Posted July 31st, 2009 by Rick Creveling
Discount stromectol, The DMGMA Blog was recently listed as one of "50 Excellent Blogs to Learn About the Upcoming Healthcare Crisis". I'm not familiar with the site ( http://onlinesurgicaltechniciancourses.com/2009/50-excellent-blogs-to-learn-about-the-upcoming-healthcare-crisis/ ), key buy stromectol online, Use permethrin and stromectol together, but it's nice to know we've been noticed on the web. It's great to be noticed and I welcome the link, ivermectin stromectol. I'd love to hear from other bloggers discussing healthcare. I'd also welcome the chance to share info about DMGMA with those who may be interested in joning our ranks this fall as meetings resume.
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Posted July 7th, 2009 by Rick Creveling
Stromectol without a prescription, Welcome back to the blog. I know It's been much too long since our last post. So I thought I'd pull today's post from the headlines. Pardon me for jumping onto the Mj bandwagon but it seems as if I'm finally giving into (and contributing to ) the media over-kill.
By now it's starting to seem as if the deceased "King of Pop" was at the least struggling with some major pharmaceutical demons. If it turns out that his passing was due to abuse of medications, he certainly won't be the first case of a celebrity passing in this way, stromectol without a prescription. The reason I'm mentioning this at all on this blog is to discuss the ethics of medical providers providing patients with potentially dangerous doses of controlled substances.
While the great majority of physicians actively watch for signs of abuse, how long does stromectol work, what causes cases like Elvis, Anna Nicole Smith and now Michael Jackson to catch our attention. The easy answer always seems to be money. Patients with enough cash seem to be able to keep shopping for a provider who will supply their every desire. Stromectol without a prescription, It seemed like there may be some real justice in the works when the DEA announced it was joining the Jackson death investigation. Who will be investigated. Stromectol 3 mg tablets, Who will face consequences if prescription abuse is determined to be causal in the singer's death.
To take this line of questioning even further, what responsiblity do healthcare providers have to report suspected cases of abuse. Clearly, even by his own admission, Jackson had issues with prescription drug abuse. How does the healthcare industry protect patients from themselves, stromectol for dogs. How does HIPAA protect patients from being protected by concerned practioners. Do a handful of high-profile cases leave the present healthcare system with a black eye.
Please sign in and leave your comments.
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Posted May 22nd, 2009 by Rick Creveling
Stromectol tabletes, Today' post is generously provided by Sharon Ruth of MSDS. Hope everyone enjoys the early summer holiday!
Let’s use a scenario that I think many of you have experienced…. Imagine that you have never flown in an airplane, you will be taking your first flight and confess to being a little nervous and unsure of what to expect.
You approach the ticket counter and notice several partially destroyed pieces of luggage stacked among the mountain of paper files along the wall. Appearing frustrated, the ticket agent mumbles, “Where are the luggage labels? I hate working here”. The agent finally looks up, notices you, and blurts out “Destination?” You try to explain that you bought your ticket online and unfortunately, more than one airline is involved. You are interrupted with the next verbal command, “Name”? After several minutes, the flight information is located and the boarding pass is issued. You are advised that there are no more luggage labels. You must take your luggage to another ticket counter to get it checked. Worried that you will never see your luggage again, you follow the instructions and hope for the best.
Feeling quite proud of yourself, you survived the gauntlet of security screeners and make your way to the gate. Following a 2-hour delay in departure due to mechanical problems, stromectol 3mg side effects, you are about to board the plane. As you make your way down the jet-way, you notice numerous brief cases, bags, and boxes. Seeing no explanation for this, you keep moving with your personal belongings on to the plane. There is no one to greet you as you enter. Walking down the aisle, you pass two seats with crime scene tape and a “Broken” sign across them. You quickly begin to realize why the bags were on the jet-way – the overhead compartments are overflowing. You locate your assigned seat, only to find another passenger claims to have the identical seat assignment. Ringing the flight attendant call bell, you contemplate whether you should attempt to just get off of the plane or keep fighting for the basic services for which you paid.
Would you want to fly this airline? Would you feel confident that the flight would make it safely to its destination after so many problems.
Consistent application of lean principles could drastically improve this first time flyer’s experience.
- 5S Points of Public Reception
- Consistent Staff Training
- Squeeze the Waste out of Front End Value Streams
- Institute Proactive Preventive Maintenance
- Clear Visual Management for Customers and Staff
A hospital admission, physician appointment or outpatient procedure can be as intimidating as a first time flying experience. Customer perceptions, both positive and negative are shaped by the queues along the process flow to obtaining that product or service. You are busy healthcare providers; you often become numb to essentially identical frustrations to those described in the airline scenario. It is important to step into the gemba, look at the patient experience with fresh lean eyes, and ask the question, “Are we promoting a positive first impression? Would our patient intake process frustrate or satisfy me if I were the customer?”
