Tag Archives: medical

Has Your Medical/Dental Practice Had It’s “Checkup?”

13 Apr

There are many things that can cause a busy medical or dental practice to be less profitable that it could be.

Meet Dr. Bob and how he found the answer to higher profits and better cash flow for his practice.

Is Your Collection Agency Putting Your Medical or Dental Practice at Risk?

11 Apr

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The collection agency industry is highly regulated and there are numerous laws on the books designed to protect consumers, which make it more difficult to collect. While it costs agencies more to be legally compliant and hinders their collections efforts, not complying can lead to class action suits and sanctions against the agency (and possibly their clients) that are more costly in the long run if not fatal to the agency’s very existence. Lets examine how this affects your practice.

The Laws You Know

Most Practice Administrators are familiar with the Fair Debt Collection Practices Act (FDCPA) of 1978 which creates a set of guidelines that collection agencies are required to follow as well as penalties for not adhering to the Act. Additionally, practices are familiar with HIPAA laws and the security requirements of Protected Health Information (PHI).

But Do You Know About These Laws?

Despite having been a law since 1991, most practices are not familiar with the Telephone Consumer Protection Act (TCPA)  which also impacts collections. Among other provisions of the TCPA (such as calls can only be made between 8am and 9pm), the TCPA prohibits the use of automated dialers to cell phones or leaving automated messages on cell phones. While auto-dialers represent a technological efficiency that allows a collection agency to make more frequent calls and collect more money, their use is not compliant with the TCPA when the phone number the patient has provided the practice with is a cell phone. In order to be TCPA compliant when calling a cell phone, it must be manually dialed. Even if a live collector will be connected with the consumer upon pick up, a cell phone can not be dialed using a computer.

Medical Collections Impact

A recent data analysis by Transworld Systems, a large national collection agency specializing in medical collections, revealed that 60% of the phone numbers that their medical practice clients are obtaining from patients are cell phones. In order to avoid fines of $1500 per incident and class action suits, Transworld Systems has enforced strict policies of identifying and separating land line numbers from cell phone numbers. Additional research is conducted to see if the patient also has a land line which can be put on an auto-dialer to obtain better contact rates.

What does all this mean for your practice?

Today with the ever-changing federal and state regulations, you need to ask more questions of your collections vendor to find out if they are compliant with all laws. Ensure your practice cannot be named as a co-defendant in a potential class action suit should your agency be accused of being non-compliant. It is important to have a Hold Harmless Agreement in your collection agency contract where the agency agrees to hold your practice free from responsibility for any liability or damage that might arise out of their collection activities. Ask questions first before you have to answer for shortcuts or missteps later that could result in hefty fines for lack of compliance. It is paramount to ensure your company of choice is an expert in their field who stays abreast of, and quickly adapts to, the seemingly endless stream of regulations designed to protect consumers rights, often at the expense of their creditors.

Here is a sample list of questions to ask your current agency and any potential collection agency you are considering working with:

1.    Is your company compliant with TCPA, HIPAA and familiar with state laws regarding collections?

This is not a yes/no question, they should be able to provide additional information including how often their collectors are re-tested for compliance and how their performance is monitored for compliance.

2.    Does your company perform background checks on collectors in required states?

3.    How are cell-phone calls handled?

If they dont maintain a separate policy for handling cell phone calls, that should be a red flag to you to find another vendor.

4.    Do you know what PHI is and what steps do you take to ensure its security during storage as well as communication with our practice?Ask how they receive data from their clients (do they accept secure electronic encrypted data or do they expect you to fax or mail patient files which are more easily compromised?) Do they provide you with a secure website to view collections status and if not, do they at least have the ability to encrypt emails when attaching a list of status updates which include PHI.

5.    Is your company licensed to collect in all states?

Even if your patients are primarily local to your office, sometimes they move out of state and your agency will have to be compliant with the laws that govern the patients new residence.

6.    Is your company bonded and insured?

Ask for copies of the documents proving bonding and insurance to make sure your money wont disappear if your agency goes out of business, either as a result of poor performance or as a result of a fatal class action suit.

Call me at 888-780-1333 for a 100% compliant option that will keep you and your practice safe during these times of changing and ever-increasing regulations.

RECOGNIZING THE FOUR PATIENT PAYER TYPES

20 Mar

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

RECOGNIZING THE FOUR PATIENT PAYER TYPES

12 Feb

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

Medical and Dental Practices, What Would You Do?

