Compliance | Reducing Documentation Time
A case of writer’s cramp Is there a way for Dr. Ben to spend less time on documentation and more time with his patients? Ben sat at his desk shaking out his hand, which had cramped up after 10 minutes of concentrated writing. He knew how important it was to provide accurate documentation of patient visits but capturing every detail in writing, then making Luisa type it into the computer, was eating up valuable time for both of them. Plus, Luisa was forever complaining about his handwriting, which he admitted was difficult to read. There was a knock on his office door. “Come in!” he called. Luisa entered with a smile. “Hello, Dr. Ben, I was wondering if you had a moment,” she asked. “Of course, Luisa, what’s on your mind?” Ben asked. “I’ve been working on entering your patient notes from last week and it’s taking me a long time,” she explained. “I know you try to be thorough but there are times when I need to extrapolate certain tidbits of information based on what I know about the patients.” “Well, we’re all taught when we go into medicine that if we don’t write it down, it didn’t happen,” said Ben. “I do try to capture every detail I can.” “And I do appreciate your efforts,” said Luisa. “But I’m not just dealing with the SOAP notes – I need to include images, forms – such as Medicare, intake and verification of benefits – lengthy tests and more.” “How much time would you say this is taking you in any given week?” asked Ben. “I haven’t tracked my time but it takes hours,” said Luisa. “Not just in typing and attaching related documents, but also in touching base with you when I have questions that I can’t figure out from your notes or past patient records. That takes time away from your day – and your patients – as well.” “It used to be so much simpler,” mused Ben. “When I opened this practice, I could scribble myself some notes, stuff them in the patients’ paper files and forget about them until the next patient visit. I was able to spend so much more time with my patients!” “It’s not just about spending time with the patients,” said Luisa. “Our goal is to help patients get better, and to feel so much better that they feel compelled to bring family and friends who may be suffering to see you as well.” “That’s true – we need happy, referring patients to make the practice grow,” agreed Ben. “I wish there was a way to keep accurate, compliant notes in less time.” “You mean besides taking that handwriting course I’m always nagging you about?” teased Luisa. Is there a way to reduce the investment of time in documentation so that Dr. Ben can focus on his practice and his patients? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Revenue | Getting Started with Billing Software
Prepare for Launch! Getting Started with Billing Software. Dr. Wilson and Luisa make final preparations to dive into their Genesis adventure together As Ben sipped his coffee and checked his email, Luisa peeked her head into the doorway and asked, “Are you ready, Dr. Wilson?” Ben smiled and said, “I’m not sure, but let’s go ahead anyway.” Luisa dialed the phone number for Charlie, their Genesis coach. After a couple of rings, Charlie picked up on the other end. “Good morning,” he said cheerfully. “So today’s the big day!” “Hello Charlie,” laughed Ben. “It sure is. And I think we’re finally ready.” “Then let’s get started – we’re going to talk about the features of Genesis that will be most useful for your practice and offer that final bit of reassurance that you’re doing the right thing,” Charlie said. “They don’t call me the King of Practice Success Coaching for nothing!” “OK Charlie, we’re ready,” said Ben. “Let’s go through this one last time.” “Let’s start with the ‘why’ of the Billing Stats Report, and relate it to some of the challenges you may be experiencing in your practice,” Charlie said. “You’re doing pretty well financially but have you ever experienced any sudden drop-offs in revenue that you couldn’t easily explain?” Luisa and Ben looked at each other and could remember several occasions when that was the case. Just a few months ago they had seen a significant and disturbing reduction in revenue and it had taken weeks of going through billing records, manually, to learn that Pam had been writing the wrong billing code on a number of Ben’s patient files. Every single one of those claims was delayed or denied outright. They were still trying to get some of the accounts sorted out. “Yes, we’ve found it very difficult to troubleshoot issues with reimbursements,” admitted Luisa. “And it’s not always the insurance companies’ fault – getting even one number wrong in the coding or forgetting to include important