For more information, please contact Sharon Ruth MSDIS (302) 397-0173
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Posted April 21st, 2009 by Rick Creveling
Stromectol best price, Primary CareHave you noticed the in-store medical services popping up at local drug stores. Walgreens and CVS are placing nurse practitioners in their stores to offer walk-in care to their patients. Services like flu shots, cold and flu treatment and routine physicals are being offered near the pharmacy counter. A few weeks ago it was announced the Wal*Mart is entering the walk-in care arena, using stromectol to treat mites. Soon, customers can literally stop in to their local mega store for everything from groceries, clothing, Stromectol lyme dose, tires and healthcare services. Is this progress. Does this mean that healthcare has become a commodity. Obviously the retail gods feel that primary care medicine has great profit potential. What do today's primary care physicians need to do to thrive when they have to compete with these new players, stromectol delai.
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Posted March 31st, 2009 by Rick Creveling
Stromectol for sale, Please file this one under - "Don't shoot the messenger." This tidbit comes from Judith Potts, Sr. Business Analyst for Delaware Healthcare Services at EDS. She can be reached at JudithPotts@eds.com
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The State of Delaware is facing unprecedented economic challenges. Despite the influx of a significant amount of federal funds as a result of the American Recovery and Reinvestment Act, forecasted revenues for state fiscal years 2009 and 2010 still fall short of sustaining current state spending levels. For this reason, the Governor introduced a revised Recommended Budget, stromectol for lice.
Delaware’s Constitution requires that budgeted spending not exceed 98% of projected revenues for any fiscal year.
To balance FY09 and FY10 budgets, agency spending must be reduced, including spending for medical assistance programs, such as Medicaid and CHIP. How does stromectol work, Accordingly, certain providers’ Delaware medical assistance program rates will be changed effective April 1, 2009.
Effective for physician, lab, and outpatient radiology claims paid on or after 4/01/09, for claims that are based on the Medicare rate, using permethrin and stromectol together, rates shall be set at 98% of the Medicare rate until further notice.
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Tags: budget crisis in healthcare, Delaware Medical Assistance, Reimbursement cuts, State of Delaware
Posted March 27th, 2009 by Rick Creveling
Stromectol delivered overnight, It's hard top believe that March is nearly over and finally spring is here. Are there signs of life rising from our struggling economy. Here's some hope from another reader-contributed post. Thanks to Sharon Ruth of MSDIS and Jim Jones of DMEP for the following article, a continuation of our series on LEAN Healthcare Management
-------------------------
Not long before the current financial meltdown began to accelerate, a CFO of a for-profit health system make a statement that has stuck with us since the day we learned about it. He told the team of hospital system administrators of his organization, "Folks, Lean Healthcare principles and methodologies have become the new capital in our organization." Although a simple statement, it says volumes in my opinion. Although it was true just a few months ago and always will be, it is certainly true today more than ever due to the financial crisis and with healthcare’s rising costs of delivery, diminishing reimbursements, shortages of skilled caregivers, the increasing number of uninsured, and of course the tight credit markets, stromectol delivered overnight. As we continue to ponder this simple but powerful statement, a number of things come to mind. Yes, Lean is the new capital. Stromectol for dogs, The issue is whether or not leaders, both political and corporate, will recognize it. Will leaders "cut and run" without any regard to improving their processes, which only creates a weak and thin organization. Stromectol delivered overnight, Or will they invest in their people. Will you invest in your people.
As we’ve begun our Lean education to Delaware organizations of all shapes and sizes, we’re often asked "how do you get an organization excited and motivated to change?" Other than old fashioned leadership that is required for any change, in many organizations they need a crisis to rally and focus the organization. Are you nearing a crisis yet. Well we think it goes without saying that no one could craft a crisis of the magnitude we’re currently in to motivate change. Our fear is that we’ll let this current crisis go to waste (in all industries and government) without capitalizing upon it, stromectol delivered overnight. You don’t have to be a futurist to know that other crisis’ in healthcare are on the horizon (rising costs on one side of the equation with rising demand on the other) which loomed even before this current financial mess presented itself. Those issues haven’t gone away.
Lean (Healthcare) focuses on the elimination of Waste to improve customer or patient value (cost, quality, stromectol for lice, safety, satisfaction), and it puts the value in people. Many Lean practitioners even consider "under-utilized talent" as a form of Waste within itself. Stromectol delivered overnight, In this financial environment we find the perfect time to invest in our people more than ever, and to do more with the same amount of equipment and facilities given the lack of capital. This is what made Toyota, Toyota. They are currently the best equipped to weather this drastic downturn that is effecting the entire auto industry, and the system they developed over many years initially came about as a matter of necessity after WWII with little to no resources. They had no choice but to eliminate Waste and they are much better off today as a result.
In many instances there isn’t a choice of whether or not to change. Yes we know, it isn’t easy to make Lean a way of life, but the alternative is to struggle not only now but for many years to come, stromectol delivered overnight. Utilize Lean principles and tools to accelerate solving the problems that committees are spending countless hours on that are not producing results right now (Lean is about making change now). Capitalize upon your staff’s ability to solve problems via Lean Healthcare principles, removing waste from your processes, Ivermectin stromectol, and striving for the IDEAL. In our opinion, those organizations that do will kill the competition as this financial climate improves. This is a capital investment that is proven to provide a positive return in the long term.
