Aug 19, 2021 | Partner
Designing a Superior Patient Experience
We live in a world of increasingly lofty consumer expectations—one where 44% of U.S. consumers will switch to a competitor following a poor customer service experience.
The medical industry is no exception to this trend.
In a study by PatientPop, 58 percent of Gen Z, Millennials, and Gen Xers, as well as 63 percent of individuals 55 and older, said that responsiveness to follow-up questions via email or phone outside of the appointment is critical or very important to overall satisfaction.
Patients want more than just excellent care from their healthcare providers. They expect easy access to medical records, convenient online scheduling and appointment reminders, prompt responsiveness, and painless ways to contact your office—24/7/365. And they’re also seeking compassionate and knowledgeable representatives who are willing to provide caring and accurate resolutions to their issues.
As a medical provider, you should not only focus on bringing in new patients but also continually strive to improve patient retention. Growth in customer retention rates by 5 percent can increase profitability anywhere from 25 to 95 percent, after all.
So how do you design an experience that increases patient satisfaction and retention? Let’s dive in.
1: Make Prompt Call Answering & Convenient Appointment Scheduling A Priority
As we mention above, patients want—and nowadays expect—your office to answer quickly as well as provide effective and swift resolutions to their health matters. But in a busy office, the staff is often focused on dealing with patients. Even front desk and administrative teams can become inundated with in-office tasks at a busy practice, leaving calls, messages, and emails unanswered.
A superior patient experience starts with prompt call answering and convenient appointment scheduling—a service that’s available to your patients whenever they need you, including weekends and holidays, and answers every call addresses delicate patient concerns with empathy, and schedules appointments quickly. If your staff is struggling to keep up with demand, consider outsourcing your phone answering and appointment scheduling. Not only will this improve patient satisfaction, but it also brings a sense of work-life balance to internal staff and allows you and your team to focus on what you do best; caring for patients.
2: Streamline and Perfect Your Patient Intake Process
The patient intake process is tedious, but it’s incredibly important to your operations, and speed and accuracy are vital. Streamlining and perfecting patient intake starts with leveraging the right software—one that makes it easy for patients to fill in their information and access their records, and provides all of the valuable data your practice needs to operate in an easy-to-navigate platform. For starters, your intake software should:
- Be encrypted for data transfer through the internet and HIPAA compliant
- Be intuitive and user-friendly
- Not require special software or hardware downloads or installation for the user
- Be portable into back-end systems
Your intake process should also be integrated with your electronic health records (EHR) software, and information should be updated and available in real-time for a smooth experience—for patients, admin staff, and providers—so that everyone is up-to-speed. Both technology and your process should remove redundancies from your workflow and streamline the intake experience.
3: Provide HIPAA-Compliant Live Chat & Text For Swift and Convenient Communication
Another great way to improve patient experience is via live chat and text, through which you and your staff can communicate with patients wherever they are, send appointment reminders, have two-way private and secure conversations, multitask as needed and be available when emergencies happen.
HIPAA-compliant chat and text messaging lets you communicate efficiently and accurately with patients and simultaneously safeguards electronically protected health information (PHI) while taking full advantage of the speed and flexibility of today’s communication technology.
Some of the many benefits of secure live chat and text in the healthcare realm include:
- Reduced response times, including in the off-hours and on weekends or holidays
- Ability to provide immediate recommendations for care and preliminary diagnoses
- Ability to send follow-ups, like reminding patients to take medications, which creates better relationships between you and your patients
- Secure PHI storage that acts as a record of past conversations, symptoms, or complaints to improve future care, diagnosis, and treatment plans
4: Leverage Technology and Software Integrations For Smarter Decision-Making
Technology and software integrations have transformed healthcare and are vital in any medical practice. Why? Because when you streamline your office functions and workflows, you improve all aspects of patient care and experience.
First, your office should be using an EHR (electronic health record) system. This system automates access to client information, helping to improve workflows and reduce incidences of errors by improving the accuracy and clarity of medical records. It should include all the key clinical data relevant to each patient’s care, including:
- Demographics
- Progress notes
- Problems
- Medications
- Vital signs
- Past medical history
- Immunizations
- Laboratory data
- Radiology reports
Communication data collected throughout your patients’ experience with your office—such as phone conversations, appointment scheduling, and reminders, and live chat and text transcripts—should also be sent to and recorded in your EHR system.
Finally, the right software can help you make better patient and business decisions. For instance, maybe you want to know the percentage of patient calls versus the percentage of calls from hospitals that come into your office. Or, maybe you want to know which hospitals call you the most or you want to know the main reasons patients call so you can use that information to improve patient care and education.
