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Fix My Practice - Blog

The COVID-19 Vaccine

As members of the healthcare profession, we should ALL do our part to educate friends, family and coworkers on the safety of the vaccine and importance of being vaccinated and model trust by being vaccinated as soon as we are eligible! The technology behind the Moderna and Pfizer vaccine was developed by an African-American researcher, Kizzmekia Corbett.

It is not a live virus, only genetic information to trigger the body’s immune system, so the expected effects (site pain, fatigue, fever) are the body’s immune system waking up–and those are good signs. The genetic information does not interact with or change the body’s cells and so is safe for pregnant and lactating women. The vaccine is a two-dose regimen, and full efficacy (95%) is not achieved until about 2 weeks after the 2nd dose. The vaccine protects against symptomatic infection, but the virus can still enter the nose and mouth and be spread to others, so mask-wearing and social distancing are still required after vaccine administration.

There is a 4-phase rollout of vaccine availability, and Georgia is still in Phase 1a (high risk healthcare, law enforcement, care facilities, and age 65+). In February, Georgia will roll out a single-site registration process, consolidating existing registration through individual providers and public health departments. This is good news, since West Virginia has a single website to register for the vaccine and ranks 2nd in COVID vaccine administration, by contrast Georgia ranks 33rd among the 50 states tracked for COVID vaccine administration.

Getting the Covid-19 Vaccine for healthcare providers in Georgia

COVID-19 Vaccine

How do provider and their staff get the vaccine if they are independent and not connect to one of the hospital systems?

GA Provider COVID-19 Vaccine Registration

The first vaccination phase includes but is not limited to healthcare personnel likely to be exposed to or treat people with COVID-19, first responders, people at risk for severe illness and other essential workers. If you are linked to a hospital it’s an easy process to get your vaccine.

But what if you aren’t link to a hospital?

Healthcare Providers/Practices NOT enrolled as a COVID-19 vaccine provider or affiliated with a hospital can request to receive COVID-19 vaccination at your local public health department for themselves and their staff.

Each provider and staff member can get the vaccine now by enrolling their office at: https://dph.georgia.gov/provider-vaccine-registration-ph-district-list

There are multiple counties listed each one having a different registration process and link. https://dph.georgia.gov/document/document/provider-vaccine-registration-district-contact-list/download

Additionally, if you would like to be a COVID-19 vaccine provider you can enroll at: https://dph.georgia.gov/covid-vaccine-information-providers

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

Educating Employee to Prevent Data Breaches

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

Fix My Practice – Educating Employees to Prevent Data Breaches 

Why are we hearing about so many breaches and I believe it is because we are not educating our staff about all the potential risk.

HIPAA security starts with employee education. You can lock your systems down, run scans, use antivirus, do regular patching etc. However, in reality, all it takes is for an employee to click on something, or upload something and like a magic trick…you now have a breach. Even Blue Cross and Blue Shield fell victim. An employee uploaded a file containing member information to a public facing website. The worst part is that was not discovered until 3 months after it happened. It exposed over 16,000 patients. While it was only 1% of its members, but it happened, and 1 patient is 1 patient to many.  The immediate questions that come to my mind regarding this were: Did they provide employee education? Did this employee simply upload the wrong file, or did they not understand what they were doing? Was it malicious?

The data was out there for 3 months and they are unable to determine if it was accessed. The breach included names, date of birth, diagnosis codes, provider details, and procedure codes. All the information needed to process claims. No social security numbers or financial data such as credit cards were exposed. This is important because that is the information that could be used in medical identity fraud.

This breach will serve as a stark reminder for practices to have proper access controls, network monitoring, policies and procedures and employee education in place. Bi-annual training and training upon hiring will help eliminate some of these unnecessary breaches.

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 

#ReginaMixonBates #practicemanagementconsulting #practicemanagement #physicianconsulting #consulting #HIPAAsecurity #breachprevention

