Does paper still have a role in healthcare facilities today?
In a world of technology and fast paced advancements, healthcare is becoming more and more paperless; but, is there still a place for paper in a healthcare setting? The answer, based on research, is a resounding yes! Why?
The biggest reason to not get completely rid of paper is for legal reasons. There are many discussions around this topic and the legal argument for maintaining medical documents on paper is not going to go away any time soon, if ever. First, documents that are on paper are more easily tracked for fraudulent entries and more easily accessed in the event of an emergency or need for the information for legal reasons. Second, the cost is lower in maintaining paper forms and records than having the costs that are associated with purchasing applications or programs that can create, track, and regulate the forms in an electronic format. Third, the versatility of paper allows for easier transportation, sharing of documents, and easier to make notes on and "think out loud." Fourth, paper records do not require cloud servers with limited space that must continually be upgraded or sorted to delete records. Yes, paper records need storage, but it is often cheaper to have storage for paper records that cloud storage that is HIPAA compliant and federally compliant with health care laws and standards. Fifth, there are no inconsistencies in the layout of paper forms when printed versus electronic forms. Often times electronic forms are inconsistent from program to program and computer to computer. Paper forms are just the same and standardized for printing. Lastly, they allow for business continuity planning (BCP) in the case of power outage or failing of electronic systems, paper records are just always there and available thus allowing for continuity of care despite the technological failure.
Perhaps the biggest key to paper forms in healthcare continuing to be "a thing" is because of the privacy and security concerns. The fear of data breach is high today and having paper healthcare records limits the ability of online hackers and others to access a patients records. While, EMR and EHR is federally mandated for practices today, having backup paper charts means that if there is a breach, the system can be shut down quickly and care can continue as the records are still available and accurate. Does this mean we need to print a record every time a patient has a visit and put it into a paper chart? No, should there be a backup paper chart that is stored for the patient that is updated on a set schedule, yes. For all the reasons above as well as ensuring interoperability of the businesses by using systems to exchange data, use data, and ensure business continuity of patient care.
Healthcare offices need to find a way to use both technology and paper to ensure they have BCP as well as the ease of customizing forms and records to their own facility. It is easy to just use a program like Word or Publisher and make a customized form to your office than have to go into an app and look for something that "fits" your office or pay someone to design a form for the app specific to your office. The key takeaway here is that technology is great and can make certain tasks easier and more organized, but at the same time paper formats can save time and make things easier. It is finding the balance of how to use both.
While electronic health records are mandatory today and do offer many advantages such as efficiency and ease of access, there is a place for paper in healthcare and often times can be seen in personalized forms specific to each office, note taking for doctors in meetings and patient visits, and fill the gaps in record keeping that technology creates. Studies have proven that paper serves as an important tool and continues to assist healthcare workers across the globe. Studies have also shown that patients prefer to leave with paper in hand regarding the care they received versus access to an online portal for the reason of out of sight out of mind thinking. If a patient leaves with a checkout record of some kind, they often are more apt to read it and see the findings, recommendations, upcoming appointment reminders, and things they can do to relieve symptoms and when to call or go to an emergency room. If they are simply told to look at their portal, studies have proven that it often does not occur as the "out of sight, out of mind" process takes over.
So, is there a place for paper in healthcare today? Yes! All practices need to find a way to have a blended approach to records, forms, and management of their facilities regarding paper versus technology. If a practice focuses on one more than the other, they may find themselves behind the eight ball. However, if a practice can find a way to fuse paper and technology they will find themselves in a better place than those facilities that use one more than the other.
References:
Electronic health records: managing the transformation from a paper-based to an electronic system by R.V. Weeks https://journals.co.za/doi/abs/10.10520/EJC141104
Electronic Health Records: Just around the corner? Or over the cliff? Richard J. Baron, MD, Elizabeth L. Fabens, MD, Melissa Schiffman, MD, and Erica Wolf, MD https://doi.org/10.7326/0003-4819-143-3-200508020-00008
Swindler of the week
Catheter Medicare Fraud scheme estimated at $2 billion dollars has come to light as a company that produced wigs and supplies for cancer patients gets hundreds of angry calls from Medicare recipients asking why their insurance was being billed for something they do not use or want. The scheme started small in 2022 but by 2023 had billed more than $1.9 billion dollars for catheters that were never shipped, requested, or needed to Medicare recipients. Click here to read more.
