Resource Centers:(News, information, and tools to support your practice)
April 2010
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The trend is techno
By Bharon Hoag
A doctor recently sold his practice in order to relocate to another part of the country.
He purchased and was a proficient user of a comprehensive software system that supported his clinical notes and documentation as well as streamlined his front office patient relations, claims, billings, and collections.
The doctor who bought the practice didn’t want the software as part of the deal, preferring to rely on the manual processes that have been used for decades.
This “retro” point of view flies in the face of current conditions and trends and it calls for a re-examination of why technology increasingly belongs in the chiropractic office: Third-party payers continue to reduce and deny claims.
To maintain practice prosperity, even survival, you may see expanding patient population as the answer. This in turn generates a new issue for you: how to handle higher patient volume while continuing to deliver quality care.
Administratively, you are further pressed by government, insurer, and regulatory demands to reduce paperwork.
You know you need a way to respond to these challenges and the reality is technology-based solutions represent virtually your only option.
Selecting a technology solution
Managing with technology begins with the selection of a solution, which is not always an easy task. New systems pop up continuously, some laudable in their performance and scope, others addressing narrow issues and slipping into the mix as somebody’s “good idea.” Some offerings are complex beyond reason, inhibiting staff acceptance and use. Others are too spare to have real value.
In selecting a solution there are a number of important considerations, among them:
• Your software is a tool: it does not necessarily replace anything; rather, it should speed, simplify, and enhance what you do.
• The techno-adage “garbage in-garbage out” (GIGO) applies. Quality input remains paramount.
• More is not necessarily better. Providing claims analysts with too much information can intimidate and confuse them — to your disadvantage.
• Understandability is an absolute, so your solution should observe some recognized protocol or standard, such as the Medicare Guidelines.
• Customization is critical: you should be able to keep your existing practice methodology intact and be able to tailor the software operability and output to your preferences.
• Insist on implementation services so that you will be able to exploit the full potential of your system right away, virtually impossible if you try to implement it on your own.
• Be sure your vendor has a history. When you make an investment in technology, you need to know that the provider is stable and will be around to support it.
Using the technology
Software solutions usually comprise notes and reporting systems (clinical), practice management systems (office), or a combination of the two.
A comprehensive, contemporary chiropractic software solution begins at the front door and ends with payment for the treatment, each step or phase conducted in an electronic, paper-free process.
Collections thus are handled readily through the integration of the clinical office software and the practice management software, but not all bills submitted are paid on time. Ideally, the software incorporates an “aging” file that indicates various stages of past-due billings. With this information at hand, front office staff can perform collection calls to unstick past-due billings or determine the reasons for delay.
The value in the clinical information and the practice management information residing together in single patient files in a single electronic database cannot be overstated. The elimination of paper in the multifaceted stream of office activities means documentation is less likely to be lost or mislaid, and when documentation is required, a few keystrokes will produce it.
Since practices are essentially specialized small businesses, the software must have the ability to produce management reports that analyze practice performance under various scenarios and metrics. If you don’t know where you’ve been, it’s hard to know where you’re going, and performance reports help provide the foundation for decision-making and practice progress.
Working with automated processes
The rationale for any automated process is to reduce tedious manual activity and replace it with replicable routines. This is noble, but it can be carried too far. One example in chiropractic office technology is the use of macros.
In concept this works; in practice, the shortcuts it enables can be problematical as, for example, when a claims analyst looks at several claims from the same doctor that repeats the same SOAP note verbiage over and over, verbatim. Reasonable or not, an auditor may begin to wonder if the treatment events claimed actually took place at all.
It is human nature to want to eliminate unnecessary work, but doing so should not risk sacrificing authenticity to 10-second note production. SOAP notes are the basis of documentation and documentation is the basis for remuneration, so doctors must strive to find a balance between speed and quality.
In acquiring software solutions, they can achieve that balance, but they should recognize there are limits to how severely they can trim the notes and documentation process and still support adequately their requests for payment. If it’s too fast or too easy, it’s probably going to fall short.
Manual processes are yesterday. But whether in the back office seeing patients or in the front office seeing them out the door, you need to match the technology to your purposes — not the other way around.
Bharon Hoag, chief consultant of ACOM Health Chiropractic Consulting Group, has worked in the chiropractic profession for 11 years and taught for eight, developing his unique “nondoctor” approach through ownership of four clinics and management of up to nine. He can be reached through www.acomhealth.com.
**See what an ideal, technology-managed office visit might resemble by visiting www.ChiroEco.com/idealvisit.
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