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.
Practice Growth Through Chiropractic Software
First Impressions Does Dr. Ben really know how to run his practice growth? Ben sat on the bench in the museum’s Impressionists room, staring at a giant canvas. His wife and son were strolling around the room, talking about details in the other paintings, and he knew that Carmen was having to focus so much on Jonathan that she probably wasn’t getting the full experience of being in an art museum. But somehow he was having trouble getting out of his own thoughts enough to enjoy time with his family. Even surrounded by amazing works of art, he was thinking about work. “Thinking about work?” Carmen asked, coming to a stop beside him. Jonathan climbed up on his lap. Ben had to laugh — it was uncanny how Carmen could read his thoughts sometimes. Although it seemed as though he was always thinking about work lately. “I guess,” he admitted. “I thought things were going well,” Carmen said, sitting beside him. “They were. They are,” said Ben. “I just feel like every time I get my problems solved, they regroup and come back at me.” Carmen gazed at the flowers on the wall. “Can I be perfectly honest?” “Of course!” Ben was surprised. “Aren’t you always perfectly honest with me?” “I try to strike the balance between honest and supportive.” Carmen darted a look at Ben. Jonathan, worn out from walking, was half asleep. “I think you don’t know as much about running your practice as you need to. Maybe not as much as think you do, even.” Ben frowned. “That’s honest, okay. Maybe not supportive.” “I’m not saying anything about how you treat your patients. I’m just saying it’s not really scalable.” Ben looked inquiringly at his wife. “Managing a small practice where you see a few patients a day is not the same as managing a growing practice. You want growth, of course, and you’re a great chiropractor, so you get more patients — and you have a crisis while you figure out how to serve them all. Then you add a partner or another staff member, and you have a crisis while you figure out how to pay for them and how to manage them. Then you get more patients so there’s enough money to go around, but then you have another crisis figuring out how to keep track of everything. Your practice grows, but you sort of go from crisis to crisis.” Ben looked back at the peaceful flowers in the painting. From crisis to crisis was a pretty fair description of how he felt. “We want growth,” he said. “We need it, even. We have to think about Jonathan’s future — lessons, sports, even college tuition. And we have to think about our retirement, and let’s face it, we want and deserve a certain kind of lifestyle. I don’t think that going back to the way things were my first year in practice is the solution. You’re right, though — I felt a lot more competent back in those days.” “What about the technology solutions we’ve talked about. Have you invested in them, yet?” “We’ve done a few things,” Ben said slowly. Now that he thought of it, though, a lot of the new tools they’d talked about were still being talked about. “I know I couldn’t have handled the growth of the pizzeria if I was trying to make all my pizzas with a bowl and a wooden spoon,” Carmen said. “You need good tools.” She stood and stretched. Ben picked up his sleepy son and put an arm around his wife. “I think I’ve had enough of the Impressionists,” he said. “But what you said definitely has made an impression on me.” “Good,” Carmen smiled. Does Dr. Ben really know how to run his growing practice? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Patient Education for Chiropractic Practices
Complications Does the complexity of Dr. Ben’s patient education needs require a complicated solution? “It’s nice to be in someone else’s restaurant for a change,” Carmen remarked. “Someone else will have to do the cooking and the dishes!” “Rough day at the pizzeria?” “Not a bad day,” said Carmen, “but this time I’m being affected by new governmental medical regulations.” “What?” Ben was taken aback. His chiropractic office dealt with medical regulations frequently, but he couldn’t see how they could affect his wife’s pizza parlor. “We have to provide full nutritional information on our menus now.” Carmen sat back, waiting for Ben to share her outrage. “That’s a good thing,” Ben said. “People should know what they’re doing when they order that sausage and pepperoni thick crust with extra cheese.” “But that’s just the point! We don’t offer a couple dozen dishes the way this restaurant does. People can order their pizza with half a dozen different kinds of meat, twice that many vegetables, several different crust options, five different sauces, plus extra this or hold that — there are thousands of different combinations.” Ben was taken aback. “I hadn’t thought of that. But the research I’ve been doing on patient education has me convinced that people really do need full health information presented to them. My patients have to understand their diagnosis or disease, plus the treatment options we’re considering, as they relate to the specific part of the body where the patient is having trouble. That might have as many permutations as your pizza ingredients.” Their waiter arrived and Ben and Carmen ordered, pausing in their conversation to discuss their choice of dishes. Carmen jumped back in as soon as the waiter turned away. “Most people don’t even look at the menus, anyway — they know what kind of pizza they like. And they know that pizza is a bit of an indulgence. Maybe they just had a salad for lunch and plan to go roller skating after dinner. How is it my responsibility to police their health choices?”