Is Tenacity in healthcare leadership important?
Tenacity is a fierce combination of persistence, courage, and willpower. For healthcare leaders, it is a characteristic that can mean the difference between their healthcare facility failing or thriving and being highly successful in patient outcomes, revenue cycle, and so much more. So, does tenacity matter more than you think?
Tenacity in leadership is all about strategic persistence and having that unwavering commitment to see things through while being flexible to adapt to the necessary changes to meet or complete a goal. Tenacity is about the brain function during challenges and leaders with high tenacity tend to find themselves better able to maintain focus and clarity during highly challenging or volatile times. They are hardwired to see past the setbacks to the finish line. They tend to manage their emotions allowing them to stay cool, calm, and collected in the face of adversity. This control of emotions allows them to transform the potential stress others would feel into a driving force to get out from under the problem and reach the goal or outcome desired.
How do healthcare leaders put tenacity into action? Often many leaders will look to cut their losses and move on. Tenacious leaders look for the shortcomings of projects, processes, and procedures to find new ways to rally their team and give them renewed vigor to continue by making adjustments that turn the sinking ship around. There is a stubbornness involved that the leaders are just not going to give up on something they believe will help their facility in whatever goal they need to meet. It is this stubbornness that helps drive them to see things from a different light. Traits of tenacious leaders are:
· Seeing the glass half full not half empty
· Strong analytical skills
· Stubborn
· Driven
· Proactive not reactive
· High levels of perseverance
· Reflective
· Inspiring
While there are so many other traits of tenacious leaders, these are the top skills that help them stay on course for completing their projects and meeting their goals.
It is important to note, tenacity is different than resilience. Tenacity is persistence and resilience is the ability to recover from a challenge that one may not see through or a goal not met. Resilient people are the ones who get up when they get knocked down and tenacious people are the ones who do not let themselves get knocked down. This does not mean that tenacious leaders will not face challenges that are designed to take them out and they will not struggle and appear knocked down. The difference is that tenacious leaders step back, regroup, redesign, and continue completing the project, or task, or meeting the goal. Resilient people are often the ones who will cut their losses, regroup, and begin again with a different approach and change in goals. They seem similar, but they are different, and knowing this can help you, as a healthcare leader or leader in any industry, find the way to not just dust yourself off and start over, but find a way to continue despite the challenges one faces.
The takeaway here is that this single trait of tenacity can make you a highly successful leader in your facility and create opportunities for your facility to become known as the best in the business or the one with the highest positive outcomes for patients, staff, and the organization. In today's ever-changing, fast-paced world tenacious leaders are a necessity for all healthcare facilities to be successful and stay in business as those just meeting standards will find themselves falling to the side. A key takeaway for readers is to find a way to be a tenacious leader, employee, or provider so that your patients can reap the benefits that come with being a tenacious leader.
References for article:
https://link.springer.com/chapter/10.1007/978-3-030-26684-4_10 Tempered Tenacity: The Leadership Required to Work Across Boundaries by Liz Wiggins from Transitions and Boundaries in the Coordination and Reform of Health Services pp 223-242
https://link.springer.com/chapter/10.1007/978-3-031-38534-6_17 Leadership and Health Scholars by Richard G. Milter and Kathleen M. White from Education Scholarship in Healthcare pp 253-263
https://www.emerald.com/insight/content/doi/10.1108/JHOM-07-2018-0210/full/html The making and sustaining of leaders in health care by Terry J. Boyle and Kieran Mervyn from Journal of Health Organization and Management ISSN 1477-7266
OIG 2024 Report Hints at Fraud Areas they will be investigating
Swindler of the Week--Normally on Fridays I post about someone who has swindled the insurance companies out of millions; however, this week I would like to focus on what the Healthcare Fraud Enforcement Agency has indicated as areas they will be looking at most in the next year or two.
The OIG report for 2024 gives us a few indicators of what the Enforcement Team will be looking for as they investigate fraud and waste claims. Some of the top initiatives are strengthening the Medicare and Medicaid Program Integrity, using strike force teams for targeting abuse and fraud, and Covid-19 fraud and abuse.