documentation can really impact our success in collecting what we’re owed.” “Exactly, it’s about achieving billing compliance AND payer compliance,” Charlie said. “But it’s important to recognize that the insurance companies are not going to give you a step-by-step reporting on the progress of your claims – it’s better for them if you’re not able to stay on top of the process.” “I’m sure I’ve mentioned to you before that the chance of getting paid on a claim decreases by 1 percent with each passing day,” he continued. “That 1 percent adds up really quickly when you’re talking about an entire practice’s worth of patients and numerous claims.” Ben and Luisa both had to swallow hard at the thought of the tens of thousands of dollars they had lost due to reimbursement issues. “It really is amazing the detail you can get,” Charlie said. “The reports are customizable to your particular needs and will tell you where problems are – whether on your end or the insurance company. Perhaps there are two codes on a claim that don’t quite go together, or a clinician forgot to include some demographic information in the claim … or maybe an insurance company is consistently underpaying certain CPT codes, or pushing the boundaries of its accounts receivable window. You can’t fix problems until you know what they are!” “That’s true,” said Ben. “I definitely don’t envy Luisa – she’s been an incredible investigator when it comes to solving cash flow mysteries but the time she has needed to dedicate to these investigations has definitely taken crucial time away from other office management needs.” “If the roots of billing problems were easy to find, we’d be able to deal with them quickly and decisively,” said Luisa. “You know how I love to have a plan!” Ben nodded and smiled. “And it’s not just insurance companies,” Charlie said. “You can stay on top of private payers, as well, and make sure that your patients are on track with visits and billing.” “That would be really helpful,” said Luisa. “We’ve had several patients who were significantly behind and once we figured out where their accounts stood, it was a real financial hardship for them to try and catch up all at once.” “But it’s not all about reimbursements – what’s great about Genesis is that it provides you with a checklist for all of your performance indicators, such as unbilled visits, patient visits, no shows, unfinished claims, or any other success measures you’d like to track,” said Charlie. “Another great feature is the radar chart, which allows you to see certain areas within your practice where attention may be needed,” he continued. “You can set parameters, such as new patient numbers, so that you will know if you’re not meeting your goals. Once you’ve set the desired parameters for a number of performance indicators within your practice, then you won’t need to refer to the Billing Statistics Report – unless the radar indicates there is a problem with performance. Between the radar and the Billing Statistics Report, you are going to be firmly in control of your practice’s financial health and performance.” “This is incredible,” mused Ben. “Being able to focus on building this practice instead of worrying about when reimbursement checks are going to arrive? I really didn’t think it was possible.” “I know you’re still probably a little intimidated about getting started but let me offer this final testimonial: In the past three years, my clients have seen average revenue growth of over 186 percent, patient visit growth of over 141 percent, and an 86 percent increase in patient visit compliance,” Charlie said. “Your patients will have more buy-in with regard to their own health care, you will have less administrative work to slog through, you will collect more money and – best of all – you will be able to spend more time with your patients.” “Well, that’s what we’re all here for,” said Ben. “Let’s do this!” Is Genesis the solution Ben’s
Revenue | Committing to a Software Solution
Much Ado About Data Committing to a Software Solution Can Dr. Ben move past being overwhelmed by data and commit to Genesis? As he made his way into work on Monday, Ben was preparing himself to take the next step in his Genesis journey. He knew that the software was going to help in innumerable ways, from records management, to tracking insurance payments, to helping to get patients reinvested in their own care plans. But with reports come data – a TON of data – and what on earth were he and Luisa going to do with all of those numbers? “Good morning Luisa,” Ben said as he entered the office. “Hello Dr. Ben – how was your weekend?” asked Luisa. “It was great,” Ben answered. “Carmen and I tried out the new downtown Indian