Ransomware Assault Threatens Hospitals

Cyber Security in Healthcare

Recently the FBI is warning there is a new threat of ransomware attacking the US Health Systems. The ransomware assault threatens hospitals and will most likely spread to the ambulatory practices. The FBI and two other federal agencies issued a joined alert stating that this malicious attack will lead to data theft and disruption of the healthcare system and services.
According to an article in www.dailymail.co.uk
The FBI is investigating the recent attacks, which include incidents in Oregon, California and New York made public just this week, according to three cybersecurity consultants familiar with the matter.
A doctor at one hospital told Reuters that the facility was functioning on paper after an attack and unable to transfer patients because the nearest alternative was an hour away. The doctor declined to be named because staff were not authorized to speak with reporters.
‘We can still watch vitals and getting imaging done, but all results are being communicated via paper only,’ the doctor said. Staff could see historic records but not update those files.
Experts said the likely group behind the attacks was known as Wizard Spider or UNC 1878. They warned that such attacks can disrupt hospital operations and lead to loss of life.
The attacks coincide with the U.S. presidential election, but do not appear to have any connection to it.
‘We are experiencing the most significant cyber security threat we´ve ever seen in the United States,’ Charles Carmakal, chief technical officer of the cybersecurity firm Mandiant, said in a statement.
He’s concerned that the group may deploy malware to hundreds of hospitals over the next few weeks.
Alex Holden, CEO of Hold Security, which has been closely tracking the ransomware in question for more than a year, agreed that the unfolding offensive is unprecedented in magnitude for the U.S. Administrative problems caused by ransomware, which scrambles data into gibberish that can only be unlocked with software keys provided once targets pay up, could further stress hospitals burdened by a nationwide spike in COVID-19 cases.
The Russian-speaking cybercriminals suspected of the attacks use a strain of ransomware known as Ryuk, which is seeded through a network of zombie computers called Trickbot that Microsoft began trying to counter earlier in October.
In the past, ransomware infections at hospitals have downed patient record-keeping databases, which critically store up-to-date medical information, affecting hospitals’ ability to provide healthcare.
While the company has had considerable success knocking Trickbot command-and-control servers offline through legal action, analysts say criminals have still been finding ways to spread Ryuk.
The US has seen a plague of ransomware over the past 18 months or so.
In September, a ransomware attack took down all 250 US facilities of the hospital chain Universal Health Services, forcing doctors and nurses to rely on paper and pencil for record-keeping and slowing lab work.
Employees described chaotic conditions impeding patient care. Also in September, the first known fatality related to ransomware occurred in Duesseldorf, Germany, when an IT system failure forced a critically ill patient to be routed to a hospital in another city.
Holden said he alerted federal law enforcement after monitoring infection attempts at a number of hospitals, some of which may have beaten back infections.

Practicing quality medicine while maintaining and managing the bottom line is a balancing act that providers face daily. The Physicians Practice S.O.S. Group is committed to helping 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
#ReginaMixonBates #practicemanagementconsulting #practicemanagement #physicianconsulting #medicalconsulting #businesscoach #publicspeaker #motivationalspeaker

5 Tips on Being True to You by Being True to Your Health

Recently I had an opportunity to speak on Being True to Your Health I truly enjoyed speaking on this subject and decided to share some of the points I shared with the group.

No matter how the laws change in Washington, D.C., you and what you do in your life is the single best way to improve your health and stay healthy.

Preventable illnesses like heart disease, type 2 diabetes, stroke, and several leading forms of cancer make up a big chunk of health care spending, costing billions of dollars. These illnesses rob us of years of life and blight our golden years with sickness and disability.

It doesn’t have to be that way. Consider evidence from a study of 23,153 adults who took part in the European Prospective Investigation into Cancer and Nutrition. Volunteers who followed four tenets of good health — they didn’t smoke or get fat, they exercised and ate a healthy diet — were 80% less likely to develop chronic illnesses such as type 2 diabetes, cancer, and heart disease. Their risk of developing type 2 diabetes was 92% lower than the risk of people who shunned the familiar health advice. Their odds of having a heart attack were 81% lower.

Results like these prove again and again that the most powerful tool we have to improve health is prevention. Yet we still have trouble convincing people to make those healthy changes.  To craft your own health care reform program and get the biggest bang for your efforts:

  1. Be More Active and Exercise

Exercise offers so many health benefits; it’s nothing short of a magic bullet. Something as simple as a brisk walk for half an hour a day dramatically reduces the risk of heart disease, diabetes, and several forms of cancer, including colon cancer – one of the leading killers.

A lifetime of regular exercise improves brain function, allows people to be active and independent in their later years, and adds years to life.

A 2008 study by researchers at Brigham and Women’s Hospital in Boston showed that regular exercise lowered the risk of dying prematurely by 30%.

  • Maintain a Healthy Weight

Easier said than done, according to findings from a new analysis of data from state health departments. Over the past five years, obesity rates climbed in nearly all states. Indeed, not a single state in the U.S. saw a decline.

Losing weight and keeping it off is difficult. Yet studies show that losing weight just a few pounds if you’re overweight will improve your health. If your weight is normal, work to keep it there by reining in calories and exercising frequently. A healthy diet includes abundant fruits, vegetables, and whole grains.

A good diet limits refined sugars and saturated fats. One easy way to shed calories from your diet: drink water instead of sugary beverages. They account for more and more calories in the American diet.

  • Get Screened and Get Your Shots

Flu shots can dramatically reduce the risk of getting this seasonal bug and its potentially life-threatening complications. Yet only 42% of people 50 to 64 get yearly flu shots. Keeping up to date on all recommended vaccinations can prevent many deadly and debilitating illnesses.

