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Customer Service Should Be Seen as A Process and Not A Project

Fix My Practice – Customer Service Should Be Seen as A Process and Not A Project

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

Customer Service Should Be Seen as A Process and Not A Project

How can you keep your patients satisfied? Is “good” customer service important? Do you ask for feedback from your patients?  Do you acknowledge the patient’s view of their experience at the doctor’s office?  These are questions that should be addressed in your office.

Patient’s view their visit as a “whole” patient experience. This begins with the call for an appointment to entering the main office door and everything else that happens before they exit the office.  The practice should ensure that every visit should be as pleasant as possible.  Why?  A practice could fail to keep or attract patients and receive low scores on patient satisfaction.

In healthcare, customer service should be viewed as important by all staff because every patient has a choice of who they want to see. If bad customer service has been experienced, then that is not only a reflection on the staff but the physician(s) as well.

Paying attention to patient experiences will help a practice to improve their customer service. To create a better impression of the practice and the physician the improvements needed may only be minor.  What you may discover is that these problems are not that challenging to fix, and these small things will make the patients feel better about you, your staff, and care/treatment they are getting.

There are several areas within the office that should be considered including:

– Scheduling – making an appointment

  • Never leave a call on hold longer than 2 mins
  • Always ask before putting someone on hold
  • Be courteous and kind in speaking with the patient
  • Physicians need to be mindful that other people time is as valuable as there’s  showing up late to the office and having patients wait, is the worse customer service you could give.

– Front Desk – checking in and out

  • Acknowledging the patient arriving and greeting them with a smile
  • If unable to assist the patient right away, let them know that you will take care of them as soon as you have completed your current task

– Waiting Room

  • Keep it clean and clutter free
  • Furniture in good condition
  • Stocked with current and recent magazines/reading material
  • Keep patient informed of any delays and give estimates as to when they will be seen

– Exam Room

  • See the patient in a timely manner or if there is a delay make sure the patient is informed
  • Provide literature or videos on current care options related to your specialty
  • Remember the new patient experience travels 5 times, what happens during their visit will be told 5 times to friends and family and potentially end up on line.
  • Prior to entering the room, the physician should know the patient’s history by reviewing their chart, listen and talk to them with respect, sit in front of the patient and make eye contact
  • Prior to the patient exiting the room, they should be made aware of what they should do next as well as direct them to check-out

Patients want to know that a physician knows them. The patients should be viewed as your guest. You want them to return as well as tell others about their wonderful experience.

Improving customer service should be seen as a process and not a project. Though the changes may be fairly minor, they shouldn’t all be done at once.  Continue asking for feedback and suggestions on customer service from your patients and staff as well.  In addition, physicians do have a significant role in setting the customer service tone.

The personality of the practice starts with the staff and the culture of the practice starts with the physicians. When a physician runs late constantly then staff thinks it is ok to do the same thing. If your first appointment is at 8:00am, then you should be in the office at 7:45am and your staff should be there at 7:30am. It is the little things that make a difference. Patients will remember these things.

Practicing quality medicine while maintaining and managing the bottom line is a balancing act that provider’s face daily. The Physicians Practice S.O.S. Group is committed to and has helped healthcare providers across the country with new practice startups, IRO needs, and providing practice management and compliance solutions. Call our office to discuss any needs you might have.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

Oh No! Is Your Practice Being Audited?

Fix My Practice – Oh No! Is Your Practice Being Audited?

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

 

Should we panic when we receive that official letter in the mail informing us of an impending medical records audit? What should we do next?

We should start with building a good defense and reviewing the top five pitfalls

1.) Not responding to the audit request.

  • Take the time to read the letter carefully.
  • If there is something that is not clear or not understood, call the contact person and ask questions.

2.) Incomplete medical records or progress notes

  • Only send the specific records that are being requested in the letter.
  • Review records to be sure that the patient’s name, date of birth, date of service is on each page.

3.) Being Unprepared

  • Fraud, Abuse and Waste is the primary focus, so audits should not come as a surprise to any of us.
  • Develop a plan or process for your office of how records are to be kept and verified along with the billed services.
  • Perform periodic internal audits.
  • Your efforts should be documented as part of the compliance plan.

