Into the Fire
Poor Communication Turns Up the Heat in the Office How do staff problems affect Ben’s chiropractic practice? “Ben? Can I talk to you about something serious?” Ben turned to his wife in surprise. Carmen was usually easygoing, taking a relaxed attitude even in serious situations. “Of course. What’s up?” “It’s the girls at the pizzeria.” Like many pizza places, Ben knew, Carmen’s had lots of part-time help, including students and musicians who needed a day job. The work tended to be fun and casual, even though Carmen ran a tight ship. She had a lot of turnover — what restaurant didn’t? — but she rarely had staffing problems. “I’m usually the one complaining about my staff,” Ben said. “You go with the flow.” “I know,” Carmen agreed. “I think we’re a happy workplace, and the systems are organized enough that the people can relax. But we have this new delivery guy…” Carmen hesitated. “Spit it out!” joked Ben. “Well, okay, he’s really cute. Whenever he’s in the shop, the girls hang out near him, flirting, instead of doing their work.” Ben couldn’t help laughing. “That’s your employee problem? Listen, I have staff absences, paperwork backing up, information silos that mean we constantly have questions that can’t be answered because the only person who knows the answer is off –” “You aren’t even listening!” Carmen objected. “I can’t bring this up with the girls without insulting them, and I can’t bring it up with the new guy at all. I can’t fire him for being too cute –” “Sorry, Carmen,” Ben insisted, “you don’t know what staff problems are if your idea of a staff problem is how to avoid hurting somebody’s feelings. My people are competent, but there doesn’t seem to be enough communication among them to keep the paperwork and billing going smoothly. We end up looking bad to the clients because their files can’t be found, or missing out on billings because the paperwork has errors. Those are staff problems.” “Maybe you’re right,” Carmen said. “Those do sound like more serious problems. Are you paying enough attention to your workers?” “That’s part of the problem, I’m sure,” Ben admitted. “I’m in with patients all day. I don’t have time to oversee the staff, and I guess they all have a lot of freedom to set up their own systems…” Carmen laughed. “If everyone just does what he or she wants, you can’t call it a system.” “Well at least I’ve got you laughing,” Ben said. “Listen, just tell your people to get back to work. You’re letting your embarrassment over the situation make it seem more difficult than it is.” As they got ready for bed, though, Ben was wondering. If that was the biggest staff problem Carmen faced in her business, why was he constantly troubled by staff problems in his? How do staff problems affect Ben’s chiropractic practice?
Chiropractic Billing Compliance | How to audit-proof your practice
An Audit Proof Practice is what Dr. Ben needs. That was definitely NOT money well spent. Ben felt red-hot anger building up inside him like boiling lava in a volcano right before its eruption. He still had a hard time accepting that Blue Insurance fined him $30,000 for failing the audit and made him refund the payments he had received for all failed claims. He promised himself that he would do whatever it takes to reduce his audit risk from now on. “Given the volume of claims, an automated monitoring system may be the only practical way to detect suspicious conduct or potential flagging for audit,” Ben read out loud from the book Practice Profitability. That made perfect sense to him. He had been racking his brain for ways to implement his friend Tom’s advice of tracking the notorious red flags for insurance companies: unsigned notes, unbilled visits, missed re-exams, and denied claims. An automated monitoring system sounded like a life saver to him. “Does your chiropractic software help you stay compliant?” Ben asked Tom. Tom was a successful chiropractor who had been through several audits, but always seemed to emerge unscathed. “Absolutely,” Tom said. “There are just not enough hours in the day to help my patients and track all potential compliance issues manually.” “But how exactly does it help you?” Ben asked. “I wonder what kind of system would be the right choice for my clinic since I am not exactly a tech whiz.” “Don’t worry,” Tom said. “You just need to find a system with several useful features that are built around your workflow. The idea is to make your life easier, not more complicated.” Ben thought about that for a minute. He had been looking for ways to simplify managing his practice. But the most pressing issue for him right now was staying compliant. “Could it cut down my error rate?” Ben said. “Definitely. Just look for chiropractic software that has automated alerts and built-in claims scrubbing,” Tom said. “Those features will help you fix any mistakes before you submit any claims to the insurance companies.” “So you are saying that your chiropractic software alerts you of compliance issues and helps you manage your entire practice workflow,” Ben said in stunned disbelief. “It sure does,” Tom said “I use the software to assign tasks to my staff with tickets and complete my notes while I’m still with my patients. This makes my life so much easier and saves me so much time. My favorite thing is the Radar on the homepage, which gives me a quick overview of my practice stats so I know what is going on in all areas at all times.” How would you advise Ben? Is there a way to audit-proof his chiropractic clinic?
