Thinking On the Run

by Erez Lirov

Stretching expectations to find an ideal solution

Can Shannon find a credit card processing system that will meet her definition of excellence?

Mike and Shannon rounded the bend of the track through the park. The weather had kept them from running for a couple of weeks, and Shannon was enjoying the feeling of getting out in the fresh air and moving through the beautiful scenery.

“Isn’t this great?” Mike asked, puffing a bit. “I love getting into the moment and not thinking for a while.”

“How can you do that?” Shannon asked, slowing to a walk. “I think even more when I’m running. In fact, that’s one of the benefits. I can think more deeply as I run.”

“What’s on your mind?” Mike asked, slowing to match her pace.

“Credit card processing,” Shannon answered quickly. “I know I need to do some research to find the best system for the center, so I’ve been organizing my thoughts. Can I try it out on you?”

“Sure.” Mike plopped down on a bench that gave a view of the park.

“Stretch out first!” Shannon urged him. “Cool down!”

Mike stretched out flat on the bench with his arms and legs hanging down. “This is the only kind of stretching I plan to do. Now tell me your credit card processing ideas.”

“Okay,” Shannon agreed, pulling her nose to one knee. Her hair fell down to the ground, but Mike could still hear her as she continued, “I figure the least a system would have to do for it to be worth the trouble of changing would be to help us catch errors.” She drew her nose to her other knee. “If it would post the payments automatically to the patient accounts, charge the accounts back if the payment got declined, and send us a report at the end of the day, that would make it worthwhile. I figure it takes a full day over the course of a month for us to take care of those things, and I don’t see why a computer couldn’t do it.”

Mike nodded. “It sounds like that would help quite a bit.”

“Right, and it should also let us charge products to the patient accounts. That seems completely realistic.” Shannon pulled her arms behind her, stretching out her chest. “Next level up, if it would notice when recurring payment information we keep on file is about to expire, and maybe alert patients about expirations and if a payment is declined so they can take care of it. It would have to alert us, too. And it could alert us when someone is getting behind, too. That would not only prevent a lot of the errors we face, but it would also improve customer service.”

Mike sat up and swiveled to look over the park. “Okay, That’s the fair-to-middling solution. What does it take to reach excellence?”

“If the payment system would send out invoices automatically and let us accept payments electronically, we’d shorten the billing cycle and save a lot of time.”

“People prefer to pay bills electronically, anyway,” Mike pointed out. “Most of us are used to paying our bills that way by now.”

Shannon pulled Mike up from the bench and they headed back toward their car.

“So this paragon of a payment system,” Mike asked, “what’s it going to cost?”

“That’s part two,” Shannon laughed. “If I can find a system that meets my definition of excellence, then I’ll just have to see whether I can afford it. But I think that a system like that could result in some real savings just because of the efficiency, so it’s worth spending some time in research.”

Can Shannon find a credit card processing system that will meet her definition of excellence?

Boxed In?

by Erez Lirov

Breaking things down helps indentify needs, avenue to expore

Will Shannon’s lack of knowledge keep her trapped in credit card inefficiency? How can she find the change she needs?

“Why Shannon, you look radiant!” Theresa said as Shannon stepped into the office. Theresa was cutting down cardboard boxes. “Taking a little break with your husband really perks you up!”

“I think that this time it’s adrenaline,” Shannon said. “I’m feeling very motivated to fix the issues with our credit cards.”

“Issues?” Theresa cocked an eyebrow. “Like high fees, errors, and the time we spend on this stuff?”

“Exactly. I know you said we should shop around for a better rate, and Mike had some ideas, but do we have to have special HIPAA-compliant processing?”

“The compliance standard for credit card processing is called ‘PCI.’ I know we’re responsible for it and that the rules change sometimes, but I don’t know how we make sure we’re up to date on that. I have heard that penalties for noncompliance are high, though — you remember when Target had a security breach? They paid more than a billion dollars in fines.” Theresa shook her head and stacked the flattened boxes. “It’s no different for health care. Besides, look at all these boxes! This is from merchandise we sell. We’re making good money from that retail area. We should get a POS — a point-of-sale system — so we can check people out easily.”

“Hold on,” Shannon objected. “I’m trying to make things simpler here.”

“It could be like the practice management software. That seemed complicated when we were just thinking about doing it, but it has actually simplified our lives a lot — and saved us money.”

“That’s true. There might be an integrated system for credit cards.”

Theresa agreed. “If we were able to reduce errors, we’d probably save enough to pay for it. I heard that something like 8 percent of recurring payments get declined, and I’m not sure we catch all those.”

“I’m completely convinced that errors and efficiency are enough of a reason to make changes, but do you think we can do anything about the size of the credit card processing fees?”

Theresa thought, her eyes on the pile of cardboard at her feet. “I still think it would make sense to shop around, but I know that the fees are based at least in part on how much volume we have. Maybe making the process easier would encourage people to use their credit cards more.”

“If it’s about volume, though…” Shannon shook her head. “We’re never going to have the kind of volume Target has. Or even Mike’s rest

aurant. A lot of people pay by check and of course insurance is a big part of our income, too.”

“Maybe we could get group rates, like with insurance,” Theresa suggested.

Shannon laughed. “I think we need to do some research. At least now we know what we don’t know! Come on, I’ll help you get all this out to the recycling bin.”

Will Shannon’s lack of knowledge keep her trapped in credit card inefficiency? How can she find the change she needs?

Sorting It Out

by Erez Lirov

Credit cards can create a variety of compliance issues for practices

What are Shannon’s next steps to sort out her credit card system?