buffet. It’s really good – and I even have leftovers to enjoy for lunch today!” “Hopefully Jonathan found something he liked to eat, too,” said Luisa. She stopped for a minute, then continued, “So… have you given any thought to moving forward on Genesis?” Ben sighed. It was going to be difficult to put this off for any longer. “I know, I know, we shouldn’t wait any longer,” he said. “Before we get started, I’m going to call our coach, Charlie, and ask her a few questions.” “Let me know if there’s anything I can do,” said Luisa. Ben placed his lunch in the refrigerator and then went into his office, closing the door. He stared at the phone for a minute and then laughed at himself. Boy, change can really be hard, he thought. He picked up the phone and, within a minute, he was connected with his Genesis coach, Charlie. “How are things going, Dr. Ben?” Charlie asked. “Well, we’re doing fine but … I have to admit, we understand that this software is going to help us manage the office more professionally and efficiently but we’re having trouble taking that last big step and rolling it out,” Ben admitted. “Oh, you’re not alone,” Charlie said. “Ask me anything – we’re here to help!” “I guess we’re overwhelmed by all the data,” said Ben. “Neither Luisa nor I are number crunchers, and the reports can get so complex. How can we be sure that this is going to help us, rather than adding to our already busy workdays?” “One of the wonderful things about the billing stats report is that it will help you to create consistent, repeatable processes for collecting patient information and assessing billing performance,” Charlie said. “It might be daunting looking at the possibilities from the outside in, but once you’ve got things set up, it will actually help you to get a handle on your office cash flow and more easily identify where – and why – things are being held up in the reimbursements pipeline.” He continued, “Have you ever looked at your revenue stream over a period of a few months and seen a decline, and panicked? With the billing stats report, instead of trying to go patient by patient, week by week, month by month, and guess what the problems are, you can actually run reports with up to 45 different parameters and pinpoint where exactly in the process things are breaking.” “I don’t see how that is possible,” protested Ben. “Let me put it this way: you can run a 60-day report and get a breakdown of the status of each claim,” said Charlie. “If the claim is not at the insurance company, then you’ll be able to figure out if you’ve got an intake problem, if your claims are going out in a timely fashion, or if there are issues with the information you’re sending out with the claim. You can also look at which CPT codes are getting paid or underpaid. With the power of accurate statistics, you can have the right conversations with front desk staff, your office manager and billers.” “What’s also great is that with the radar chart, you can set parameters for your practice,” Charlie continued. “If you get to a point where everything is within the parameters you’ve set, then you will render the billing stats report unnecessary. That’s a terrific thing about Genesis – we help you achieve best practices in your office management so that you can be in control of your practice and focus more on your patients.” “That’s exactly what we want,” said Ben. “I don’t know anyone who went into medicine so that they could spend most of their day staring at a computer screen!” “But do you want to hear the most wonderful thing of all about Genesis?” Charlie asked. “Of course,” said Ben. “Whenever you have a question, a concern or simply want to talk through some numbers that don’t seem to make sense, you can call me,” Charlie said. “We are committed to being here when you need us.” “Well, that is the most wonderful thing I’ve heard all day!” laughed Ben. “I can’t thank you enough for your time today.” After a few more minutes of small talk, Ben emerged from his office and walked toward Luisa, who knew just by looking at him that change was afoot. “That must have been some phone call,” said Luisa. “It was,” smiled Ben. “I think we’re ready to begin our Genesis adventure – together!” Is Dr. Ben ready for launch? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Revenue | Automating Billing Reports