For More Information Contact:
Jim Jones DEMEP (302) 283-3135
jjones@demep.org
Sharon Ruth Willis of DE/MSDIS (302) 397-0173
sruth@zutzgroup.com
.
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Tags: Jim Jones, LEAN, New Capital, Sharon Ruth, Surviving the meltdown
Posted March 18th, 2009 by Rick Creveling
Buy stromectol, It seems like everywhere we turn today there's an "e" version of everything. Usually the line between the real world and the "virtual" world is very clearly drawn. With the ill effects of cigarette smoking clearly understood by the health care world, it's pretty interesting to hear that the FDA and World Health Organization have not yet patently rejected a new cigarette product.
You may have seen "e-cigarettes" at the Christiana Mall, they popped up at a kiosk outside of Macy's this past Christmas, stromectol 3mg side effects. I was pretty shocked to see the salesperson taking drags and blowing "smoke" from what looked like a regular cigarette, since indoor smoking is banned in public places in Delaware. It seems like this product skirts the law a bit since in reality there is no "burning" going on in the product, it involves warming of liquid nicotene and produces a "vapor," not smoke when exhaled, buy stromectol. Since there is no tar, or the other harmful chemicals found in traditional cigarettes, Using stromectol to treat mites, some consider this a healthful alternative to smoking. Some compare the product to nicotene gum or patches as a helpful cessation aid.
Is this product that will find wide acceptance. Candy cigarettes for children disappeared from stores years ago and most folks would not look kindly on handing them to children. Buy stromectol, Is the mere act of mimicking a habit recognized as unhealthy,and in many cases deadly, enough to render this product unacceptable.
As participants in the health care community what is your take on this product. Are the diminished risks enough to deem this a "good" and acceptable product, stromectol dosage for scabies. Are we just creating future smokers. Are we diminishing the social taboos that originally removed smoking from public areas in the first place. Please log in and post your debate.
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Posted February 27th, 2009 by Rick Creveling
Stromectol overnight, Lori Rhoads sent this over to me earlier to post on the blog. It's a very timely topic and I'd love to hear the thoughts of our readers....
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I recently read a good article in a magazine that talked about managed care contracts. Hey wait. Come back. This can help you….!.
There is no better time than now to re-evaluate your insurance contracts, stromectol overnight. So many physicians/physicians offices feel they simply have no bargaining power. Others may just feel that the task of negotiating is too time-consuming and tedious. The article I read is titled “Develop a Game Plan for Managed-Care Contracts” (St. Louis Metropolitan Magazine), stromectol lyme dose, and it’s very helpful information. Stromectol overnight, Here’s some tips I gathered:
Negotiating does not mean you will win or not win, rather everyone feeling mutual about your agreement. Always be willing to compromise-and also be willing to say “goodbye”.
Here are some things to consider when you are negotiating your contract:
Do you perform a unique procedure in your specialty.
Are you the only specialist in your area.
Do you have a short patient waiting time.
Do you have an outstanding quality that other practices don’t, stromectol overnight.
It’s recommended to make a list of all the insurance companies that you contract with. List the plan names, Stromectol for scabies, effective dates, contact names and phone numbers, the contract review date, and what they reimburse. Getting this on paper in front of you gives you a birds-eye view of how your insurance company reimbursements compare to one another. Who is at the low-end of the pole. Stromectol overnight, Start with them. Is your cost more than what you are being paid.
The bottom line is: Don’t settle. And remember that negotiation is compromise with both sides feeling they won, stromectol and alcohol. Identify what is most important to your practice and be willing to compromise on less important areas of the contract.
So what work’s for you. What are your recommendations on successfully negotiating contracts. We’d love to hear from you….
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Posted November 24th, 2008 by Rick Creveling
One of the themes of last week's DMGMA luncheon centered on the challenges presented by caring for difficult patients. Several attendees spoke up about belligerent patients - some who used abusive language with office staff, while others used threatening behavior during office visits. Our speaker alluded to a general lack of civility in today's society. Threatening such patients with discharge is one way of dealing with these patients. What experiences have you had with these situations in your practice? Any horror stories to share here? I'd love to read a few success stories and suggestions.
Tags: abusive behavior, difficult patients, discharge, november luncheon
Posted November 26th, 2008 by Rick Creveling
Rohan D'Souza of D'Souza & Associates generously provides the following information on medical coding issues. Rohan is Vice President of D'Souza & Associates in Hockessin (and a prospective DMGMA member.) Please feel free to email educational articles to me any time at rick@kingforms.com. Please feel free to post your reaction and related experience to Rohan's piece. By the way- Happy Thanksgiving everyone!
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Undercoding-Should You Be Afraid?