Chiropractic EHR software | Improve patient retention with Care Plans
Does paying your monthly overhead stress you out because your chiropractic clinic is plagued by patient no-shows? It is impossible to predict your clinic’s cash flow when your patients are non-compliant with your prescribed care plans. Needless to say, patients who miss their appointments won’t get better. Inconsistent patient flow also hinders practice growth and profitability. But your clinic’s cash flow can take an even bigger hit when you have to return payments for unfinished care plans. Not to mention the possible compliance issues resulting from this. You can figure out how much your chiropractic clinic might be losing due to unfinished care plans when you replace the assumptions below with your own numbers and complete the calculations. For example: Assumptions: 1 visit = $30 1 care plan = 30 visits Average number of no-shows per care plan: 15 Calculations: Potential income and losses from unfinished care plans per patient: Potential income from 1 care plan: 30 visits x $30 = $900 Potential loss from no-shows per care plan: 15 visits x $30 = $450 Conclusion: You risk losing half of your income when patients don’t finish their care plans! Just how can you identify patients who don’t understand the need for multiple visits to achieve their health goals? First of all, you need to know what the entire care plan looks like in order to track multiple visits. All patients go through a traditional treatment step-down ladder, such as four visits per week for the first four weeks, then three visits per week for the next three weeks. Such unique nuances on many patient schedules are difficult to track manually, and this difficulty grows dramatically with each added chiropractic care plan. Tracking the respective discounts given for each care plan is nearly impossible without a tool. Thousands of care plans are created for new patients every month, to schedule multiple appointments and then track all payments and visits in your Genesis EHR software. When patients don’t show up for their appointments you can receive automated notifications in form of tickets on your Genesis chiropractic software workbench. When patients don’t have a future appointment scheduled or when they cancel their existing appointments you can receive alerts via tickets. That way you can assign your staff the task of scheduling the next appointment. Another useful tool for helping your patients stay on track with their care plans are appointment reminders sent via phone, text, or email. Genesis chiropractic software has integrated several apps which serve this purpose. To set up chiropractic care plan when your patients come into your clinic, simply go to the Genesis Scheduler and click on the “More” tab to open the wizard. You can also create a full care plan from the patient account. Make sure you turn on the settings in your Genesis chiropractic software for Patient Relationship Management and Reminders.
Chiropractic EHR Software | Symmetry Spine and Wellness Center Dream Practice of the Month
Dr. Cynthia Boyd knows how to build a chiropractic dream practice: it takes hard work, a concerted team effort, and the expertise of Genesis chiropractic software and billing staff. “I have my dream practice,” says Dr. Boyd. “There are not many areas that need improvement.” The key to success for Dr.Boyd is balancing all aspects of practice management using Genesis cloud-based chiropractic software: “The [Genesis] system is amazing. I was 3,000 miles away for a month and I knew exactly what was going on.” Dr. Boyd doesn’t have time to micromanage her staff. With Genesis, she can easily track everyone’s individual performance anytime from anywhere. Dr. Boyd can also keep an eye on vital Key Performance Indicators, such as chiropractic billing, with the Genesis Radar. Best of all, Dr. Boyd does not have to change the way she runs her practice to optimize her workflow, complete her patient SOAP notes, and control compliance. As Dr. Boyd keeps growing her practice, she uses Genesis workflow engine to help manage teamwork among her staff and Genesis support team. The staff at Symmetry Spine and Wellness Center keeps the AR past 120 days low at 8 percent by consistently clearing the claims workbench while the weekly phone communications with her Practice Success Coach Heather Miller ensure her practice gets paid in full and on time. Coach Heather Miller: “Dr. Boyd is passionate about what she does and her business. She has found a balance with her practice and all of the other projects that she works on. Dr. Boyd trusts her employees to do their jobs without having to micromanage them. She has a great staff that works well together to get the job done and continue to grow the practice. In the end it all comes down to teamwork.”