Where Should We Go Tonight? Can Dr. Ben make the commitment to automate his billing reports and take control of his office finances? Ben and Carmen were having a familiar conversation: what should we do about dinner? They had both returned home from busy days at work, both were a little frazzled and hungry and – as usual – the refrigerator was lacking in appetizing options. “I’ve heard that the new Indian buffet is very good,” said Carmen. “But it’s downtown and it’s almost 6:30, so there might be a bit of a wait.” Ben thought about that. “That sounds delicious and we should definitely get there at some point, but I’m too hungry for a long wait. Why don’t we just go grab some Chinese at our usual place – there’s never a wait there.” “You know, Ben, we’re never thrilled with our meals there and we’ve tried everything on the menu,” Carmen said. “There’s a pretty good reason why there’s never a wait there.” They looked at each other testily for a moment – hunger and a lack of accord might become a threat to their nice evening out. Just then Jonathan came running out of the living room and hugged Ben, happy to see his father. “Daddy, you’ve got to see my new art book – I drew all of the pictures myself!” “Of course, Jonathan, I’d love to see it,” Ben said. “Listen, Carmen, I’m going to look at Jonathan’s artwork and then we can go try that new restaurant downtown. It sounds like fun.” He went into the living room with Jonathan and sat down on the couch with him. He wondered why he was so irritable this evening as he turned the pages of the book. Ben’s thoughts kept returning to earlier in the week, when Luisa explained the difficulty she was having keeping track of the office finances. Too often they were surprised to learn that some patients had accounts that were past due. And between varying accounts receivable windows and some insurance companies that were dragging out the reimbursement process due to even minor errors in data entry, it was making confident budgeting impossible. Ben pondered how difficult it was for him to keep track of crucial patient information until he put a system in place. Between his voice recorder, written notes and meticulously organized files on his computer, he felt confident in his mastery of the most important details for each patient. But then he thought about how many areas of office management that Luisa was expected to stay abreast of: office supplies, scheduling, working with outside vendors, insurance reimbursements… her plate was truly full, even with Pam’s able assistance. And considering that third parties don’t always respond when and how you want them to, the level of complexity and the time it takes to handle each task can be multiplied exponentially. Carmen – who had a business degree and always seemed to be several steps ahead of Ben in understanding the ins and outs of finance – and he had talked about the program that could automate many of the functions of his office and Ben had been serious about actually following through and implementing it. But there always seemed to be a crisis to attend to… trying to collect from patients who owe balances beyond a certain date, trying to figure out where long-overdue insurance reimbursements were. Ben knew when he started his practice that it wouldn’t only be about attending to patients – he knew there would be crucial administrative work that would have to be handled by his staff. Luisa had certainly had shown she understood the benefits of having data to inform business decisions. But customization is key when reviewing large amounts of detailed data and it didn’t seem like Luisa was tapping the full potential of the system when it came to the billing reports. Ben knew that there were reports that could be broken down in a number of different ways and could be endlessly customized so that they could stay on top of potential problems. Well, maybe we should take some time to figure it out together, Ben thought. Without getting these reports done – and done right – we really have no idea how well our office is functioning. This sounds like something we should talk about on Monday. But first he wanted to enjoy a nice dinner with Carmen and Jonathan. He appreciated how Carmen listening to him talk about the various issues in his office, and she often responded with some great feedback. That business degree had served both of them well over the years. When Ben had finished looking at Jonathan’s artwork and congratulating him on being the next Rembrandt, he found Carmen in the hallway, ready to go – her purse in one hand and a small lunchbox in the other. “What’s in the lunchbox, Carmen?” Ben asked. “Well, since you’ve agreed to my pick of restaurants, I wanted to reciprocate by packing some snacks for the drive so you won’t be starving while we wait for a table,” Carmen said with a smile. “I’ve got some fruit, cheese and crackers, and your favorite – cashews.” Ben took Jonathan’s hand and smiled at Carmen, who never failed to make even the most hectic and frustrating day better. “We’d better get going,” he said. “Maybe we can be on the lookout for a new Chinese place on our way there.” Both were laughing on their way out the door. Can Dr. Ben make the commitment to automate his billing reports and take control of his office finances? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Revenue | Understanding Practice Cashflow