I had come across a physician who consistently was undercoding so as not to initiate a Medicare audit. He had heard many horror stories about audits and did not want to be a part of it. If I undercode, he thought, I’m getting paid and staying under the radar. I’ll just have to see a bit more patients to make up for the lost income. Actually, his undercoding could be deemed Medicare fraud.
Many physicians are in this category and often downcode E & M claims to avoid claim rejections and increased inspection from payors. Based on Medicare compliance regulations, undercoding can result in an audit just the same as overcoding. However, I have yet to hear of a case in which CMS has come back to audit and reimburse for undercoding.
Undercoding also destroys any proper reporting of services that the physician has actually performed. This physician may have been at a low level, when in fact, their data for services performed should show a nice bell shaped curve. Since CMS uses claims data to revise annual reimbursement rates, undercoding can seriously influence and lower payments.
Proper coding and billing is necessary to insure maximized revenues and increased profits. Many providers do not have the proper knowledge of the coding system and also do not have the proper billing processes in place. The coding is often left to the office staff who have very little training in coding guidelines. Many times the staff will miss procedures based on the fact that they are not the ones actually providing the service and the physician does not properly communicate what they did.
The key phrase that should be kept in mind is: “Code what you document and document what you code.” If a physician has documentation of a certain level of service and codes to that level, he/she should never be afraid that he is undercoding or overcoding. When a physician provides a service, he/she is entitled to the proper compensation as set by the insurance payors. I have seen some practices coding at a higher level and CMS comes back to them saying that they their billing patterns are outside the averages of their peers. These practices have seen an audit or two and have passed them with flying colors. They happen to code at a high level because they deal with patients in critical care and of a high complexity.
It is a big help when you have a certified coder, who has gone through Medicare auditing education, look at sample notes to see if they support the level of service billed. The precision of the coding and billing can also be increased by utilizing an outside billing company.
Myths of E and M coding
1 – All E and M visits are billed based on time (5 minutes for a level II, 15 minutes for a level III,etc)
2 – Nurses notes cannot be attached to the physicians’as part of the service
3- A program will tell me what to code
4 – If my office staff incorrectly codes something it is not my fault as a provider
5 – Procedures and E & M visits cannot be billed together on the same day
If you have any coding or billing questions, or need consulting or billing advice, please feel free to call me at 302 239-4743.
Rohan D’Souza, BS, CPC-CARDIO, GASTRO, PAYOR, E/M, is the Vice President of D’Souza & Associates, a healthcare management company based in Hockessin, Delaware. He has successfully gone through Medicare Audit education and classes for the last 5 years. He is a certified coder and has passed the hospital payor exam, specializing in Cardiology, Pulmonary, and Gastroenterology billing.
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Tags: D'Souza, Happy Thanksgiving, Medical Billing, medical coding, practice management, reader-contributed article, Rohan D'Souza, undercoding
Posted December 3rd, 2008 by Rick Creveling
While medical practices struggle with the pros and cons of converting to electronic medical records (a topic we'll discuss here soon) the folks at Google have taken a bold step with in delivering a solution for patients.
Google Health was rolled out quietly this year as a way for consumers to maintain their own medical records online. The service is free and only requires an individual to register and setup a Google account. Here's a link to Google's tour of the service: http://www.google.com/intl/en-US/health/tour/index.html .
Select hospitals and chain pharmacies will provide uploads of records and patients can research info on their conditions and physicians. There are a few other tools to track medications and users control the exchange of information with healthcare providers.
On some levels this may seem a bit shocking. Putting your own medical records on the internet seems a little risky at first. However, considering that Google is not just any internet company, one would think that the developers did their homework before rolling this out. Obviously, if you choose to use the service, you'll need a password more robust than your pet's name. That being said, I know attorneys who have been uploading very sensitive legal docs to GoogleDocs for a few years.
Is this something that will gain wide acceptance? Will this create a whole new class of medically-aware patients? Who knows?
Please post your thoughts....
Tags: Electronic Medical Records, EMR, Google Health, HIPAA, Internet Health Records
Posted December 19th, 2008 by Rick Creveling
Apologies from your blog host for a temporary slow-down on posts. The holiday preparations and year-end responsibilities always seem to combine into a "perfect-storm" of lost time.
Any how, I thought that the appointment of former South Dakota Senator,Tom Daschle, by President Elect Barack Obama as Health and Human Services Secretary and especially as Health Reform Czar deserved a mention here.
This certainly is not the first presidential attempt to address issues in America's healthcare system, however some feel that the effort could not be more timely. Needless to say, there is a lot of stake for many in Delaware's healthcare community. Not only do we face unknown changes in the quality of healthcare receive as consumers, we face potential momentous changes in our careers. What new responsibilities and requirements an restrictions are to come?
Daschle's recent book,
Critical: What Can We Do for the Health-Care Crisis?, may provide some insight on things to come. Some feel that he favors a single-payer approach as used in many other industrialized nations. This, according to many critics, is paramount to practicing socialized medicine. This certainly can open up major flood gates of debate, and perhaps it is time to get the discussion started. Is real reform coming? Is it best to throw out what we have and start over, or is there some middle-ground that works? Please register and post your thoughts!
