One of the first steps to optimizing the revenue cycle for a Pediatric Practice is to develop and incorporate a consistent Billing Processes, Procedures and Policies Manual for the practice. This manual should be customized to the practice based on how the revenue cycle is managed for the Pediatric Practice. Some items to include in this manual are:
• Payment Plan Agreement
• Examples of letters that will be used for final collections, payment plan, etc.
• List of responsibilities for front desk team members
• Registration forms
• Notices such as privacy policy
For all of our new billing clients we develop or edit the Billing Processes, Procedures and Policies Manual to the needs of the practice. This written document helps to provide clarity to all parties involved related to the Processes, procedures and policies for managing the revenue cycle of the Pediatric Practice. Developing and implementing this manual is an important first step to optimizing the revenue cycle for the Pediatric Practice. If you develop your own manual, recommend you obtain assistance from either a Pediatric Practice consultant or from another Pediatric Practice Administrator to identify if the manual is within the current standards of the industry. We have obtained new clients that were managing the practice based on revenue cycle rules of the late 1990s. In some of these cases, the practices were missing thousands of dollars a month in unrealized revenue due to outdated practices and processes.
child healthcare records
Does Your Pediatric Practice have a clear and consistent Billing Policy Manual?
Some Potential Effects on Pediatric Care due to September 11th, 2001
My 9th grade daughter asked me, as an assignment for school, where I was and what was my first reaction when I learned of the news related to the tragic events of 9-11-01. Most of us whom were adults at the time could describe the exact location and what we were doing when we learned this shocking news. The tragic events of this day changed many things in our country. What are some of the potential additional treatments in Pediatrics due to 9-11-01? The answer to this question is that it depends.
If you were a Pediatrician in New York, NY, you might have children that had early development of asthma. The Pediatrician would need to do a detailed history to see if there is any link to the events of 9-11-01. Where was this patient on 9-11-01? Where their parents exposed to the debris and air associated with 9-11-01? Asthma is not the only disease that the Pediatrician needs to complete a detailed history. Other potential diseases such as acid reflux, depression, anxiety, or sinus congestion might also might have a link.
Today is a day to remember the tragic events of that day as well as to remember our brave fire fighters, police officers, and other public servants that risked their lives to help others in a difficult situation. Although 9-11-01 was 11 years ago, the negative impact is still felt today.
Phase I Meaningful Use for Pediatric Practices: The Need to Change or Modify Practice Processes
I was on the phone with one of our valued customers this morning discussing Phase I Meaningful Use and the details on the “how” related to Meaningful Use. The overall goal of Health and Human Services is that providers utilize a certified E.H.R. in a meaningful way. A group of individuals invested months of discussions and feedback to obtain a list of parameters. One challenge for the group is to provide a universal list that applies across all fields of medicine. Some of the parameters in Pediatrics only apply to a certain segment of the population. For example, smoking status is for patients greater than 13 years of age. There are core measures that each provider needs to meet the benchmark for all these measures during the 90 day period being measured as well as selecting a list of 5 of the 10 menu measures.
A good E.H.R. system should provide a simple manner for a physician and/or Practice Administrator to evaluate performance of each of these benchmarks as well as very easily ‘drill down’ to identify how to correct/update patient data associated with the measure. How to use a meaningful use dashboard should take minimal training and review. The E.H.R. vendor should be able to guide an individual in the practice on the process via a web meeting or teleconference. So if you selected the ‘right’ E.H.R. system for Pediatrics, using the software and monitoring meaningful use should be straight forward.
The ‘tough’ part of Meaningful use: Changes to how the practice operates. For example, most practices did not record language, race and ethnicity as part of their intake/demographics. This needs to be captured for over 50% of patients seen during the 90 day measurement period for Phase I. If your E.H.R. system is well design, the practice should be able to click on a link and show the patients that do not have this information during the 90 day period. The most efficient way to enter this information is to capture the data when the patient visits the office. The “ah-ha” moment for many individuals is when they first run a meaningful use report, then they make the changes to their office flow and intake forms as needed.