Dr. Ernie Landi Shows You How To Grow a 1000 a Week Practice
Since the beginning of Chiropractic as we know it, the “Chiropractic Philosophy” has been the corner stone of our profession. Some chiropractors seem to know it, practice it, and explain it better than others. For that reason Genesis Chiropractic Software has sought out, and interviewed a living-legend. Someone who has a very strong understanding of the chiropractic philosophy, and who has been practicing it for the last 45 years (and still going strong). Of the 45 years Dr. Ernie Landi has been practicing, 20 of them were at over 2,600 patient visits a week, and the last 20 have been over 1000. When it comes to building a practice, he is certainly no stranger to success. Thanks to Genesis Chiropractic Software, now you can experience that same success! Check out our interview with the man himself, Dr. Ernie Landi… In this philosophy-packed webinar you will learn: – How Dr. Landi went from 700 visits per week to 1,700 visits per week in one weekend! – How Dr. Landi built a practice up to almost 2,500 patients per week on pure Chiropractic philosophy! – How you can build a huge 90% cash based clinic, just like Dr. Landi did! – and why chiropractor’s offices are exploding when they get their Chiropractic philosophy down! There is no wonder why this interview has been one Genesis Chiropractic Software’s most popular of all time. In the first two minutes of the interview you can see that Dr. Ernie Landi is not only one of the most knowledgable in the area of chiropractic philosophy, but he is also one of the most passionate chiropractors in the profession today!
Chiropractic Software | Improve your practice performance by choosing a singular focal point
Can you prioritize the many daily tasks at your chiropractic clinic without feeling anxiety and puzzlement? Getting a singular focal point for you and your staff is necessary for building your dream practice with the right chiropractic software. This focal point basically serves as road map to success while increasing accountability and transparency. It also fosters teamwork and cooperation, which in turn increases predictable profitability growth and control. In order to build your dream practice, you have to set clear goals and balance Key Performance Indicators (KPI) such as Charges, Collections, Visits, No Shows, No Future Appointments and percentage of A/R over 120 days. All the while you have to stay compliant with your chiropractic SOAP notes. But without measuring your practice performance and tracking how each staff members contributes to the chosen goals you will never achieve your dream. In order to solve any practice performance problems that block your path to long-term profitability you need to be able to see the big picture at a glance and look up the necessary, detailed practice stats. Improving your practice performance requires diligent measuring and tracking of each chosen KPI. Only when you know how your practice is doing today, a reliable prediction of how it will perform tomorrow is possible. And by removing the factor of unpredictability from your practice performance you can gain much needed peace of mind. Of course, you don’t have time to search for and analyze multiple reports, let alone track your practice stats. Moreover, this kind of information overload can prevent you from being decisive about allocating resources. The only way to manage your practice effectively is to choose and balance the right KPI so that you can make progress in the selected areas and shift your focus as needed. At the same time this allows you to keep an eye on your overall practice performance. But without the right tools this approach is merely wishful thinking. Genesis Chiropractic Software, however, makes it a reality by providing you with a Radar to track KPI as well as automatically generated, detailed reports on all areas of practice performance, such as chiropractic billing. When you first log on to the home page of your Genesis Chiropractic Software, you can get a quick overview of your practice performance simply by looking at the Radar. It displays selected, vital stats on a single chart across two time points so that you can quickly see where you are right now and discover any trends before they turn into huge problems. You can also drill down into a particular KPI for a comprehensive sense of practice performance. If you want to get to the root of a performance problem you can look up any stats down to the lowest claim aspect and action taken for the appropriate KPI in a detailed, interactive report. For example, you might notice that your chiropractic billing stats are off and discover that the amount for ‘Insurance Collected’ is much lower than ‘Insurance Billed.’ This might indicate a problem with your chiropractic billing claims cycle. You can then look at the ‘Claim Status’ report to find out what might be causing any issues and fix the problem. You can access your practice Radar on your Genesis Chiropractic Software home page and click on a specific KPI to open a single graph. To look at any details of a particular area of practice performance, such as chiropractic billing stats, go to ‘Reports’ in the top menu and select the appropriate one from the drop down menu. Drill down into the desired details by specifying the date, provider or location. Genesis chiropractic reports also include: Context Search Department-wide Saved Queries for Repeat Usage Configurable, Sortable, and Drillable Report Layout by Arbitrarily Customizable Criteria Reconciled Error Reporting Within Standard HCFA form Export to Excel Reporting Across Multiple Departments/Sites Contact your Genesis chiropractic software Profitability Manager to configure your practice Radar with the right KPI’s to help you achieve your goals and build your dream practice. Watch Dr. Haas demonstrate the documentation interface.