How The Highest-Performing Medical Practices Prioritize Patient Experience
Medical practices that provide a superior service experience are available to their patients 24/7, have a streamlined and accurate intake process, are tech-forward, and have omnichannel communication options that empower patients to reach out any time and from anywhere. But most medical practices don’t do it all on their own. The highest-performing medical providers leverage an outside service provider like Nexa to improve client satisfaction, increase retention and grow their revenue. Learn more about how Nexa can help your medical practice level up by visiting nexa.com/medical.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
[ Contribution from the marketing team at Nexa ]
Jul 27, 2021 | HIPAA, Live Compliance, Partner
HIPAA Social Media Do’s and Don’ts in Healthcare
There are many benefits to social media in the healthcare industry, however, there is also huge potential for HIPAA violations of patient privacy to be violated on social media networks. The Privacy Rule protects All “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper or oral. The Privacy Rule calls this information “protected health information (PHI).”
Did you know that more than 71% of recorded data breaches in the healthcare industry are attributable to employee actions?
The most important rule is to never share Protected Health Information or Personally Identifiable Information on social media. Social media may include personal blogs and other websites, including Facebook, LinkedIn, Twitter, YouTube, or others of the like.
A few common identifiers include but are not limited to:
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- demographic data
- medical histories
- test results
- insurance information
- and other information used to identify a patient or provide healthcare services or healthcare coverage.
What is a breach and what can I do to avoid it?
A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information. This means employees should refrain from posting, commenting, or sharing patient information on social media including patient names, photos, and descriptors that would identify the patient.
What is considered identifiable information?
The most common social media HIPAA violations include:
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- Posting of images and videos of patients without written consent
- Posting of gossip about patients
- Posting of any information that could allow an individual to be identified
- Sharing of photographs or images taken inside a healthcare facility in which patients or PHI are visible
- Sharing of photos, videos, or text on social media platforms within a private group
“Friending” patients on social media websites is also strongly discouraged. This can lead to accidental identifying of patients, especially if your place of work is listed in your profile and accidental ‘discussion’ about the patient’s care. Therefore, employees in inpatient care roles generally should not initiate or accept friend requests. Do not enter into social media discussions with patients who have disclosed PHI on social media.
Employees should also refrain from messaging or texting PHI or PII on social media or messaging applications not approved by your organization. In general, no personally identifiable health information should be sent in any manner which does not ensure communication encryption in transit and at rest.
So, what do you do if you think you may have exposed a patient’s protected health information or personally identifiable information?
In general, it’s advised to, follow your organization’s Incident Response Policy immediately and notify your supervisor and/or designated HIPAA Security Officer for immediate next steps.
At Live Compliance, we make checking off your compliance requirements extremely simple.
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- Reliable and Effective Compliance
- Completely online, our role-based courses make training easy for remote or in-office employees.
- Contact-free, accurate Security Risk Assessments are conducted remotely. All devices are thoroughly analyzed regardless of location. Conducting an accurate and thorough Security Risk Assessment is not only required but is a useful tool to expose potential vulnerabilities.
- Policies and Procedures are curated to fit your organization ensuring employees are updated on all Workstation Use and Security Safeguards in the office, or out. Update in real-time.
- Electronic, prepared document sending and signing to employees and business associates.
Don’t risk your company’s future, especially when we are offering a free Organization Assessment to help determine your company’s status. Call us at (980) 999-1585, or email me, Jim Johnson at Jim@LiveCompliance.com or visit www.LiveCompliance.com
For more information about DarkWeb breaches please contact us at (980) 999-1585 or email us at support@livecompliance.com
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
Jul 14, 2021 | BillFlash, Partner
There is no surprise that the cost of healthcare continues to rise creating financial hardships not only for patients but for physicians as well. While the COVID-19 pandemic severely impacted how patients interacted with their physician’s office, it is important to understand that patients want to be financially responsible for their medical bills and have preferences on communication methods to increase revenue.
In order to improve the overall patient experience and collection of revenue, it is important for physician offices to truly understand the demographics of their patients and the differences amongst their generational behaviors. Using a one-size-fits-all approach to communicate with patients is an outdated method and oftentimes leads to patient frustration, lack of engagement, poor retention, and missed opportunities to enhance revenue collection.
In a recent article published last month, physicians must adapt to the patient’s digital experience in order to enhance receiving payments for medical bills (Healthleaders, 2021). Patients desire modern payment options such as a payment portal, mobile ability, texting capabilities, and/or scanning a QR code. In addition, 76% of healthcare consumers desired a contactless method that allowed them to view their statements online and make payments without the need to visit the doctor’s office. According to (Healthleaders, 2021), the number one payment option patients desire is contactless debit and credit card options. In addition, patients desire payment options to help them manage their medical expenses such as payment plans and/or auto-pay methods.