4.) The outcome should be reviewed

  • Avoid unnecessary trouble by reviewing the letter and taking into consideration the advice within the letter.
  • Read the letter/report in detail.
  • The goal is to avoid repeated mistakes, so it would be advantageous to look for anything that would be helpful to our practice.
  • Inform the staff and physicians of the audit results.

5.) Illegible medical records, (*if you are still writing out notes)

  • Keep in mind that if the auditor cannot read the medical record it cannot be audited.
  • The physician’s signature must be legible as well.
  • NOTE: perform a legibility test if notes are still hand-written.

Lastly, a good defense is always a good offense. When was the last time you had a baseline audit done? If it has been over a year, then you should consider having a baseline audit done. Many providers think because they are on EMR they are fine but in fact over 75% of all templates are incorrectly set up.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

 

3 Tips for Patient Portal Engagement

Fix My Practice –3 Tips for Patient Portal Engagement

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

Two-thirds of the practices that participated in the 2017 Physicians Practice Technology Survey said that getting patients to sign up and use patient portals consistently is a challenge. Is this the case for your practice, if so, try these 3 simple tips to help get your patients more involved in the process?

Within these 3 things make sure you market and/or talk about the benefits, not just the features and get the staff involved in that process, for instance:

  • Have staff members from the front to the checkout promote the patient portal throughout the patient’s visit. Every staff member should have a script to talk up the patient portal to patients, and is ready to list benefits items that is available in the portal.
    • For instance, a front office staff member might ask how did you make your appointment, and then let the patient know they can request appointment via the portal and even receive appointment reminders by email.
    • When patients are checking out, staff and tell the patient they’ll be able to pay their bills online if there is a balance after the insurance.
    • When someone calls for Rx refill, the Medical Assistant may tell them about the benefits of requesting this via the patient portal.
  • Use every patient handout, paperwork or marketing collateral to promote the patient portal.
    • Add a line to bills letting patients know they can pay online using the portal and include a note on patient education flyers that they can access more helpful information in their portal.

In promoting the use, offer incentives that the staff also promote to the patients during their visit and those incentives include entering their name into a monthly prize drawing if they schedule an appointment online or do a Rx refill request.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

Can Independent Physicians Survive in the Current State of Healthcare?

Fix My Practice –Can Independent Physicians Survive in the Current State of Healthcare?

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

If you feel like you’re glued to your computer or tablet for much of the day, it’s not your imagination. Many independent physicians say mounting paperwork is keeping them from spending enough time with patients. According to the Practice Profitability Index, the percentage of physicians who spend more than one day per week on paperwork has increased. This trend is eroding physicians’ on-the-job happiness. The physicians I know truly enjoy spending time with patients and teaching, and anything that takes them away from that is a negative.

A Kaiser study a few years ago indicated physicians spend more than 868 million hours annually on prior authorization activities. Payers say prior authorizations hold down costs, improve treatment efficacy and ensure patient safety. To physicians, however, they are an obstacle to providing the best care for their patients.

Then we have the technology-driven changes — from meaningful use to ICD-10 — which are key administrative tasks that take up time. However, surveys show that for three quarters of physicians, electronic health record (EHR) systems do not save time – despite increasing costs.

It seems that payer interference is increasing and dictating healthcare. Physicians have to deal with a range of audits tied to meaningful use and other programs. The federal government can audit Medicare patients’ charts, while individual states can audit the records of Medicaid patients (since they fund Medicaid), up to 10 years after a patient’s treatment. The audits are just one sign of a trend toward payers influencing—or some would say dictating— patient care that can erode job satisfaction for medical professionals.

Audits are not the only way payers insert themselves into the physician-patient relationship. Prior authorizations are another way payers attempt to take decision-making out of physicians’ hands. In addition, more payers are tightening their provider networks in an attempt to rein in costs. This move toward narrower networks results in more physician evaluations.

More and more physicians must decide whether to stay independent or join a hospital system.  For some, joining a large hospital system offers a haven from the rising administrative burdens of staying independent, and from competitive pressures that can drive a small practice into insolvency. But joining a hospital system is not a panacea for the challenges facing physicians.

Some physicians are returning to private practice because their compensation from hospitals were not as lucrative after their initial contract expired. During the initial “honeymoon period”, pay is typically based on the previous three years of tax returns. When physicians’ contracts ended however, hospitals would often switch to performance-based fee schedules, which are usually much lower.

