Improvements to the Genesis SOAP note coding
Dr. Brian Capra quickly demonstrates an improvement to the Genesis SOAP notes coding feature. If you click the new button with an arrow on it, then you can copy the diagnosis codes and the procedure codes from your chiropractic documentation SOAP note to the billing claim.
Overcoming Workflow Bottlenecks
Traffic Jams Can running the right reports improve workflow bottlenecks in Dr. Ben’s practice? “Mrs. Wilson!” Pam said, looking up as Carmen came through the door. “Did I hear you talking about me?” Carmen asked her husband playfully. “I was hoping you could come to lunch with me.” “Dr. Ben was talking about our workflow bottlenecks,” Pam put in. “Workflow matters,” Carmen said. “And I think you also should be talking about scalability. Naturally you pay full attention to one patient at a time, but for the sake of the practice you have to be able to look at the big picture and identify the bottlenecks in your workflow.” Pam was silent. “We’re speechless,” Ben said. “I’m glad to see you, of course, but I have no idea what you’re talking about right now.” Pam darted a glance at the patients around them and welcomed a new patient. “Should we be discussing these things in front of them?” she asked quietly when she was free again. “It’s business,” Carmen shrugged. “Your practice is growing because you give your patients excellent care. So you want to continue doing that. How could they object?” She stepped behind the desk and looked over Pam’s shoulder. “For example, can you run a report that shows all the tasks that are coming up tomorrow and who is assigned to do them, and what tasks are still left from today?” “Honey, I don’t think you should be–” Ben began, but Pam stopped him. “I’ll just pull up the list of reports I can run,” she offered. “There’s no sensitive information there.” “There sure are a lot of reports!” Carmen said, her eyes widening. “New Patients, No Shows, No Future Appointments–” “There are lots of patient reports,” Pam agreed, scrolling down the page, “and then we also have things like Inventory, Billing, Patient Balances, Third Party Vendors…” Ben joined them in staring at the screen. “Is that going to help us identify bottlenecks in our workflow?” “I only run a few of them,” Pam admitted. “Mostly, I don’t really know how to set them up the way I want or how to use them once I run them. I think they’re open to interpretation, too, because sometimes they make me think we should do something but the partners don’t agree — sorry, Dr. Ben!” “That’s okay,” he said. “I know what you mean. Often we partners don’t agree with each other, either. It’s like we’re all looking at different information.” “Reports like these are for analysts,” Carmen said firmly, “not for doctors and nurses. You can’t expect to look at a couple hundred lines of a Tasks and Events report and see what you need to do next.” “Plus,” Pam added, “it’s hard for me even to figure out which report to look at. If we’re talking about how smoothly the work goes, I know that a lot of the tasks we do involve multiple aspects of the practice, not just one of the things listed on those pre-made reports.” Ben took his wife’s arm. “We’ll get out of your way now, Pam,” he said, “but thank you for your help.” “How much time do you spend on those reports?” Carmen asked her husband as they walked. “Hardly any,” Ben shrugged. “As Pam said, I don’t really understand how to use them. Plus, I don’t exactly have lots of free time — and I’d rather have lunch with you.” Can running the right reports improve workflow bottlenecks in Dr. Ben’s practice? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Improving Practice Workflow and Accountability
How can Dr. Ben improve workflow and accountability in his chiropractic practice? Ben smiled reassuringly at his patient, snapped the file closed, and headed to the office. “I think I might need a translator for this patient,” he said. “Of course, Dr. Ben,” Pam assured him, picking up her phone. Ben headed back down the hall with long strides, but when he had finished with the patient, he returned to talk with his office manager. “So, Pam,” he began — and then stopped while she answered a phone call and handed a clipboard of forms to a new patient. “Sorry about that,” Pam smiled. “What can I do for you?” Ben lowered his voice. “Would you say things are going smoothly in the office? I noticed that you were able to provide a translator immediately and it looks as though you have everything under control.” “I pride myself on looking like I have everything under control,” Pam assured him. “And mostly I do, even if sometimes I’m like a duck.” “A duck?” “Gliding along the water on top and paddling like crazy underneath,” Pam laughed. “Seriously, I think things are going pretty well. We have issues. What chiropractic practice doesn’t? But overall it’s good.” “What issues do you see?” Ben pursued the question. “Sometimes we have to search pretty hard to find the information we want,” Pam said promptly. “I’m still waiting for that new software we’ve been talking about.” Ben nodded. “I just haven’t gotten around to it.” “And it would help a lot if staff could really know what their daily workload was going to be. Everyone just comes in and waits for me to tell them what to do. If I don’t have time to tell them anything, they don’t do anything.” Pam’s eyes widened. “I think they’d rather be able to take ownership of their work and get the satisfaction of accomplishing things and being part of the team instead of just hanging around in case they’re needed, but the work just isn’t set up that way.” “The work just doesn’t happen that way,” Ben said. Pam’s face alerted him that he had raised his voice and he lowered it again. “Like the translator — we don’t know ahead of time when we’re going to need him.” Pam looked doubtful. “I’m not so sure that’s true. I mean, it’s not like Mrs. Vargas suddenly didn’t understand. Maybe we should have a note in her file. Maybe we should ask people when we make the appointment. Maybe we could even cluster the appointments of people who might need a particular translator.” Ben frowned. “I feel like we’re getting off track here. Isn’t this just one little thing?” “Yes,” Pam agreed, “but every day is made up of those little things. We do some stop gap thing to solve a problem and after a while it becomes what we do. It’s hard to hold people accountable when they never know what they’ll be accountable for.” “I see your point,” Ben said. “It’s like what my wife calls ‘workflow.’ You’re telling me the work isn’t exactly flowing.” Pam smiled. “I’m not sure that’s what workflow means, exactly, but yes, I guess that’s another way of saying we’re just paddling like crazy under the water.” Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Chiropractic Business Tips – Riskiest Investment is a 401K