7 Jan
WWYDLogoWhat would you do if your patient data was stolen or a fire or flood destroyed your office?  Suppose one of your employees opened a malicious e-mail and your patient data was encrypted and held for ransom?   I know this sounds absurd, but just Google “data for ransom”.  What would be your first step?  With most medical records being stored digitally, it’s not a matter of if you’ll experience an incident regarding your electronic patient information; it’s a matter of when.
Technology is moving so fast in every industry, but in the medical industry, technology advancements are leading to more and more protected health information (PHI) theft and data breaches.   Patient information is not being properly protected. As you are well aware, protecting your patient’s confidential information is the law. Computers, laptops, e-mail, mobile devices, and thumb drives, all store and send ePHI.  Without the proper controls in place, your patient information can easily fall into the wrong hands, exposing your OMS practice to large governmental fines, and reputational risk.
HIPAA just announced that they will be conducting random audits starting in 2016.  Their pilot audit program revealed that many small to mid – size medical practices are not taking the necessary steps to protect their patient information and are not complying with even the basic HIPAA Security and Privacy Laws.   The HIPAA Security Rule now mandates that every practice take an annual risk assessment. The government also strengthened its ability to enforce the law in medical practices with fines reaching up to $50,000 per violation with a maximum $1.5 million annual penalty.  This is why Cash Flow Strategies is recommending PCIHIPAA, as a dedicated source for protecting your practice.
Cash Flow Strategies has many of our clients participating in their Compliance Program.  They have agreed to provide a complimentary HIPAA Risk Assessment (a $599 value).  You can take the Risk Assessment online and immediately receive your risk score with no further obligation.  I encourage you to take 5 to 10 minutes as soon as possible to complete the Risk Assessment  by clicking here. You’ll receive a 23- page Risk Analysis, and a 30-minute consultation that you can also schedule online.
Just click here to start your Risk Assessment.  It will be a great way to start your practice off on the right track in 2016.

INSURANCE MONEY WON’T PAY YOUR BILLS ANYMORE, DOC!

16 Jun

I was told today by a doctor that he refrains from pushing too hard to collect from a patient who owes him money, because of all the money he makes on the patient from insurance companies.  He is willing to write off patient balances, to keep making insurance money from the patient visits, and doesn’t want to offend the patient into leaving the practice by insisting he pay his bill.

This is the general attitude many doctors had 25-30 years ago.  It may have had some validity back them but times have changed!  Insurance money alone will not keep your doors open and your lights on any more doc.  You are putting your practice in jeopardy by not seeing what is happening around you!

High deductible health plans are the norm these days, and co-insurance is rising all the time.  Despite what the government tells us, there are more and more patients who do not have insurance, or have adequate insurance.  Self pay is now the highest payer in the medical world behind Medicare and Medicaid, and it is catching up fast.  According to recent statistics, patient balances now represent over 35% of a doctors income and soon, if major changes aren’t made, will be over 50%.

You can’t wish it away, or ignore it away.  You MUST find a way to motivate patients to pay you, and pay you faster than before.

Medicine, whether you like or not, or understand it or not, is a business.  You are trading a service for money, and the patient knows it.  They also know when you are leaving them alone about their bill so that you can continue to collect insurance money. Not only do they know, but guess who they tell?  EVERYBODY!!!  And guess what happens?  You get all the patients who don’t want to pay their bills.  Great!  Until, that is, until you watch your patient A/R go through the roof.  By the time you see this happen, you are already in trouble.

Don’t waste time.  There are automated tools to help your practice both maintain your good relationships with your patients, AND get them to pay you their portion of the bill sooner.  Call me today at 888-780-1333 and I will tell you about them.  Isn’t it worth 20-30 minutes of your time to keep the lights on in your practice over the long haul?

Medical and Dental Practices: Is insurance follow-up eating up your staff time?

11 Feb

Insurance companies have a vested interest in paying your practice as slowly as possible. They will delay, deny, and “on-hold” you to death just to keep your money a few days longer and earn interest on that money.

 

Living “on-hold” with insurance companies seems to be a way of life for some of your office staff, as clerks search forever for claim information. Sitting and waiting while they look up claims is costing you big time, not just in employee salaries, but also in lost productive time.

 

What if there was a highly effective, inexpensive way to motivate insurance companies to contact you regarding those claims? What if you didn’t have to waste the time of your employees “on-hold?” What if you could get an answer or your money more quickly?

 

Transworld Systems, a sponsored program with the AMA, a Preferred Vendor with the MGMA, and the largest collector of medical debt in the US, has a unique Insurance Resolution service that you can use to make these things a reality. For a low flat fee per claim, you can have them contact the insurance companies for you. When the insurance companies are contacted by a third party such as Transworld Systems, they will treat the inquiry with much higher priority than they will when they are contacted by your practice or a hospital. When receiving a third party inquiry, they are required to escalate the inquiry to a supervisor, and then have the supervisor contact your practice to resolve the claim.

It’s quick, it’s inexpensive, and it’s easy. And best of all, you can have your “on-hold” person spend their time on something less frustrating and more profitable for your practice.

It is just one of a whole suite of services that Transworld Systems can provide for your practice to help you get paid faster by both patients and insurance companies. Contact me for a free 30 minute demonstration of their services and a no-obligation analysis of your Accounts Receivable. Call me at 888-780-1333, or email me at davidhwiener@gmail.com.

Shopping For An EMR System?