“It’s not about policing,” Ben objected. “It’s about giving people the information they need to make good choices. I see that the nature of your product makes it hard to provide the information you’re being asked to provide, and that’s true for my patient education situation, too, but that doesn’t make it any less of a good idea.” “Have you found a solution?” Carmen asked. “Maybe it’ll work for me, too.” Ben smiled. “I’ve found this amazing library of 3-D medical images and animations. It’s in the cloud, so we can all access them from every room–” “Unlike anatomical models or charts,” Carmen put in. Ben nodded. “We can email patients custom reports to help them keep up at home — and it’s fully integrated with that new software system we’ve been planning to implement. That means that it’ll fit into the workflow instead of changing it — and I know the whole team will be happy about that. It’s a simple, elegant solution to a complicated problem.” “It sounds perfect!” “I think it will be. Ah, here’s our dinner. Now we can see about coming up with a solution for your health education issue.” Does the complexity of Dr. Ben’s patient education needs require a complicated solution? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Chiropractic Software Patient Education Promotes Compliance
Getting Past No Can Dr. Ben get past the negativity and work out a solution for his patient education needs? Carmen was helping Jonathan with his homework when Ben arrived home from work. He hadn’t expected kindergarten to have homework — but he also hadn’t expected the meeting at his practice to go so badly. Ben gave a feeble smile over Jonathan’s head as the little boy excitedly told him all about his day, and Carmen responded with a concerned look. Ben was able to set aside the workday as Jonathan described the wonders of kindergarten to him, and the whole family finished up the homework and put it carefully into Jonathan’s backpack. “He’s really enjoying school,” Ben observed as Jonathan ran outside to play. “I know! It’s such a relief — I was worried that he wouldn’t like it,” said his wife. “And of course he’d have to go anyway.” Ben nodded gravely. “Looks like you didn’t really enjoy work today,” Carmen prodded. “And I had to go anyway!” Ben chuckled. “Actually, it was great up until the meeting at the end of the day. I hate meetings.” “You were so well prepared! How come it didn’t go well?” “Actually, the partners had some good points,” Ben admitted. “I guess that’s why I’m so frustrated by it. Somehow when we get together, we just end up in one big negative group mood, listing all the reasons ideas won’t work. I left pretty convinced that my idea won’t wor “So you went in and told them that patient education would increase compliance, and that you need some kind of tool that’s more versatile than a skeleton. Then what?” Ben leaned in. “They said that the body is a very complex system, and we all went to school for years to know what we know. Our patients can’t expect to understand it more fully than they do, and no special tools are going to make it completely clear.” Carmen frowned. “There’s a difference between being a doctor and being an informed patient. Just because patients don’t always fully understand the explanations they’re getting right now, that doesn’t mean that they couldn’t understand enough to help them see the value of adhering to their treatment plan. Especially with some kind of visual or hands-on support. I know those things make a difference when I’m training new workers.” “That’s a good point,” said Ben. “I guess just deciding that it’s hopeless doesn’t make a lot of sense.” “What else did they say?” Ben sighed. “At one point someone said that our patients should just trust us, and that it was all the fault of the internet.” Carmen laughed. “I know it sounds funny, but at the time, we were all getting into that discussion. Some of us are more committed to patient education than others, but even I joined that complaint fest. It does seem as though noncompliance is getting worse.” “So patients with a little information are deciding that they don’t have to do what their doctors say?” Carmen scoffed. “Even if that’s true, the solution surely would be more education, and more accurate information. You can’t stop people from finding information online, but you can be the most trusted source of information.” “You’re making a lot of sense here,” Ben said. He was feeling more cheerful. “I think I can go back with these points, once everyone has had a chance to think about it. I guess a lot of the negative reaction was just about change.” “Change is stressful,” Carmen agreed. “Even if it’s going to be better, it’s more trouble to change than to keep doing what you’re doing.” “What we’re doing isn’t working as well as it should,” Ben said. “I guess I went in with an idea and no real solution, and when everybody went into the usual naysaying, I got swept up in it.” “That’s probably why you hate meetings,” Carmen suggested. “But sometimes people just automatically shoot down an idea even though, with more thought, they’d see the value. I think you should go ahead and identify the tools you need. Make sure they’ll fit into the practice’s regular routine, and bring it up again.”
