Eyeworld

EW NEWS & OPINION 32 September 2017 To the point: Simple practice tune-ups for complex times by John B. Pinto, and Corinne Wohl, MHSA, COE Facilities management • Is there one single person (typical- ly the practice administrator) who is responsible for the condition of your office facilities? Does this person impose high enough stan- dards? • Are our facilities slowly degrad- ing, staying about the same, or improving? • Are building maintenance, cleaning, painting, and gardening vendors staying on top of their respective jobs? • Is the quality of our facilities in line with the image we want to project? Marketing and development • Do we have a written marketing plan and goals this year for things like new patients, cataract cases, and number of referring doctors? Are we on track with these goals? • What have we done this month to ascertain patient or referral source satisfaction? What were the results? • Have we written thank you notes to patients who referred to us this month? of a denial? Are we working our denials actively? • Are we on top of refunds, or have we allowed these to creep up? Reception and call center management • What percentage of our desired template are we actually filling? (If you have the capacity and desire to see 40 patients per day, you should have 42 appointment slots, allowing for the typical 5% no- show rate.) • What is the average primary wait- ing time now? (That's the time passing between the patient's ac- tual appointment time and when they are first roomed by a staffer and should be under 20 minutes in most settings.) • When is the next available non-emergency appointment? (It should ideally be 3 weeks out or less.) • What do our phone reports tell us about how diligent we are in answering the phone promptly and not letting callers roll over to voicemail? and testing payroll hours in a month, and divide by the number of total patient visits, including postops. The normal figure is about 1 staff hour per visit in general care, and up to 1.3 hours in subspecialty care.) • Has sufficient cross-training oc- curred to allow techs to scribe or scribes to do testing, so that the team is more flexible and can flow during the clinic day to where they are most needed? • Is any equipment out of repair or in need of replacement? Billing and patient accounts • What is the cycle time now between seeing a patient, post- ing the charge, and submitting a claim? (You want to hear that it's taking no more than 24 hours to post and another 24 hours to submit—less is always better.) • Looking at our aging report, what percentage of our open accounts are out more than 90 days? (Less than 12% is desirable; less than 8% is seen in superior departments.) • What is our claims denial rate? What is the most common cause "I told the doctor I broke my leg in two places. He told me to quit going to those places." —Henny Youngman B ack at the dawn of time, before computer-aided learning, when the oldest quintile of this publica- tion's readers was wrap- ping up their formal education, a prominent learning aid was "round- ing" patients in the hospital. Individually or in small groups, you would go from one patient bed to the next, checking progress, sharing a laugh if time permitted, scanning the latest vital signs, and ordering new tests, all under the watchful eye of your superiors. Such case-based learning is grueling and occasionally embarrass- ing, but effective. And it is the basis for many non-medical graduate programs, including business and finance degrees. Even if you haven't stepped onto a medical school campus for many years, you have hardly left academics behind. The most clin- ically successful ophthalmologists we know approach each patient as another opportunity for medical learning. What we've observed in our fieldwork is that the most financially successful ophthalmologists apply the same intellectual curiosity to their administrative "rounds." How can you get started with this? Doctors in training memorize various question sets to ask each patient, depending on their present- ing condition. With experience, the clinical question set expands; some questions are skipped and others added. We present here a starter set of questions you can apply in the various business domains of your practice. Clinical services • Are we conducting enough tech training, of high enough quality, to have everyone on the team up to speed? (Shoot for no less than 2 hours of training per month.) • What is our current back office staff-to-patient-visit ratio? (Count the total number of tech, scribe, Performing rounds on your practice's support systems

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