Improved patient control leads to better outcomes

By Derek Greenwood

When it comes to patient management, many practitioners believe it is something akin to a black art steeped in mystery — a kind of “voodoo” that few can understand or master.

Some believe it doesn’t matter what they do to change things — patients show up in the waiting room as if by magic. Since they believe there is nothing they can do about patient compliance, they just leave well enough alone so at least things won’t get worse.

Solve the problem

Patient management is no mystery at all. It is a science with rules and laws just like any other science. Thankfully, patient management problems in your office can be solved as predictably and reliably as any basic math problem, if you know what to do and how to do it.

Look at the subject of patient control. Many people think that control is bad; a tool of dictators and a sign of power run amok. Yet, that is not necessarily the case. Only when control is misused or poorly executed is it considered bad.

Consider these examples of good control:

• If you were walking on a tightrope across Niagara Falls and someone was helping you by guiding your every step, would you consider that bad? Most would consider it an example of good control.

• When parents prevent their children from running out into a busy street, that is control.

• A stop sign that gets a motorist to stop before crashing into another motorist, is good control.

In the same way, good patient management is getting patients to arrive and obtain care at the optimal time, pay what they owe so they can continue to receive care, and ensure they follow their home health programs.

If you and your staff can get patients to do these things, this kind of good control leads to good patient management.

In the beginning

Good patient management starts at the beginning: When patients call in, have the front desk schedule an appointment for a specific time. When they arrive, have them fill out the necessary forms and read your office policies.

They need to know and agree to your policies on missed appointments, payment of services, and performance of assigned home programs. This should be a signed agreement.

Some advanced computer systems even allow this to be done on a tablet PC, including the patient’s signature. This cuts down on paper and filing costs, and ensures the patient knows you are running a high-tech, modern office.

Next, the patient treatment plan needs to be explained in a definite and positive manner so the patient can be

expected to follow it.

Then, the front desk needs to schedule the treatment plan and give the patient a card with all their treatments. A computerized system can help here, too. 

Many computer systems are based around appointment books. These can be used to schedule treatment plans and print appointment cards, saving time and money.

Many offices call or text reminders to patients before every visit, which can help prevent missed appointments and reinforces the importance of regular care.

Improvements pay off

Try to get patients to pay for their visits, copay, or coinsurance at the time of their treatment, which you may find difficult to calculate accurately and quickly while the patient is at the front desk. Some feel only the billing staff can perform this task, given the multitude of insurance companies involved.

It is never fun to try and collect payment several months after a visit. This can upset patients and degrade retention and referrals.

Fortunately, modern software has made it easier to track fee schedules, copays, coinsurance, deductibles, insurance maximums, and treatment limits, and some programs add the proper modifier when certain criteria are met. This allows the front desk to know exactly what to collect at the time of the visit, which promotes good patient management.

What happens when patients drop out of care or go missing?  Follow up and get them rescheduled. Do you know who to call? Do you wait until a doctor walks out of the treatment room and says, “Hey, whatever happened to Irene?”

This is a clear indication of poor patient management. A modern computer system can provide advanced messaging, recall reports, and flag patients who leave the office without a future appointment.

You may be aware that the government will pay you up to $44,000 to implement electronic health records (EHR). If you are smart, you will take this opportunity to upgrade your computer systems at the same time.

Luckily, chiropractic systems are relatively inexpensive compared to medical systems. This will allow you to upgrade to a fully integrated billing and EHR system for a fraction of what the government is paying out.

Think about it: You can get better patient management, better documentation, better billing, better collections, and Uncle Sam will reimburse you.

That sounds like a no-brainer to me — or maybe it really is voodoo.

Derek Greenwood is the founder and CEO of EON Systems Inc., creators of The Digital Office. He can be reached at 800-955-6448, info@eonsystems.net, or through www.eonsystems.net.