Med Monthly May 2017

PHYSICIAN SOLUTIONS PRESENTS

Med Monthly MAGAZINE

May 2017

Improving Your Patients’ Check In/Check Out Experience: 5 Tips for a More Efficient Front Office pg. 30

The Hidden Profit Center: Your Front Desk pg. 22

OPTIMIZING YOUR FRONT OFFICE pg. 26

12 STEPS TO DRIVE TRAFFIC TO YOUR BLOG pg. 12

the

In Checking ing & Check Out issue

contents

26

features

OPTIMIZING YOUR OFFICE

22 THE HIDDEN PROFIT CENTER: Your Front Desk 26 OPTIMIZING YOUR FRONT OFFICE 30 IMPROVING YOUR PATIENTS’ CHECK IN/ CHECK OUT EXPERIENCE: 5 Tips for a More Efficient Front Office

14

EXEMPT VS. NONEXEMPT MEDICAL PRACTICE STAFF

practice tips 6

WHERE DO WE STAND WITH HEALTH CARE?

10 HOW TO DEVELOP A BRAND FOR YOUR MEDICAL PRACTICE 12 12 STEPS TO DRIVE TRAFFIC TO YOUR BLOG 14 EXEMPT VS. NONEXEMPT MEDICAL PRACTICE STAFF

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Med Monthly May 2017 Publisher Creative Director Contributors

Philip Driver Thomas Hibbard Naren Arulrajah Michelle L. Durner, CHBME Jewell Lim Esposito Vishal Gandhi, BSEE, MBA Barbara Hales, M.D. Nick Hernandez, MBA, FACHE Thomas Hibbard

contributors Naren Arulrajah is President and CEO of Ekwa Marketing, a complete Internet marketing company which focuses on SEO, social media, marketing education and the online reputations of Dentists and Physicians. If you have questions about marketing your practice online, call Naren direct at 877-249-9666.

Michelle L. Durner, CHBME is the President of Applied Medical Systems, Inc. – a Durham, NC-based company which provides revenue cycle management, coding, practice management, and consulting services to start-up practices, hospitals, private practices, and hospital based physician groups across the nation. To contact Michelle or to learn more about Applied Medical Systems, visit www.appliedmedicalsystems.com

Vishal Gandhi, BSEE, MBA

Med Monthly is a national monthly magazine committed to providing insights about the health care profession focusing on practical advice for physicians and practices. We are currently accepting articles to be considered for publication. For more information on writing for Med Monthly, please email us at medmedia9@gmail.com.

P.O. Box 99488 Raleigh, NC 27624 medmedia9@gmail.com Online 24/7 at medmonthly.com

is the founder and CEO ClinicSpectrum Inc. He is a well-known and widely respected authority on the “nitty-gritty” of medical practice workflow and technology. His Hybrid Workflow Model is quickly becoming a new healthcare industry standard model for combining human and computer workflow, to maximize revenue and minimize cost and he has appeared in prominent health IT publications.

Barbara Hales, M.D. is a skilled expert in promoting your health services. As seen on NBC, CBS,ABC and FOX network affiliates as well as Newsweek, Dr. Hales writes all the content you need to promote your medical services.

Her latest book is on the best seller list and she can do the same for you. Check out her site at www.TheMedicalStrategist.com. For a free marketing assessment, call 561-325-9664.

Nick Hernandez, MBA, FACHE is the CEO and founder of ABISA, a consultancy specializing in solo and small group practice management.

He has consulted with clients in multiple countries and has over 20 years of leadership and operations experience. Visit www.abisallc.com for more information.

MED MONTHLY MAGAZINE |5

practice tips

Where Do We Stand with Health Care?

By Jewell Lim Esposito Principal, Jackson Lewis P.C.

22|| DECEMBER 6 MAY 2017 2013

T

he American Heath Care Act was designed to provide health care reform and to replace former President Obama’s Affordable Care Act (the “ACA”). However, the House of Representatives, under President Trump’s direction, cancelled its vote in late March because of lack of overall support from Republicans to get passage of the bill in the House. Now what?

ACA is Still in Effect The stop-and-start and vacillation regarding health care reform produces confusion: for those on the Hill, for businesses, for lawyers, for individuals and for those in the health insurance business itself. For now, however, the ACA remains the law of the land.

Companies For companies, the “play or pay” provisions of the ACA apply only to “Applicable Large Employers” (“ALEs”), generally those with 50 or more full-time employees in the prior calendar year, including fulltime equivalent employees. A company with fewer than 50 full-time employees, including full-time equivalent employees, is not an ALE subject to the ACA (and not subject to the employer shared responsibility provisions or the employer information reporting provisions). Those companies that are not ALEs may be eligible for the Small Business Health Care Tax Credit and should seek advice to determine how the ACA affects them.

• We often see clients encounter problems in determining “full-time” employees and how “full-time equivalent” plays into the calculation. Knowing the difference between those terms and what the ACA requires is why a company, who may have 80 full-time equivalents, has to offer health care to only its subset of 40 full-timers, as the ACA imposes a penalty only for the failure to extend an offer of coverage to full-time employees, but not those who are counted as part of the full-time equivalent formula.

• We also see clients considering shifting their employees between related companies (to a parent company, a subsidiary, or a company owned by a spouse), so that each company has an employee count below the ALE threshold of 50 full-time equivalents. For the most part, such maneuvering

will not work, as related companies are generally grouped together as one ALE under ACA controlled group rules.

• We also caution against simply reducing an employee’s work hours to below 30 hours (the hour requirement for an employee to be considered “full-time”), in an effort to avoid having to offer health care to that now lower-hour employee.

Since the enactment of ACA, there has been a rise in claims from employees who were denied health care because employers reduced their hours, under what ostensibly could have looked like a viable business solution.

Generally, ALEs must either (a) offer “affordable” “minimum essential coverage” that provides “minimum value” to “full-time employees” (and offer coverage to the full-time employees’ “dependents”) or (b) pay an employer shared responsibility excise tax. All the quoted terms have complex meanings, and compliance often requires a company to coordinate with outside experts to ensure that any offered health care program meets applicable requirements. Even when a company unequivocally has the requisite “affordable” “minimum essential coverage” with “minimum value,” if the company fails to offer such health coverage to enough of its full-time employees, there can be a substantial penalty.

We also have clients who decide simply not to offer health care at all to their employees, choosing instead to pay the non-deductible employer shared responsibility tax.

With the ACA still in effect, so too are the IRS mandatory health insurance reporting requirements. For employers, this generally includes reporting the value of the health insurance coverage provided to each employee on Form W-2 and certain information regarding health insurance offerings to full time and other individuals on Forms 1094-C and 1095-C. The IRS uses the information provided on such information returns to administer the employer shared responsibility provisions.

Individuals Under the ACA, individuals must report qualifying health coverage for themselves, their spouse (if filing jointly), and any of their dependents on an individually-filed federal tax return, or pay a penalty. In fact, continued on page 8 MED MONTHLY MAGAZINE

| 7

continued from page 7

Line 11 on Form 1040-EZ and Line 61 on Form 1040 asks for self-disclosure: Health Care [Tax]: individual responsibility. . . Full year coverage [check for yes; pay tax if no]

IRS Enforcement of ACA President Trump’s very first Executive Order “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal,” released on the day of his inauguration, mandated: Sec. 2. To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the [Patient Protection and Affordable Care] Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchas-

ers of health insurance, or makers of medical devices, products, or medications.

Now that initial repeal and replace efforts have failed, and the ACA remains governing law, focus turns to whether we will see relaxed enforcement as a response to the President’s Executive Order. It is unclear how and when the IRS and other agencies will act to “exercise authority and discretion available to them to…reduce [the ACA’s] burden.”

Because there is nothing published indicating how the IRS will respond to the Executive Order, companies should continue to comply with their obligations under the ACA. With respect to individuals, the IRS has already indicated that it will accept electronic and paper Forms 1040 and 1040-EZ returns for processing even if those forms not indicate compliance with the individual health care coverage requirement. We will continue to monitor the Executive Order’s impact on enforcement activities, especially with respect to employer penalties.  Jackson Lewis P.C. © 2017 Source: http://www.natlawreview.com/article/wheredo-we-stand-health-care

PRIMARY CARE PRACTICE East of Raleigh, North Carolina We are offering a well established primary care practice only minutes east of Raleigh North Carolina. The retiring physician maintains a 5 day work week and has a solid base of patients that can easily be expanded. There are 6 fully equipped exam rooms, a large private doctor’s office, spacious business office, and patient friendly check in and out while the patient waiting room is generous overlooking manicured flowered grounds. This family practice is open Monday through Friday and treats 8 to a dozen patients per day.

