Does the concept of FREE Medical Software exist in the Healthcare Marketplace?
Who doesn’t love a bargain? I like saving money just like the next person but have you ever thought as to how a FREE product could eventually affect your business? Can you really trust your livelihood, making payroll, and managing patient care with a FREE medical software program? Those who say ‘yes’ are more than likely just happy with status quo regardless of the limitations they may face. In this particular post, I’ve decided not to include the actual medical software company name I’m referring to, as I figured they’ve had enough of a challenge in the press lately.
Are They Stable?
In the past 6 months alone, this FREE medical software company has laid off 25% of its workers to create a positive cash flow. They’ve been slapped on the wrist by the U.S. Federal Trade Commission after reaching a settlement after charges that it misled users of its patient portal into reviewing their physicians-often including sensitive medical information that was then posted online. Within the last 12 months it has shuffled around some high level employee positions in hopes of an impending IPO.
From the outside looking in, there is so much more to a medical software company however one could say that after this kind of news, it’s time to open your eyes.
After nearly 13 years of working with award-winning Practice Management and Electronic Health Records software, I’ve seen a lot, stood on the sidelines surrounded by product acquisitions, and have experienced enough to keep me content for quite some time.
As we are all aware, the healthcare industry is full of moving parts from government mandates, pharma breakthroughs, new developments in disease treatment and more! And let me assure you, whether you pay now or later, your FREE software isn’t as it seems. If we parallel the term Opportunity Cost (economically speaking) with a new medical software implementation, time and money will both be involved. More than likely, you will go through similar steps with your FREE medical software as you would a paying medical software program—one of the biggest differences may be the scope of available resources, efficient implementation structure, personnel on hand or training tools. Your team will need to train on a new system and that won’t happen overnight. A few practices may contact an IT Professional to ensure all computers meet spec for Cloud or Server based optimal performance. Some practices will re-construct patient flow in the new software so it runs like a fine oiled machine. Lastly, the creation of Charting templates typically don’t occur with a wave of a magic wand. I don’t know how many providers want or are willing to use templates right out of the box, the ones I know all want to put their personal touch on documentation efforts. In order for a successful product launch, a practice needs a myriad of options and flexibility when it comes to the Clinical component. Scheduling delays are more than likely a reality when it comes to instituting a new system throughout a practice as well. I am having a hard time trying to see how FREE medical software would be advantageous at this point. I nearly despise the following statement but have to deploy it because it rings true in the medical software arena, “You get what you pay for.”
It’s bad enough most physicians are combating alert fatigue, burnout or having to refocus on a variety of electronic devices on a daily basis; who needs an advertisement on the screen while entering in important patient data. A provider’s view no matter where they are at in the software should remain laser sharp on the patient’s care not reading or clicking on some ad to learn more. As Benjamin Franklin referenced in Advice to a Young Tradesman, “Time is Money.”
Items to consider
I am currently working with a 5 physician group who has this FREE medical software and are dumping it. They’ve quickly learned an important lesson and now have the desire to work with a progressive software manufacturer who will help transform their practice into the future. Don’t get me wrong, in the medical industry there are surprises around every corner and no medical software is safe from being acquired, going into maintenance mode—which means no further development is taking place, going bankrupt or being sunsetted all together. I tell prospective medical offices that since my crystal ball is in the shop, it is difficult for me to predict what is to come. What I do suggest is making sure the foundation of the respective manufacturer is solid because their product output will be directly affected if it isn’t.
Another way to conduct a health check on a software company is to see how many times they come out with a forward-moving product update. Are steps being taken to aggressively prepare and address new government directives, are enhancement requests from users actually instituted or ignored, and is the company under scrutiny more often than not?
When are business owners and providers going to wake up? There is no such thing as a FREE medical software program. Maybe you don’t have to pay any money upfront or on a monthly basis however the concept of Opportunity Cost does come into play. There are so many things to consider and I think some providers are quick to make a decision or jump on the neighbor train to get on board with what their colleagues may be using.
In reality, each and every medical office is unique and should be treated as such. Every staff member in your practice will be affected by this software decision. A Clinical data conversion of patient records can be costly so would you rather select a so-called FREE system now and pay for it later by having to change to another software program because the FREE one didn’t pan out? Or select the right software program that is vested in technological advancements, superior customer support, physician satisfaction as well as patient engagement and enjoy the benefits of knowing that “if it sounds too good to be true, it probably is.”
Dana Deardorff is the Office Administrator at MediPro, Inc. She is working toward her 13th year in the medical software industry and specializes in the many challenges independent physicians face in today’s healthcare marketplace.