Some questions to ask related to Meaningful use and your Pediatric Practice: Are we entering all medications in the system and sending medications via electronic prescriptions? Do we list the problems for each visit and maintain the patient problem list? Are we maintaining our Medication list and Allergy List? Does our standard protocol for demographics include recording smoking status of patients >13 years of age? Do we record vitals on each visit? Can we connect to the immunization registry? Are we connected to the lab companies that we send the majority of our labs?
This is not meant to be an a complete list of questions but a list to stimulate thinking around meaningful use. There are many resources, websites and references to obtain detailed information. Good luck on meeting Phase I Meaningful Use!
Customer Service and Pediatric Practice Management
I had a HORRIBLE customer service experience with a technology company this week. During business hours, I waited on hold for 29 minutes prior to a representative being available. After about 20 minutes on the phone with the customer service representative, it was obvious that she did not understand the issue
or how to resolve. She asked for another 20 minutes to check out some aspects of the issue but was unsure if she would be able to resolve the issue (technical issue with a phone they support for us). At this point I was extremely frustrated and needed to take charge of the call to provide options to her (she should have provided the options to me). She did not have an understanding of the problem for us – unsure if it was lack of listening skills or lack of knowledge. Investing more of my time on hold would have increased my frustration so we terminated the call with no resolution – missed opportunity. What could have this organization done differently? Plenty. First, no customer should wait more than 5 minutes to speak to a customer service representative. Management needs to be on the hook for staffing as well as monitoring customer service. Second, the company posted a ‘green light’ on their systems while the customer representative stated there is a major problem with their systems. The internal processes and procedures need to align when there is a problem. There are other items this company could do to further the customer service experience after they can move to an acceptable/basic level. Although we are not perfect, we are on the pursuit of perfection each day which causes continuous improvement of a ‘good’ customer experience. Constant re-engineering of processes and methods should be the norm with all organizations including the investment of people and resources.
How does this relate to Pediatric Practice Management? Pediatric practice management requires good customer service. When a patient calls during business hours, they need to be able to speak to a live person without waiting for more than a few minutes or receive a voicemail that they can leave a message when the question relates to a bill or other administrative function (e.g. follow-up on insurance information). Also, patients need to be able to leave a message any time after hours (this saves them time). We have picked up clients for which the previous billing service did not provide this level of service. Appropriate level of service is critical to managing the revenue cycle and the revenue cycle is a ‘team’ effort.
Continuity of Care in Pediatric Practices & the Link to Cloud-Based E.H.R. Systems
While at the pharmacy waiting for prescription Medication, I experienced the gap in knowledge by the average patient. One patient requested a medication to treat his wife’s pink eye from the pharmacist. When she explained that his wife will need an antibiotic he asked if he could use the antibiotic he was using to treat his ears. She explained to him that his wife needed a health care provider to exam her then based on the diagnosis, prescribe the appropriate medication for her red eyes. The husband was not coordinating care with his wife’s primary care physician.
Many in the health care system are missing the big picture when they do not call their primary care physician. In pediatrics, the outcome of the patient can be improved via strong continuity of care. If a patient is atopic and calls the office about a reaction to a medication, the pediatrician can use this information to appropriately manage the patient as well as record the incidence in the patient’s history. From the patient’s point of view, strong coordination with their pediatric office could reduce their burden and costs associated with using the Emergency Room. The pediatrician receives calls after office hours. The information available to the pediatrician should be able to be accessed easily at any time. Cloud-based Pediatric E.H.R. systems provide the best option for easy access to patient information on multiple devices in multiple locations…smart phones, IPads, lap tops, home computers. Who wants the burden of ‘dial in’ to the office server as well as maintaining constant security of the server?
As coordination of care continues to evolve as well as the option in wireless devices, Pediatricians can continue to reduce admin burden, costs and improve continuity of care with cloud-based E.H.R. Systems.