Genesis Chiropractic EHR | New user tip #1 – Practice makes perfect
By Lisa Ogden ~ Profitability Coach for Genesis You can achieve success with the Genesis Chiropractic EHR system and build your dream practice when you and your staff complete the recommended training prior to going live. Chiropractors who wait until they actually see patients to learn the system “on the go” commonly run into the following 4 problems: Frustration: Not being able to use something when you most need it can be very frustrating for anyone. Even more so when your livelihood depends on it. Wasted time: Without establishing a level of comfort, documenting a patient visit can take much more time than Genesis is designed for. Compliance issues: Very similar to the paperwork that might be piling up on your desk, not getting to know your Genesis system can often result in incomplete and/ or unsigned SOAP notes. Unsigned notes are a major compliance or audit risk. Delayed payments: Payers don’t submit payment for incomplete or unsigned notes. The good news is that these four issues do not occur for practices that take the following 4 steps PRIOR to going live with their Genesis platform: Step 1: Participate in live online training session with Genesis staff: Our staff will walk you through proper visit documentation, step by step. Step 2: Create mock patient accounts: Spend time documenting several test patient visits including note sign-off and claim submission. Document the type of visits that are common for your practice. Document initial and follow up visits. Initial visit documentation will obviously take more time than follow up. You should be shooting for under 2 minutes for documenting initial and 10 seconds for most follow up visits. Step 3: Customize your Genesis platform: After you have spent some time getting to know your new platform, you may discover that minor customization is needed to improve efficiency. Schedule a second live training session to learn how easy it is to improve your user experience with customization. Step 4: Practice documenting: Now that you have made some minor tweaks to your documentation platform its time to practice documenting again to ensure you have everything set the way you want it. Your goal should be to document a visit, sign off on your notes, and submit a claim while the patient is still in your office. If you haven’t achieved this level of efficiency yet, it is important to contact your profitability coach and discover what might be holding you back. Take the time to get to know your new platform to eliminate frustration and achieve the top tier performance you are looking for with your chiropractic EHR.