Revenue Matters Can Dr. Ben stay on top of his practice’s revenue stream – and help his patients to manage their health care costs – without accurate and customizable reports? Dr. Ben walked out of a treatment room whistling, feeling great about the session. His patient, Ryan, had come a very long way since the car accident and was actually going to return to work the following week. But he stopped cold when he saw Luisa sitting at her desk with her head in her hands. “What’s wrong, Luisa?” asked Dr. Ben with concern. “I know that I’m pretty good with numbers but some days I can’t make heads or tails of where our finances stand!” Luisa said bitterly. “Tell me what happened and let’s see if we can talk this out,” encouraged Dr. Ben. Luisa explained how frustrated she was with the insurance reimbursement process. Since they were still generating reports by hand, she never felt as though she had control of financial matters. Some insurance claims were dragging out for months and, without being sure of when reimbursements might come, she was having difficulty budgeting – or at least budgeting confidently – for other office expenses. “I was positive that the claims for Christine Jackson and that handsome young teacher, John Santos, would have come through by now, so I went ahead and began the process of purchasing a new copy machine,” explained Luisa. “You know how frustrated Pam gets when you ask her to copy home care instructions for new patients. But the claim hasn’t come through and we’ve got other major expenses coming down the pike. I just don’t feel like I’ve got a handle on our finances at all.” Dr. Ben was quite troubled to hear this. The practice was in good financial shape but she had never imagined that tracking insurance reimbursements might cause such trouble for Teresa, who worked so hard to keep the practice’s financial status pinpointed precisely. “Well, don’t you know by now how long each insurance company’s accounts receivable window is?” questioned Dr. Ben. “It’s just not that simple!” said Luisa, exasperated. “We accept more so many different types of insurance, and each of those companies has plans with various levels of coverage. Plus, you know that some companies are just a lot less helpful than others, so even the smallest error in the treatment code or a line left blank can hold the process back for weeks!” Dr. Ben thought about that for a minute. It really was unfair to expect Luisa to track all of these things manually. “The worst thing is that some of our patients are really struggling to pay their bills but, by the time they really understand what their care plan might cost, it’s almost too late for us to even try and help work things out for them,” Luisa finished. The two looked at each other uncomfortably, Dr. Ben’s satisfaction in his recent treatment session forgotten. He wished he could simply focus on what he loved to do – to help people feel better – instead of worrying about administrative issues. And he hated to see Luisa so upset. Might there be a solution to the insurance reimbursement issue at 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.
Software Addresses Practice Workflow Issues
Ready to Order? Is Dr. Ben ready to take the plunge on practice management software? “I don’t get it.” Carmen gazed at her husband across the table. “You find this software — what’s it called?” “Genesis.” Ben looked up from the menu. “Genesis, which will simplify your workflow, let Pam do her job better, and free up your time to concentrate on the patients, which is what you really care about — and you don’t buy it. “I haven’t bought it yet,” Ben corrected her. “I think the decision’s pretty much made.” “It has a dashboard, right? I know that was something that you wanted in your practice management software.” “It does. It’s awesome, too — easy access current practice stats, month to date daily progress, all the patient information, and then it’s easy to get from the data to the actions the team needs to take.” “From what you’ve told me about it, it seems as though Vericle really empowers the staff. They get to see their importance as partners in patient care.” “That’s what the Vericle people tell us.” Carmen nodded. “I’ve seen the difference it makes when your team really feels like a team. You might think you’re giving away some of the power, but giving people responsibility and accountability and making sure everyone