Upload File

small practice mgmt 21st century 1 thriving in the 21 st century small practice management steven d....

  • Home
  • Documents
  • Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,
51
small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield, MO [email protected] www.adultmedicine.com/presentations/

Upload: melina-mcdowell

Post on 26-Dec-2015

213 views

Category:

Documents


0 download

Report

Tags:

TRANSCRIPT

Page 1: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century1

Thriving in the 21st Century

Thriving in the 21st Century

Small Practice ManagementSmall Practice Management

Steven D. Atwood, MD, FACP Internal Medicine – Springfield, MO

[email protected]

www.adultmedicine.com/presentations/ small-practice-mgmt

Steven D. Atwood, MD, FACP Internal Medicine – Springfield, MO

[email protected]

www.adultmedicine.com/presentations/ small-practice-mgmt

Page 2: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

2 small practice mgmt 21st century

Marcus Welby, MD

How to keep your practice profitable and enjoyable Suggestions to help you thrive in 2004

Remember when …

Page 3: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century3

Income Overhead

Time Stress

Mechanics

extra revenue sources suggestions to cut your overhead

tips to save time and effort suggestions on how to prevent a little stress

a few ideas to help with office operation

Page 4: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century4

OverheadOverheadOverheadOverheadTranscription

time to go digital

Page 5: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century5

OverheadOverheadOverheadOverhead

Digital Dictation Service Providers UnlimitedTranscriptions.com

Doctor:Dictate!.com

Medical Transcription.com

List at

Yahoo>business>health>medical_transcription

TranscriptionGear.com

Page 6: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century6

Transcription EquipmentTranscription Equipment

Page 7: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century7

Digital Dictation Digital Dictation Digital Dictation Digital Dictation dictate

Transfer to computer then send via the Internet

• Return 1 day, 6-12 cents per line

• No office space or equipment for transcription

• No personnel issues like hiring, payroll,benefits, coverage if out, training

• Better quality sound and transcription

• Works well with voice-to-type software

Page 8: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century8

Cell Phone as PagerCell Phone as PagerCell Phone as PagerCell Phone as Pager

1. $50 / 1,000 minutes or per month vs. 25¢ / page or e.g. $180 / mo

2. Store all your phone #

3. Caller ID

4. Auto-forward

5. Text Messages & E-mail to phone

6. Change recorded message in seconds

7. Why carry both pager & phone

Page 9: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century9

OverheadOverheadOverheadOverhead

Claim Clearing House e.g. GatewayEDI

11¢ per HCFA claim sent via the Internet vs 37¢ stamp for snail mail vs up to $5 / claim for interface & large corporation system

Print-to-File can be ideal way to easily and inexpensively transfer your data

Page 10: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

10 small practice mgmt 21st century

Print to FilePrint to File

How to let what you printeasily transfer the data to a database

How to let what you printbe easily stored or sent with an e-mail

Page 11: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century

11

Print to FilePrint to File

If you can print it,you can also make it a digital file

Digital files can link up with other programs

Your text data can automatically fill in a database or spreadsheet

Page 12: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

12 small practice mgmt 21st century

Print to File-- UsesPrint to File-- Uses

Send your claims to a clearing house no interface needed

Save your 10 page spreadsheet digitally

Query your database then e-mail the report

Page 13: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

13 small practice mgmt 21st century

PRINT TO FILEPRINT TO FILE

Page 14: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

14 small practice mgmt 21st century

Print to File Print to File

Generic text printer

Prints to your computer port LPT-1

Page 15: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

15 small practice mgmt 21st century

Print to File Print to File

Generic text printer

Prints to your computer port LPT-1

Page 16: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

16 small practice mgmt 21st century

PRINT TO FILEPRINT TO FILE send / store print

Three key points for printing 1) specific to a chosen printer 2) should use printer port LPT1 3) must be generic text printer to transfer text

Page 17: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century

17

Print To File – DOS CommandPrint To File – DOS Command

Select printer then click print to file option Go to DOS prompt (in Windows>Accessories) Enter the command PRINT and file name e.g.