12 Feb

Many practices, eager to get into the EMR incentives early, are now finding that they need to change systems to keep up with meaningful use criteria.  Others, who were slow to adopt EMR, are now scrambling to choose the right system for their practice.  Here are some suggestions that might be helpful as you evaluate potential EMR/EHR systems for your practice:

EVALUATE THE EMR VENDOR

Be sure to check out referrals and references for this particular vendor.  What is their level of experience?  How many installs do they have?  What specialties do they specialize in and what specialties do they have little experience with?  What size practice do they typically install?  Do they have certified products for 2014?  Have they merged or acquired other vendors recently?  What other products do they offer?  Is the EMR/EHR product their main source of business, or is it just an add-on product to their main product line?

EVALUATE THE SYSTEM

How many installs and conversions has this system accomplished?  How many physicians and non-physician practitioners have used, and are currently using, this system.  Is this system integrated with a practice management system, or is it a standalone product that can be integrated with different PM software systems?  If this is a standalone product, what is the cost and the process to integrate the system with current PM systems?  Is there migration and integration assistance?  How long has the system been in active use?  Are there guarantees?

SEE THE PRODUCT IN ACTION

If at all possible, observe other practices that are using the system.  Be detailed.

If you are currently in the market for a new PM system and/or EMR/EHR system, I would like to be of help to you.  There is no cost for the consultation.  In most cases, I can make recommendations to you for systems that would specifically match your practice size, specialties and needs.  Through my contacts in the business, I can also arrange demos for you of systems that would be appropriate for your needs.

This consultation can be accomplished through a brief phone conversation.  I welcome the opportunity to help.  Respond to me through the form at the bottom of this blog, or give me a call at 888-780-1333.

A Warning You Need to Read: Don’t Believe in Something For Nothing!

14 Jan

Many businesses have been told by their collection agency that they can provide free collections to them simply by adding the percentage fee onto the debtor’s balance as “the cost of collections”  In other words, promising prospective customers “something for nothing.”  With the high cost of collection agencies, this is a very tempting offer for a business who needs to collect their money and hesitates at paying an agency their typical 30-50% fee for collecting.

DON’T BELIEVE IT!!

First of all, the match doesn’t work anyway.  If the fee is 50% and the agency or the client adds the 50% back into the bill before it is collected, the client will only receive 50% of the new balance, which is not the full amount (only 75% of the original bill)

More importantly than that, the agency is tempting you to violate Federal Laws against usury.  The agency is setting themselves, AND POTENTIALLY YOU, up for a law suit and stiff fines and penalties.  Even if you put a statement to that effect into your financial policy, you may not charge these percentages to recoup your collection fees.

Please take a moment to read this article, copied from the ACA International (American Collector’s Association) website about a recent court case against such an unscrupulous agency.

Court Rules Against Collecting Percentage-Based Fees

Eleventh Circuit Court of Appeals ruled that charging consumers a percentage
of their account balance as a collection fee is a violation of the FDCPA unless
the consumer explicitly agreed to pay a percentage-based fee.

In a Jan. 2, 2014, ruling, the Eleventh Circuit Court of Appeals found that a collection
agency may not collect a fee based on a percentage of the account balance if the
original contract between the consumer and creditor did not specify the consumer
would be responsible for a percentage-based fee.

In the case, Bradley v. Franklin Collection Service Inc., the consumer plaintiff had
signed a patient agreement when receiving medical treatment that stated, “In the
event of nonpayment… I agree to pay all costs of collection, including a reasonable
attorney’s fee…” The creditor subsequently added a 33-1/3 percent fee (reflecting
the contractually agreed upon fee between the creditor and the collection agency)
before forwarding the account to the collection agency.

The court ruled that the plaintiff, “agreed to pay the actual costs of collection; his
contractual agreement with [creditor] did not require him to pay a collection agency’s
percentage-based fee where that fee did not correlate to the costs of collection.”
The court found that the percentage-based fee, assessed before the collection
agency’s attempt to collect, was not related to the agency’s actual cost of collection,
thus breaching the agreement between the consumer and the creditor. Therefore,
the court held that the collection agency violated the FDCPA by collecting the 33-1/3
percent fee when the consumer only agreed to pay the actual costs of collection.

© 2014 ACA International

In other cases, medical practices, along with the agency, were charged under racketeering laws for the very same offense.  The fines and penalties that they were required to pay were astronomical.

Please, let me show you a way to avoid the percentages charged by these collection agencies, without running afoul of the law, and while collecting more money than they do in the process.

Respond to me through the form below and I will rush you the information on how to avoid these kinds of unscrupulous methods and still collect more of your hard earned money.

Diagnosing Practice Fraud – Astinel Security & Forensics

25 Nov

This is an exceptional article written by a friend and recognized expert in dental practice fraud prevention and investigation.

I have, unfortunately, been called in to consult with medical and dental practices who have been embezzled by staff.  It is much more difficult to react after the fact than it is to use “preventative medicine” and prevent these horrible things from happening.

Zane, and his company, Astinel Security & Forensics, would be my recommendation to you and your practice to prevent practice fraud.

Diagnosing Practice Fraud – Astinel Security & Forensics.

Please feel free to contact me using the form below if I can be of any assistance to your practice.

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