To find out more information, click this link for a great article with a lot of great information.
Swindler of the Week—Covid 19 test Scam
Swindler of the week--focused on two Jacksonville women who have been accused of scamming Medicare out of nearly $4 million in Covid-19 reimbursements for tests. Their scam involved creating a company, using a billing company to submit the claims for reimbursement, and obtaining a list of Medicare beneficiaries and submitting false Covid-19 tests under those names. Sometimes they submitted as many as eight tests per person. To read more about their scam and their upcoming court hearing, click the link.
Navigating Conflicts in the workplace
Conflicts--disagreements or a variance of interests, goals, or understanding of direction (dictionary.com). Conflict resolution--the process of ending or resolving the disagreement or dispute in a way that satisfies all involved to some degree. Conflicts happen all the time in our lives, both daily and in the workplace. Addressing those conflicts in the workplace can be harder than those handled in our daily life.
Conflicts in the workplace can occur between employees, managers and employees, and employees and customers/patients. How it gets addressed and resolved can both define the practice and determine the retention of employees and patients. So, how should conflicts in the workplace be resolved? In a healthcare setting, conflicts can affect patient care and resolving these conflicts immediately is of utmost importance. There are seven key points that can help guide you as a manager or employee on navigating conflicts in your workplace.
Open Communication
Communication is the key and open communication is of utmost importance. Open communication involves establishing a culture that engages your employees to speak openly, respectively, and comfortably. Having open communication from day one of each hire where they feel comfortable coming to others with their questions, challenges, concerns, or ideas helps foster open communication during conflicts and discussions surrounding those conflicts.
Active Listening
Active listening is a way of defusing conflicts through actively listening and waiting to respond until the complete statement or statements of the others are done. Active listening means you have eye to eye contact with those involved in the conversation, do not interrupt, do not jump to conclusions, listen without judging, and do not start planning what you are going to say as you will miss what the person talking is trying to convey. This gives you, the manager, the ability to identify what the real problem is and helps you create the proper response at the right moment.
Ask Questions
Resolving a conflict is almost impossible when it feels like you are being attacked or like you, as the manager, are attacking your employees. When you hear a conflict happening or you become part of a conflict, it is important that you approach those involved in the right way. This means choosing your words carefully and avoid starting the conversation with negative feedback. If you start by asking questions such as, "I heard there was a disagreement about job descriptions/role and wanted to check in. Can you share with me what happened or how you are feeling?" This approach opens the door for you and is less triggering and more receptive by the employee(s) involved in the conflict.
Pause
Before you, the manager, begins to jump right into the conflict with your thoughts and opinions that may be biased, it is important to take some time to pause. It is important to avoid having an opinion or bias until you have heard all the information and have a complete picture. This does not mean that you can validate their feelings or concerns right away, but rather do not give your opinions or thoughts on the conflict. Take a moment to digest the information you have received by saying, "I hear what you are saying and I am going to just go and think about this and we will meet in a few minutes to discuss this further." This approach not only gives you time to digest all the information, compile your thoughts, but also to set aside personal feelings for the employees involved and focus only on how the conflict affects production or the environment of the workplace.
Stay Objective
It is vital that you do not take sides or involve your personal feelings or experiences in the situation. Your role as the manager is to help your employees, patients, or team members resolve the conflict and not simply determine who is at fault or to blame. To stay objective, it is imperative that you as the manager guide the conversation to stay focused on the facts of what occured, what the specific scenario was, and do not let employees become focused on whose fault it is or their personal feelings and opinions of others. Do not use the words always or never as these words tend to feel aggressive to those involved. Keep the focus on what you as the manager are hearing and continue clarifying the situation.
Encourage Ownership
It is important, as the manager, to not find the solution for your employees or those involved in the conflict, but rather help your team to find solutions on their own as this helps them learn and grow. It is important, though, that as the manager you listen, guide, ask questions to help clarify the situation for yourself and those involved, and encourage each person involved to take responsibility for their part in the conflict and the importance of resolving the conflict.