13 Reasons Why Your 401(k) Is Your Riskiest “Investment” by Garrett B. Gunderson As a financial advocate to business owners, I’ve worked with hundreds of professionals, most of whom diligently save in a 401(k). But when I teach them the following concepts, they’re eager for alternatives. Consider these 13 dangers of 401(k)s: 1. No Cash Flow The theory is that the money compounds, but this really means it stagnates. Most people will not choose to utilize these funds even when a compelling opportunity will make them far more money than the 401(k) would, even accounting for the penalties. Numerous legitimate opportunities are passed by as people stay “in it for the long haul.” 2. Lack of Liquidity The money is tied up with penalties attached for early withdrawal—unless you know how to safely navigate specific, obscure IRS codes for penalty-free withdrawals. 3. Market Dependency The performance of the funds is dependent upon uncontrollable market factors. Therefore, your retirement plans are based on unknowable projections. Do you want to live your ideal life only if the market cooperates? 4. Lack of Knowledge How much do you really know about your 401(k)? Do you know the funds in which you’re invested? Do you know the details of the companies inside those funds? Do you know the fund manager’s philosophy, history, and performance? How can you expect to gain a return from something you know so little about? And how can this be called investing? It’s not investing—it’s gambling. 5. Administrative Fees The funds are subject to various (and usually hidden) administrative fees in addition to expense ratios and 12-b1 fees—a fact ignored by most contributors and advisors. 6. Under-Utilization Because of Tax Deferral If you don’t like paying taxes today, why would you want to pay them any more in the future? The tax deferral aspect, which is touted as a great boon, is actually a primary factor contributing to under-utilization. Most retirees let the money sit for fear of triggering tax consequences. 7. Higher Tax Brackets Upon Withdrawal It’s ironic that people project healthy returns on their qualified plan while also projecting they’ll be in a lower tax bracket at retirement. If you have achieved any measure of success, you should actually be in a higher tax bracket at retirement, although most advisors assume the opposite. Do you think taxes will be higher or lower in the future? Deferring your taxes results in a far greater tax burden than would be incurred using different products and strategies. 8. Estate Taxes 401(k)s are sitting ducks for estate taxes. Much 401(k) money is never utilized because contributors don’t make withdrawals in fear of paying taxes. Yet when the money is passed on to the next generation, there is not only a likely income tax, but also an estate tax. 9. No Exit Strategy Getting into a 401(k) seems simple enough. But how are you going to get out of it? Do you understand the penalties and tax consequences? 10. Subject to Government Control and Change Your 401(k) does not even technically belong to you. Read the fine print and you will find “FBO” (For Benefit Of). It’s technically owned by the government, but provided for your benefit. It’s essentially a tax code. Judging by history, 401(k)s are in great jeopardy. What will keep them from changing the rules and taking your hard-earned money? 11. Disinvesting Suppose you’ve retired and begin taking interest payments from your 401(k). You project you can withdraw 6 percent a year, based on an average annual return of 8 percent. But what happens to your principal when the market is volatile? If in one year your fund is down 10 percent, you’re tapping into your principal to take your interest withdrawal. At that point, you have only two choices: start withdrawing principal leave the money alone until your account is up again. 12. No Holistic Plan I’ve witnessed many people whose finances are in shambles, yet they diligently contribute to their 401(k). It’s like a person trying to take care of a scraped knee when their wrist is slit. They urgently need a macroeconomic plan that identifies, prioritizes, and manages all pieces of their financial puzzle, with all pieces coordinated and working together. 13. Neglect of Stewardship 401(k)s cause contributors to abdicate their responsibility. They think they can just throw enough money at the “experts” and somehow they’ll end up thirty years later with lots of money. And when things don’t turn out that way they blame others. Interestingly, traditional media is finally realizing what I’ve been warning investors about for more than 10 years. For example, see the 60 Minute special, “Retirement Dreams Disappear With 401(k)s” and the Time Magazine article, “Why It’s Time to Retire the 401(k).” Saving for retirement is wise and prudent, but there are other investment philosophies, products, and strategies that would meet your financial objectives much more quickly and safely than a 401(k). Ok, so if a 401(k) isn’t the best option, what is? See how sustainable wealth can be created with investing and get a check-up on how you are currently applying it to your life. Go to www.freedomfasttrack.com/cfw and take our Financial Health Assessment at no charge and learn about our Curriculum for Wealth to get a deeper dive and more answers.