Do You Know Your Practice Management Metrics
Too Many Variables How can Dr. Ben effectively put his information and ideas into his chiropractic practice? Ben closed his office door gently and pulled his chair up to the desk. He pulled his wife’s crayon-made chart from his pocket and smoothed it out on the desktop. Carmen knew a lot about business, he thought. He had to admit that he found that part of his job challenging, but he was also confident that he’d be able to take control of this aspect of the practice now that he had some direction. With medical information, he could look at a few pieces of data and see what was going on — or what else he needed to know to find the answers to his questions. If he needed additional information, he knew where to look for it. And generally speaking, the patients’ charts had the data he needed in the places where he expected it to be. His own experience with that data made it instantly meaningful. It didn’t seem to work that way with practice management. So Carmen had grabbed one of their son’s crayons and drawn him a chart. Ben chuckled. Ben copied the chart into a spreadsheet and hit “print.” He heard “Dr. Ben?” at his door and just had time to put away the original chart before Pam entered. “Dr. Ben, we have another last-minute cancellation.” Pam handed Ben the patient folder. “She’s done this before, hasn’t she?” he asked, checking the file. “She does it pretty regularly,” Pam admitted. “She always says something about work, but I wonder whether maybe she just finds herself short before the appointment comes up, and makes excuses so she won’t have to pay.” “Do we have other patients who work at the same place she does? Do we have the same kinds of problems with them?” “That’s a good question. I’ll check on that. I hate to have to charge her if it’s work-related and she can’t help it.” “If we take that position, though,” Ben pointed out, “we’d never charge anybody for cancelling, even though we have a sign out there explaining the policy. Everybody probably has a reason they think is important.” “I know, but if the cancellations are caused by financial problems, then charging…” Pam continued, but Ben had stopped listening. “This is paralysis by analysis,” he interrupted. “What?” “I mean, we’re looking at so many possibilities and so many hypotheticals that we’re never going to be able to make a firm decision. If cancellations are enough of a problem to us that we have a policy, we ought to follow that policy. She could go to her boss and explain that she’ll lose that $35 fee if she cancels, and then it would be in the boss’s court. Or if it’s financial, she could level with us and we could work out a payment plan for her. All those things about her life are just muddying up the waters for us.” Pam nodded. “You’re right.” “Or if our data shows that cancellations don’t really make any difference to the bottom line, then we could get rid of that policy. But let’s narrow this in to the most basic information we need for the decisions, instead of broadening it out to include all the possibilities we can imagine.” Pam left looking satisfied, but Ben remained in the office, lost in thought. It sounded good when he said that, but the truth was, he didn’t know what no-shows cost him and whether they needed to be firm or not. He didn’t even know how often this particular patient had made a last-minute cancellation or not shown up for an appointment, and Pam simply had a feeling about it, not hard facts. This was definitely a case in which having fast access to the KPIs would improve decision-making at his chiropractic practice. In fact, if he or Pam could spend a little time sorting these things out, they would probably make it up by having fewer conversations agonizing over decisions of that kind and second-guessing their earlier decisions. Ben looked at his spreadsheet. Why couldn’t someone from the office staff pencil in the current figures every week and calculate a running total? Then when questions arose, they could take a quick look at the spreadsheet and find exactly the information they needed. Pam wouldn’t like it, he was sure, but it seemed like just the right solution. How can Dr. Ben effectively put his information and ideas into his chiropractic practice? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