Currently operating on paper charts, there is no EMR in place. The Gross revenue is about $235,000 yearly.

We are offering this practice for $50,000 which includes all the medical equipment and furniture. The building is free standing and can be leased or purchased.

Contact Philip at 919-848-4202 to receive details and reasonable offers will be presented to the selling physician.

MedicalPracticeListings.com | medlisting@gmail.com | 919-848-4202 22|| DECEMBER 8 MAY 2017 2013

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practice tips

How to Develop a Brand for Your

Medical Practice

By Vishal Gandhi, BSEE, MBA Founder and CEO

Managers and Healthcare PR usually compare marketing and advertising, leading to standardizing of marketing as only ads in television and newspaper ads, billboards, etc. The best way to attract new 10

| MAY 2017

patients is not only through publicizing, promoting and newsletters, but also ‘Word of Mouth’ publicity, which is often overlooked.

‘Word of Mouth’ marketing is a very substantial and significant

tactic to improve your response rates and patient conversion ratios.

Several medical practices today gain their patients through a solid word of mouth marketing strategy.

There are online forums for

patients, where they can express their judgments and views about your practices. These forums, if used properly, have the potential to make or break your reputation.

Below are a few basic points to ponder to build a brand for your practice: 1. Building a brand is very similar to building a personal reputation. Make sure to align your services with what you say about your brand. The key here is ‘Consistency’.Focus on consistency in your interactions and build a strong visual impression with your brand. Being consistent in your approach will help patients to easily identify your practice and the information received through it.

2. One of the next crucial steps is to make yourself visible online with the help of a website.

Almost 80% of the U.S. population search online for healthrelated information before going to the doctor. Develop a mobile-friendly website with proper SEO strategies and quality content. Your website is a virtual extension of your practice and so it is important to keep it up-to-date by regularly flushing out the unwanted content. Always request for honest feedback to ensure that your brand matches with your goals.

3. Referrals are a prominent and easily available marketing method. Connect with your colleagues and physicians from

other specialties and collect information on how to collect referrals. For better results, claim and verify your local listing in various search engines.

Once you get verified, optimize your listing by adding all the necessary information about your practice.

There are various other marketing tactics such as monthly newsletters (emails, print, etc), direct mail, pamphlets, and brochures, offline ads or even press releases. It is also advised to conduct patient surveys related to patient experience for a better track of things. In conclusion, for best return of your investment, try different marketing methods instead of holding on to just one strategy. 

MED MONTHLY MAGAZINE

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practice tips

e v i r D o g t o s l p B e r t u S o 2 Y 1 o t c fi f a Tr

By Barbara Hales, M.D. www.TheMedicalStrategist.com While the messages that you post may be valuable to your patients, you won’t be seen unless you have an audience. Here is a strategic plan to get viewers to your blog without having to spend a big budget on ads.

Problem: How do you • Increase your visibility?

• Build an Audience?

• Establish your authority?

Solution: 1. Sharing is Caring Encourage people to share your posts and make it easy to do so by providing a noticeable share button for social media sites and a RSS feed button.

Make your headline enticing so that people want to open the post. Ensure that the images on your post are in the right format for the various social networks so that they can be seen on them.

2. Tell Everyone Let all your patients know about the posts as well as friends and family. Encourage them to talk about the 12

| MAY 2017

posts and to share them with others. Don’t keep the posts a secret until they are well established. After all, they won’t spread if no one knows about them.

3. Build links to your blog People will better be able to find your blog if your website, email signature and social media profiles are connected to it.

4. Blog Frequently The more often you post to your blog, the more content can be picked up by the search engines (increasing your ranking) and the more content that you can share with others in social media channels.

5. Advice Ask patients and everyone you communicate with online for feedback on your blog posts. This will give you great information for blog improvement and will establish a relationship with an audience.

6. Identify the Most Effective Channels Figure out which social media sites your target market (i.e. your prospective and current patients) spends their time on. This is where you should

concentrate your efforts. For many, it will be Facebook. Here you can have a site solely for your practice or business which will link back to your website and until you have a wider audience, you can invest a small amount in Facebook ads for traffic.

LinkedIn is mostly for business professionals but don’t forget that you want to be visible to your colleagues and referral sources as well, not just your patients! LinkedIn Pulse also gives visibility and strengthens your brand as an authority in your field who has information to provide.

7. Guest Blogs Post blogs on other sites that have the same niche.

By doing so, you are exposing yourself to a built in audience with more visibility. Offer to be an interview partner for their blog sites.

8. Participate Find forums and chat rooms where people are struggling with problems in sync with the services that you provide. Become active and give solutions to these problems. This will establish you as an authority in your field and will encourage prospective patients to increase communication with you.

9. Create a VLog or Video Blog People love viewing videos and seeing short movies about the topics that you post will attract many people who will find the topic easier to understand when seeing images.

Interview celebrities or people in the news so that your video trends and spreads faster.

10. Call To Action The most important key of your blog posts is including a call to action. This is what you want your reader to do upon reading your post. Don’t assume that they will take the following steps that you want them to take. They may just read your post and then move on to something else. Examples of good calls to action include: • Contact the office to make an appointment • Request a copy of a whitepaper or tip sheet with the most common questions and answers • Register for a newsletter • Comment on the blog post and share their thoughts

• Offer a freebie that would be desired by your target market 11. Hold a Contest People love contests and enjoy seeking out answers to questions that are being posed. You can have the contest of the week or month with questions that are pertinent to your posts or where they must refer to older posts to get the answers. In addition to adding popularity, it will increase your email list.

12. Curate Find breaking news or other blog posts that are in sync with your niche. Post a list of topic sources, best articles on the topic or best post of the week. Readers will return often to see what you are highlighting.

Lists are quite popular. You can also contact the authors of the posts and ask them to share the posts that you feature.

For the first 25 people to respond to Barbara@ TheMedicalStrategist.com, I will create a video for you to place on your website. Act fast before someone takes your spot! 

The Medical Strategist

Ezines and NewslettersCost Effective Powerful Tools • Drive traffic to your business website • Build relationships between yourself and patients • Get new patients • Announce a new service or product • Give great impact Have you got a newsletter yet or want to spread a message?

Contact Barbara Hales, M.D. for a free consultation.

Barbara@TheMedicalStrategist.com 516-647-3002

MED MONTHLY MAGAZINE

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practice tips

Exempt vs. Nonexempt Medical Practice Staff

‘‘

“It is the employer’s responsibility to determine whether to classify an employee as exempt or nonexempt under the FLSA. The key consideration: Exempt workers aren’t eligible for overtime pay. Rather, they’re paid for the job they do, not the hours they keep.”

By Nick Hernandez, MBA, FACHE CEO and Founder of ABISA

14

| MAY 2017

It is a recurrent challenge for human resource professionals: Determining whether an employee is exempt from the overtime requirements of the Fair Labor Standards Act (FLSA). The FLSA is the federal law that governs minimum wage, overtime pay and working hours. Consequently, the classification criteria for exempt and nonexempt workers are part of that law. It is the employer’s responsibility to determine whether to classify an employee as exempt or nonexempt under the FLSA. The key consideration: Exempt workers aren’t eligible for overtime pay. Rather, they’re paid for the job they do, not the hours they keep.

I have often seen practices classify an employee as “salaried” with the belief that they then do not have to pay overtime to this employee. However, it is not nearly that simple. Recently there was an article in the Wall Street Journal (“Can You Sue the Boss for Making You Answer Late-Night E-mail?”) discussing the legalities of overtime pay for employees who answer late-night e-mails and texts over the weekend. To comply with the FLSA, employers need to regularly review their employee classifications. Generally, two requirements must be met to classify an employee as exempt: 1) they must earn a salary and 2) hold a position with duties the U.S. Labor Department designates as appropriate for exempt positions.

Employees whose jobs are governed by the FLSA are either “exempt” or “nonexempt.” Nonexempt employees are entitled to overtime pay. Exempt employees are not. Most employees covered by the FLSA are nonexempt. For most employees, however, whether they are exempt or nonexempt depends on (a) how much they are paid, (b) how they are paid, and (c) what kind of work they do. These requirements are outlined in the FLSA Regulations (promulgated by the U.S. Department of Labor). Most employees must meet all three “tests” to be exempt: salary level test, salary basis test, and the duties test.