understands his or her place in the mission of your business — it’s amazing how much difference that makes.” “I believe you,” Ben said, “and it’s certainly not a question of worrying about giving away power.” “What is it then?” Carmen leaned forward. “What’s keeping you from taking that step?” “There are costs involved,” Ben said, “and change, and I’ve gotten a lot of pushback from some of the partners.” “Tools cost money,” Carmen agreed, “but they’re an investment in your business. They pay off in the long run, if you choose the right tools. In this case, it seems like you’d see an increase in productivity.” “Maybe,” said Ben, his eyes back on the menu. “But what if it doesn’t work?” “What if it does — and you don’t try it?” Carmen waited for Ben to look up at her. “If you’re going to do it eventually and you expect it to have a positive ROI, waiting just means you’re losing money and opportunity until you take action.” Ben thought about how much he’d already learned from the people at Genesis Chiropractic, and the changes he had already made in his practice — and the benefits he’d already seen. Why was he still waiting? “You’re right,” he said. “I’ll call them this afternoon.” “If it doesn’t work out, you can blame me,” said Carmen, “but I think Pam will be calling to thank me for helping you make the decision.” The waitress appeared. “Hi, folks. I didn’t want to interrupt that intense conversation, but it looks like you’ve solved the problems of the world, so maybe you’d like to order now?” “Maybe not all the problems of the world,” Ben laughed, “but enough that we can concentrate on lunch.” Is Dr. Ben ready to take the plunge on practice management software? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Software Addresses Practice Workflow Issues
Ready to Order? Is Dr. Ben ready to take the plunge on practice management software? “I don’t get it.” Carmen gazed at her husband across the table. “You find this software — what’s it called?” “Genesis.” Ben looked up from the menu. “Genesis, which will simplify your workflow, let Pam do her job better, and free up your time to concentrate on the patients, which is what you really care about — and you don’t buy it. “I haven’t bought it yet,” Ben corrected her. “I think the decision’s pretty much made.” “It has a dashboard, right? I know that was something that you wanted in your practice management software.” “It does. It’s awesome, too — easy access current practice stats, month to date daily progress, all the patient information, and then it’s easy to get from the data to the actions the team needs to take.” “From what you’ve told me about it, it seems as though Vericle really empowers the staff. They get to see their importance as partners in patient care.” “That’s what the Vericle people tell us.” Carmen nodded. “I’ve seen the difference it makes when your team really feels like a team. You might think you’re giving away some of the power, but giving people responsibility and accountability and making sure everyone understands his or her place in the mission of your business — it’s amazing how much difference that makes.” “I believe you,” Ben said, “and it’s certainly not a question of worrying about giving away power.” “What is it then?” Carmen leaned forward. “What’s keeping you from taking that step?” “There are costs involved,” Ben said, “and change, and I’ve gotten a lot of pushback from some of the partners.” “Tools cost money,” Carmen agreed, “but they’re an investment in your business. They pay off in the long run, if you choose the right tools. In this case, it seems like you’d see an increase in productivity.” “Maybe,” said Ben, his eyes back on the menu. “But what if it doesn’t work?” “What if it does — and you don’t try it?” Carmen waited for Ben to look up at her. “If you’re going to do it eventually and you expect it to have a positive ROI, waiting just means you’re losing money and opportunity until you take action.” Ben thought about how much he’d already learned from the people at Genesis Chiropractic, and the changes he had already made in his practice — and the benefits he’d already seen. Why was he still waiting? “You’re right,” he said. “I’ll call them this afternoon.” “If it doesn’t work out, you can blame me,” said Carmen, “but I think Pam will be calling to thank me for helping you make the decision.” The waitress appeared. “Hi, folks. I didn’t want to interrupt that intense conversation, but it looks like you’ve solved the problems of the world, so maybe you’d like to order now?” “Maybe not all the problems of the world,” Ben laughed, “but enough that we can concentrate on lunch.” Is Dr. Ben ready to take the plunge on practice management software?