As a medical billing expert, EZClaim can help medical practices improve their revenue through their billing and scheduling software in conjunction with BillFlash, which provides contactless and modernized communication methods that patients highly desire. Let EZClaim and BillFlash enhance the options to modernize your medical billing and communication systems.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
Apr 5, 2021 | Medical Billing Software Blog, Revenue, Support and Training, Trizetto Partner Solutions
In the world of healthcare revenue cycle management, there are numerous scenarios that can put a stranglehold on your revenue if you’re not prepared. With the COVID-19 pandemic causing varying degrees of change in inpatient volumes and visits, and telemedicine coming further into play, physicians and their practices are having to quickly navigate the nuances of their financial well-being. A practice may be buttoned up from the time the patient walks in the door, but what happens after the visit will determine when the practice will get paid. This element of the revenue cycle starts with coding. Here are five medical coding challenges that will ruin your bottom line.
1. Coding to the Highest Specificity
Missing data on a claim relative to the patient’s diagnosis and procedure can easily cause a rise in denials once received by the payers, resulting in potentially thousands of dollars in write-offs. Medical coders are responsible for coding patients’ claims to the highest level of specificity, ensuring the appropriate CPT, ICD-10-CM, and HCPCS codes are applied based on the patient’s chart from the day’s services.
COVID-19 and telemedicine are frequently bringing on new codes and code sets, all with different variations and modifiers to make the matter even more complex. Medical coders spend a lot of time researching and learning new codes, but every year – and throughout the year – changes and updates are made. Payers don’t only want to know the diagnosis and the treatment; they want to know the cause as well. The Coronavirus Aid, Relief, and Economic Security Act passed in March of 2020 allows for an additional payment from Medicare of 20 percent for claim billed for inpatient COVID-19 patients, however, it was later indicated that a positive COVID-19 test must be stored in the patient’s medical records in order to be eligible for this payment. Being able to stay on top of codes specific to the patient’s diagnosis at treatment is more difficult than ever before.
2. Upcoding
While code specificity is important, so too is ensuring the claims do not contain codes for exaggerated procedures, or even procedures that were never performed, resulting in reimbursement for these false procedures. This seems logical enough, but upcoding can easily occur as a result of human error, misinterpretation of a physician’s notes, or lack of understanding of how to appropriately assign the thousands of ICD-10-CM codes in existence. To add to the pressure, the Office of the Inspector General issued a plan with objectives to prevent fraud and scams, and remedy misspending of COVID-19 response and recovery funds.
Much like under-coding or not providing enough data on the patient’s visit can create issues, upcoding can be a major contributor to financial loss for a practice. Questionable claims can be denied and sent back for corrections and appeals, but upcoding can have more serious ramifications outside of paper-pushing between coders and payers.
Whether it’s making sure the codes are in accordance with the care provided, understanding the code sets that apply for each procedure, or comprehension of the medical record, refraining from upcoding will help ensure a sturdy and compliant revenue stream.
3. Missing or Incorrect Information
There’s a common theme to coding challenges, and that’s having the sufficient information necessary. This information typically is pulled from a patient’s chart or record of a visit, which is often completed by the attending physician. However, even when a claim is submitted, providing required information relative to the procedure to the payer is critical as well. Situations such as failure to report time-based treatments (such as anesthesia, pain management, or hydration treatments) or reporting a code without proper documentation can result in denials.
Furthermore, information in a patient’s electronic health record may also contain inaccurate information. Keystrokes and other human errors can cause these situations to flare up, and it takes a diligent, thoughtful coder to read between the lines and ensure claims have the appropriate information.
4. Timeliness of Coding
The Medical Group Management Association (MGMA) suggested in their 2018 Setting Practice Standards report that a Primary Care Physician should maintain a claim submission rate of 3.11 days after the date of service, but it is becoming increasingly difficult for practices to sustain anything close to this rate. Constant changes to code sets, an increased focus on submitting claims with sufficient and compliant information, and the requirement to code claims to the highest level of specificity, can easily delay the submission by days or weeks.
Nevertheless, delays in coding and submitting claims can cause major lags in payment and substantial loss in revenue. Insurance payers have statutes of limitations that require claims to be submitted anywhere from 120 to just 60 days after the date of service. Simply put – the more time spent coding the claim, the later it will be submitted, thus increasing the odds that the claim will be denied. Expert coders are aware of this and do everything in their power to get coded claims out the door.