The differences between exempt employees and nonexempt employees can cause a lot of confusion for both workers and employers. Whether or not you are entitled to minimum wage and/or overtime pay for working more than 40 hours per week depends on your exemption status, as governed by FLSA. The FLSA regulations concerning salary basis employees require at least a minimum of $455 per week for consideration as a salaried employee. Some states have a higher minimum weekly wage for salaried employees. To complicate matters further, many states have wage and hour laws that may have more requirements than the FLSA. Employers must make sure they abide by both federal and state wage and hour laws to avoid legal trouble.

Furthermore, there are other issues to consider such as employee comp time and breaks. Although there are exceptions, it’s usually illegal to give nonexempt employees comp time (time off) instead of paying them overtime. Employers also need to make sure they follow federal and state law requirements regarding breaks, including meal breaks, for workers. The FLSA doesn’t require meal or rest breaks, but many states have laws that do. For breaks to be unpaid, the employee normally must be relieved of all work duties. Rest breaks of less than 30 minutes must be on the clock.

It is extremely important to take the time to periodically review the classification of your employees. To help in that endeavor, there are free FLSA exemption test questionnaires on the Internet. However, there are many nuances to consider as it relates to your particular practice and you should have a qualified individual carefully review your employee classifications.  MED MONTHLY MAGAZINE

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What’s your practice worth?

When most doctors are asked what their practice is worth, the answer is usually, “I don’t know.”

Doctors can tell you what their practices made or lost last year, but few actually know what it’s worth.

In today’s world, expenses are rising and profits are being squeezed. A BizScore Performance Review will provide details regarding liquidity, profits & profit margins, sales, borrowing and assets.

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919.846.4747 bizscorevaluation.com

U.S. OPTICAL BOARDS Alaska P.O. Box 110806 Juneau, AK 99811 (907)465-5470 http://www.commerce.state.ak.us/dnn/ cbpl/ProfessionalLicensing/DispensingOpticians.aspx Arizona 1400 W. Washington, Rm. 230 Phoenix, AZ 85007 (602)542-3095 http://www.do.az.gov Arkansas P.O. Box 627 Helena, AR 72342 (870)572-2847 California 2005 Evergreen St., Ste. 1200 Sacramento, CA 95815 (916)263-2382 http://www.optometry.ca.gov/ Colorado 1560 Broadway St. #1310 Denver, CO 80202 (303)894-7750 http://www.dora.state.co.us/optometry/ Connecticut 410 Capitol Ave., MS #12APP P.O. Box 340308 Hartford, CT 06134 (860)509-7603 ext. 4 http://www.ct.gov/dph/cwp/view. asp?a=3121&q=427586 Florida 4052 Bald Cypress Way, Bin C08 Tallahassee, FL 32399 (850)245-4474 http://www.pof.org/opticianry-board/ Georgia 237 Coliseum Dr. Macon, GA 31217 (478)207-1671 http://sos.ga.gov/index.php/licensing/ plb/20 Hawaii P.O. Box 3469 Honolulu, HI 96801 (808)586-2704 http://hawaii.gov/dcca/pvl/programs/ dispensingoptician/

Idaho 450 W. State St., 10th Floor Boise , ID 83720 (208)334-5500 http://www.ironforidaho.net/

Oregon 3218 Pringle Rd. SE Ste. 270 Salem, OR 97302 (503)373-7721 http://www.oregonobo.org/optque.htm

Kentucky P.O. Box 1360 Frankfurt, KY 40602 (502)564-3296 http://www.opticiantraining.org/optician-training-kentucky/

Rhode Island 3 Capitol Hill, Rm 104 Providence, RI 02908 (401)222-7883 http://sos.ri.gov/govdirectory/index. php? page=DetailDeptAgency&eid=260

Massachusetts 239 Causeway St. Boston, MA 02114 (617)727-5339 http://1.usa.gov/zbJVt7

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4665 www.llr.state.sc.us

Nevada P.O. Box 70503 Reno, NV 89570 (775)853-1421 http://nvbdo.state.nv.us/

Tennessee Heritage Place Metro Center 227 French Landing, Ste. 300 Nashville, TN 37243 (615)253-6061 http://tn.gov/health

New Hampshire 129 Pleasant St. Concord, NH 03301 (603)271-5590 www.state.nh.us New Jersey P.O. Box 45011 Newark, NJ 07101 (973)504-6435 http://www.njsop.org/aws/NJSOP/pt/sp/ home_page New York 89 Washington Ave., 2nd Floor W. Albany, NY 12234 (518)402-5944 http://www.op.nysed.gov/prof/od/ North Carolina P.O. Box 25336 Raleigh, NC 27611 (919)733-9321 http://www.ncoptometry.org/ Ohio 77 S. High St. Columbus, OH 43266 (614)466-9707 http://optical.ohio.gov/

Texas P.O. Box 149347 Austin, TX 78714 (512)834-6661 http://www.tob.state.tx.us/ Vermont National Life Bldg N FL. 2 Montpelier, VT 05620 (802)828-2191 http://vtprofessionals.org/opr1/ opticians/ Virginia 3600 W. Broad St. Richmond, VA 23230 (804)367-8500 http://www.dpor.virginia.gov/Boards/ HAS-Opticians/ Washington 300 SE Quince P.O. Box 47870 Olympia, WA 98504 (360)236-4947 http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission. aspx

MED MONTHLY MAGAZINE

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U.S. DENTAL BOARDS Alabama Alabama Board of Dental Examiners 5346 Stadium Trace Pkwy., Ste. 112 Hoover, AL 35244 (205) 985-7267 http://www.dentalboard.org/ Alaska P.O. Box 110806 Juneau, AK 99811-0806 (907)465-2542 https://www.commerce.alaska.gov/web/ cbpl/ProfessionalLicensing/BoardofDentalExaminers.aspx Arizona 4205 N. 7th Ave. Suite 300 Phoenix, AZ 85103 (602)242-1492 http://azdentalboard.us/ Arkansas 101 E. Capitol Ave., Suite 111 Little Rock, AR 72201 (501)682-2085 http://www.asbde.org/ California 2005 Evergreen Street, Suite 1550Â Sacramento, CA 95815 877-729-7789 http://www.dbc.ca.gov/

Hawaii DCCA-PVL Att: Dental P.O. Box 3469 Honolulu, HI 96801 (808)586-3000 http://cca.hawaii.gov/pvl/boards/dentist/ Idaho P.O. Box 83720 Boise, ID 83720 (208)334-2369 http://isbd.idaho.gov/ Illinois 320 W. Washington St. Springfield, IL 62786 (217)785-0820 http://www.isds.org/LawsLegislation/ boardOfDentistry.asp Indiana 402 W. Washington St., Room W072 Indianapolis, IN 46204 (317)232-2980 http://www.in.gov/pla/dental.htm

Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7800 https://www.colorado.gov/pacific/dora/ Dental_Board

Iowa 400 SW 8th St. Suite D Des Moines, IA 50309 (515)281-5157 http://www.state.ia.us/dentalboard/

Connecticut 410 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/cwp/view. asp?a=3143&q=388884

Kansas 900 SW Jackson Room 564-S Topeka, KS 66612 (785)296-6400 http://www.dental.ks.gov/

Delaware Cannon Building, Suite 203 861 Solver Lake Blvd.

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ

Kentucky 312 Whittington Parkway, Suite 101 Louisville, KY 40222 (502)429-7280 http://dentistry.ky.gov/

Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://floridasdentistry.gov/ 18

Georgia 237 Coliseum Drive Macon, GA 31217 (478)207-2440 https://gbd.georgia.gov/

| MAY 2017

Louisiana 365 Canal St., Suite 2680 New Orleans, LA 70130 (504)568-8574 http://dentistry.ky.gov/

Maine 143 State House Station 161 Capitol St. Augusta, ME 04333 (207)287-3333 http://www.mainedental.org/ Maryland 55 Wade Ave. Catonsville, Maryland 21228 (410)402-8500 http://dhmh.state.md.us/dental/ Massachusetts 1000 Washington St., Suite 710 Boston, MA 02118 (617)727-1944 http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/ dentist/about/ Michigan P.O. Box 30664 Lansing, MI 48909 (517)241-2650 http://www.michigan.gov/lara/0,4601,7154-72600_72603_27529_27533---,00. html Minnesota 2829 University Ave., SE. Suite 450 Minneapolis, MN 55414 (612)617-2250 http://www.dentalboard.state.mn.us/ Mississippi 600 E. Amite St., Suite 100 Jackson, MS 39201 (601)944-9622 http://bit.ly/uuXKxl Missouri 3605 Missouri Blvd.