“Mike!” Shannon checked everything in the physical therapy facility with a practiced eye as she walked across the carpeted floor. She loved to see everyone busy and engaged, and things were going well at the moment. She had a word with the receptionist and steered her husband out the door.

“I was hoping you’d have time to come for a walk,” Mike said. “I needed to get away from the restaurant for a bit.”

“Problems?” Shannon’s voice was concerned.

“No, just a need for a change of scenery, a breath of air.” Mike took his wife’s hand. “It looks as though things are going well at your place, too.”

“Definitely,” Shannon agreed. “I know it won’t last –”

Mike laughed. With two small businesses in the family, there were bound to be plenty of problems to discuss.

“Seriously,” Shannon continued, “I want your advice about something. It’s not really a problem, but I think I could cut costs if I made some changes with the credit cards.”

“Now you’re talking!” Mike threw his arms wide. “I can’t believe you guys post everything manually!”

“I never really thought about it before,” said Shannon, “but today I was watching and it just seems so complicated. We take cash, checks, credit cards, and debit cards for deductibles, balances, all the things we sell at the counter… And we take the information over the phone or copy it off the card. Tana took the info via text today.”

“I’d have thought that might be a HIPAA issue,” Mike said with one eyebrow raised.

“I think it might be all kinds of an issue,” Shannon confirmed. “Plus, since we have so many different things going on, I can really see how there could be errors. Theresa said she wasn’t sure we always know when a card is declined, or if we always follow up on those cases to get alternate forms of payment, and I can believe it. It seems like practically everyone in the place took a payment at some point this morning. I don’t see how we could keep track of everything.”

“At the restaurant, the server picks up the card at the end of the meal. One type of transaction, and we know exactly who did it and when. It doesn’t sound like that’s true for you.”

“Exactly. I wonder, too, whether there isn’t a bit of psychological barrier in having to pull out that credit card.” Shannon checked her watch. “I’d better get back to work. Thanks for listening.”

“I’m happy to listen,” Mike said, turning back. “What’s your next step? I could hook you up with the company that supplied our credit card terminal.”

“I don’t know whether that’s what we need or not,” Shannon said. “Do you think we have to have something different  to be HIPAA compliant?”

“I don’t think I can answer that question,” Mike said. “Time for me to get back to my own credit card machine.”

What are Shannon’s next steps to sort out her credit card system?

Does your office staff argue about who is responsible for completing tasks generated by your patient visits?

How do you assign those tasks to your staff?

How can you see if the tasks have been completed?

Can you track those tasks automatically?

Do you micro-manage your staff?

How can you foster staff teamwork, promote staff autonomy and reduce the time you spend on staff management?

These are questions that each physical therapy practice owner has to answer. Each patient visit generates a list of tasks that need to be completed. Each patient needs an account set-up with their complete demographic information, their insurance information and other details you need to file insurance claims and to collect cash or co-payments.

If you break those tasks into a step-by-step list, then how do you assign those tasks to a member of your staff? How do you determine if every task has been completed for every patient? What happens if steps are forgotten? How will your patients judge your mental health practice if your staff forgets something? Would your patients think your office is unorganized?

Q: What’s the problem?

A: Office staff including the front desk, the office manager and any employee physical therapists are supposed to make life easier for the practice owner. However they often inadvertently create additional challenges regarding patient retention, revenue and compliance. Many of these challenges are related to issues that the practice owner simply doesn’t have time for. If your staff goes on vacation or calls in sick then a backlog of tasks is created, resulting in tasks being forgotten about and mistakes being made. Every member of your staff needs to be managed and be held accountable to ensure that each task is completed correctly.

Q: Why is this problem important:

A: The short answer is Cost, Compliance and Patient Attrition.

• Cost – Front office tasks prevent the practice owner from seeing patients, which is the only billable time for your practice. Mishandling of billing and collections results in lost revenue with denied claims and delayed payments. Ineffective patient relationship management leads to attrition.
• Compliance – Includes incomplete/incorrect documentation, interrupted care plans, incorrect CPT/Diagnosis codes, staff unfamiliarity with procedures and staff failure to collect copays leads to overpayment by the Payers.
• Patient Attrition – Failure by staff to follow-up on no shows, incomplete care plans and patients with no future appointments.

Q: Why is this problem difficult to solve?

A: There’s high front office staff turnover which could be due to poor training, lack of knowledge and unorganized micro-management. Some staff have a poor attitude towards training on new procedures and systems and they’re more comfortable with the old way of doing things. There’s also a lack of redundancy leaving tasks undone when somebody is absent and the ultimate responsibility falls to the practice owner.

Q: What’s bestPT’s approach or solution?

A: A complete practice management solution for your office.

• Improve staff teamwork with effective training to ensure optimal practice performance.
• Improve teamwork and staff autonomy with automatic checklists of tasks that need to be completed when patients are checked-in.
• Track practice goals to more easily improve the number of patient visits, increase revenue, submit every insurance claim, follow-up with every no show and schedule patients with no future appointments.
• Manage staff remotely on your laptop or your smart phone by tracking task completion.
• bestPT is a complete practice management solution that includes:
  • office workflow
  • patient relationship management
  • staff management
  • while also incorporating everything else you need like:
    • scheduling
    • billing
    • EHR
    • claim scrubbing
    • claim submission
    • claim follow-up
    • staff task checklists
    • training, etc.
  • bestPT also includes a Coach to ensure your practice uses everything in the most efficient way possible.

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