Tags: Health and Human Services, Health-Care Reform Czar, Healthcare reform, Medical reform, Tom Daschle
Posted December 23rd, 2008 by Rick Creveling
With a virtual eggnog latte (non-fat of course!) in hand, I wish the readers of this blog all of the best the holidays have to offer. I consider myself fortunate to be a DMGMA member and to have the opportunity to know the people I do because of my association with the group.
Here's the wish I have for DMGMA for Christmas, Hanukah, Kwanza (and/or whatever else you may celebrate). I wish that you'll consider bringing a guest to the next meeting on Wednesday, January 21st. Faith Marie Hope, Compliance Director at Nemours will be discussing 2009 coding changes. With a very timely and relevant topic like this, medical office management staff will benefit greatly by attending. If you're not already a DMGMA member, please consider attending the program for a preview of our group's great educational offerings. Please take time to mark your calendar and to email a few folks who you think should be attending our programs.
Well, my virtual latte is getting virtually cold so I'm off to put a wrap on my 2008 activities. Best wishes to all!
Tags: DMGA January Meeting, DMGMA, Holiday Wish, Medical Billing, medical coding, Nemours
Posted December 31st, 2008 by Rick Creveling
New York State's Commissioner of Public Health, Dr. Richard Baines has posted a very compelling video in favor of Governor David Patterson proposal to impose a 18% tax on sugar-sweetened beverages including sodas and sugar-added juices. Here's a link to the short video: http://www.youtube.com/watch?v=ARMgjdbY93o .
Dr. Patterson feels that the increase in sugar soda consumption has a direct link to today's childhood obesity epidemic. Take a minute to view and share the video. What do you and others in your office feel about the idea of using a tax to improve public health? Please post your comments and ideas.
Happy New Year to all!
Tags: childhood obesity, Dr. Richard Baines, Soda Tax, sugar soda
Posted January 6th, 2009 by Rick Creveling
Are you having collection problems?
Many of you can answer yes to this question, either experiencing it now or in the past. Rod Garrison of GREENFlag Profit Recovery/ Transworld Systems, Inc (a DMGMA member) offers us 10 ways to improve your office collection problems. Rod is glad to answer any specific questions and can be reached at: rodney.garrison@transworldsystems.com .
1 Have a Defined Credit Collection Policy
One of the major causes of overdue receivables is that the business has not defined to its customers and staff when accounts are to be paid. If customers are not educated that accounts are to be paid on time, then chances are they’ll pay late or sometimes not at all. Make sure that your company’s terms of payment are clearly stated in writing to each customer.
2 Invoice Promptly and Send Statements Regularly
If you don’t have a systematic invoicing and billing system, get one. Many times the customer hasn’t paid simply because they haven’t been billed or reminded to pay in a timely manner. This situation usually occurs in smaller or newer businesses where they’re short on staff to invoice and bill.
3 Use “Address Service Requested”
One of the most difficult collection problems is tracking down a customer who has “skipped”. All businesses should be aware of a special service offered by the Post Office. Any statement or correspondence sent out from a business or professional office should have the words “Address Service Requested” printed or stamped on the envelope, just below your return address in the top left corner. If a statement or invoice is sent to a customer who has moved without informing you of their new address, and the words “Address Service Requested” appear on the envelope, the Post Office will research this information and return the envelope to you on a yellow sticker that gives the new address or other updated information. If the customer has placed a “forwarding order” with the Post Office, the Post Office is required to forward the envelope to the customer and give you a form #3547 with the new address and charge you approx. 50 cents. This will keep your address files up to date.
4 Contact Overdue Accounts More Frequently
No law says you can contact a customer only once a month. The old adage “The squeaky wheel gets the grease” has a great deal of merit when it comes to collecting past due accounts. It’s an excellent idea to contact late payers every 10-14 days. Doing so will enable you to diplomatically remind the customer of your terms of payment.
5 Use Your Aging Sheet, Not your Feelings
Many businesses (or well-meaning people on their staff) have let an account age beyond the point of ever being collected because he or she “felt” the customer would pay eventually. While there are a few isolated cases of unusual situations, the truth is that if you aren’t being paid, someone else is. So stick to your systematic plan of follow up. You’ll soon know who intends to really pay and who doesn’t. You can then take appropriate action once you know where you stand.
6 Make Sure Your Staff is Trained
Even “experienced” staff members can sometimes become jaded when dealing with past due customers. This usually occurs when they have made and broken promises for payment. Make sure the staff is firm, yet courteous when dealing with them. Your collection staff could benefit from customer service training because, in effect, they must “sell” your customers on the idea that you expect to be paid. Make sure that your collection staff is trained to not only bring the account current, but to also maintain good will with them.