P.O. Box 1367 Jefferson City, MO 65102 (573)751-0040 http://pr.mo.gov/dental.asp Montana P.O. Box 200113 Helena, MT 59620 (406)444-2511 http://bsd.dli.mt.gov/license/bsd_ boards/den_board/board_page.asp

Nebraska 301 Centennial Mall South Lincoln, NE 68509 (402)471-3121 http://dhhs.ne.gov/publichealth/Pages/ crl_medical_dent_hygiene_board.aspx

Ohio Riffe Center 77 S. High St.,17th Floor Columbus, OH 43215 (614)466-2580 http://www.dental.ohio.gov/

Nevada 6010 S. Rainbow Blvd. Suite A-1 Las Vegas, NV 89118 (702)486-7044 http://www.nvdentalboard.nv.gov/

Oklahoma 201 N.E. 38th Terr., #2 Oklahoma City, OK 73105 (405)524-9037 http://www.ok.gov/dentistry/

New Hampshire 2 Industrial Park Dr. Concord, NH 03301 (603)271-4561 http://www.nh.gov/dental/

Oregon 1600 SW 4th Ave. Suite 770 Portland, OR 97201 (971)673-3200 http://www.oregon.gov/Dentistry/

New Jersey P.O Box 45005 Newark, NJ 07101 (973)504-6405 http://njpublicsafety.com/ca/dentistry/

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)783-7162 http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Dentistry/ Pages/default.aspx#.VbkfjPlPVYU

New Mexico Toney Anaya Building 2550 Cerrillos Rd. Santa Fe, NM 87505 (505)476-4680 http://www.rld.state.nm.us/boards/Dental_Health_Care.aspx New York 89 Washington Ave. Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/prof/dent/ North Carolina 507 Airport Blvd., Suite 105 Morrisville, NC 27560 (919)678-8223 http://www.ncdentalboard.org/ North Dakota P.O. Box 7246 Bismark, ND 58507 (701)258-8600 http://www.nddentalboard.org/

Rhode Island Dept. of Health Three Capitol Hill, Room 104 Providence, RI 02908 (401)222-2828 http://1.usa.gov/u66MaB South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4599 http://www.llr.state.sc.us/POL/Dentistry/ South Dakota P.O. Box 1079 105. S. Euclid Ave. Suite C Pierre, SC 57501 (605)224-1282 https://www.sdboardofdentistry.com/ Tennessee 227 French Landing, Suite 300 Nashville, TN 37243 (615)532-3202 http://tn.gov/health

Texas 333 Guadeloupe St. Suite 3-800 Austin, TX 78701 (512)463-6400 http://www.tsbde.state.tx.us/ Utah 160 E. 300 South Salt Lake City, UT 84111 (801)530-6628 http://1.usa.gov/xMVXWm Vermont National Life Building North FL2 Montpelier, VT 05620 (802)828-1505 http://governor.vermont.gov/boards_ and_commissions/dental_examiners Virginia Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4538 http://www.dhp.virginia.gov/dentistry Washington 310 Israel Rd. SE P.O. Box 47865 Olympia, WA 98504 (360)236-4700 http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/Dentist.aspx West Virginia 1319 Robert C. Byrd Dr. P.O. Box 1447 Crab Orchard, WV 25827 1-877-914-8266 http://www.wvdentalboard.org/ Wisconsin P.O. Box 8935 Madison, WI 53708 1(877)617-1565 http://dsps.wi.gov/Default. aspx?Page=90c5523f-bab0-4a45-ab943d9f699d4eb5 Wyoming 1800 Carey Ave., 4th Floor Cheyenne, WY 82002 (307)777-6529 http://plboards.state.wy.us/dental/index.asp

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U.S. MEDICAL BOARDS Alabama P.O. Box 946 Montgomery, AL 36101 (334)242-4116 http://www.albme.org/ Alaska 550 West 7th Ave., Suite 1500 Anchorage, AK 99501 (907)269-8163 http://www.medlicense.com/alaskamedical-license.html Arizona 9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 (480)551-2700 http://www.azmd.gov Arkansas 1401 West Capitol Ave., Suite 340 Little Rock, AR 72201 (501)296-1802 http://www.armedicalboard.org/ California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815 (916)263-2382 http://www.mbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7690 http://www.docjungle.com/medicalboards/colorado-physician-licensing/ Connecticut 401 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/cwp/view. asp?a=3143&q=388902 Delaware Division of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904 (302)744-4500 http://dpr.delaware.gov/ District of Columbia 899 North Capitol St., NE Washington, DC 20002 (202)442-5955 http://doh.dc.gov/bomed 20

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Florida 2585 Merchants Row Blvd.

Tallahassee, FL 32399 (850)245-4444 http://www.stateofflorida.com/Portal/ DesktopDefault.aspx?tabid=115

Louisiana LSBME P.O. Box 30250 New Orleans, LA 70190 (504)568-6820 http://www.lsbme.la.gov/

Georgia 2 Peachtree Street NW, 36th Floor Atlanta, GA 30303 (404)656-3913 http://bit.ly/vPJQyG

Maine 161 Capitol Street 137 State House Station Augusta, ME 04333 (207)287-3601 http://www.maine.gov/md/

Hawaii DCCA-PVL P.O. Box 3469 Honolulu, HI 96801 (808)587-3295 http://hawaii.gov/dcca/pvl/boards/medical/

Maryland 4201 Patterson Ave. Baltimore, MD 21215 (410)764-4777 http://www.mbp.state.md.us/

Idaho Idaho Board of Medicine P.O. Box 83720 Boise, Idaho 83720 (208)327-7000 http://bit.ly/orPmFU

Massachusetts 200 Harvard Mill Sq., Suite 330 Wakefield, MA 01880 (781)876-8200 http://www.mass.gov/eohhs/gov/departments/borim/

Illinois 320 West Washington St. Springfield, IL 62786 (217)785 -0820 http://www.idfpr.com/

Michigan Bureau of Health Professions P.O. Box 30670 Lansing, MI 48909 (517)335-0918 http://michigan.gov/lara/0,4601,7-15472600_72603_27529_27541-58914--,00. html

Indiana 402 W. Washington St. #W072 Indianapolis, IN 46204 (317)233-0800 http://www.in.gov/pla/ Iowa 400 SW 8th St., Suite C Des Moines, IA 50309 (515)281-6641 http://medicalboard.iowa.gov/ Kansas 800 SW Jackson, Lower Level, Suite A Topeka, KS 66612 (785)296-7413 http://www.ksbha.org/ Kentucky 310 Whittington Pkwy., Suite 1B Louisville, KY 40222 (502)429-7150 http://kbml.ky.gov/Pages/index.aspx

Minnesota University Park Plaza 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414 (612)617-2130 http://bit.ly/pAFXGq Mississippi 1867 Crane Ridge Drive, Suite 200-B Jackson, MS 39216 (601)987-3079 http://www.msbml.state.ms.us/ Missouri Missouri Division of Professional Registration 3605 Missouri Blvd.