Set measurable goals for practice growth with Key Performance Indicators
Some chiropractors may chose the wrong Key Performance Indicators (KPI) to measure the success of their clinics. Among the most frequently used metrics are charge growth, payment growth, patient visit growth, pay per visit, referrals per patient, no-shows, no future appointments, in addition to patient loyalty, and service quality. With this many options to choose from, the question begs just how do you select the right KPI? But first let’s take a look at how not to measure success for your clinic. Two of the most frequent business mistakes made by chiropractic clinic owners and managers when selecting a KPI: Measurement of the wrong thing Focus on the right things but in the wrong order If you make such mistakes, the statistic you rely on to assess your office performance is disconnected from your overall objective. Consequently, your strategic and resource allocation decisions may not support your goal, driving poor decisions and undermining performance. To determine cause and effect productively, always start with two key questions: What’s your objective? What factors help you achieve that objective? If your objective is to increase value per visit, then you know that higher charges may result in higher payments. What procedures can you deliver to maximize your charges? What Point of Sale items can you offer your patients? How much added revenue can you expect from Point of Sale items? If, on the other hand, your objective is to increase the number of visits, then you know that having more new patients will result in more visits. What can you do to increase your exposure to referring doctors and to get your patients to make patient referrals? Can you help organize and participate in community events? Can you stay in touch with your patients via email or use a patient portal? What can you do to instill a sense of expertise and office teamwork in the eyes of your patients? Next, to determine the right metrics, we need to understand the cause-and-effect relationships between your objective and possible actions. If your objective is to improve patient satisfaction you need to understand its sources. If you do not understand what improves patient satisfaction, how can you decide what you need to measure? Intuitively, we rush to explain things, to find an easy cause-and-effect link in every situation. So our intuition makes it too easy for us to assign and measure the wrong cause to an outcome. To be a useful and reliable link between cause and effect, our statistics need to be both persistent and predictive. Persistency means that an outcome of an action is independent of its timing. Predictability means that the value of the cause predicts the value of the effect. Statisticians use the coefficient of correlation to quantify persistence and predictability: the closer the coefficient is to 1 or -1, the more persistent and predictive the link is. The closer the coefficient is to zero, the less related the two parameters are.
Reduce task completion anxiety at your clinic with ticket macros
Are you worried that some of your staff members might forget to complete any of the mandatory 10 tasks for each new patient visiting your chiropractic clinic on any given day? With approximately 300 weekly new-patient-tasks to be accomplished, chiropractors can gain peace of mind by using ticket macros that assign certain tickets to the appropriate staff members for improved workflow and accountability within the clinic. In that way, ticket macros can help ensure that every new-patient-task gets completed in a timely manner for compliance, maximum profitability, optimum patient flow and consistent practice growth. On the other side of the coin, any missed steps/tasks, such as forgetting to ask for the patient’s credit card or not scheduling the next appointment can result in loss of income and reduced patient flow. This often happens when chiropractors have to rely on their staff members’ memory and diligence instead of using a system for effective teamwork. Ultimately, task coordination, transparency, and accountability are the only way to avoid loss of control and loss of predictability, especially when training new staff members for your chiropractic clinic. Other advantages of using ticket macros are faster growth and higher profitability for your clinic since more tasks get done faster. Orderly completion of scheduling tasks not only fosters patient retention, but also makes a positive, professional impression on patients. Impressed patients are more likely to refer their friends and family to you and further contribute to your clinic’s growth by maximizing your patient flow. Orderly completion of billing tasks such as speedy submission of compliant claims will increase your clinic’s monthly cash flow, further accelerating your success. Naturally, chiropractors don’t have time to micromanage their employees and need to rely on delegation as well as verification of thousands of individual tasks. The only effective solution for successful practice management consists of a cultural change that substitutes convenience with benefits and automated processes to eliminate any dependency on human error or motivation. This automated process splits the entire patient life-cycle into a series of projects to reduce the complexity of 100 steps per new patient down to 7-10 projects. These projects are then further broken down into a series of predetermined tasks (a macro of tickets) that is triggered by a predetermined combination of events. For example, when a new patient visits your clinic you can create a ticket macro for Day One consisting of eight separate tickets that are assigned to the appropriate staff members. You can also create a ticket macro for Plan of Care for any patients that were referred by an MD to ensure all required documentation and insurance verification are handled by your staff. Follow these 4 steps to create a ticket macro in Genesis’ chiropractic software platform: 1) Ticket Macros are created by going to Configuration>System>Ticket Macros. 2) The screen will show any previous ticket macros you have created so you can edit them or you can create a new one by clicking the ‘Add Ticket Macro’ button at the top of the screen. 3) This will bring up a pop up window where you can enter the name for the ‘Macro’ and indicate whether or not it should be ‘Public.’ Please leave the Macro marked as ‘Active.’ 4) Create individual tickets for this macro and assign them to the appropriate staff members.
How Genesis Chiropractic Software Can Help You Build Retention In Your Practice!