Routine health screens are also lifesavers. Knowing and managing your cholesterol levels and blood pressure is crucial to reducing your risk of heart disease. Cancer screening tests have been shown to catch some forms of the disease early enough to eliminate them.

For the latest recommendations on what tests to get when, check out the U.S. Preventive Services Task Force recommendations at www.ahrq.gov.

  • Don’t Smoke: Quitting Saves Lives

A no-brainer. But lung cancer remains the leading cause of cancer death — between 80% and 90% of cases are directly caused by smoking, according to the National Cancer Institute.

Here is some good news: smoking rates are falling in the U.S. And thanks to a variety of new nicotine replacement therapies — from patches to nasal sprays — quitting is easier than ever. One recent analysis of studies found that nicotine replacements can almost double the odds that smokers will successfully quit. New medications to help smokers kick the habit are also available. Talk to your doctor about the best strategies for success.

  • Find Joy from Family and Friends

Enjoying life and maintaining a circle of supportive friends is a big part of good health. Indeed, having friendships may be second only to not smoking for preventing heart attacks. People with extensive social networks, according to research at the Uniformed Services University, are less likely to have calcification in their arteries, a sign of heart disease risk.

One way to increase your happiness is to foster cheerful friends. It turns out that happiness spreads through social networks – among friends and even friends of friends. A person is 15% more likely to be happy if a close contact is happy.

Practicing quality medicine while maintaining and managing the bottom line is a balancing act that providers face daily. The Physicians Practice S.O.S. Group is committed to helping 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.

Billing for E/M, Preventive Visits on Same Date…

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

Fix My Practice – Billing for E/M, Preventive Visits on Same Date

“Split billing” for patients who come to the office for a preventive visit and have multiple, serious, chronic medical conditions (for instance, diabetes, hypertension, atrial fibrillation, and congestive heart failure). Is it okay to use the evaluation and management (E/M) code along with the preventive code (with modifier 25) to discuss and bill for discussing these conditions, which might be stable but should be addressed during the preventive visit? Assuming these problems require several prescriptions, the ordering of lab tests/x-rays and that all the proper documentation is included to cover the preventive and E/M codes.

Then yes, it is appropriate to bill a preventive and E/M service for the same patient on the same date of service as long as the documentation supports the codes being billed. Two key questions to ask yourself:

  • Did the patient present with acute problem(s) and/or chronic abnormality/ies that required significant additional work? The narrative portion of the preventive services section of the CPT manual states: “If an abnormality/ies is encountered or a pre-existing problem is addressed in the process of performing this preventive medicine [E/M] service, and the problem/abnormality is significant enough to require additional work (emphasis added) to perform the key components of a problem-oriented E/M service, then the appropriate office/outpatient code 99201–99215 should also be reported.”

Given the fact of several prescriptions being written and lab tests and/or x-rays were performed. This would constitute significant additional work.

  • Does medical necessity support an E/M service in addition to the preventive visit? It isn’t simply a matter of the patient having chronic underlying conditions; all services billed to any insurance carrier must be medically necessary (it’s part of the attestation statement included in the physician signature box—Box 31—on the 1500 claim form or the electronic equivalent).

So, if the patient had been seen fairly recently for a follow-up visit for these conditions and he or she was stable at that time, and nothing found during the preventive medicine portion of the current assessment indicated that any of the problems had worsened or weren’t adequately controlled, then a problem-oriented visit wouldn’t be medically necessary today.

 

If a significant amount of time had passed since the patient’s last formal assessment of those conditions, however—or, in other words, the patient was due for a follow-up visit anyhow and the patient and the doctor simply chose to conduct the medically necessary follow-up assessment at this visit—then the problem-oriented visit would be substantiated in addition to the preventive service.

If this was a medically necessary assessment of the chronic problems (and not just a “quick peek” to make sure nothing had changed since your last assessment of those problems), how do you calculate the level of service for the problem portion of the visit? The key is the “additional work” specified by the CPT manual. The work performed over and above what normally would be performed in a preventive exam is all that can be counted toward your E/M code level. For example, you would assess the patient’s lung function during a preventive exam, so this element cannot be counted toward your E/M code level. You can count only the additional work.

While not always done, it is much easier for you to determine which elements can be counted toward an E/M code level if you do a separate note for the E/M service, because the chief complaint and specific history, exam, and medical decision-making elements that support the additional work are clear. However, if it is done this way you will never have a carrier deny your claim.

To bill appropriately, append the 25 modifier to the E/M code to indicate that a significant, separately identifiable service was provided by the same physician on the same date as the preventive service. Also, bill the preventive medicine code with the GY modifier, indicating that the service is statutorily excluded, does not meet any Medicare benefit, or, for non-Medicare insurers, is not a contract benefit.

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

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

 
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