P.O. Box 1335 Jefferson City, MO 65102 (573)751-0293 http://pr.mo.gov/healingarts.asp

Montana 301 S. Park Ave. #430 Helena, MT 59601 (406)841-2300 http://bsd.dli.mt.gov/license/bsd_ boards/med_board/board_page.asp Nebraska Nebraska Department of Health and Human Services P.O. Box 95026 Lincoln, NE 68509 (402)471-3121 https://www.nebraska.gov/LISSearch/ search.cgi Nevada Board of Medical Examiners P.O. Box 7238 Reno, NV 89510 (775)688-2559 http://www.medboard.nv.gov/ New Hampshire New Hampshire State Board of Medicine 2 Industrial Park Dr. #8 Concord, NH 03301 (603)271-1203 http://www.nh.gov/medicine/ New Jersey P. O. Box 360 Trenton, NJ 08625 (609)292-7837 http://www.medlicense.com/new-jerseymedical-license.html New Mexico 2055 S. Pacheco St. Building 400 Santa Fe, NM 87505 (505)476-7220 http://www.nmmb.state.nm.us/ New York Office of the Professions State Education Building, 2nd Floor Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/ North Carolina P.O. Box 20007 Raleigh, NC 27619 (919)326-1100 http://www.ncmedboard.org/

North Dakota 418 E. Broadway Ave., Suite 12 Bismarck, ND 58501 (701)328-6500 http://www.ndbomex.com/

Texas P.O. Box 2018 Austin, TX 78768 (512)305-7010 http://www.tmb.state.tx.us/

Ohio 30 E. Broad St., 3rd Floor Columbus, OH 43215 (614)466-3934 http://med.ohio.gov/

Utah P.O. Box 146741 Salt Lake City, UT 84114 (801)530-6628 http://www.dopl.utah.gov/licensing/physician_surgeon.html

Oklahoma P.O. Box 18256 Oklahoma City, OK 73154 (405)962-1400 http://www.okmedicalboard.org/ Oregon 1500 SW 1st Ave., Suite 620 Portland, OR 97201 (971)673-2700 http://www.oregon.gov/OMB/ Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)787-8503 http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/ Pages/default.aspx#.Vbkgf_lPVYU Rhode Island 3 Capitol Hill Providence, RI 02908 (401)222-5960 http://1.usa.gov/xgocXV South Carolina P.O. Box 11289 Columbia, SC 29211 (803)896-4500 http://www.llr.state.sc.us/pol/medical/ South Dakota 101 N. Main Ave. Suite 301 Sioux Falls, SD 57104 (605)367-7781 http://www.sdbmoe.gov/ Tennessee 425 5th Ave. North Cordell Hull Bldg. 3rd Floor Nashville, TN 37243 (615)741-3111 http://tn.gov/health

Vermont P.O. Box 70 Burlington, VT 05402 (802)657-4220 http://1.usa.gov/wMdnxh Virginia Virginia Dept. of Health Professions Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4400 http://1.usa.gov/xjfJXK Washington Public Health Systems Development Washington State Department of Health 101 Israel Rd. SE, MS 47890 Tumwater, WA 98501 (360)236-4085 http://www.medlicense.com/washingtonmedicallicense.html West Virginia 101 Dee Dr., Suite 103 Charleston, WV 25311 (304)558-2921 http://www.wvbom.wv.gov/ Wisconsin P.O. Box 8935 Madison, WI 53708 (877)617-1565 http://dsps.wi.gov/Boards-Councils/ Board-Pages/Medical-Examining-BoardMain-Page/ Wyoming 320 W. 25th St., Suite 200 Cheyenne, WY 82002 (307)778-7053 http://wyomedboard.state.wy.us/

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features

THE HIDDEN PROFIT CENTER:

Your Front Desk

By Michelle Durner, CHBME Applied Medical Systems, Inc.

‘‘

“Long gone are the days of hiring just anybody for the front desk. Your front desk staff is the gatekeeper to your practice.”

Your front desk staff are the first people to greet your patients when they walk through your door and the last people they see when they leave. They have the ability to set your patients at ease before their visit begins and to tie up all loose ends when it is over. They collect a seemingly endless amount of

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information about the patient, from demographic details to ever-changing insurance information, and are responsible for making sure that everything is up to date. Regardless of this, the front desk staff, and the importance of their job function to both your practice and your patients, is greatly underrated in today’s

healthcare environment.

Imagine a scenario where a patient receives a statement from your practice and is being charged the full cost of your services as a self pay, even though the patient presented their insurance card at the time of the visit. Already frustrated, the patient now has to take the time out of their own busy day to call the office and update their insurance information.

Hopefully they have no issue getting through to the right person in your office and everything is updated and a new claim is sent immediately. And let’s hope that the original statement was sent in a timely manner and the claim is not approaching the filing limit. And let’s hope that the patient doesn’t complain to their friends and co-workers about the time and effort they spent on something that should have been handled already. And let’s hope etc., etc. You get the point. It is in your best interest to get all of this right the first time.

There is no debating that the revenue cycle continues to become more cumbersome. What used to take two steps now takes four, and there is generally a pitfall somewhere in the middle. So how can you ensure that your front desk staff aren’t just the people that answer the phones and check patients in, but are also recognized as a profit center to your practice?

Easy, the best way to beat cumbersome is with knowledge and expertise.

Hiring

Long gone are the days of hiring just anybody for the front desk. Your front desk staff is the gatekeeper to your practice. They will be the liaison between provider and patient and will likely be the first impression that the patient has of you, the provider.

Job responsibilities at the front desk now range from customer service to collector to scheduler to insurance guru, and sometimes these responsibilities change on a daily basis.

Expertise

While your front desk staff may not actually do your billing, they should at least have the knowledge of what elements are necessary to file a clean claim.

Demographics, eligibility, preauthorizations, referring providers, co-pays, coinsurance, deductible, etc. They should understand the purpose and importance of each task

that they perform and how essential each is to the revenue cycle and your bottom line.

Information

Every time a patient visits you should verify their demographic and insurance information. Verifying does not mean asking “Has any of your information changed since the last time you were here?”. Have the patient tell you their address and phone number and ask to see their insurance card.

Once you have the insurance card in hand, check the eligibility. Just because you are looking at an insurance card does not mean that the coverage is active. Depending on your technology, eligibility checks can be done through EMRs, your clearinghouse, phone calls or a website search. An eligibility check will provide you with information regarding a patient’s co-pay, coinsurance and/or deductible levels and will set the stage for a discussion with the patient regarding the amount that you will collect from them at that time.

Make sure that you have an eligibility process in place that is efficient for your office even if it means an extra expense. In a chaotic office environment, comprehensive eligibility checks are often one of the first tasks to be skipped because people assume that “billing” will catch any issues that arise. However, by the time the claim reaches billing, it will be too late to collect the proper co-pay from the patient or to discuss coverage.

Better yet, have your registration process available through your website so that it can be done ahead of time. At a minimum, have forms available on your website so that they can be brought in already completed. The more efficient you are on the front end, the better the experience for the patient and the more efficient your front desk staff can be.

Also, depending on your specialty, a preauthorization could be required before you see the patient. If that’s the case, that should be done PRIOR to the patient presenting for their scheduled appointment. Pre-authorizations can be very time consuming, and similar to co-pays, you need to have an efficient system for handling them. Spend the time to figure out what works best for the flow in your office.

Additionally, the front desk staff should be able to discuss a patient’s account or have a dedicated continued on page 24 MED MONTHLY MAGAZINE

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continued from page 23

contact that can speak to the patient while they are at the provider’s office. Chances of collecting an outstanding balance are far higher face to face than via the post office. This is key and is the point of failure in most offices. Your practice is a place of business and your front desk needs to treat it as such. There will occasionally be difficult conversations about outstanding balances, co-pay collections, etc. and it is important that your front desk staff is prepared to have these conversations. When they occur, knowledge is your most powerful defense. The better your front desk staff understands why an outstanding balance is what it is, the better chance they have of explaining it in a way that the patient can understand.

Nuances

In addition to the front desk basics already discussed, there are always nuances that are specific to the state, the MAC, the plan and/or the patient.

As an example, with the Affordable Care Act, there are new plans being added to existing carriers. Just because you participate with a carrier does not mean that you are automatically enrolled in ALL the plans that are offered. Have someone on your front desk or billing staff that can stay on top of new plans that your patients have and can keep the rest of your staff updated so that they know what to look out for.

Other potential issues revolve around simple data collection so your staff needs to be diligent and not distracted when checking a patient in. Something as trivial as a date of birth being incorrect or using someone’s nickname vs. the name on their insurance card can automatically eliminate the chances of a clean claim.

Additionally, the more information that is given to the patient via the front desk, the more accepting they will be to your policies and procedures. If it’s clear that you expect payment at time of service then the patient comes prepared. If you make sure that the patient understands preventative visits versus medical visits and how that impacts their co-pay then there are no surprises and no resulting disgruntled patients.

The reason for the patient’s visit, or chief complaint, drives the type of service that they are going to be billed for. Be clear and be persistent. Everyone on your front desk staff should handle the check-in / check-out process in exactly the same way.

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Training

The healthcare industry is quickly changing.

Without continuous training for your staff, they cannot serve you and your patients to their best ability. Local medical societies are a great resource for staff training. Your clearinghouse or billing company should offer training opportunities. Finally, there is no shortage of free webinars available these days. If you allow your staff just an hour a month for training, the difference in your bottom line will more than make up for the time you set aside for them to train.