Then strike enter and your file prints thus you can save anything you want to print

if you can print it, you can save it, send it, or pull the text data into another program

Page 18: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century19

OverheadOverheadOverheadOverhead BenchmarksBenchmarks

Rent e.g. 5%

Lab Stamps Paper Toner / Copy Machine

Utilities Meds Insurance

Staff e.g. 22%

Transcription Phones e.g. 1.3 %

Software Hardware

total monthly overhead / doctor

total collection / doctor

% collected after discount

Page 19: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century20

Stress PreventionStress PreventionStress PreventionStress Prevention

• No phone service at noon hour or day off

• No voice mail for incoming receptionist calls

• Voice mail to back line for simple replies

• 1 incoming line not 3 when needed

• Incoming phone line busy when needed

>>Patients do the leg work for PA (prior authorization) for meds PA for procedures Schedule their own referral appointments

Phones

Page 20: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century21

Stress PreventionStress PreventionStress PreventionStress Prevention

• Backup for Nurse and Receptionist

Cross Train !!

Page 21: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century22

wireless pocket phone call prescriptions to voice mail refill meds prn X date test order sheet everyone has a computer and every station can schedule

TIMETIME SaversSavers

Page 22: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century23

TIMETIME SaversSaversMessage Form

if it’s not written, it didn’t happen

paper benefits take message with 1 hand get all the needed info via form to complete easy to pass along to other staff

digital system (e-mail) better if headset so both hands can work keyboard

www.adultmedicine.com/forms (for examples that work well for me)

Page 23: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century24

TIMETIME SaversSavers Auto-Text with MS Word

the key to quick data entry

1) Imagine a 3 page physical dictated in 30 seconds

2) No more letterhead to buy

3) Add your signature from your computer

Page 24: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

25 small practice mgmt 21st century

AUTO-TEXT -- the key to quick data entry

1) just memorized phrases or pictures

2) pastes in with two key strokes type name for the copied information -e.g. 1

then hit the F3 key

3) works for anything you can highlight pictures-- logo signature entire normal exam or review of systems field to add something like date entire page with pictures, tables, text boxes

Page 25: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

26 small practice mgmt 21st century

AUTO-TEXT examples to be shown

1. full physical2. header for notes3. full letterhead—no special paper to buy4. signature insert5. bookmarks to jump from top to bottom–

Control-F9 to insert F11 to jump6. calculated fields automatically add dates7. med sheet8. fax sheet

Page 26: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century27

Template file 2

Template file 3

Template file 1 Memorized Phrase group 1

Memorized Phrase group 2

Memorized Phrase group 3

Insert can be from any of the three files

list to chose from can be any one or all of the files

Auto Text Example

Page 27: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

1

open auto text file options withTools then Templates

Page 28: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

2

Select your groups of memorized

phrases

Page 29: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

3 Trade phrases (auto-text) from one file to another

Page 30: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

4

Select Auto Text

Page 31: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

5

Choose whichtemplatesto select from

Page 32: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

6

Insert signature forletters etc.

Page 33: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

34 small practice mgmt 21st century

Time Savers

Fax directly Fax directly from word processor from word processor

Page 34: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century35

TIMETIME SaversSavers

Let everyone in the practice be able to easily schedule an office visit for an established patient

Page 35: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

–2

–4

–6

–10

0

Relative Value Of Technology Time SaversRelative Value Of Technology Time Savers

TimeSaved

MessageForm

doesn’twork well for

wholesalers

can refillPRN a date

or x 5 by date etc

Call Scripts

to X Date

Voicemail

Voicemail

staff or

doctoruse

DictationFaxes to send

Letters

Auto-text

Pocket Phone

Analog$29

Analog$29 follow-up

work inslab only

call backs

All staff havecomputerand can

schedule

helps esp.if group

testsor needICD-9

all testsany date

useto order

to get results

TestForm

These are just my estimates for my solo practice

total hoursper week

–8

Use to callScripts

ScheduleCT / MRI

ect.