Here are a few survival tips for Independent Practice and Employment Options:

INDEPENDENT PRACTICE                             

  • Join Forces:  Consider joining an IPA (Independent Physicians Association) to align with other physicians and create negotiating power.
  • Look for High Impact Saving:  Major expense items that practices can easily investigate are occupancy and personal cost. Look at your leases, overall expenses, and automatic deductions.
  • Revamp Billing Practices: Make sure someone on your staff is held accountable for checking that all services are billed and reimbursed, and that no claims go over 90 days.
  • Re-examine Fee Schedules:  This is much easier to do if you are part of an IPA.

EMPLOYMENT

  • Get It In Writing: No matter how minor it seems, delineate all responsibilities in writing.
  • Learn About Compensation Details:  It is to your advantage to be an expert on your compensation package and method. Knowing RVU’s and quality-based compensation are very important.
  • Find out Who to Call:  Going from a private practice to a large corporation is a big change in culture. One of the most helpful things to know is who to call when something goes wrong. Make a flow chart that shows who contact and how to do so depending on the problem.
  • Know Your Limitations: Sometimes other people really do know their stuff and can teach you quite a bit. When you find these people, listen to them.

Whatever your choice in practicing medicine make sure you do your leg work, read every contract in great detail, and hire the right consultant and/or attorney familiar with healthcare laws when needed.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

Fix My Practice – 8 Business Plan Myths

Fix My Practice – 8 Business Plan Myths

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

  1. A business plan has to be long

Not necessarily so. A business plan can take whatever form is most useful, even if that’s just a few lists and tables.

  1. A business plan is hard to make

It doesn’t have to be. List your key strategy points and key tactics, and a few important major milestones like deadlines, tasks, the new launch or new website, and necessary hires. Include projected sales, costs, expenses, and cash flow. Voila! You have a business plan.

  1. Nobody creates business plans anymore

Well-run businesses use business planning the right way. They keep a up-to-date plan and review and revise it monthly. Smart startups use basic business planning to help them see starting costs, projected early sales and spending, cash flow, and key strategy points and milestones before they launch. Then, they review these monthly.

  1. Business plans are for only startups

True, well-run startups generally use business planning to help figure out which steps they need to take, and which resources they need. But that doesn’t mean mature businesses can’t use business planning to constantly set milestones, strategy reminders, and forecasts. Mature businesses keep a business plan up-to-date, and review and refresh it often. The more a business grows, the more it can benefit from good business planning.

  1. You can’t plan because change comes too fast

In the real world, a good business plan changes. It isn’t voided by change. You keep the plan current by making revisions as real events unfold. Having a plan means that you’ll have the information you need to make quicker, easier, and more natural revisions.

  1. Business plans require market research

Business owners have to know their market, and taking a step back to review your market is a good idea. Startups looking for investment, or businesses applying for loans, need market research. Mature businesses know their market and plan without the research requirement.

  1. Investors don’t read business plans

The business plan is a vital part of due diligence. Ultimately, seeking investors without a plan doesn’t work.

  1. Nobody needs a business plan

Does every business need a plan, strictly speaking? No. But every business would benefit from good business planning.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

4 Symptoms of Burnout in Healthcare Employees

Fix My Practice – 4 Symptoms of Burnout in Healthcare Employees

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

Burnout and efforts to prevent it are as common in the healthcare industry as stethoscopes and syringes. Unlike stethoscopes, however, burnout has the potential to cause problems not just for the provider affected, but for the whole organization and patient roster.

Burnout symptoms such as poor decision-making, poor job performance, and a lack of empathy for patients make the number of providers suffering from burnout truly concerning. If you’re concerned about burnout in your facility, be on the lookout for these symptoms:

  1. Frequent Errors

Surgeons are more likely to make serious mistakes when displaying burnout symptoms, and long hours are linked to burnout in nurses, which is believed to be a factor in medication errors and other costly mistakes. These and other provider errors are thought to cost the healthcare system between $17 billion and $29 billion each year.

The bottom line for organization administrators? If an employee is uncharacteristically and continuously making mistakes, they could be suffering from professional burnout symptoms.

  1. Decreased Empathy

The link between empathy fatigue and burnout is complex, but the two are undoubtedly related: Regardless of whether burnout “kills” empathy or excessive empathy causes burnout, a distinct lack of caring is a clear sign of burnout among healthcare providers.