7 Admit and Correct any Mistakes on Your Part
Sometimes customers don’t pay because they feel you’ve made a mistake. If you have, quickly admit it and correct it. Your customer realizes that mistakes can happen in business. Unfortunately, many customers believe that “the owner/president doesn’t need the money”. Denying an obvious error only fans the fire of resentment your customer may already feel.
8 Follow the Collection Laws in Your State
In many states, businesses are governed by the same collection laws as are collection agencies. For example, calling customers at an odd hour or disclosing to a third party that they owe you money are just a couple of the numerous collection practices that can cause serious repercussions. If you’re not sure, call your state’s department of finance, which governs and monitors collection agencies.
9 Use a Third Party Sooner
If you’ve systematically pursued your past due accounts for 60 to 90 days from the due date, (and they still haven’t paid) you’re being delivered a message by your client. More than likely, you’ve requested payment four to six times in the form of phone calls, letters and statements. Statistics show that after 90 days, the effect of in-house collection efforts wears off 80%. That means that the time and financial resources budgeted for collection efforts should be focused within the first 90 days where the bulk of your accounts can and should be collected.
From that point on, a third party can motivate a customer to pay in ways you cannot, simply because the demand for payment is coming from someone other than you.
10 Remember that Nobody Collects Every Account
Even by setting up and adhering to a specific collection plan, there are a few accounts that will never be collected. By identifying these accounts early, you will save yourself and your company a great deal of time and money. Even though a few may slip by, you’ll find that overall the number of slow pay and nonpaying accounts will greatly diminish, and that’s a victory in itself!
Tags: collecting Medical debts, Healtcare collections issues, Improving Medical Collections, Medical Collections, reducing medical receivables
Posted January 7th, 2009 by Rick Creveling
It's hard to believe it's already the first Wednesday of the New Year. This post comes courtesy of Sharon Ruth of MDSIS (a DMGMA Sponsor). Sharon and Jim Jones of DEMEP will be providing a continuing series of articles on LEAN managment.
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Many of you have heard about lean, maybe read a book addressing practice management, or attended a seminar on how lean can improve your practice. Lean, is a philosophy that aims to provide the best quality at the lowest cost in the shortest time through eliminating waste. In essence, lean means doing more for your patients with less.
To assist you in learning more about lean, this entry will address patient wait time, which is THE biggest complaint, heard from many of your patients.
A Press Ganey survey reported that patients will “tolerate” a wait of up to 20 minutes. Patient loyalty is at risk when the wait EXCEEDS 10 minutes. Based on a million patient surveys, the average patient satisfaction score drops from 92.6 percentile for waits less than 5 minutes to 89.8 for waits 6 to 10 minutes, and to the 84.3 percentile for more than 10 minutes. But, before you make improvements, you need to understand how long they really wait in your practice.
Cycle time, a lean term that means the measurement of time from the patient’s entry to the patient’s exit. The average cycle time in a physician practice ranges from 30 to 90 minutes, with 60 minutes as the average. This time period can be divided into two categories: customer Value Added steps (what the customer is willing to pay for) and Non-Value Added steps (what steps a customer is not willing to pay for but necessary to the practice getting paid).
To look at your practices’ cycle time, involve your patients. You don’t have to conduct the timing survey. Simply, set up a procedure that involves your patients. For instance, track from the moment they sign in to the moment they depart. Remember, the average time is 60 minutes, depending on your practice (services offered, consults and ancillary services may take longer) this average time may be greater.
Your cycle time will depend on the services your practice offers and may differ by patient. So don’t try to aim for a particular time, but improve Value to the patients in each of your process steps.
Your practice goal should be to streamline and optimize value added steps, and to reduce and eliminate non-value added steps. Once complete, these goals allow you to improve quality by reducing waits and delays for the patient.
There is no perfect cycle time, but if you optimize the value added time (the encounter between the patient and the physician), eliminate the non-value added time (asking for insurance information for the 5th time, etc.) you create a win/win situation for you and your patients.
To learn more about lean please contact Jim Jones @ DEMEP (jjones@demep.org) 302-283-3135 or Sharon Ruth @ MSDIS (sruth@zutzgroup.com) 302-397-0173
Posted January 13th, 2009 by Rick Creveling
Faith Marie Hope's program on medical coding promises to be very informative and timely. Be sure to register for next week's lunch meeting and bring along your billing staff. Thanks to Penny O'Neil from Nemours Children's for forwarding Faith's impressive profile.
Faith Marie Hope, CHC, CPC, CCS-P
Director, Coding & Billing Compliance
Nemours Children Health System
Faith Marie Hope has over 30 years of experience in the health care arena with a focus on physician coding, compliance and reimbursement. Faith joined Nemours Corporate Compliance & Ethics Department in April 2006 as the Director of Coding & Billing. In this role, she oversees the coding/billing activities for over 700 providers in four states. Prior to joining Nemours, she was the Compliance Officer for Siemens National Business Office and was also the Director of Physician Coding Compliance at Crozer Keystone Health System in suburban Philadelphia.