paperfasterwith

circlereplyoption

e-mailbetterforsavingorfinding

Page 36: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

37 small practice mgmt 21st century

Mechanics

Patient Mix– new patients upon prior approval

HIPAA release – form and on registration sheet include patient e-mail and permission to discuss with family redo copy of insurance cards yearly

Convert paper to digital format – SCAN / FAX e.g. Fax records to computer then print later with laser printer e.g. scan Insurance Cards e.g. incoming faxes go to computer

upon prior approval

Page 37: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

38 small practice mgmt 21st century

Mechanics Patient E-Mail How to get paid 1) get paid by webpage notice and only send message from page 2) advanced arrangement--boutique practice

3) Auto-reply to incoming message

Page 38: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

39 small practice mgmt 21st century

Mechanics Patients Sending E-Mail

Encryption1) patients operate at a very basic level

2) direct e-mail from desktop computer better ?

3) incoming message– HIPAA requirements? should incoming message be encrypted?

Page 39: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

40 small practice mgmt 21st century

www.adultmedicine.com/contact-office

Page 40: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

41 small practice mgmt 21st century

Page 41: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

42 small practice mgmt 21st century

Network SecurityMechanics

1. BIOS (bootup) password

2.Network & Program password

3.No guest passes

4.Only share required programs

5. Hide file property

6.Server in lockable room

7.Wires only in office

8.Firewall Virus scanner Router

Page 42: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

43 small practice mgmt 21st century

Network SecurityMechanics

1. BIOS (bootup) password

2.Network & Program password

3.No guest passes

4.Only share required programs

5. Hide file property

6.Server in lockable room

7.Wires only in office

8.Firewall Virus scanner Router

Passwords

1. Try 1st letter of every word in a sentence

2. and include a number

3. a character that needs 2 key strokes like ?

4. And at least 8 characters

eg: How Do You Do 5 Things At Once?HDYD5TAO?

Page 43: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

44 small practice mgmt 21st century

Network SecurityMechanics

1. BIOS (bootup) password

2.Network & Program password

3.No guest passes

4.Only share required programs

5. Hide file property

6.Server in lockable room

7.Wires only in office

8.Firewall Virus scanner Router

Page 44: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

45 small practice mgmt 21st century

Pre-employment Background Checks – web detective

www.PublicRecordsSources.com

www.ChoicePointOnline.com

www.CrimeTime.com/onine.html

PACER (pacer.psc.uscourts.gov )www.USInformatonSearch.comwww.PreemploymentScreening.orgwww.Web-Detective.comwww.USSearch.com

http://www.publicrecordssources.com/
http://www.choicepointonline.com/
http://www.crimetime.com/onine.html
http://www.usinformatonsearch.com/
http://www.usinformatonsearch.com/
http://www.usinformatonsearch.com/
http://www.preemploymentscreening.org/
http://www.web-detective.com/
http://www.ussearch.com/
http://www.ussearch.com/
http://www.ussearch.com/
Page 45: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century

46

Income

Stop those NO Shows

1) call 2 days pre-visit 2) ask for call back to confirm 3) open slot if no confirm 4) call 1 hour after NO SHOW

Page 46: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century

47

Income

Revenue Enhancement e.g. 1) Liquid Nitrogen and Cryotherapy 2) Medicare Allowed Screening Tests Pap Collection Q0091 / v76.2 Pelvic G0101 / v76.2 Prostate Check G0102 / v76.44

Stool Guiac G0107 / v76.51 3) Extender (PA) – job share? Pay by hour or % of their collections ?

Every 2 yearsEvery 2 years

Every 1 yearEvery 1 year

Page 47: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century48

Income

New Revenue Sources No Shows

Time Savers

Pocket PhoneMessage Form / digital versionAuto-TextVoice Mail for Scripts refill x 1 yearAll staff can schedule office visit

Stress PreventersTelephone Prior Authorizations

Overhead ReductionDigital DictationClearing HousePrint to File

Operational Mechanics

Network SecurityScan PaperInternet Pre-employmentCell Phone PagerE-Mail to Patients

Page 48: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st centurysmall practice mgmt 21st century49

Solo vs. Small Practice

I made a conscious decision to stay solo Like to do things my own way Like full flexibility Better control work and stress and all aspects of practice

