By Rosemarie Nelson
It doesnt matter how much or how little your practice has invested in a practice management system: if the systems capabilities are not being put to full use, your investment is being wasted. We work, live and play in a world where the goal seems to be do more with less. Yet, many physician practices seem to do the opposite with their computer systems.
If your practice is like most, the medical practice information system you have purchased is a networked system. In addition to dumb terminals that work only with a central disc drive, the network might be linked to one or several personal computers (PCs). (Windows98 is an operating system that allows even nontechnical users to create their own simple networks of PCs.)
Many users of networked PCs fail to use all the tools their PC contains. Every time someone on your staff has to thumb through a card file for a phone number or print out a document in order to fax it, a little bit more of your investment in technology is squandered.
For example, a Windows-based PC can maintain an electronic address book that, when linked with other PCs in a network, can be instantly updated from any terminal. Say goodbye to the well-worn card file of phone numbers thats always on someone elses desk when you need it.
And, most current PCs contain fax/modems capable of sending and receiving documents, even spread sheets, in electronic form.
Use macros. Most word processing software programs, including Microsoft Word and Word Perfect, allow users to create "macros." A macro can save many keystrokes over time by automating a standard phrase or sentence. Even a standard closing to a letter, i.e., sincerely yours, name/title; or "thank you for the opportunity to share in the care of your patient."
Online office notes. Save the electronic files and store each note as an individual file in physician directories. Adopt a naming convention for each file with the patient name and date of service, and voila! You have online, electronic notes available throughout your network. (And maybe even available via modem!)
Shop Cyberspace. Your standard office supplies can be found online and ask your medical supplier about ordering those routine disposables electronically as well.
Get on the electronic remittance bandwagon. The best way to maximize your practice management system in terms of billing is to submit everything you can electronically as often as you can. Accept electronic remittance posting. It may appear cumbersome to set up but will quickly pay off once it is operational. Let your system process the routine payments while your staff follows up on problematic payments.
Payment plans for patients. Establish monthly payment plans and use your accounts receivable management system to track missing monthly payments. Management by exception (MBE) is the most effective use of technology and resources when managing your receivables (probably your second largest asset after your facility).
Store payment profiles. Store in your practice management system the dollar amount of the copayment and/or approved amount you expect to receive for each procedure according to insurance plan. Each month, compare the total actual payments received vs. what you expected to receive. Then, have the system generate a detailed report only of the patients whose claims-expected payment vs. claims-posted payment records show significant discrepancies so you can pursue those with the payer or patient. You need to monitor payments received against the amounts you have contracted to receive from each insurer.
Analyze insurance payments every months. At the end of each month print out reports of payments received by procedure code for each payer during the previous month. Compare the amounts received from the different payers on a procedure code level. Analyze which carriers reimburse adequately for which procedures and use this information to determine the basis for your future relationships with these payers. It is critical to review payment levels in relation to the volume levels of the specific procedures. (It may be irrelevant that a reimbursement is $200 lower from one carrier on a specific procedure if you only perform this procedure a couple of times each year.)
Rosemarie Nelson is a health care information technology consultant in Syracuse, N.Y.
Computer Link welcomes suggestions about future topics for the column and questions about the use of computers in orthopaedic practice. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.