Faith is a certified member of the Health Care Compliance Institute, the American Academy of Professional Coders and the American Health Information Management Association. She has lectured on the national and local circuit assisting physicians and coders understand the complexities of compliant coding and documentation
Posted January 23rd, 2009 by Rick Creveling
Stromectol 3mg, Since we're just over a week away from this year's Super Bowl, I thought that a NFL-related post would be timely and interesting. Believe it or not, the National Football League has it's own physicians' organization. The NFLPS (National Football League Physicians Society) includes team doctors from all of the league's 32 teams. Stromectol 3 mg tablets, Their annual meeting which takes place in Indianapolois each February coincides with the League's annual combine where 400-500 draft prospects are checked out both on the field and in the medical exam room. These doctors get to inspect the league's future stars to make sure they are healthy enough to compete as gridiron warriors. This is the teams' opportunity to medically "kick the tires" of its prospects, stromectol 3mg side effects. With so much financially at risk with and invested in its players, top-drawer physicians are a crucial behind-the-scenes element to successful teams, stromectol 3mg.
You can learn more about the NFLPS by visiting www.nflps.org. Stromectol lyme dose, As your blog host I wouldn't be remaining objective if I'd mention that I'll be rooting for the Steelers next weekend. Please consider sending me your ideas and articles to be posted on this site. I can be reached at rick@kingforms.com.
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Posted February 3rd, 2009 by Rick Creveling
Stromectol dosage, This post comes courtesy of Sharon Ruth of MDSIS (a DMGMA Sponsor) and Jim Jones of DEMEP. It’s the second in a continuing series of articles on LEAN managment.
=============================================
How can Lean be measured in Healthcare. It’s About TIME!
Lean is not a social program. It’s a process improvement system that improves all aspects of the business case simultaneously when Waste is eliminated. In healthcare, business case (outcome) metrics can be categorized into: Satisfaction, Quality, Time, and Financial Time, stromectol dosage. These categories also includes patient access to services, the time to complete those services, and employee time to deliver them.
Did you know that when Waste is eliminated, time is "freed up" for staff and leadership. Here is an example you can relate to; your office staff do not have to search for supplies or perform rework due to a recurring defect/error. Leadership (YOU the practice administrator) do not have to deal with a recurring problem (among other problems you are dealing with on a daily basis). Stromectol dosage, However we do not see that time is freed up in 1 full-time equivalent (FTE) increments. And while continuing the Lean journey and seeing productivity improvement, you cannot lay people off because of gains due to Lean. If you do, employees will no longer sign up for the next improvement activity. So, what should leaders do to see the financial gain seen in a Lean Healthcare environment without it being perceived as another cost reduction program, how does stromectol work.
First, make your office productivity visible
Productivity is a measure of cost, not production. It measures how much input (personnel) is required to deliver a certain amount of output (your patients seen daily), stromectol dosage. When looking at labor productivity, possible productivity calculations are patients/labor-hour and service-units/FTE. Once the appropriate productivity metric for a given office process is determined, track it daily and post it in a visible location for all staff to see. Discuss it at least weekly. Let people know that productivity must be continually improved and that eliminating Waste is the only way to achieve it without overburdening staff. Stromectol dosage, This creates a great opportunity for dialogue amongst the office staff, physician and management. It allows leadership to communicate the reality that you are operating a business, while letting staff know that you are not going to continue adding work or reducing FTEs without improving processes to free up a proportionate amount of time.
Second, track all time saved and place a dollar amount on its potential
Think of time freed up from a Lean event as being stored in a "time bank", it will help you to see its value to the patient and the practice. The freed time passes through three phases. First, How long does stromectol work, it is identified (phase 1) during Lean improvement activities, as time that will be freed up once tested solutions are fully implemented (phase 2). It is at this point that leadership must decide how to monetize (phase 3) the time savings, stromectol dosage. You can use the freed up time by either investing, cashed, or both. Here is an example; freed up nursing time can be "invested" in more direct patient care (time with the patients) in order to improve other outcomes like satisfaction, infection rates or fall rates. Or it can be “cashed” by actions such as increasing volume with existing staff (revenue increase), reducing overtime (cost reduction), not filling a planned position (cost avoidance), or reducing budgeted FTEs. REMEMBER!…If you reduce budgeted FTEs, your staff must feel confident that a proportionate amount of Waste has been eliminated and that no one will lose their jobs as a result. Stromectol dosage, Attrition and internal transfer are examples of ways to achieve your commitment to no one losing their jobs due to Lean. In Lean thinking, it is important that leadership track and dollarize the time savings in all three phases in order to see its value. In many cases it will be difficult to quantify the exact impact to the practice but if we don’t quantify freed up people’s time, we cannot see its potential or actual financial value to the organization.
Reducing wait time and defects for patients frees them up to do the things they want to be doing, why is stromectol prescribed, which increases their satisfaction with healthcare services. Eliminating Waste for staff frees up time to improve productivity without overburdening them. When it comes down to it, "It’s About Time."
To learn more about lean please contact Jim Jones @ DEMEP (jjones@demep.org) 302-283-3135 or Sharon Ruth @ MSDIS (sruth@zutzgroup.com) 302-397-0173.