Coping With the No-Shows
by Physicians Weekly | May 18, 2016
5,941. Are you kidding me?
Disturbed by a rising no-show rate in our residents’ practices, we ran the numbers the other day. Looking back over the past year, we discovered something remarkable, and worrisome, about patients scheduling appointments in our practice.
Surprisingly, that number, 5941, represents those patients who have made and no-showed (i.e., broken) three to 10 appointments in our practice during the year.
When we include those that have broken only 1 or 2 appointments, the number goes well over 10,000.
What is disturbing is what this represents. This is 10,000 lost opportunities for those patients who didn’t come in to be seen and get care, as well as missed opportunities where we had to tell 10,000 other people that there was no availability on the schedule because those appointments were locked up.
If you think about it, that represents several practitioners sitting around essentially doing nothing for an entire year. Or thinking about it another way, if those slots were available we could have three other practitioners taking care of patients full-time for a whole year, providing an awful lot of necessary care.
A Warning Letter
One of the decisions we’ve made after reviewing this, is for those who have broken a large number of appointments, we will offer their providers the opportunity to send a warning letter. It seems reasonable if someone has broken, just not showing up, 10 appointments in our practice over a year, that it’s worth letting them know that they are preventing us from caring for them — as well as others who desperately need to be seen — from getting the care they need.
Each provider is different. Some have a different level of tolerance for no-show appointments. I know some providers who, if you break two appointments with them, will send a letter warning you that you may be kicked out of their practice. Some feel much more lenient with their established patients, and are more understanding of no-shows for those that they’ve cared for over many years. Some providers will give an initial visit one or at most two chances, and after that they tell them not to bother making an appointment with them.
Clearly, the whole process of access to appointments, scheduling, show rates, and all the rest, is complicated, and there are many factors that go into why patients make appointments, keep appointments, or no-show for appointments. But how do we optimize this, how do we make sure that patients are not blocking off our schedules and then letting it sit there unused?
Let’s be honest. When we have a packed day, our schedule crammed with overbooked patients, and suddenly someone doesn’t show up, that brief opening in your day can seem like a breath of fresh air. A small pause, or at least a moment where you can catch up a little bit.
But it does come at a cost. What did the patient need that day? Were they sick, and was there something we really needed to attend to?
We can’t chase them all down, call them up and make sure that they’re okay, rescheduling to see make sure we see them the next day.
The Downsides of Open Access
Different models of advanced access and open access can certainly be seen as advantageous for patients; we want them to be able to be seen, to come in when they want to be seen, but for those wasted appointments that are clogging up the system, we need to restructure and tighten up the process.
One of the newer pieces of functionality in our patient portal that is about to go online is the ability for patients to schedule themselves, to actually directly put themselves right onto your schedule into an available appointment slot. Some see this as exciting, the wave of the future, true open access, but some see it as worrisome, that patients may make appointments that they may not need or even really plan to keep.
It reminds me of smartphone apps where people can make reservations at restaurants, with very little sense of responsibility. Theoretically you could make 20 reservations for dinner Friday night, keep none of them, and it’s no skin off your teeth. The restaurant wants you to make a reservation at their place, but they certainly don’t want you not showing up.
In the olden days, you actually had to call the restaurant to make a reservation and speak to the maître d’, and there was somehow some shame in not showing up for that reservation. In fact, many places would take a credit card and hold it for you, and use that to make sure you kept your reservation.
You feared not showing up and then dared try to make another reservation. Missed a dinner reservation last week? Table by the bathroom.
To Overbook or Not to Overbook?
One of my psychiatrist friends tells me that they never overbook psychiatric appointments, and yet at the same time they worry mightily about their no-show rate. Understandably, it would be hard to see two complex psychiatric patients during a single time slot, when everybody wants to feel that the full attention of the therapist is focused on them during those 45 minutes.
We primary care providers, on the other hand, will almost always overbook our schedules, squeezing someone in for a blood pressure check, a minor illness, a single issue, using two rooms to run back and forth between patients — while someone is getting an EKG we’ll check in on the other one, while someone is undressing we’ll go take a look at that rash, maximizing our efficiency to keep things moving.
But the worry is always that if you overbook to your no-show rate, that is if you know your no-show rate is going to be 40% this week among all your providers and you book your practice at 140%, then there are certainly going to be days when everyone shows up. And that can get crazy, leading to provider burnout, and patient dissatisfaction.
