Overcoming practice management challenges

So what’s “the right approach”?

That’s different for every practice, but here are a few strategies that I see working in the real world.

Keep patient satisfaction at the forefront

Small and medium-size practices are dependent on – and driven by – word of mouth in a way that larger healthcare organizations aren’t. Successful, well-established practices have earned trust within the community, and in all likelihood, their patients are doing the bulk of their marketing (in the sense of recommending them to family, friends, and colleagues).

Using patient satisfaction as the starting point ensures that you build on and enhance that trust, so that the practice doesn’t lose existing patients or inadvertently dampen the enthusiasm of those who are its best advocates.

Train staff to have effective financial conversations with patients

Asking for money isn’t easy, and it’s something a lot of healthcare employees might not be comfortable doing – especially when it’s a new part of their workflow. Staff who aren’t used to having financial discussions with patients may avoid doing so because they’re afraid of offending patients or making them upset.

The right training can help your staff understand how offering details about out-of-pocket responsibility benefits patients. People will always be happier knowing what they’ll have to pay before the visit, as opposed to being surprised by a bill for a previously undisclosed amount later. In fact, it’s only after debt goes uncollected for too long that the organization must turn to more aggressive tactics that negatively impact patients – and the provider’s reputation.

One recommendation I consistently hear from clients is to first conduct an audit of collections best practices in your organization. What should staff be saying? Are they saying it? Is it working? This exercise helps management identify key role-playing scenarios – and clarifies whether staff would benefit from refresher training, or whether instead current best practices simply aren’t working and need to be updated.

Regardless of whether you choose to conduct a communications audit, you should give staff tips on how to initiate and conduct effective financial discussions with patients:

• Address the patient by name to make it clear that you value the person and to make the interaction more personal.
• Don’t ask patients if they are going to pay or want to pay – ask how they would like to pay. The former method lets the patient easily say they’d rather wait, while the latter will focus the discussion on the best form of payment.
• Have options ready if the patient is hesitant. It’s helpful if staff members are aware of all the options so they can describe them to patients and help people choose what works best for them. Options make patients feel more empowered, giving them more of a say in how they meet their financial responsibility.

Even those patients who might be surprised by the request for payment at the point of care can recognize the benefit of receiving an accurate estimate (as opposed to waiting some undetermined amount of time to be billed some unknown amount) and are usually open to paying up front once they understand what’s behind the request. That’s why the right tone and approach remain critical to the patient collections process. Helping your patients understand why you’re providing estimates and collecting at the point of care helps them appreciate your efforts to be transparent and patient focused.

Convenience matters. It communicates to patients that you understand their time is valuable and that you appreciate their loyalty as consumers. Tactfulness matters. It demonstrates to patients that you understand the challenge of balancing multiple types of financial obligations, and it also communicates that you trust them to pay what they owe and be straightforward about what payment plan works for them.

Now let’s shift gears and talk about strategies to address back-office challenges, and the role of vendors overall.

Improve your denial management

Denial management continues to be an industry-wide challenge, yet studies show that 90 percent of denials are preventable, and nearly two-thirds are recoverable.

A few tips:

• Optimize your denial workflow: There is a great need to streamline the workflow for denials to identify root causes and to research and respond to denials in less time. You must find a way to help reduce the research time and provide the ability for your staff to effortlessly resubmit denied claims.
• Gain visibility into performance to reduce bad debt: Once you gain deep visibility into the performance of your staff in working denials, you can measure and motivate individual successes or challenges, and address the root issue or cause. This will also allow management to strengthen control of bad debt by approving write-offs exceeding thresholds.
• Automate prioritization of denials: In order to effectively manage denials, you must focus your efforts on denials with proven success. You want to identify the type of denial with the largest financial impact, so that you can focus on those first. By gaining insight into payer-specific denials, you can then tailor your approach to payers and have the ability to avoid payer-specific errors.
• Know the root cause and prevent revenue leakage: Control and grow your margins by gaining visibility into root causes of your denials across payers, preventing revenue leakage by addressing the issue and prioritizing denials by their potential success rate.
• You have to know, understand, and apply root-cause data-driven workflow changes: Why did we get this denial? Is your staff doing what they should be doing? What are the payer-specific tendencies and repeat habits?
• Improve the speed of the collection process: An effective way to reduce denials is to be aware of a consolidated view of denial history activity and to follow the full story of what happens with the denial.

Find a partner, not just a vendor

Your vendors should be proactive; they should be reaching out to you every time they see a way you could get more value out of the software or services you’re already paying for. They should also be speaking with you on a regular basis about how their offerings could be improved: What would make the products work better for you? What aren’t you currently able to do that you’d like to be able to do in the future?

If they aren’t, that could mean one of several things:

• They don’t believe in what they’re selling.
• Their organization isn’t structured in such a way as to reward client satisfaction; it’s a “sell it and forget it” culture.
• They don’t have a mechanism in place (or don’t trust the mechanism they do have) to translate client feedback into enhancements, new offerings, and the long-term product roadmap.

In short, they aren’t focused on being your long-term partner. If they were, one of their top concerns would be where you’re headed and what you need to help you get there.

Here’s how a client explained it to me recently:

“I can run financial and other types of reports nine ways from Sunday. I can spend hours and hours trying to find the richest vein of additional revenue to help my practice, or the most impactful cost-containment strategy for us. But my feeling has always been, if I have to do all of that, what the heck am I paying a vendor for?

“I don’t want a vendor who just throws a bunch of data at me and expects me to do the work of interpreting it. I want a vendor who shows me the opportunity and backs that up with data that is rooted in my practice and the patients we serve. I want a vendor who is willing to sit down with my team and walk through – patiently, simply, and clearly – exactly what we can do to address a challenge we’re facing. I want someone who helps me use their products rather than just checking in to see ‘how it’s going.’

“Our practice doesn’t need a vendor – we need a partner. Once we committed to that, selecting the right vendor was actually pretty simple.”

Find a real partner. That may be the best advice of all when it comes to addressing practice management challenges.