Another free training option is to have your billing staff communicate with your front desk regarding errors and denials that originated from the front desk.

Discuss ways to avoid the errors and create processes that the front desk can follow while still maintaining their general flow of work. Most people want to do the best possible job, but if they aren’t given the proper training and feedback then they will not be successful.

Customer Service

Finally, your patients are no longer just “patients”, they are consumers. As consumers, they shop around, they compare pricing and they choose providers who provide the best overall experience. Though extremely important, time spent with the physician is just one part of their visit. Your front desk is a key function of that consumer experience and they can make it an exceptional experience or they can cause the patient to leave feeling frustrated and underappreciated. The front desk is a key factor in patient loyalty and it is up to you to build a strong front desk staff and to take the time to provide the support that they need to be successful. An ounce of prevention...  About the Author: Michelle Durner, CHBME is the President of Applied Medical Systems, Inc. – a Durham, NC-based company which provides revenue cycle management, coding, practice management, and consulting services to startup practices, hospitals, private practices, and hospital based physician groups across the nation. Michelle is serving as President of the Healthcare Business Management Association (HBMA) for 2017 and is also fulfilling a 3 year term on the Board of Directors.

Michelle served as Chair of the Education Committee from 2014-2016 and has also served on the Finance, Certification and Nomination committees. To contact Michelle or to learn more about Applied Medical Systems, visit www.appliedmedicalsystems.com

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features

Optimizing Your Front Office

By Naren Arulrajah Ekwa Marketing 26

| MAY 2017

When you think of quality medical care, you naturally think of clinical excellence. You have spent your educational years and professional career pursuing that goal. The business side of running your practice can seem like a nuisance, something that takes your time and attention away from your patients. However, neglecting office procedures and staffing issues can ultimately take patients away from your practice.

A Check-up For Your Office How well is your business staff performing, how efficient is your office, and how effective is your marketing? If you haven’t noticed any problems, you might think they must be okay. Now, imagine speaking to a patient who is using the same rationale for avoiding regular checkups.

You know there are specific indicators of health that should be monitored, and regular examinations can detect serious problems long before any noticeable symptoms develop. The same is true of your business.

The secret to optimizing your practice and stopping problems before they start is identifying and tracking quantifiable performance metrics.

• Utilize patient feedback forms, surveys, or other methods of measuring satisfaction. Avoid making the request too long or complicated, but offer the option to rate specific experiences such as wait times, staff friendliness, and provider competence.

• Keep track of how much time your employees spend on tasks such as filing new patient forms, sending out emails, and verifying insurance information. Once you identify the time-wasters, check for services and software to automate or streamline processes. If you choose wisely, the savings in labor hours will compensate for the cost. Also, look for inexpensive and low-tech solutions, such as “cheat sheets” for commonly used insurance codes.

• Watch your financial flow closely. For example, excessive rejected insurance claims may be a sign that someone isn’t coding them properly. If you frequently receive payments from patients past the due date, your staff may be lax in billing.

• Monitor your patient wait times. The national average in a physician’s office is just under 20 minutes, and in a dental office it is under 14 minutes. If your typical times are longer than average, you need to find out why. Patient satisfaction decreases as wait times increase.

• Measure the success of marketing campaigns. Facebook engagement rate, advertisement views, link clicks, newspaper circulation, and other metrics offered by advertisers only tell part of the story.

Leads are great, but they are worthless if they don’t convert to new patients. Call tracking phone numbers, dedicated landing pages, publication-specific promotion codes, split testing campaigns, and similar techniques can help you track appointments generated from your campaigns for an accurate measure of ROI (return on investment). continued on page 28 MED MONTHLY MAGAZINE

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continued from page 27

Assessing the Metric You Can’t Measure – Employee Attitude Unfortunately, the most important part of your front office is not so easy to measure and track. That is your staff. Technical qualifications and proficiency do not define an employee’s true value.

A good employee has a good attitude. It is evident in the way he or she treats patients, coworkers, clinicians, and others at your practice.

The people who answer your phones and greet patients as they walk through the door are the face of your practice. Their friendliness and efficient customer service can turn a potential patient into a confirmed appointment, and help turn new patients into returning patients.

If it seems like your patients are unhappy before you see them, or are looking for things to complain about, you could have a customer service issue at the front desk. An excellent indicator of your staff ’s teamwork skills is your own stress level. You should not feel like a parent with bickering children every time you hold an employee meeting.

Replacing or Retraining Problem Employees Sometimes the solution to staffing problems can be as simple as presenting clear expectations and holding each employee accountable for his or her responsibilities. A written policy manual, code of conduct, and job descriptions detailing duties and expectations are valuable tools in human resource management.

Retraining programs, employee mentoring, and even counseling can be beneficial, especially when your 28

| MAY 2017

office is plagued by poor teamwork or personal issues between staff members.

Unfortunately, there are some people who are not capable, reliable, or dedicated enough to do the job right. Some are simply not a good fit for your practice and your team. Firing an employee may be one of most unpleasant, and financially expensive, aspects of business, but it is inevitable at times. When it happens, or when you need to add staff, take care with your hiring process.

According to a global CareerBuilder survey of six thousand HR (human resources) personnel and hiring managers, the average cost of a bad hire is about $50,000. The United States Department of labor estimates the cost to be about 30 percent of that person’s annual income.

Choosing the right person the first time can save you a significant amount of money, and an immeasurable amount of stress. How can you avoid bad hires?

• Always verify certifications, education, previous employment, and other credentials listed on the resume before you spend any time interviewing.

• Advertise your job opening widely, to get the largest possible pool of applicants.

• Make the interview a conversation, and pay attention to the applicant’s tone of voice, mannerisms, and general attitude.

• Invite senior employees and other clinicians to participate in the final interview.

Conclusion From checking in to checking out, every patient’s first and last experience at your practice is with the front office. Optimizing your team and procedures can help get more people in the door, and keep them coming back.  About the Author: Naren Arulrajah is President and CEO of Ekwa Marketing, a complete Internet marketing company which focuses on SEO, social media, marketing education and the online reputations of Dentists and Physicians. With a team of 140+ full time marketers, www.ekwa.com helps doctors who know where they want to go, get there by dominating their market and growing their business significantly year after year. If you have questions about marketing your practice online, call 855- 598-3320 to speak one-on-one with Naren.

features

Improving Your Patients’ Check In/Check Out Experience: 5 Tips for a More Efficient Front Office

M

ore than any other area of your practice, your front desk has an impact on efficiency and patient flow. By implementing some simple procedures for checking in and checking out, you reduce the burden on your front desk staff and increase both the performance and revenues of your practice.

A study of nearly 35,000 online reviews of physicians nationwide found that customer service while checking in and out is patients’ chief frustration, not physicians’ medical expertise and clinical skill.

The study, published in the Journal of Medical Practice Management, reveals that 96 percent of patient complaints are related to customer service, while only four percent are about the quality of clinical care or misdiagnoses.

To summarize, the study found that fewer than 1 in 20 online complaints cite diagnosis, treatments and outcomes in healthcare as unsatisfactory, whereas 19 of 20 unhappy patients said inadequate communica-

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tions and disorganized operations drove them to post harsh reviews.

In a medical practice, front office staff members often are treated as the least-necessary employees. These employees, however, meet and greet patients, schedule their visits, collect their co-payments, and field their phone calls. They are indispensable members of the medical office staff. They play an integral role in practice operations. From patient flow to patient loyalty, how the front office performs directly affects the bottom line.

To anyone with a business administration degree, this observation would be an obvious one. But to many people with medical degrees, it may not be obvious at all. And their practices often pay the price.

What sort of constructive role can the doctor play at their practice’s front desk? Here are some suggestions, each requiring a minimal amount of time and yielding every effective results.

‘‘

“More than any other area of your practice, your front desk staff has an impact on efficiency and patient flow.”

By Thomas Hibbard Creative Director, Physician Solutions 1. Show Respect by Setting an Example To show respect for the staff in the front office, it’s the little things that count. Know and address each staff member by name. Remain professional by avoiding the use of nicknames. Recognition, acknowledgement, and appreciation are important, so be generous with all three. “Thank you” and “great job the other day” go a long way, particularly when the words come from the lead physician.

2. Take an Active Role in Hiring and Training New Staff Initial interviews are conducted by the office manager and are based on a candidate’s knowledge, experience, and ability to get along with other people in the practice, but it’s the doctor who must make the ultimate decision whether this person will fit into the practice. Be proactive in the final decision.