One way to encourage ownership is to ask questions that help those involved recognize their power and ability to improve the conflict or situation moving forward. This can be done by asking questions that involve asking what will make them feel better going forward, what would they do differently if this happens again, or how do you want to talk to the others involved and find a solution. Asking these types of questions helps to guide your employees or patients to feel satisfied and empowered to fix the problem and find solutions on their own. It also helps guide them into taking ownership of their role in the conflict.
Celebrate
Recognize that solving the conflicts help build relationships within the organization and foster a positive work culture. The most effective teams are those that recognize a conflict, find solutions, and celebrate in the conflict resolution. This allows individuals, teams, and patients to feel more comfortable with conflict and understand that conflict helps grow the organization through resolution and relationship building. This is done by giving credit where credit is due!
Report
This step is often overlooked by many managers. When a conflict occurs, it is important that the manager creates a brief report of the conflict that documents those involved, the discussion that was had, the circumstances surrounding the conflict, the solution decided on, what could have been done differently and why as well as how it was celebrated. This is important so that when other conflicts happen you can review what was done and if it was successful then taking cues from that report can help resolve the new conflict quicker.
Conflicts happen every day to some degree in the workplace. In a healthcare setting though, conflicts--even minor ones--can create lasting effects for the patients and the practice. It is important to have a conflict strategy or plan in place before conflicts happen. Have someone you as the manager can go to for advice and can remain neutral and be able to offer you good advice and direction when needed.
Sources:
https://www.armyandnavyacademy.org/blog/effective-communication-is-key-to-resolving-conflicts/
a perfect storm for audiology in 2024
As we move to the end of the first quarter in 2024, I have noticed a few trends that have created a perfect storm for the audiology industry. First, the economical situation for most Americans is one of uncertainty. Second, the boomers are now becoming the older generation and with that means almost 430 million people world-wide with disabling hearing loss according to the World Health Organization's statistics. Third, the ever changing, progressing, and fast moving advancements of technology. These three aspects combined have created a significant need for audiologists and yet the industry lacks the number of audiologists needed to meet the demand. To better navigate this storm and help those facing hearing loss, the audiology industry must confront these three issues head on.
The economical situation for Americans, and world-wide, has created a situation where patients must decide between a house payment, food on the table, basic bills paid or hearing aids. Hearing aids, while a necessity for a qualitative life, are often not covered by insurance companies and if they are they are limited to the quality of aid they can choose from. This creates a problem for audiologists who are trying to make sure their patients have the best to live their best life.
The big generation of boomers, has now reached an age where they are facing significant hearing loss. It is this group that is most affected by disabling hearing loss, according to WHO, and yet this group is the median on the economic scale. Making sure your practice targets this group and yet has different economical packages available is a challenge for many audiologists today.
The rapid development of technology has taken every industry by storm and especially the industries that deal with devices such as hearing aids, mobile phones, computers, and more. This is both a blessing and curse for the audiological industry. Advancements in cochlear implants have helped so many hear and have better outcomes in their health plans. Advancements in hearing aids have helped varying generations have better outcomes with conversations, hearing, understanding, and even using their bluetooth devices such as phones. Today's hearing aids can often connect to the phone so that the user does not even need to have their phone next to them or holding it in their hand. They can just talk like normal while doing other things. Hearing aids can block out the background noise so often heard on mobile phones thus creating a better outcome and more enjoyable experience for the patient. Again, leading to a higher quality of care being given to the patient.
These three challenges combined with the challenges of CPT coding and the ever changing guidelines from CMS on how and what audiologists can bill, a perfect storm has been created that leaves audiologists and patients in the middle of the storm. There is a need for new codes to be created as old codes are outdated and not encompassing of all the new technology. There is a great need for providing more expansive codes that are more comprehensive and draws the complete picture of the patient's hearing health, not just a snapshot.
With this perfect storm brewing, Audiologists need to make sure that there practice is prepared to weather this storm and come together to help create new codes and code definitions. Those of us in the consulting business, coders, and medical insurance billers know that if we can all come together and find new ways of helping our patients navigate the storm, your office can also be successful and increase your patient base and your revenue.
Article source: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss#:~:text=Overview,will%20have%20disabling%20hearing%20loss.
