Michele’s Thoughts on Time Management

Wow! I can’t believe that we are already to the end of January! This year is already flying by. Alice and I have so many ideas and so little time to implement them. What it all really comes down to is time management. I’m sure you’ve all heard how important it is, yadda yadda yadda! Well guess what? It is not just important it is crucial! I recently heard a quote – “Everybody ends up somewhere, but not everybody ends up somewhere on purpose.” That means if you don’t decide where you are going in your business and how you are going to get there then you will just float aimlessly along without any control. Leaving your destiny up to chance. How do you prevent that? Decided what you need to be doing, when you need to be doing it, and how you will get it done. Each day you MUST decide what is important to get done that day. Leave time for those ‘fires’ that arise because we all hav e them. Unplanned emergencies that must be handled, but if you leave time for them they are not so disruptive. Another good quote I remind myself of often is “situations don’t cause stress, how you react to the situations causes stress”. Don’t get stressed out about things. It will only rob you of more precious time. Keep a list of your things that you need to do, continue to update it constantly, and don’t beat yourself up if you get off track. Just re-plan your route and get back to work. Remember, if you don’t decide what you will be doing, somebody else will decide it for you.

Use EMR Free and Pocket $44K

Sound to good to be true? I’ve always said there is no such thing as a free lunch, but I think I’ve found an exception to that. With all the talk about EMR and the deadlines for switching, I finally took some time to do some research. We are strictly a billing office, so we aren’t directly affected by EMR, but our providers are! So it will affect us to, in the long run. Anyway, what I found out was quite interesting.

There are MANY EMR companies out there. The prices range from upwards of $20,000 down to – believe it or not – free. When I first heard of the free ones I was a little skeptical, but I’ve actually talked to some providers using the free ones. They are quite happy. Of course the first question is “how can they offer EMR for free?” “It must be a limited version!” Well actually, what they do is sell advertising on the EMR, so while you are using it, a one inch banner of ads will be also displayed on the screen. If you don’t want to see the one inch banner then you can pay a small monthly fee to not have the advertising on the screen. The providers I spoke with didn’t mind viewing the one inch banner. They said they don’t even notice

So ok, I can understand how the free works, so my next question was, “does it qualify for HITECH?” HITECH, Health Information Technology for Economic and Clinical Health Act, is part of the $789 billion economic stimulus package that President Obama signed into law on February 17, 2009. Under HITECH, physicians can qualify for up to $44,000 in Medicare EHR incentives if they demonstrate Meaningful Use of a certified Electronic Medical Record system. In a practice with three eligible providers, the incentive would total $132,000 across five years.

So do these ‘free emr’s’ qualify for Hitech? Well, the ones that I looked at did! Basically the government defines what “meaningful use” is and what you need to make sure is that the EMR you are using is ONC-ATCB 2011/2012 compliant and is certified as an EHR Module in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services (HHS). Now I don’t know what makes it ONC-ATCB 2011/2012 compliant, but it is important that if you are looking to qualify for HITECH that you make sure the EMR program you are choosing has been certified. It should be clearly
posted on their website, or in their information.

If a provider qualifies for HITECH, the incentive is paid out over a five year period, starting with $18000 being paid the year the EMR is adopted.

OK, so the last thing you may be wondering is “who are the free companies?” Well, I cannot personally vouch for these as I haven’t used them directly, but I have had a couple recommended by providers. I will give you the web addresses, but I strongly urge you to do your homework and check them out before jumping in. You can find others by googling “free EMR software”



Mental Health Billing Made Easy

Our Newly Expanded and Revised “Mental Health Billing Made Easy” is this close (ll) to being released. (that’s close) 🙂

Seriously, we will be sending an email next week announcing that it is ready. We were shooting for this week but I guess I should have read Michele’s article below on time management as I didn’t quite make it.

We added several chapters including neuropsychological testing, EAP visits, nursing home visits, billing medications, secondary and tertiary claims, and denials and appeals. This book also contains 20 completed claims for mental health with an answer key.

We will send a free link to the new revision to anyone who purchased the book in the past year. If you’ve purchased our “Mental Health Billing Made Easy” or our “Mental Health Big Pack” in 2010 we will be sending you a link to the revised version absolutely free of charge. Make sure you download your copy within 24 hours of receiving it as it has a ton of new information for you.

PS A special thanks to Linda Walker for looking it over and adding her suggestions.

New Medical Billing Service Needs Help

As a billing service we often receive emails, phone calls or letters like the following email I recently received. (copied and pasted. You can’t make this stuff up!)

Hi everybody,

This is sharan from India am looking for starting an BPO jobs at my native, i have 4 year US medical billing experience , right now i have 10 sys with men power. if you ready give a one medical billing project i’ll ready to start with happiely medical billing outsource with you great support.
First am looking for Demographic entry project or payment posting project for time being with building confedental with youself and myself,


Personally we do not feel that it is a good idea to send our jobs to other countries so I am usually offended by this type of communication. But when I look at it from a marketing position I just have to laugh. I could send this email to 1000 or 10,000 people and not expect to get one response. Is poor Sharan sitting there in India thinking “Oh dear! No one sent me any work. What will I do with my 10 sys with men power? Why did no one send me their work? I hope I didn’t waste my 4 year US medical billing experience”.

