenue cycle (29.4 percent), and 16 percent use technology to facilitate patient check-in and registration ( a 2 percent increase over 2015). While small, this number is significant given the fact that every dollar counts in medical practices, especially so for the smaller groups. In fact, when asked "What is your most pressing information technology problem?" after citing EHR-related problems, 8 percent of survey respondents said, "Costs to purchase and implement other technologies."
In this regard, solo physician or two-doc practices are less likely to purchase and use new technologies, according to consultant Laurie Morgan of California-based practice-management firm Capko & Morgan, yet paradoxically, she says they are the ones that stand to gain the most help from technology.
"I think that smaller practices in my experience have been reluctant to look at some of these tools, partly because if they have looked in the past they have found that it just isn't available for the platforms they are using, or maybe they thought it was it was too expensive," she says. "But actually they can benefit from it so enormously because they have smaller teams and everyone is trying to do multiple jobs, so this technology can actually help a smaller practice even more, potentially, than a larger one."
In an industry overwhelmed by government mandates, using front-office technology to help with data reporting just makes sense. And according to experts, the return on investment may be greater than docs think. If you are wondering which technologies would help your practice most, here are four that our experts say you should consider:
REVENUE CYCLE MANAGEMENT
The 2016 Physicians Practice Technology Survey indicates that 30 percent of respondents use some type of revenue cycle management (RCM) software in their practices. Tom Furr, chief executive officer at Patient Pay, a payment software company based in Durham, N.C., points out that RCM can mean many things to different people. The term can encompass patient insurance eligibility verification, medical billing, claims processing and follow up, and both payer and patient collections, typically using some type of billing software and a practice management system. Practices can also outsource some or all of those functions to outside vendors. "But at the end of the day… RCM is there to help you collect your dollars," Furr says. "The revenue cycle is the ability to capture dollars quickly and efficiently, and that is both insurance payments but also patient payments." That's why, he says, new high-deductible health insurance plans are becoming a game changer when it comes to spurring efforts to collect patient payments effectively.
Jeff Wood, vice president of product management for Navicure, a Duluth, Ga.-based RCM software company, agrees. Because uptake of new high-deductible plans has been relative slow, practices are just now feeling the pinch when it comes to collecting growing patient financial responsibilities, he says. Wood uses the metaphor of the frog sitting in a pot of slowly heating water, noting that "… the [amount of patient financial responsibility] has increased every year and then all of a sudden the water is boiling, and [practices] say, 'Wait a minute! I really have to do something about the patient [collection] side of things.'"
Aside from tightening up collection policies and procedures, physicians can look to technology to assist them in collecting patient copays and deductibles. There are several tech vendors that can provide electronic payment and collection services to practices and their patients, and in some cases, eliminate the need to send paper billing statements. Another bonus stemming from the use of an online payment solution is patient satisfaction: Both Wood and Furr say that patients are increasingly paying for services online and they want the same convenience from their medical providers.
Thirty-three percent of respondents in the 2016 Physicians Practice Technology Survey use some type of data analytics in their practices. Good data analytic capabilities can be the lifeblood of a practice, Furr says. "It's just like financial information that you get from your bookkeeper," he notes. "'How much cash do we have in the bank? How much do we need to collect?' All these basic data elements. It's important in the RCM space to kind of understand who's paying, who's not paying, how quickly are you being paid, and what's the preferred method for being paid."
In small practices, tracking patient cost-sharing amounts can be absolutely vital, especially given the growing predominance of high-deductible health plans that shift a greater percentage of costs to patients. Matthew Parker a family medicine physician who owns a solo practice in Birmingham, Ala., says oftentimes he is essentially seeing patients for free, as he waits for payer reimbursement. "Practices traditionally have relied on the copays to buy supplies and make payroll occasionally, and things like that," he says. And that is where the rub is for Parker: "I will say this … about the high deductibles - that has been a real challenge. And there are so many zero dollar copays now. It's strangling us."
That's where data analytics can give a practice much more power over its revenue cycle. Furr says business intelligence (BI) software will provide physicians and administrators with a dashboard of financial metrics that can be customized to meet the needs of the individual practice. "It is a visual representation of a whole bunch of data. It is very easy to understand. You can look at one page and get six, eight, or 10 different data points of interest that the doctor or the head of the practice would like to see." The utility of a dashboard that displays key practice metrics at a glance is that busy physicians can see where their payments are coming from and how long they take to come in. In Parker's case, knowing which of his patients will not be required to pay a copay at the office visit could give him the ability to make changes to his payer mix, for example, or adjust the types and numbers of patient visits he schedules in a day.
POS PAYMENT TECHNOLOGY
The 2016 Physicians Practice Technology Survey revealed that 26 percent of respondents use some type of point-of-sale (POS) payment terminal to collect patient copays and deductibles at the time of service. Studies show that the rate of successfully collecting patient coinsurance drops precipitously once patients leave your practice, according to a 2013 study by Greenway Health. Mary Pat Whaley, a Durham, N.C.-based practice management consultant, says not collecting at the time of service can bring a host of problems. "To me, the worst thing [a practice can] say is 'Oh don't worry about it, we'll send you a bill after your insurance pays.' I think the patient has a right to know what to expect, and if they are not expecting to pay the full freight at the office visit, they may be really shocked," she says.
The proliferation of high-deductible health insurance plans is putting an even greater burden on practices as they struggle to collect much larger patient balances, and in some cases, explain to new patients what insurance terms (copays, deductibles, co-insurance, etc.) mean and why they have significant payment responsibilities. Patient collectibles used to make up 5 percent to 10 percent of the physician's fee, says Whaley, with insurance being responsible for the remainder. Now that figure is closer to 30 percent of the bill. That's why Whaley's consulting firm, Manage My Practice, recommends using a secure credit card on file (CCF) solution. CCF technology relies on software that interfaces with a cloud-based server to securely retain patient credit card information so that practices never have to physically store credit card numbers onsite, eliminating the risk of theft, fraud, or electronic data breaches. "The benefits are you don't have to send out statements, you save staff time, you don't have to chase patients to get them to pay, and payment is given upfront or a commitment to payment," says Whaley.
PATIENT REGISTRATION TECHNOLOGY
A small number of practices (16 percent of respondents in the 2016 Physicians Practice Technology Survey) use some type of patient registration technology in their practices. While that number may seem low, there is great potential to streamline front-office work flow through self-service technology, says Morgan. "The whole benefit of these systems is eliminating extra work that the front-desk person would normally have to do, and also improving the accuracy of the [patient] information," she says, "… Patients enter the information directly and it goes right into the [EHR/PM] system." There is a range of registration technology that is available to practices: kiosks, tablets, and even patient portals. Morgan says that slow adoption is likely tied to compatibility issues with existing practice PM and/or EHR systems, but that is slowly changing as tablet/kiosk companies continue to add new partners.
Aside from collecting patient demographic and insurance information, tablets and kiosks can be used for short patient satisfaction surveys and also collecting patient copays at the time of service. Patients often don't fully understand their insurance benefits, so it is reassuring, says Morgan, for them to look up their financial responsibility on a self-service tool. It divorces the practice from what is essentially a contract between the patient and insurance company.
"Many of these systems allow the patient to set up a payment plan too, so they can take some of the anxiety out of [the doctor's visit] for the patient," she says. "Definitely staff are getting better at [collections] because they've had to, but if there's an opportunity to make it easier for everybody, why not take advantage of it."
Erica Spreyis associate editor at Physicians Practice. She may be reached at firstname.lastname@example.org.