For this small practice, managing from the cloud is key

May 6, 2015

An Expert Q&A with Susanne Tetzlaff, Practice Manager, Austin Cardiac Clinic

The Austin Cardiac Clinic in Austin, TX, consists of one provider, four full-time employees and four contract technicians. At their two locations, they see more than 5,000 patients a year. The clinic utilizes athenahealth’s EHR and practice management solutions.

Q: Independent practice management is becoming a thing of the past, as more hospitals and health systems purchase practices and clinically consolidate. Small practices are also seeking the security and reliability of employment, rather than independent ownership. How has the Cardiac Clinic navigated this powerful industry trend?

We feel lucky to have avoided that paradigm shift in our own practice, because we believe that the best patient care is provided in a personalized environment, as opposed to a more corporate setting. Philosophy aside, our ability to remain independent has a lot to do with controlling our accounts receivable (AR) and staying on top of claims so that we don’t have the financial incentive to sell.

Our collections at Cardiac Clinic have increased, and our ability to know and understand a patient’s health insurance benefits has vastly improved thanks to our cloud-based revenue cycle management partner. We’ve seen our collections improve by 32 percent since the days when we just used an outsourced billing service. We have a first-pass claims resolve rate of 97 percent; our days in accounts receivables went from 34 to 21 days; and 96 percent of all our claims get processed, adjudicated and paid well within the 30-day timeframe.

The financial success we’ve experienced has allowed us to remain independent and stay the course practicing medicine the way we want to, without having a corporation or anybody else standing over our shoulder. That makes us feel good and, hopefully, it makes our patients feel good too. We’re able to offer certain tests and procedures in a much more cost-effective way than if we were partnered with a hospital or corporation.

Q: Personalized care is something that practices give a lot of lip service to but oftentimes don’t have a chance to put into practice. What does personalized care mean for the Cardiac Clinic?

As a practice manager at Cardiac Clinic, I really enjoy my day-to-day interactions with our patients. It’s a great feeling to know that we’ve made a small difference in somebody’s life and cardiovascular health. That’s what personalized care means to us. The reason why I’m able to immerse myself in this front-office interaction is because I’m not tied up on the back end with a lot of difficult administrative billing and software functions. With our cloud-based practice management service, I’m able to focus on patient care and customer service – as opposed to a model driven by the needs of a computer system, billing system, or EMR that’s out of control and burdensome.

Our scheduling tool in particular helps us provide personalized care. It gives us the control we need to manage and adjust Dr. Tiblier’s schedule so he can provide the excellent, personalized care each patient deserves. Cardio patients aren’t just coming in for a simple blood pressure check. They’re complex patients. They require a lot of attention, and they deserve our attention. We can see various provider schedules within one template so that patients who may have multiple appointments and tests scheduled aren’t lost in the shuffle. … Our technology enables that focus on personalized care; it doesn’t distract us.

Q: Meaningful Use (MU) is one of the biggest administrative burdens that practice managers complain about? Are you spending your days checking boxes?

One of the primary reasons we chose (athenahealth) was because of the guarantee that they offered – that doctors who signed up were guaranteed to meet the Meaningful Use criteria. By simply following along with the platform and the program, we were able to attest to Meaningful Use Stage 1 and 2. The qualifying criteria are complicated and require a lot of attention. It would have been extremely difficult for a practice like ours to try to conquer MU without vendor support. On the one hand, our vendor supports us with an intuitive platform that guides us through the necessary data collection during the clinical encounter. On the other, it marshals an entire account management and professional services team to benchmark our performance and coach us over the finish line

I think most medical practices are finding that the most difficult aspect of MU Stage 2 relates to the requirement that patients contact or communicate with the practice outside of the office encounter electronically. Our vendor has definitely made that process easier for us and for our patients by allowing them to access the patient portal.

Q: We have access to more patient health information than ever before, but healthcare is still struggling to find meaningful ways to integrate and act upon it. What does information availability and accessibility look like at the Cardiac Clinic?

Both the clinical and administrative staff at Cardiac Clinic appreciate the ability to access patient information quickly and efficiently within their workflows. Front-office staff can set appointments, schedule, bill and follow up with insurance.

The clinical staff … has benefited hugely from the accessibility of patient data. They can look at the patient’s health history and assist Dr. Tiblier in making clinical judgments and decisions about each patient’s individualized care. But most important is the ability to take that information on the go. Healthcare doesn’t happen in one exam room. We have a practice in Austin and a satellite location in Lakeway. It’s not atypical for Dr. Tiblier to round at two or three hospitals in a day. Tracking patients, referencing their charts as well as transferring records to other providers is all seamless with our mobile tools. We can provide care here in the office, in the hospital or in what Dr. Tiblier jokingly refers to as his “mobile office.” Being connected to information wherever you go is critical.

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