How’s your Patient Retention? Picture this; you start noticing a strange phenomenon going on in your office. You can’t explain it, but people seem to be disappearing. Every time you think of a particular patient, you look through your chiropractic software for their name, and realize they are no longer in your practice. Another face pops up in your mind, and they are gone too! What is going on? These patients were not “one-timers”. They have been in your office many times. They told you they were ready to regain their health. You thought these people understood the principles of chiropractic. So, what happened? You have been hard at work ever since you started your practice—,putting in long hours, networking, marketing, getting new patients in the door, then educating and orientating those new patients while trying to cultivate a community of practice members that will be with you to the end! And yet, here you sit, in front of your computer, looking at your office stats for the month and saying, “Where the HELL have all my patients gone?!”… Does this scenario sound familiar to you? You may find yourself thinking that maybe it’s just the “name-of-the-game” in chiropractic. Maybe you should just accept the fact that people come and go while you have to work your butt off for the rest of your life to fill the vacancy of every patient who mysteriously disappears; is that it? I’m here to tell you (thank goodness), “That’s not the case! You don’t have to be the Bermuda Triangle of chiropractic anymore.” Something happened to all of those patients, yes. They slipped through the cracks in your office. That’s what happened— some offices have “cracks” and others have huge, gaping holes! Either way, as the captain of your ship you are responsible for finding and fixing those leaks. Leaks in your office could be anything that causes (or encourages) a patient to leave before they should. A “leak” could be caused by one, or more, of four things: poor education, poor service, poor procedures, or poor organization in your office. Now, I’m going to show you FOUR TIPS TO STOP LEAKS IN YOUR OFFICE NOW. By following this advice, you will be able to help more people, grow your practice to the next level, and sleep easier knowing your patients will still be there when you go to work the next day. 1) Educate: Education is key. Most chiropractors educate their patients in some way, shape, or form, but are you really providing the patient with a valuable education in health that will change their life forever? Are you really teaching them the chiropractic story with passion? After all, there are hundreds of thousands of self-proclaimed “health gurus” bombarding your patients with info every single day, but simply “providing info” is not educating! Start passionately educating your patients about the body’s healing power, adding value by instructing them how they can maximize that power! 2) Great Service: Do you train your staff to give great service to each and every person who walks in your door? Does your staff greet the patient with a smile every time they come in? They should. Great service should start with the first phone call and continue throughout the patient’s interaction with your office. Make sure you and your staff are trained and conscious about giving exceptional friendly service. Now let me ask you another question related to service: How long do your patients have to wait when in your office? If your patients are spending hours in your office, that is bad service. Even if they love the care they are receiving from you, people just don’t have time to spend hours in a doctor’s office anymore. Get your procedures down and start creating a smoother, more efficient visit for your patients. This single tip could blow your retention through the roof! 3) Get Your Procedures Down: Allow me to give you a sports analogy— Do you think there has ever been a world champion team that couldn’t run a proper play? No way. That’s one of the first things coaches go over in the beginning of a season. If you can’t run a play, and I mean run it with perfection over and over again, then the synergy will be off. If this is the case with your office, be aware that patients take notice. You must have your procedures down and train each your staff members to know their position in your office. If you do not do so already, set up a weekly staff training session where you practice running through office procedures. You may even be surprised by how many questions your staff members have about their specific roles and responsibilities. 4) Get Organized! This may just be the single biggest reason behind your poor patient retention. Your patients are walking out of your practice, and you don’t even know it! This happens to so many chiropractic offices it’s not even funny. A patient who has been coming in for years suddenly stops coming in, and by the time you realize you have not adjusted Mary in a while and check the schedule, she has been gone for two months. Now, what do you do? Do you call and check on her? Oh yeah, that will look great, “Hi Mary I noticed you missed your appointment.” Mary replies, “Yeah, two months ago Doc. You’re just now calling me?” Don’t do that to your patients and don’t do that to your practice. The fact is that Mary didn’t just quit your practice two months ago. She started showing signs of leaving way before that. Maybe she started asking you questions about how her spine was doing, and whether she was “fixed” yet. Perhaps she’d already missed an appointment or two. Maybe she didn’t show up to the workshop she told you she would attend. All of those things are just some of the signs of a patient who is