The addition of a new telephone electronic reminder system seems to be chipping away a little bit at our no-show rate. The system calls patients (for whom we have an active telephone number) reminding them of their appointment 48 hours in advance, giving them the option to confirm that they are keeping the appointment, or selecting an option that allows them to tell the practice they will not be keeping it. This created availability has been extremely helpful in getting us a bunch of same-day or next-day appointments for patients who want to be seen urgently.
It does seem fair in the big picture, however, that if you’ve made multiple appointments to see one of our providers as a new patient, and just don’t have the courtesy to call and cancel, you just don’t show up, that at a certain point we can send you a gentle reminder letter that this is preventing us from caring for you and preventing many of our other patients from being seen in a timely fashion. And after that, it certainly seems like it’s time for you to get your care elsewhere.
It’s true, if someone has broken 10 appointments with us in a year, it is worth us trying to figure out why they aren’t coming, what we can do to help them get into care, do they need help with transportation, insurance, finding a provider who better matches their personality and health needs?
But at the same time, these 10,000 no-show appointments represent lost care opportunities, as well as lost income for the practice, and lost learning opportunities for our physicians in training.
Make and keep an appointment, and we will get you all the care you need. Table for two, by the window with a view, is ready and waiting for you.
Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine. Pelzman’s Picks is a compilation of links to blogs, articles, tweets, journal studies, opinion pieces, and news briefs related to primary care that caught his eye.
**Note from MediPro, Inc.: Is your practice having a similar problem? We offer Automated Patient Appointment Reminder solutions that integrate with the CureMD PM/EHR and Lytec software. Give us a call today at 1.800.759-1321 opt 2 to see how easy it is to implement in your office.
Doctors, hospitals can charge more than $6.50 for electronic records, Civil Rights Office says
Providers are permitted to calculate the actual cost of electronic copies of records, and charge for those costs, OCR clarified.
The Office for Civil Rights, a division of the United States Department of Health and Human Services, today (5/24/16) clarified that doctors and hospitals can charge more than $6.50 to provide patients an electronic copy of their records if they can show that the actual costs were higher.
In a set of guidelines issued earlier this year, the OCR stipulated that organizations covered by the Health Insurance Portability and Accountability Act of 1996 could only charge for copies of records within certain parameters, such as covering the cost of printing and mailing copies. Charging a flat fee of $6.50 was suggested.
Providers, however, are not shackled by that price limit. They are permitted to calculate the actual cost of electronic copies of records, and if they’re permitted by the Privacy Rule — and deemed appropriate — they may charge more than the suggested rate.
The $6.50 guideline, OCR said, is “an option available to entities that do not want to go through the process of calculating actual or average allowable costs for requests for electronic copies of PHI (protected health information) maintained electronically.”
OCR said in its guidelines that it would examine whether the fee was prohibitive to access of the requested records, and revisit the Privacy Rule from time to time for routine reassessment.
6 privacy landmines and how to avoid stepping on them
While the healthcare industry grapples with data breaches and privacy and security regulations, there are common pitfalls that are easy to run into without proper planning.
Erin Whaley, a partner at the law firm Troutman Sanders, outlined what those are and shared half-a-dozen tips for avoiding them.
Here is Whaley’s advice:
- As long as I have cybersecurity insurance I’ll be covered in the event of a breach. It’s not that simple. Whaley said that even healthcare organizations that stack policies to get to $50 million in coverage may not have enough – though she’s not espousing that everyone simply plunk down for more insurance. Providers, instead, need to deploy solid security practices. “Having good security is a prerequisite to good coverage.”
- Our team can handle any incident internally. We don’t need outside help. Even providers who really have the best professionals in the country should seek outside help. Here’s why: Those top-notch professionals already have a full-time job and when a breach occurs, you don’t want them distracted working to resolve that all day for weeks or months because that can create entirely new vulnerabilities. “Get outside experts to supplement your expertise and bandwidth,” Whaley urged, including crisis communicators, public relations professionals, and even standing up a separate call center to respond to the breach. That last one, in fact, could help prevent a civil suit by assuaging angry patients before they come together to sue your health system.
- Social media isn’t a big concern for us. “Do not think social media is not a problem for you,” Whaley contended. She pointed to two facets of social media: internal staff that could release PHI via networks and human resources. Even employees who think they understand the rules can be dangerous, she said. For HR, Whaley warned that even non-unionized employers are subject to rules that prevent you from taking action against prospective hires or employers based on what you learn from social media.