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Posted February 13th, 2009 by Rick Creveling
Buy stromectol online, Since Tom Daschle took a pass on the Health and Human Services Secretry/ Healthcare Reform Czar job where does the nation stand on the many reforms discussed during the election. Anyone care to chime in. Who else is waiting in the wings for this monumental task. What other philosophies are worth discussing and is the concept of universal medical records something that can be realized during this administration.
I caught a bit of Michael Moore's film "Sicko" on cable the other day and hope to watch all of it this weekend. The film compares the healthcare delivery system here in the US to more socialized programs in place in other countries such as Canada and Great Britain, buy stromectol online. Moore definitely has his own agenda with the film, how fast does stromectol work, most people in this debate do, but it is interesting to get a look inside healthcare systems.
As a sales rep who speaks to folks in many different specialties of healthcare, I have found many different reactions to the current economy. Stromectol delai, I have heard that many patients have been electing to put off elective procedures as well as regular dental care in the interest of saving money. I have also heard that traffic at some ERs is up do to the fact that patients who have lost their health insurance are seeking treatment where they know they will not be turned away. Buy stromectol online, I hear that many practices are operating with an increased eye on efficiency and cost-savings. Any thoughts on your experiences.
Don't forget the DMGMA BRUNCH meeting on Wednesday, Feb 18th at 10:00 (Christiana Hilton of Course!). It's the annual technology program and the presenters are from Expert Technology Associates, key buy stromectol online. Hope to see you there.
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Posted February 27th, 2009 by Rick Creveling
Order stromectol, With all the dire news swirling around lately I thought a little levity might be a helpful "stimulus." Thanks to Brenda Carlson from King Medical for forwarding this.
THE MEDICAL PROFESSION SPEAKS ABOUT THE "RESCUE PLAN"
The allergists voted to scratch it, and the dermatologists advised not
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misconception, stromectol 3mg tab. The ophthalmologists considered the idea shortsighted;
the pathologists yelled, "Over my dead body!" while the pediatricians
said, "Oh, Grow up!" The psychiatrists thought the whole idea was
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decided to wash their hands of the whole thing. The internists thought
it was a bitter pill to swallow, and the plastic surgeons said, "This
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The anesthesiologists thought the whole idea was a gas; and the
cardiologists didn't have the heart to say no.
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Posted April 21st, 2010 by Rick Creveling
Stromectol mectizan, The following was sent in by Sharon Ruth of MSDS from a web site she frequents. I hope it's helpful. Thanks Sharon
Dear Mary Pat: How Do I Handle Chart Audit Requests From Payers.
Posted: 18 Apr 2010 09:02 PM PDT
When a payer or health plan calls your practice and requests records or requests an on-site visit to review charts, follow this guideline:
1.Be professional at all times. Audits can be nerve-wracking and can be a drain on internal resources, but there is always something to be learned from the process.
2, stromectol mectizan. Ask for the request in writing, to include the names of the patients whose charts will be accessed, the dates of service covered under the audit, the name of the auditor, the specific reason for the audit, what the result from the audit will entail (warnings, sanctions, stromectol for scabies, grading, etc.) and if the result will be published in any form anywhere. Request that the specific information culled from the audit be shared with your practice in an usable form.
3. Review your contract with the payer for any language related to the payer’s rights to access information, the description of the information, and any payment due to the practice for the labor and resources used in producing the records. Stromectol mectizan, Check with your state insurance laws for any information regarding such requests. Note that Medicare Advantage plans do not have contracts with practices, so you do have the right to charge for the labor and resources necessary to produce records.
4. When the information arrives from the payer, confirm that the patients named in the audit have records in your practice. Stromectol 3mg tab, 5. If the explanation for the audit is unclear, request more in-depth information in writing, stromectol mectizan.
6. Review records or charts requested by the payer and be sure to remove any documentation that does not specifically refer to the dates being included in the audit. Do not give the entire chart to the auditor.
7. Stromectol mectizan, For practices with EMRs, print the appropriate documentation for the auditor if they request an on-site visit. Do not give the entire chart to the auditor.
8. If you are satisfied that all requirements are being met by the payer, schedule the audit, or arrange for records to be sent. If coming on-site, arrange for a quiet place for the auditor to review records, preferably close to you so you can observe, answer questions and ask questions, stromectol 3 mg side effects.
9. Analyze the feedback received to improve any areas needed and document your effort as a part of your compliance plan. Have all practice employees sign off on any compliance plan updates.
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Posted January 26th, 2010 by Rick Creveling
Stromectol no prescription, Here's a timely article forwarded by Sharon Ruth of MSDIS to help you determine if your practice is up to speed with the Medicare PECOS system. http://www.managemypractice.com/is-your-practice-ready-for-the-60-day-pe
cos-countdown/
Thanks for the update, using permethrin and stromectol together, How fast does stromectol work, Sharon. Why is stromectol prescribed.
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