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 and Tax Tips
In The Waning Days of 2014, This May Be The Most Valuable Tax Savings Tip You’ll Read Anywhere By Garrett B. Gunderson This is the perfect time of year to be looking ahead and working in partnership with your accounting advocate to review your tax strategy and be certain you are on course to keep your tax bill in check – for 2015. Yes, you read that correctly. 2015. The 2014 calendar year is almost history, and while many business and practice owners awaken each November and December to go hunting for year-end tax savings ideas, they are approximately 12 months too late to truly maximize the potential advantages of well-thought and executed tax planning. You may have noticed that in the opening sentence of this article I referred to your “accounting advocate.” Most people describe this under-utilized and under-appreciated professional as an “accountant” – which technically is correct. But too often the images we have of our accountant – whom we meet with maybe once or twice a year, usually between January 2nd and April 15th – is of a cyborg-like records processor – part human, part machine – who ingests our bank statements, credit card logs, cash receipts and other documents and then, voilà, spits out our business and personal returns like a can dispensed from a soda machine. I refer to my accountant as my “accounting advocate,” because a quality, properly utilized accountant is really a tax-planning and savings partner. I speak with or meet with my accountant throughout the year, to review our tax philosophy (more on this in a minute), monitor my financial performance to date, telescope any IRS rule changes that might be on the horizon, and embrace tax savings strategies that will accelerate both my income and my deductions. Here’s another unusual aspect of my relationship with my accounting advocate: I pay him richly. When small business owners commoditize their accountants, assigning their tax preparation to the lowest-priced bidder, what they typically get is qualified performance, but not quality. Would you select your family physician, dentist, or chiropractor primarily on the basis of the lowest available hourly rate? Likely, not. Then why subject the health of your business and finances to low-cost operators? I find that the added value my well-paid accounting advocate brings to me and my businesses is an investment whose returns far offset any savings I might realize by scrimping on my choice of CPAs. Selecting and working closely with an accounting advocate who will help you develop and implement a long-term tax philosophy is one of the “New Rules of Business Success™” that sets Freedom FastTrack members apart – and ahead – of so many other business owners. There is a sharp distinction between tax preparation and savings tips, and a financially rewarding tax philosophy. Most people can sum up their current philosophy as it pertains to taxes in just three words: “I’m against them.” A bona fide, Freedom FastTrack-style tax philosophy is a little more sophisticated than that. It begins, as Brett Sellers so articulately details in this edition’s Monthly Spotlight, with the conviction that how you pay and avoid taxes must support your primary business goals and strategies. Falling over backwards – in the business sense – to cut your tax burden is a rookie mistake. Each business and practice is unique, so it requires an individualized tax philosophy that supports the business owner’s unique objectives and Soul Purpose. All of the false financial idols that I topple in my bestselling book, Killing Sacred Cows, must be expunged from your tax planning: So long 401(k)s; adios scarcity mindset; ta ta to cash flow corks. In their place, you and your accounting advocate want a flexible approach that provides for long-term wealth generation, married to an abundance ethos, and the pursuit of your life’s calling. I liken a good tax philosophy to a speedboat – sleek, powerful, capable of fast acceleration and easily maneuvered. By comparison, Uncle Sam and the IRS are co-captains on a massive cruise ship. In the time that it takes the U.S.S. Taxman to turn and displace one of my tax philosophy components, my accounting helmsman and I have prepared for the contingency with multiple other well-plotted courses. At the moment, I personally am working with my accounting advocate set up a tax-advantaged trust for my two boys – consistent with my life’s Sole Purpose which includes providing well for them. As art lovers, my wife Carrie and I have also been taken by the prospect of purchasing photographs that we love, enjoying them and displaying them for colleagues and clients, then donating them down the road in return for a deduction of the then-appraised value. What excellent examples of a tax philosophy – tied to my family and my business – in ways that my accounting advocate can suggest because he and I have taken the time to look at tax strategy through the prism of the Gunderson Family’s lives. A robotic, cyborg accountant – if he or she would offer any advice whatsoever – would likely trot out the go-to mantra of all board-certified CPA lemmings: “Why not start a tax-qualified, employer matching, defined contribution pension plan – typically a 401(k) – for your employees?” (I could write a book about why that’s not a good idea. Oh, yeah. I did write a book explaining why.*) A savvy accounting advocate can contribute in innumerable ways. He or she can help determine if you’re paying yourself properly; whether you’ve set up the right legal structures to insulate you from unnecessary tax obligations; if cost segregation of your office space is being handled well; if it’s really wise to defer this year’s taxes to future years; what role charitable trusts might play for you; how to minimize or avoid capital gains taxes, etc. One Freedom FastTrack member recently saved roughly $250,000 in the first year alone by moving from a cash to an accrual accounting method. So, indeed, pick up the phone when