Why You Need a Compliance Plan

Most billing services know and understand the importance of having a well written contract but not all realize that they also should have a compliance plan in place. A compliance plan is for the protection of both the billing service and the provider and it defines the policies and procedures followed by the billing service. Each provider that they bill for should be given a copy of their compliance plan, and the plan should be reviewed on a regular basis. Improper billing practices can lead to civil or criminal offenses.

More and more providers are turning to third party billing services due to the complexity of billing. Some third party billing services also provide coding and other services as well. It is important that the provider is aware of the third party billing services policies and procedures regarding claims submission and coding. It is best that the policies and procedures are outlined in writing to protect both the provider and the billing service.
In 1998 the Office of the Inspector General issued a guideline for compliance plans for third party billing services. The complete guideline can be found at http://oig.hhs.gov/fraud/docs/complianceguidance/thirdparty.pdf .

This guideline includes general principles that can apply to any compliance plan as well as guidelines specific to third party billing services. It identifies risk areas specific to third party billing services such as billing for services not documented, unbundling, upcoding, and inappropriate balance billing. There are seventeen specific risk areas identified.

It also suggests seven steps to prepare an effective compliance plan. The suggested steps are:
Step 1 – Implement written policies, procedures, and standards of conduct. A billing service should determine what and how services will be performed and write it down. All billing services know what they do and how they are going to do it, this just puts it in writing. It is a good tool not only for the provider, but for employees of the billing service as well. Employees need to follow the policies and procedures and it helps if they are in writing. If issues arise, the owner or manager can refer back to the compliance plan.

Step 2 – Designate a Compliance Officer and compliance committee. HIPAA mandates that any person or company handling PHI must have a designated compliance officer. Even if you are a one person show, you should be designated as the compliance officer. If the organization is larger, there should be a compliance committee as well. Any complaints or concerns would be addressed to the compliance officer. If there is a compliance committee then the issue would be brought to them by the compliance officer. The compliance plan should include the name of the compliance officer and contact information.

Step 3 – Conduct effective training and education. All billing services should have some form of training for all employees. They should also have ongoing education on any new issues or policies that arise.

Step 4 – Develop open lines of communication. Communication is the key to success. A compliance plan should encourage communication. Contact information for any owners or employees that would be appropriate for a provider to contact should be included.

Step 5 – Enforce standards through well-publicized disciplinary guidelines. In a perfect world this wouldn’t be needed, but unfortunately there will be occasions where policies and procedures are not followed properly whether it was intentionally or not. It is important to have written guidelines for how infractions will be handled.

Step 6 – Conduct internal monitoring and auditing. Again, in a perfect world this wouldn’t be needed. But, even the best of employees may make mistakes. It is important that monitoring and auditing is done on a regular basis to make sure that policies and procedures are being followed. When included in the compliance plan it assures the provider that the billing service is aware of what is going on internally.

We once had an employee who was a star from the beginning. She was young, smart, quick, quiet – had some great qualities. Unfortunately her work started slipping and one day she came to us complaining about another worker. She stated that we really didn’t need the other worker as she did that other girl’s work anyway and the lazy one spent all day in Facebook and hotmail. We investigated what all our workers were doing on their computers and guess what! The snitch was the guilty one. But the bigger problem was her work. She wasn’t handling her work to our standards. We found a patient bill she falsified just to make the bookkeeping numbers end up correct. This not only goes entirely against our way of handling things, but could be interpreted as fraud. We fired her on the spot. She packed up her desk and went home.
We can be very trusting but we now monitor our workers much closer. This is a must in every office, especially a medical office.

Step 7 – Respond promptly to detected offenses and develop corrective action. When an offense is detected whether it was discovered internally or reported, it is important to respond promptly. Spelling out the actions that will be taken is effective for both the provider and for the billing service.

If you do not currently have a compliance plan you should implement one as soon as possible. The above list of suggestions should help. When your compliance plan is complete make sure you give a copy to each of the providers you bill for.

Protect Your Business With This Valuable Tip

As our business grows we find more and more things that either change or situations that appear that require changes to our business. Whether you are a medical office or a billing service, things are always changing and it is necessary to find new solutions to problems and challenges that arise.

Something that is often not thought of when an office is small and has just a few employees is a non-compete agreement. But as you grow it is much more sensible to consider the problems that can arise as a result of not considering this agreement.

Our Big Lesson

Once your office is hiring employees you really need to consider a non-compete agreement. We once had an employee who had been with us for over five years decide she did not like a new employee we hired. Our new employee was with us only two weeks when the five year employee called our largest account and asked for a job. She didn’t discuss it with us or admit what she had done. To our surprise two weeks later our largest account called us and told us they had hired her. It is amazing how quickly someone you considered a trusted employee can become a threat to your existence. Three months later the account terminated our agreement to do the billing in-house.

We immediately wrote up a non-compete agreement and asked all our employees to sign it. If they were not willing to then they no longer had a job with us.

When you work with the same people every day you consider some of these people your friends as well as your co-workers. We usually spend more time with our fellow employees than we do with our spouses. It is difficult to believe that some people will do the things that some people will do. Having a non-compete agreement can prevent hurt feelings and a damaged business.

Thanks to one of our readers we were notified that in California non-compete agreements are not generally enforceable. So you might want to check with your attorney.