5. Staffing Shortages
However, finding experts well versed in coding claims quickly, accurately and in compliance with the False Claims Act is not always an easy task. As you can imagine, the increasing need for care within the senior population is causing a rise in claim volumes, and trying to find a team of coders who know the ins and outs of complex ICD-10-CM coding can easily cause a bottleneck in the revenue cycle. Health executives expressed their struggles to find talent back in 2015, and some forecasts expect a decline in commercial payments by 2024 to further hamper a C-suite’s ability to manage labor costs. The ramifications of incorrect coding are still a key topic of discussion to this day.
The time has come for practices to begin looking outside of their organization for coding support. How is your practice planning to tackle the coding conundrum? When choosing a partner for your medical coding needs, you need to pick an expert to help your practice stay on target. TriZetto Provider Solutions, a Cognizant Company, has available highly-trained, AAPC & AHIMA certified coders with the experience of getting the details right the first time and understand the importance of coding to the medical practice.
For more information about TriZetto Provider Solutions, a partner of EZClaim, visit their website, contact them, or give them a call at 800.969.3666.
ABOUT EZCLAIM:
EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support. Combined, they help improve medical billing revenues. To learn more, visit EZClaim’s website, e-mail them, or call them today at 877.650.0904.
[ Contribution of the TriZetto Provider Solutions Editorial Team ]
Mar 10, 2021 | Credit Card Processing, Medical Billing Customer Service, Medical Billing Software Blog, Trizetto Partner Solutions
What is Price Transparency?
It’s a story we hear too often. A person visits a hospital for a medical issue—whether it be a trip to the emergency room for a broken arm or a pre-scheduled appointment for a headache that just won’t go away—and receives a myriad of services and tests. Then comes the dreaded bill in the mail a few weeks later. Although they may inquire about an estimate at the time of service or have an idea of their coverage, the exact financial responsibility is often a mystery until that bill arrives. While the changes vary greatly, one thing that is certain: many people have trouble with their out-of-pocket costs. So much so that a recent survey from The Commonwealth Fund found that 72 million Americans have some sort of trouble with medical debt.
So, on January 1, 2021, the price transparency rule was put into effect—from the Centers for Medicare and Medicaid Services (CMS)—requiring all hospitals within the United States hospitals to publish the prices of various medical procedures. In particular, standard charges for services and items must be published online, available for patients to access. Until now, these prices were hard to find. The timing of this change—the beginning of the calendar year—comes at a time when healthcare pricing is top of mind since many customers most likely renewed or changed insurance carriers and coverage on January 1, 2021. With this comes a focus on out-of-pocket costs, deductibles, and more.
What Brought About This Radical Change?
Part of this change can be attributed to the consumers themselves. With the increase in high deductible health plans and increased out-of-pocket costs, finances are top of mind. In addition to these factors, today’s consumers demand a better overall patient experience. With the prevalence of online shopping, patients expect the same seamless transaction at the hospital that they receive with companies like Amazon, Walmart, and Home Depot. Just as consumers read product reviews before placing an item in their online shopping cart, patients research services and access peer reviews of physicians before they go to the office. In short, they want to be knowledgeable about their healthcare and crave tailored services with exceptional customer service.
Many believe this change will be well received, with Forbes calling the ruling a “gift to all Americans.” From the consumer’s standpoint, it will now be easier to make educated decisions based on cost. This will then cut down on the “unknown”—hopefully eliminating those hefty surprise bills—and opens the door to comparison shopping. Advocates are hoping this newfound transparency will eventually lower costs, with the competition eventually driving down the prices.
How Can Healthcare Organizations Navigate This Change?
This will not only promote transparency but will also increase convenience. By enabling patients to access and pay their bills on their own schedule with easy-to-implement solutions, organizations are meeting them halfway, so to speak. With easy-to-understand statements, integrated credit card processing, and 24/7 payment portals, it is no longer a hassle to manage medical financials. For healthcare organizations, facilitating proactive management of a person’s cost of care accelerates revenue collections and patient satisfaction improves.
In the larger sense, executives recognize that patients are taking more stock in their personal care. In order to thrive, hospitals and health systems must work toward creating the optimal patient experience, beyond just price transparency. With this, providers should aim to be more engaged and C-suite executives should try to provide additional benefits to their patients.
What Will This Mean for the Future of the Industry?
Only time will tell what the price transparency will mean for the industry. However, it is safe to say that this concept has the possibility to shape healthcare policies and processes for years to come.
So, for more information on solutions that equip you to have informed conversations about eligibility and financial responsibility, contact one of EZClaim’s partners, TriZetto Provider Solutions, to talk with one of their representatives today.
ABOUT EZCLAIM:
EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support. Combined, they help improve medical billing revenues. To learn more, visit EZClaim’s website, e-mail them, or call them today at 877.650.0904.
[ Article contributed by TriZetto Provider Solutions Editorial Team ]