Published by
Julie Barth, DM, MBA Julie Barth, DM, MBA
Leadership and Management Consultant--specializing in processes and procedures for best practices of leadership and management Leadership and Management Consultant--specializing in processes and procedures for best practices of leadership and management
Published • 1d
The Perfect Storm Facing the Audiology Industry
Friday’s Swindler of the week
Mathew James of East Northport used his medical billing companies to scam insurance companies into paying millions in fraudulent claims. From impersonating patients and family to requesting appeals and reviews of services that were never done to advising his physicians to schedule elective surgeries through the ER so that reimbursement was higher. He was found guilty on February 2, 2024 and ordered to pay more than $336 million in restitution. To find out more, click the link.
What are your three main problems with billing in your healthcare office?
Wednesday's Question of the Week--What are the three main top challenges with billing in a healthcare office? Understanding what these are and how to combat them and help your practice solve these problems before they affect your revenue. Click here to find out easy solutions.
Spotting Health Insurance Scams
In today’s world, there are many scammers out there trying to make a quick buck off vulnerable people. Today’s Swindler of the Week is focusing on 5 signs of health insurance scams. Click here to find out what those five signs are and how to protect yourself and your loved ones—especially those of the older generation—from being scammed.
Wednesday Question of the Week
Can NP's bill the same as Physicians in Wisconsin? Billing for NPs is a complex set of rules that need to be followed and can often be confusing for the medical biller. Click here to read the article that helps simplify some of the confusion surrounding the policies, laws, and exceptions.
Swindler of the Week
It's time for Swindler of the Week. This week's case comes to us from Columbia, South Carolina where St. Francis Physician Services, Inc and their entities agreed to pay $36.5 million to resolve allegations that it violated the False Claims Act, Stark Law, and the Federal Anti-kickback Law. The violations were founded in the fact that this group made payments to orthopedic surgeons based on volume of referrals. Click here to read all the details and the outcome to the group after this settlement.
Click our services page and see what we can do for you and how we can help you avoid this same situation for your facility.
Value-based care vs. fee-for-service
As we navigate toward payments for value-based care versus fee-for-service, what are your thoughts? Understanding the difference can help clarify why value-based care is going to improve patient outcomes and reduce overall healthcare costs. Click here to find out how value-based care is supposed to work and the benefits when it does.
2024 CY Final Medicare Physician Fee Schedule Ruling
Every year providers wait anxiously to find out what the changes will be with the Medicare Physician Fee Schedule. These changes effect the bottom line and revenue that a provider brings in each year. This year, there is a 1.25% reduction in the payment rates. Click here to read what codes, specialties, and services are affected.
ICD-10 April 2024 Updates out now
Any biller and coder knows that ICD-10 codes tell the story to the insurance companies on what was done and why. Click here to find out all the updates that will go into affect April 1, 2024.
2024 Medicare final rules for Specialty—Audiology
Every year specialty providers are faced with changes in how they can bill, what they can bill, and what they will be reimbursed. This link takes you to the specialty, audiology, and brings you updates for 2024 on new physician fees for 2024, coding updates, and two new timed codes that can be billed and potentially allow for greater services for your patients.
CPT Coding updates 2024—What you need to know
As anyone healthcare facility and employee knows, coding updates are crucial in the industry. Coding updates reflect the evolving environment of medical services, procedures, and equipment. Click this link to find out the changes, revised codes, and deleted codes for 2024.
Eight Trends All Healthcare Billing Specialists Need to Know for 2024
With the new year here and the ever changing world of healthcare billing, here are eight trends in healthcare billing that continue to evolve as technology changes. It is important for all billers to know these trends and help their providers engage in these to ensure they do not risk loss of revenue and patients.
Eight Trends All Healthcare Billing Specialists Need to Know for 2024
OIG Released Opinions Relating to Healthcare Providers
The OIG just released the first four advisory opinions of 2024. The opinions are regarding the use of gift cards for referrals, preferred hospital networks, and retiring physician buy-out policies. Check these out today as they affect your practice in one way or another. If not now, then in the future! Click this link to read the opinions now.
Insurance coverage changes
Insurance changes constantly. Are you ready for what the new year has in store?
Insurance is ever changing and in the field of medical billing, it is imperative that billers understand those changes when they occur. 2024 has many changes coming. Click this link to find out what changes are coming and how you can use those changes to your advantage.