After hiring a new employee, be sure to make an appearance on their first day of work to extend a personal welcome. It will mean a great deal to them and will convey that even though you are busy, they are an important new member of the practice.

Even before office duties are addressed, the doctor should take a new employee through the entire day, step by step, so they understand how the practice operates and what the patient flow is like. This allows new front office staff members to understand the big picture, foster teamwork, and improve performance.

Then make clear to new staff members what the office duties include: l Reception Duties: The front desk staff greets incoming patients, directing them in person or by phone to the proper areas. Front desk workers also greet professionals, such as pharmaceutical continued on page 32

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representatives or consulting doctors. The receptionist is also responsible for keeping the flow of patients moving smoothly and maintaining a neat front area. l Collecting Patient Information: A patient’s personal information may change between visits.

The front desk staff verifies the patient’s current address, contact information and allergy information. Regular insurance verification may also be necessary. Front desk staff will need to locate, review and update paper and computer files for the physician. Some other duties are collecting electronic medical records and laboratory results. l Making Appointments: Another important front desk duty is making follow-up appointments.

Many patients need continuing care and require regular appointments with their physician. The medical office assistant reviews the schedule, locating an appointment date according to the time period recommended by the physician. Also, office staff assist the patients when they need appointments for referred specialists, surgery or hospital procedures.

These tasks require medical office staff to be proactive and intuitive, have excellent organizational skills, and exude a helpful, friendly attitude.

3. Hold Meetings Open to All Staff Front office staff members are often excluded from meetings at which everyone else in the practice is present. When front office staff members are invited to meetings and encouraged—even expected—to make a contribution, they will start to feel more like equal partners in the practice, and the rest of the staff will view them in that way, too.

4. Strive to Retain Good Staff Retaining good front office staff definitely is about money, but it’s about so much more as well. If front office staff members are treated as second-class citizens, if doctors don’t acknowledge their existence, if other staff members look down on them or criticize them, if they are excluded from staff meetings as if they are non-persons, then turnover will be high regardless of pay. Staff members must feel not just that they’re being fairly paid but also that their contributions are valued.

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If staff members are treated appropriately as valued members of the team, they are more likely to stay.

5. Implement New Time Savers to Make Check In/Check Out More Efficient l Pre-registration:

Whether through the practice’s website or patient portal, all practices need to have new patients pre-registering and completing paperwork prior to their first visit. The front desk bottle-neck created by new patients filling out a stack of insurance and history forms can derail your day. l Simplify Patient Paperwork: One of the easiest ways to save time at the front desk is to streamline patient paperwork. Does the patient history form make sense? Should they be filling out insurance card information when you will be making a copy of the card? Holding onto old paperwork standards can slow down your office flow, reduce the number of patient visits, and decrease patient satisfaction. l Patient Portals: With a portal, patients can sign in to request appointments, print copies of records, pay bills, and ask questions…all things that your front desk would normally have to spend time handling. Not all patients will embrace the portal, but the ones who do will drastically reduce the strain on your front desk staff.

More than any other area of your practice, your front desk staff has an impact on efficiency and patient flow. By implementing some of these suggestions, you will reduce the burden on your front desk staff, increase both the performance and revenues of your practice, and improve your patient’s office experience.  Sources: http://www.beckershospitalreview.com/hospital-management-administration/patients-no-1-complaint-frontdesk-staff.html http://medicaleconomics.modernmedicine.com/ medical-economics/news/modernmedicine/modernmedicine-feature-articles/front-office-investmentsimpr?page=full http://smallbusiness.chron.com/front-desk-duties-doctors-offices-10136.html http://gopractice.kareo.com/article/5-medical-practicefront-desk-time-savers

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Location: Minutes South of Raleigh, North Carolina List Price: $145,000 Gross Yearly Income: $350,000 Year Established: 1980(s) Average Patients per Day: 16-22 Total Exam Rooms: 5 Building Owned/Leased: Owned. Will sell or lease.

Contact: Philip or Wendy at (919) 848-4202

Urology Practice near Lake Norman, NC Location: Minutes from Charlotte, NC List Price: $165,000 Gross Yearly Income: $275,000 Year Established: 1980 Average Patients per Day: 12 to 15 Building Owned/Leased: Leased Contact: Philip or Wendy at (919) 848-4202

Primary Care specializing in Women’s Practice

Family Practice/Primary Care

Location: Hickory, North Carolina List Price: $425,000 Gross Yearly Income: $1,5000,000 Year Established: 2007 Average Patients Per Day: 24-35 Total Exam Rooms: 5 Building Owned/Leased: Lease or Purchase Contact: Philip or Wendy at (919) 848-4202

Location: Morehead City, N.C. List Price: Just reduced to $20,000 or Best Offer Gross Yearly Income: $540,000 average for past 3 years Year Established: 2005 Average Patients per Day: 12 to 22 Building Owned/Leased: MD owned and can be leased or purchased Contact: Philip or Wendy at (919) 848-4202

Med Spa

Family Primary Care Practice

Practice Type: Mental Health, Neuropsychological and Psychological

Location: Minutes East of Raleigh, North Carolina List Price: $15,000 or Best Offer Gross Yearly Income: $235,000 Average Patients per Day: 8 to 12 Total Exam Rooms: 6 Physician retiring, Beautiful practice Building Owned/Leased: Owned (For Sale or Lease) Contact: Philip or Wendy at (919) 848-4202

Location: Coastal North Carolina List Price: $550,000 Gross Yearly Income: $1,600,000.00 Year Established: 2005 Average Patients Per Day: 25 to 30 Total Exam Rooms: 4 Building Owned/Leased: Leased Contact: Philip or Wendy at (919) 848-4202

Location: Wilmington, NC List Price: $110,000 Gross Yearly Income: $144,000 Year Established: 2000 Average Patients Per Day: 8 Building Owned/Leased/Price: Owned Contact: Philip or Wendy at (919) 848-4202

Special Listings Offer We are offering our “For Sale By Owner” package at a special rate. With a 6 month agreement, you receive 3 months free.

Considering your practice options? Call us today.

MED MONTHLY MAGAZINE

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We have several qualified MDs seeking established Urgent Care Practices in North Carolina.

Urgent Care Practices Wanted If you have an urgent care practice and would like to explore your selling options, please contact us. Your call will be handled confidentially and we always put together win-win solutions for the seller and buyer.

Call Medical Practice Listings today and ask for Philip Driver 919-848-4202.

Internal Medicine Practice for Sale Located in the heart of the medical community in Cary, North Carolina, this Internal Medicine practice is accepting most private and government insurance payments.

The average patients per day is 20-25+, and the gross yearly income is $555,000.

Listing Price: $430,000

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

Eastern North Carolina Family Practice Available Well-appointed Eastern North Carolina Family Practice established in 2000 is for sale in Williamston, NC. This organized practice boasts a wide array of diagnostic equipment including a GE DEXA scanner with a new tube, GE case 8000 stress testing treadmill and controller and back up treadmill, Autoclave and full set of operating equipment, EKG-Ez EKG and much more. The average number of patients seen daily is between 12 to 22. The building is owned

by MD and can be purchased or leased.

The owning physician is relocating and will assist as needed during the transition period. The gross receipts for the past three years average $650,000 and the list price was just reduced to $185,000. If you are looking to purchase a well equipped primary care practice, please contact us today.

919-848-4202 medlisting@gmail.com medicalpracticelistings.com

34 | MAY 2017

Located on NC’s Beautiful Coast,

Morehead City

Primary Care Specializing in Women’s Health Practice established in 2005, averaging over $540,000 the past 3 years. Free standing practice building for sale or lease. This practice has 5 well equipped exam rooms and is offered for $20,000.

919.848.4202 medlisting@gmail.com medicalpracticelistings.com

Discounts as big as a house.

Or condo.

Or apartment.

Lindsay Gianni, Agent 12333 Strickland Road Suite 106 Raleigh, NC 27613 Bus: 919-329-2913 lindsay.gianni.f23o@statefarm.com

North Carolina Dentist Opportunities

See just how big your savings could be.

Your savings could add up to hundreds of dollars when you put all your policies together under our State Farm roof.

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Physician Solutions has immediate opportunities for dentists throughout NC. Top wages, professional liability insurance and accommodations provided.