Chiropractic Practice Management Decision Making
Wake Up and Smell the Coffee Dr. Ben might be able to make better decisions by tracking KPIs — but would it be worth it for practice management? “Do you really cut out coffee in the break room when cash flow is tight at the practice?” Carmen asked Ben, pouring him a cup of her special brew. Ben inhaled the aroma of freshly ground coffee beans brewed in a French press with filtered water. Their son was coloring at his end of the table while Ben and Carmen enjoyed a cup of coffee, the family’s usual evening ritual. “Why not? It’s a small thing that doesn’t affect the patients,” said Ben, breathing in the scent of coffee again. It would be just another minute before it reached the ideal drinking temperature. “I think that’s a mistake,” Carmen said firmly. “What happens when everyone is crazy busy all day and the waiting room is a zoo and Pam goes for her coffee break — and finds no coffee. You save yourself seven dollars, and you have a dissatisfied staff. That’s no bargain.” “So where should the savings come from if we need to scrimp a little bit? Sometimes we have to.” “There’s always something you can do to bring in a little more money in the short term,” Carmen said, swirling her cup. “You can call patients you haven’t seen in a while and invite them in, or offer a referral bonus or something.” “This isn’t like pizza,” Ben objected. “Plus, we don’t always have too little business when we have a cash flow issue.” Carmen frowned. “The solution to every problem in business is more customers. Cash flow for the pizzeria means we’ve had a slow week. It’s not that way at the practice for practice management?” “Not necessarily. There are a lot of things that can affect our income. No shows, for example. When people make an appointment but don’t show up, we lose that income. NFAs, no future appointments — those are the people who may have been coming regularly and providing predictable revenue, but then they leave without making another appointment.” “Recurring revenue is good,” Carmen agreed. “But when you expect it and it doesn’t happen, it can take a while to make up the difference.” “There’s also payment. When people order a pizza, they pay for it. We have accounts that are 60 or 120 days late, plus insurance payers who are slow or even dispute the claims.” “Hold on!” Carmen grabbed a piece of paper and a crayon from Jonathan’s hoard. “Can I have this one, sweetie? Thanks. Okay, Ben, let’s get this figured out. Things affecting your income include no-shows, NFAs, slow pays, and payers like insurance companies that aren’t always predictable. It’s all practice management.” Carmen drew a neat chart with the crayon. “Wait, I think the insurance companies need their own column. You need to keep track of which payers are fast and cooperative and which aren’t. You also need to know how many claims you have and when there’s a significant backlog so you can respond to it. Maybe also which specific procedures cause problems with which payer.” Ben admired the chart. “Looks like that about covers it.” Carmen sat back and admired her work. “I think these are your KPIs. Your key performance indicators that let you see if you’re on track and if you need to trim your costs a bit.” “Where will these numbers come from?” Ben asked. “You’re acting like I should know these things.” “You should,” Carmen shot back. “You have to know your numbers to make the right decisions at the right time. When you know your numbers inside and out, you can make strategic decisions wisely. Maybe there are vendors you can safely put off paying if you know that you have money coming in soon, or maybe you can put a staff member to work getting those overdue accounts cleaned up.” Carmen returned the crayon to their son. “Either way,” she went on, “you won’t have to mess with the coffee!” Ben drained his cup. He could see where Carmen was coming from. Her plan sounded sensible. But he wasn’t sure it would be worth taking time away from what he did best — patient care — to mess with all those numbers. Dr. Ben might be able to make better decisions by tracking KPIs — but would it be worth it for his practice management? Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.