Unfortunately, there are no surefire solutions to this burnout symptom; it’s dependent on the situation and provider. Physicians and advanced-practice clinicians claim a hard stance on taking time off is one way to approach the problem. Jetting off on a much-needed vacation could be the perfect way to solve both provider and empathy fatigue.

Organizations may also wish to undertake initiatives that “rehumanize” patients, encouraging staff to think of them as real people with real problems instead of just another name to check off a busy appointment list.

  1. Workplace Toxicity

Like many of the symptoms listed here, a toxic healthcare workplace can be both a cause and an outcome of burnout. Bureaucratic burdens, unrealistic administrators, and conflicting personalities can lead to frustration, anger, and the resulting burnout symptoms. This in turn can exacerbate the issues that caused the bitter feelings and burnout in the first place, creating an endless cycle.

The good news? Addressing one cause of workplace toxicity may help stop and prevent this destructive cycle from beginning in the first place. Openly and frequently congratulating employees on their accomplishments, actively addressing frequently reported problems and interpersonal issues, and making efforts to prevent overworking providers can help you manage workplace burnout and toxicity.

  1. Reduced Patient Satisfaction

As the healthcare industry continues along the path of consumerization, patient satisfaction has become a growing area of focus for many facilities. In one study, organizations with high levels of job satisfaction among nurses reported vastly higher patient satisfaction and a lower incidence of burnout.

Obviously, increasing patient satisfaction levels does not cure provider burnout symptoms. Instead, organizations should focus on the opposite: Addressing the symptoms and causes of burnout will help improve provider job satisfaction, and therefore, patient satisfaction. It’s a serious undertaking, but one that will have a positive effect on not just providers, but patients as well.

Have you seen burnout symptoms in your employees? Talk to a consultant today about hiring healthcare talent.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

Fix My Practice – Understanding Business Structure Basics

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

Ready to start your practice? Have you asked yourself what type of business entity you should be? There are several types of business entities to choose from when starting a business. It is important to consider tax treatment and benefits, sale of interest in the business and limiting your personal liability.

  1. Partnerships expose you to greater liability than sole proprietorships. In a general partnership, you are also responsible for certain actions of your partner(s). Partnerships must also file yearly returns with the IRS to report losses, profits and deductions. Before conducting business, partners should draft an agreement outlining how profits, expenses and workload will be divided. Disputes between partners can become costly to resolve and damaging to your business. Setting terms early on will help minimize the risk of a dispute.
  2. Corporations are independent entities formed and owned by one or more shareholders. Corporations may raise capital by selling stock or rely upon capital contributions of its shareholders. Shareholders’ personal assets are protected from legal liability, including business debts and lawsuits. The corporation pays taxes, conducts business and distributes profits to shareholders. Starting and maintaining a corporation requires a great deal of time and paperwork. It is important to keep thorough corporate records and ensure your corporation is fully compliant. In some instances, corporations may be taxed both on profits and on dividends paid out to shareholders. It is vital to consult an accountant or tax attorney regarding your corporate taxes.
  3. Limited Liability Companies (LLC) offer protection to their members similar to that of a corporation. As the member of an LLC, your personal assets are protected from the LLC’s liabilities. The liability protection is limited and does not protect members from illegal or wrongful acts, even if that act was committed by an employee. LLCs require less record keeping than corporations. It is up to the members of the LLC to determine how profits are distributed. There are fewer restrictions on the distribution of profits than with a corporation.

Practicing quality medicine while maintaining and managing the bottom line is a balancing act that provider’s face daily. The Physicians Practice S.O.S. Group is committed to and has helped healthcare providers across the country with new practice startups, IRO needs, and providing practice management and compliance solutions. Call our office to discuss any needs you might have.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

 

Fix My Practice – Are You Keeping the Right Business Records?

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

 Every business, regardless of its size, needs a system for retaining important records. Records are vital for tax filing, legal compliance and planning.