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Call us today if you are available for a few days a month, on-going or for permanent placement. Please contact Physican Solutions at 919-845-0054 or physiciansolutions@gmail.com MED MONTHLY MAGAZINE

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Internal Medicine Practice in the Heart of Raleigh

Pediatric Practice Available Near Raleigh, NC

Pediatric practice located minutes south of Raleigh, North Carolina is now listed for sale. Located in an excellent area convenient to Raleigh, Cary, and Durham, it is surrounded by a strong health care community. This is a well established practice with a very solid patient base. The building is equipped with a private doctor’s office, five exam rooms, and an in-house lab.

This is a beautiful practice, well appointed with great street visibility, parking and a very strong patient following. There are 4 exam rooms and a procedure room. The lobby is very comfortable with hardwood floors and tastefully decorated.

Established: 1980s l Gross Yearly Income: $350,000 Average Patients per Day: 16 to 22 l List Price: $145,000

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

The gross revenues are over $600,000 with a strong income after expenses.

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

PHYSICIANS NEEDED: Mental health facility in Eastern North Carolina seeks: PA/FT ongoing, start immediately Physician Assistant needed to work with physicians to provide primary care for resident patients. FT ongoing 8a-5p. Limited inpatient call is required. The position is responsible for performing history and physicals of patients on admission, annual physicals, dictate discharge summaries, sick call on unit assigned, suture minor lacerations, prescribe medications and order lab work. Works 8 hour shifts Monday through Friday with some extended work on rotating basis required. It is a 24 hour in-patient facility that serves adolescent, adult and geriatric patients.

FT ongoing Medical Director, start immediately The Director of Medical Services is responsible for ensuring all patients receive quality medical care. The director supervises medical physicians and physician extenders. The Director of Medical Services also provides guidance to the following service areas: Dental Clinic, X-Ray Department, Laboratory Services, Infection Control, Speech/Language Services, Employee Health,

Pharmacy Department, Physical Therapy and Telemedicine. The Medical Director reports directly to the Clinical Director. The position will manage and participate in direct patient care as required; maintain and participate in an on-call schedule ensuring that a physician is always available to hospitalized patients; and maintain privileges of medical staff.

Permanent Psychiatrist needed FT, start immediately An accredited State Psychiatric Hospital serving the eastern region of North Carolina, is recruiting for permanent full-time Psychiatrist. The 24 hour in-patient facility serves adolescent, adult and geriatric patients. The psychiatrist will serve as a team leader for multi-disciplinary team to ensure quality patient care/treatment. Responsibilities include:

evaluation of patient on admission and development of a comprehensive treatment plan, serve on medical staff committees, complete court papers, documentation of patient progress in medical record, education of patients/families, provision of educational groups for patients.

Send copies of your CV, NC medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624 PH: (919) 845-0054 | email: physiciansolutions@gmail.com 36

| MAY 2017

MD STAFFING AGENCY FOR SALE IN NORTH CAROLINA The perfect opportunity for anyone who wants to purchase an established business.

Primary Care Practice For Sale in Wilmington, NC Established primary care on the coast of North Carolina’s beautiful beaches. Fully staffed with MD’s and PA’s to treat both appointment and walk-in patients. Excellent exam room layout, equipment and visibility.

Contact Medical Practice Listings for more information.

l One

of the oldest Locums companies l Large client list l Dozens of MDs under contract l Executive office setting l Modern computers and equipment l Revenue over a million per year l Retiring owner

Medical Practice Listings

Please direct all correspondence to driverphilip@gmail.com.

Only serious, qualified inquirers.

PEDIATRICIAN

or family medicine doctor needed in

FAYETTEVILLE, NC

919.848.4202 | medlistings@gmail.com www.medicalpracticelistings.com

NC MedSpa For Sale MedSpa Located in North Carolina We have recently listed a MedSpa in NC This established practice has staff MDs, PAs and nurses to assist patients. Some of the procedures performed include: Botox, Dysport, Restylane, Perian, Juvederm, Radiesse, IPL Photoreju Venation, fractional laser resurfacing as well as customized facials. There are too many procedures to mention in this very upscale practice. The qualified buyer will be impressed with the $900,000 gross revenue. This is a new listing, and we are in the valuation process.

Comfortable seeing children. Needed immediately.

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com

Contact Medical Practice Listings today to discuss the practice details.

For more information call Medical Practice Listings at 919-848-4202 or e-mail medlistings@gmail.com

www.medicalpracticelistings.com MED MONTHLY MAGAZINE

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Modern Med Spa Available

Located in beautiful coastal North Carolina Modern, well-appointed med spa is available in the eastern part of the state. This Spa specializes in BOTOX, facial therapy and treatments, laser hair removal, eye lash extensions and body waxing as well as a menu of anti-aging options. This impressive practice is perfect as-is and can accommodate additional services like primary health or dermatology.

The Gross revenue is over $1,500.000 with consistent high revenue numbers for the past several years. The average number of patients seen daily is between 26 and 32 with room for improvement. You will find this Med Spa to be in a highly visible location with upscale amenities. The building is leased and the lease can be assigned or restructured. Highly profitable and organized, this spa is POISED FOR SUCCESS. 919.848.4202 medlisting@gmail.com medicalpracticelistings.com

Practice for Sale in Raleigh, NC

Urology Practice minutes from Lake Norman, North Carolina

Primary care practice specializing in women’s care Raleigh, North Carolina The owning physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however, that could double with a second provider. Exceptional cash flow and profit will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several well-appointed exam rooms and beautifully decorated throughout. New computers and medical management software add to this modern front desk environment.

List price: $435,000

Urology Practice minutes from Lake Norman is now listed for sale. This excellent located practice is convenient to Charlotte, Gastonia, Lincolnton and Hickory. With a solid patient base, procedures currently include; Adult & Pediatric Urology, Kidney Stones, Bladder Problems, Incontinence, Prostate Issues, Urinary Tract Infections, Wetting Problems, Erectile Dysfunction and related issues. Three exam rooms with two electronic tables and one flat exam table.

Established: 1980 l Gross Yearly Income: $275,000 Average Patients per Day: 12 to 15 l List Price: $165,000

Call Medical Practice Listings at (919) 848-4202 for details and to view our other listings visit www.medicalpracticelistings.com

38 | MAY 2017

Contact Philip or Danielle at 919-848-4202 or email medlistings@gmail.com

Pediatrics Practice Wanted

State of Cha-Ching.

Pediatrics Practice Wanted in NC Considering your options regarding your pediatric practice? We can help. Medical Practice Listings has a well qualified buyer for a pediatric practice anywhere in central North Carolina.

Lindsay Gianni, Agent 12333 Strickland Road Suite 106 Raleigh, NC 27613 Bus: 919-329-2913 lindsay.gianni.f23o@statefarm.com

Get discounts up to 35% * Saving money is important.

That’s why you can count on me to get you all the discounts you deserve.

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Contact us today to discuss your options confidentially.

Medical Practice Listings Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

*Discounts and their availability may vary by state and eligibility requirements.

For more information, please see or call a State Farm agent.

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PRIMARY CARE PRACTICE - Hickory, North Carolina This is an outstanding opportunity to acquire one of the most organized and profitable primary care practices in the area. Grossing a million and a half yearly, the principal physician enjoys ordinary practice income of over $300,000 annually.

Hickory is located in the foot-hills of North Carolina and is surrounded by picturesque mountains, lakes, upscale shopping malls and the school systems are excellent. If you are looking for an established practice that runs like a well oiled machine, request more information.

The free standing building that houses this practice is available to purchase or rent with an option. There are 4 exam rooms with a well appointed procedure room. The owning physician works 4 to 5 days per week and there is a full time physician assistant staffed as well.

For the well qualified purchasing physician, the owner may consider some owner-financing. Call us today.

List price: $425,000 | Year Established: 2007 | Gross Yearly Income: $1,500,000

MedicalPracticeListings.com | medlisting@gmail.com | 919-848-4202 MED MONTHLY MAGAZINE

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Physician Solutions, Inc. Medical & Dental Staffing

The fastest way to be $200K in debt is to open your own practice The fastest way to make $100K is to choose

Physician Solutions

THE DECISION IS YOURS Physician Solutions, Inc. P.O. Box 98313 Raleigh, NC 27624 Scan this QR code with your smartphone to learn more.

phone: 919-845-0054 fax: 919-845-1947 www.physiciansolutions.com physiciansolutions@gmail.com