- Business associate agreements are just a form agreement. Our lawyers don’t need to review them. Whaley explained that more BA’s fall into this trap than healthcare providers, there are some hospitals that do as well and for a variety of reasons, most notably that they think BA agreements are similar and they don’t want things held up in legal review. “Do not fall into this pitfall. It can be tremendous. You can dig yourself a huge hole thinking this way. They’re not a form agreement anymore,” Whaley said. Rather, providers need to inspect those contracts, understand the changes, how HIPAA and other regulations figure in, and ensure they make sense from a business and legal perspective.
- As long as I’m HIPAA compliant, I don’t have to worry about other privacy laws.“That is not true,” Whaley said. “There are other privacy laws.” Those include: State privacy laws, state medical records laws, Part 2 regulations for substance abuse treatment information, the Telephone Consumer Protection Act (TCPA) applies to all auto-dialer technology and treats landlines and cell phones differently, among others.
- We do a fine job responding to requests from individuals for their records. Updating this process is not a priority. “You should go ahead and look at the process for responding to individual requests for records,” Whaley said. She explained that the Office for Civil Rights offers guidance for providers to address and recommended comparing your own policy to that, which doesn’t take long. “This is clearly an issue for OCR so I would expect to see greater enforcement.”
6 Ways To Free Up Time In Your Practice
Patient care is the top priority and a source of passion for physicians, but making sure the business side of your practice is healthy also can contribute to better outcomes and patient satisfaction. Learn six ways to streamline revenue-related processes to maximize the amount of time available for patient care from the AMA Wire®.
Once you have Practice Management software (PMS) in place that works for your practice, take advantage of these six ways to make your revenue cycle management processes more efficient:
- Verify insurance eligibility electronically before visits.
Most health plans allow patient eligibility to be verified by phone or through a Web portal, but these methods are often inefficient and may not provide all the necessary information. Electronic eligibility verification can be a big time-saver. When a patient schedules an appointment, the scheduling or registration staff collects their insurance information and submits an electronic eligibility request by entering the patient’s data into the PMS. Federal regulations require health plans to respond within 20 seconds. Patients can then be made aware of any financial responsibility that will be requested at check-in.
- Reduce prior authorization burdens through electronic transactions.
Newly available electronic pharmacy prior authorization transactions enable physicians to complete prior authorization requirements as part of the e-prescribing work flow. E-prescribing system vendors are in various stages of implementing the technology for these transactions, so find out your vendor’s timeframe and request this new technology for your practice.
- Submit claims electronically to save time and money.
Submitting these health care claim submissions electronically can save time and speed up health plan adjudication and payment. After your PMS generates an electronic claim, your practice can either submit it directly to the health plan or indirectly through a clearinghouse or billing service, which may pre-audit or “scrub” claims prior to submission to check for missing or incorrect information. The built-in checks allow any potential issues to be addressed before the claim reaches the health plan’s adjudication system, reducing payment delays and denials.
- Determine the status of a submitted claim.
Practices often don’t know if a claim has been received by the health plan until it is paid, pended or rejected. Use an electronic claim status inquiry to confirm receipt and determine status of submitted claims. Health plans are required to support real-time claim status processing. Practices can send “batch” transmissions to health plans to check the status of multiple claims at the same time. By law, health plans must respond by the next business morning. Rather than waiting two or more weeks before taking action, the electronic claim status request provides your practice with an immediate status report on the claim.
- Use electronic remittance advice (ERA) to simplify processing of payment information.
An ERA is an electronic version of a paper explanation of benefits and holds all of the same details. The standardized ERA can reduce burdens, more quickly identify claims that require reworking and save time for staff to spend on higher-value activities. When implementing ERA in your practice, engage all involved trading partners, including health plans, your PMS vendor and any billing service that your practice uses. Determine the ERA capabilities of your PMS software. Taking full advantage of the ERA transaction may require an upgrade to the software.
- Maximize collection of patient payment.
The growing prevalence of high-deductible health plans means many patients bear additional financial responsibility for their treatment. Collecting payments while the patient is still in your office is a vital first step in any effective patient collections strategy. It will increase cash flow, decrease accounts receivable, and reduce billing and back-end collection costs. To bill at the time of service, your staff will need to know the correct amount to charge. Completing an electronic eligibility check before the appointment will provide information about the patient cost. Use this information, along with the health plan’s current fee schedule, to calculate the amount the patient owes.
To view the article in its entirety with additional AMA module links, please click here.
NOTE: MediPro, Inc. can help practices with the mentioned services of Eligibility checking, Claims submission, Troubleshooting, ERA, automated patient statements and in-person or online payment collections. Simply call 1.800.759.1321 opt 2 to learn more.