  • Why is record keeping important? Preserving records on employees, patients, sales, inventory, contracts, insurance and other aspects of your practice will help you track vital information about your business, file taxes in a timely and accurate manner, stay compliant with regulatory agencies and plan for the future. Your records will also be useful if your business is audited or involved in any type of litigation.
  • Which records should I keep? There are a wide range of records your business should retain; some are required by law while others help your business function more efficiently.
    • Original copies of any permits or licenses
    • Articles of Organization, Incorporation, DBA or other state business registration forms
    • Sales records
    • Expense records
    • Customer records
    • Tax returns, bills and statements
    • Inventory
    • Payroll and Personnel information (including but not limited to)
      • Job descriptions
      • Hiring documentation
      • Employee evaluations and performance records
      • Time sheets
      • Withholdings
      • Benefit information
      • Workers’ Compensation documents
      • 1099 documents for contractors
    • Insurance policies
    • Original signed copies of any contracts, agreements and leases
    • Patent, copyright or trademark documents
    • Depending on your business, there may be other records that you should retain.
    • Consult with your LegalShield provider law firm if you have questions.
  • How long should I retain records? The IRS, state tax authorities, regulatory agencies and contract terms may stipulate retention schedules for specific types of documentation. Develop a written retention policy that includes a schedule for keeping various types of records, as well as policies for safe and secure document disposal.
  • Do I need to keep my own personal financial records? It is vital, particularly for small business owners, to keep accurate personal financial records. LLCs and corporations, must keep a barrier between personal and business accounts. If a business is audited and it is found that this barrier was not properly maintained, personal records may be subject to scrutiny. In addition, small business loan applications often require the business owner’s personal financial records.
  • Should I hire a professional to help me manage my record keeping? This depends largely on your resources and the complexity of your records. In some cases, such as payroll and accounting, it may make sense to employ a payroll service or accountant to manage your filings and record keeping. Payroll record keeping requirements and tax filings can be extremely burdensome for small business owners. Using a contractor will save you the trouble of keeping up with changes in the law and dealing with a substantial amount of paperwork.
  • What if I can’t afford to hire a professional? Find a solution that fits your budget. There are many different options for accounting and document management software in a wide range of prices. No matter what system you select for record keeping, it is important to begin using it as soon as possible. Waiting to begin sorting your records will leave you with a disorganized mess that will grow more difficult to manage each day.
  • Can I store all of my business records on a computer? In some cases, such as signed and executed contracts and lease agreements, you should retain original paper documents. Most documents can and should be stored electronically. Even if you are required to retain a hard copy, having a digital file will serve as a backup. Electronic filing systems require far less space to store data and make filing, organizing and searching for documents much easier. If you store documents electronically, make sure you complete a daily offsite or online backup of your records. Cloud storage offers a combination of secure offsite storage and accessibility. If you need assistance, speak with an IT professional.

Practicing quality medicine while maintaining and managing the bottom line is a balancing act that provider’s face daily. The Physicians Practice S.O.S. Group is committed to and has helped healthcare providers across the country with new practice startups, IRO needs, and providing practice management and compliance solutions. Call our office to discuss any needs you might have.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

 

Fix My Practice – 8 Tips for Managing a Difficult Employee

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

Without a formal HR department, many small practice owners and managers put off dealing with challenging employees. No matter how small your practice is, it is important to set formal policies, properly document job performance and follow any applicable regulations. Failing to properly document and deal with a problem employee could damage morale and your bottom line