I missed out on some revenue and benefits of extender, office lab, office xray, group health plan, some pension options & deferring all headaches to office manager

Page 49: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

50 small practice mgmt 21st century

So What about the FutureSo What about the Future

Do we all invent the wheel ?Do we all invent the wheel ?Remember the Dinosaurs—they couldn’t changeRemember the Dinosaurs—they couldn’t change

Page 50: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century51

Technology & Efficiency Manage Increasing Complexity and Increasing Information

Technology & Efficiency Manage Increasing Complexity and Increasing Information

Overhead

Improved Bottom Line

Improved Bottom Line

Collections

Office of 21 Office of 21 STST Century Century

Rapid ChangeDo More with Less

Quality

Page 51: Small practice mgmt 21st century 1 Thriving in the 21 st Century Small Practice Management Steven D. Atwood, MD, FACP Internal Medicine – Springfield,

small practice mgmt 21st century52

Thriving in the 21st Century

Thriving in the 21st Century

Small Practice ManagementSmall Practice Management

Questions -- Comments Questions -- Comments


Classroom Practice 21st Century

21st Century Choral Performance Practice: Presenting the

Managing Lymphoma in Small Animal Practice

ICD-10 Small Practice Readiness - dch.georgia.govdch.georgia.gov/.../document/ICD-10_July16_Webinar_FINAL_07152013.pdfICD-10 . Small Practice Readiness. Presentation to: ... billing

Fdcc small firm practice in the 21st century

Successful Small Firm Practice Series Session Four › bar-resources › practice-management... · Successful Small Firm Practice Series Session Three: Ethics and Small Firm ... Law

Tpack best practice with a 21st century makeover

PSYCHOLOGY OF THE 21ST CENTURY: THEORY, PRACTICE, …

21st Century Regionalism and Production Sharing Practice

21st Century Small Unit Leaders - Defense Technical Information

Small Animal General Practice

A CENTURY OF FREE EXERCISE JURISPRUDENCE: PRACTICE …

CODE OF PRACTICE FOR SMALL WASTEWATER TREATMENT PLANTS/media/Publications/500.pdf · CODE OF PRACTICE FOR SMALL WASTEWATER TREATMENT PLANTS Code of Practice CODE OF PRACTICE FOR SMALL

Contemporary and historical performance practice in late eighteenth-century violin ... · PDF file · 2016-06-17Contemporary and historical performance practice in late eighteenth-century

A network mindset - 21st century workplace practice

CODE OF PRACTICE FOR SMALL WASTEWATER …/media/Publications/500.pdfcode of practice for small wastewater treatment plants code of practice code of practice for small wastewater treatment

General Practice, solo & small Firm

HEMOSTATIC DRUGS IN SMALL ANIMAL PRACTICE

Control Operating Costs. Amsco Century Small and AMSCO... · 2015-04-27 · Provide Big Efficiency in a Small Size Amsco Century Small and Amsco Millennium Steam Sterilizers have

Theory and Mathematical Practice in the Seventeenth Century

Managing a 21st century legal practice for the Canada Bar Association Practice Management Section

Small Office Practice - USModernist

ASD: Research to Practice in the 21st Century

Practice and Reform in Fourteenth-Century Damascene ...mamluk.uchicago.edu/MSR_XI-1_2007-Ibrahim.pdf · Practice and Reform in Fourteenth-Century Damascene Madrasahs Prior to the

Small Practice Solutions Service Delivery Overview

(Webinar Slides) Building a 21st Century Law Practice

Practical Physiotherapy for Small Animal Practice

CHANGING BURIAL PRACTICE IN SEVENTH-CENTURY · PDF fileseventh-century hampshire: the anglo-saxon ... changing burial practice in seventh-century hampshire 67 ... anglo-saxon period,

Unit Fractions Small Group Practice

My Twentieth Century Evening -- and Other Small

21 st Century Learning and Practice

Practice Standards Scheme: Small Animal

Successful Small Firm Practice Course

AMSCO Century Small V116 and V120 Sterilizers

Rules of 21st Century Law Practice