  1. Set clear expectations with an employee handbook. A carefully written HR handbook will clearly define expectations for all employees and managers. An employee handbook will also help protect your business from litigation. Your handbook should outline everything from benefits, time away from work, harassment, non-discrimination policies, performance evaluations and workers’ compensation. Provide each employee with a copy of the handbook and have him or her sign a document stating that it was received.
  2. Create a personnel file for every employee.  Each file should contain the employee’s resume, job description, signed policy documents and any other documents related directly to job performance. A personnel file should not contain personal details such as medical information, financial history, social security number, race, gender, nationality, sexual orientation or any other personal information not directly related to job performance. Personal information should be kept in a separate file not to be used in evaluating an employee’s performance.
  3. Schedule regular performance reviews for all employees. It is important to set a standard performance baseline for all employees. Focusing only on problem employees will make your actions seem arbitrary rather than purposeful. Evaluations allow you to set realistic goals for improvement and growth.
  4. Be proactive in Addressing specific concerns when they arise.  It is vital to discuss matters when they happen instead of waiting for a review. Waiting may make the issue seem trivial or may catch the employee off guard. Use the annual review to address how the employee has responded to any issues that came up during the course of the year.
  5. Document your concerns in the employee’s personnel file. If you discuss a concern with an employee make a note in their file. Many companies hold off on terminating employees because they do not have any documentation. Any significant discussion of job performance or violation of company policy should be noted in the employee’s file.
  6. Provide feedback and set concrete goals for improvement. Avoid taking punitive action to correct a concern. Do not badmouth the employee around the office or talk to them in an unprofessional manner. Set specific goals and put them in writing for the employee to sign and acknowledge. If an employee fails to meet the goals you have set then you can take further action.
  7. Clearly define consequences for failure to improve or to take corrective action. Failing to define what will happen if the employee does not improve provides little incentive for improvement. If an employee will be terminated for not meeting specific goals, make sure they understand that is the consequence.
  8. When necessary do not hesitate to terminate an employee. Firing an employee is one of the most difficult jobs a business owner or manager can face, but sometimes there is no alternative. If an employee violates specific company policies involving harassment or customer privacy or if they steal or commit any other action that jeopardizes your clients, business or another employee’s safety, document what happened and take immediate action. If you are concerned the employee may become confrontational ask another owner or manager to sit in on the termination meeting.

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

Have you heard about “Virtual” credit cards (VCCs)?

Fix My Practice – Have You Heard about “Virtual” Credit Cards (VCC)?

The Physicians Practice S.O.S. Group® www.ppsosgroup.com

“Virtual” credit cards are an emerging method for health plans and third-party payment vendors to issue payments to physician practices for patient services. VCCs are 16-digit credit card numbers, most commonly faxed or emailed to the practice by the plan or vendor. The practice is expected to run the number through its credit card terminal as it would for charges associated with patient payment of copays and deductibles. The practice is responsible for paying all interchange fees, typically ranging from 2% to 5% of the total amount of the charge for these “card not present” transactions.

Payments made via VCC do not meet the requirements for the Electronic Funds Transfer (EFT) mandate included in the Patient Protection and Affordable Care Act (ACA), as they are not considered “electronic” payments under the law. In addition, the EFT transaction is designed to correlate with the Electronic Remittance Advice (ERA) and facilitate reassociation of the payment with the remittance. VCCs do not offer the practice the ability to automatically reassociate the VCC payment with the ERA. Those providers adopting EFT can accelerate claim payments while reducing staff time spent processing VCCs or paper checks.

Accepting credit cards from patients, in addition to the convenience factor, shifts the patient debt collection responsibilities to credit card companies, thereby eliminating potential bad debt risk for the practice. For that service, the practice is willing to accept the associated fees. There is not the same advantage with VCCs, and plans and vendors issue them to save them the cost of printing and mailing paper checks. Payment delays and requirements to submit additional EFT enrollment paperwork can also be used by plans as a disincentive for the practice to reject VCCs.

Many practices have been forced to accept VCCs or encounter significant barriers in trying to move away from this form of payment to EFT. The Centers for Medicare & Medicaid Services (CMS) recently issued guidance in an effort to accelerate adoption of EFT and discourage the use of VCCs. The agency stipulated that:

  • Health plans sending VCCs must stop if a provider requests to receive payments via EFT;
  • Health plans and third-party payment vendors must not to charge fees for the use of EFT and costs are limited to banking transaction fees (maximum of $.034 per transaction);
  • Health plans cannot deduct funds from a provider’s account unless contractually authorized by the provider; and
  • Practices are not required to contract for additional “value added” payment services from third-party payment vendors.

Action steps for practices:

  • The agency encourages providers to lodge a formal complaint against any payer refusing to support EFT, ERA or requiring providers accept VCCs.
  • Determine which of your plans and vendors are sending you payments via VCCs (or charging you EFT fees)
  • If you receive an unwanted VCC, do not process the payment. Contact the plan or vendor and immediately request all payments via EFT
  • Remember that payers MUST send you EFT if you request!
  • Refuse to sign any plan or vendor contract that requires the practice to accept VCCs (or EFT fees)
  • Talk to your financial institution about any fees they apply
  • Stand firm against VCCs, EFT fees
  • Lodge a formal complaint directly with CMS

Regina Mixon Bates, CEO | The Physicians Practice S.O.S. Group | www.ppsosgroup.com

#iamMsSos #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting

 

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