PROFESSIONALISM IN YOUR PRACTICE

Webinar provided by Cindy Pezza, PMAC

Pinnacle Practice Achievement, LLC Physician Engagement Program

YOUR PRACTICE’S REPUTATION

� From the initial phone call until check-out, there are countless ways to improve or tarnish the reputation of your practice.

� Your TEAM members are the front line of defense and the lasting impression that patients take home.

LET’S BEGIN WITH THE PHONE

SMILE THROUGH THE PHONE

ANSWER WITH A SCRIPT

Good Morning, Affiliated Foot and Ankle,

This is Cindy, How may I help you?

MAKE SURE THEY CAN HEAR YOU

BE POLITE (EVEN IF IT HURTS)

NEVER CHEW ON THE PHONE

KEEP HOLD TIME TO A MINIMUM AND ONLY PLACE THEM ON HOLD ONCE!!

REQUIRED INFORMATION

� Reason for visit (yes this comes before insurance type) to determine the need for urgent care (diabetic with red, hot, swollen foot)

�  Referral source – also important for triage **

�  Patient name (Given name as listed on their insurance card) �  Patient Date of Birth

�  Patient Insurance and ID # (do not wait until the patient arrives)

� Guarantor and Date of Birth

�  Patient Mailing Address

�  Patient Email Address

�  Repeat spelling of name and date of birth back to patient

TRIAGE (WHAT YOU MAY NOT HAVE TAUGHT YOUR STAFF)

� Medical necessity URGENT NON-URGENT EMERGENT

�  Example: Diabetic with possible infection

�  Practice Impact � Consider referral source, condition and future relationships

�  Example:

� A patient with heel pain calls and wants to be seen as soon as possible. The receptionist asks how long he has been in pain and the patient replies, “6 months, but I just can’t take it anymore.”

� Where/when would this patient be placed on the schedule?

APPOINTMENT TYPES

� Doctors should review the differences between urgent/non-urgent/emergent visits

� All TEAM members should shadow in the treatment room and understand what happens with each common visit type

� Scheduling systems/appointments should reflect the amount of time needed to treat the most common visit types

ARE WE PREPARING OUR PATIENTS?

� Patient Portal (is it being used?) � Intake forms filled out ahead of the visit whenever possible � Medication/allergy lists � Medical history � Primary Care information including referral in place prior to

visit � Pharmacy Information � Copay/deductibles due at time of service � Directions to your office (via your website) � Arriving early as a new patient

ENDING CALLS ON A POSITIVE NOTE

� Personalize ,thank them for calling and sound like you mean it!

� Remember, they could have called someone else!

GREETING PATIENTS

At the time of visit, there are multiple opportunities to impress or disappoint prior to doctor entering the treatment room.

�  Training in this area is vital to the success of the practice and at times your online reviews.

�  There are more negative reviews regarding the front desk and wait times than other areas of the patient experience.

�  Follow these rules:

�  1. Patients should be greeted promptly upon entering the reception area.

�  2. Patients who present in person take precedence over patients on the phone (front office team should be trained to understand this and to immediately make eye contact, smile and give the “one minute” finger while asking the caller if they mind being placed on a brief hold, waiting for a response before doing so). . .

�  3. The customer is always right.

SCRIPTING SHOULD BE DEVELOPED AND IMPLEMENTED WITH ALL TEAM MEMBERS

�  For collecting copays at the time of service

�  For collecting/explaining balances and handling patients when they become difficult

�  For patients who present without proper documentation, referrals, copays, etc.

�  For when the doctor is running behind

�  For when the patient is late or very early

�  For patients who are time vampires

YOU MUST FOLLOW THE RULES

�  Rule 1. In the grand scheme of things, it is you (your practice) and the patient against the big bad insurance companies

�  Rule 2. By not collecting copays, deductibles, and other out of pocket expenses as termed in the patient’s insurance plan, you are breaking contract with that carrier.

�  Rule 3. Out of pocket expenses are increasing each year and it is our job (through the efforts of trained TEAM members) to collect what is owed at the Time of Service

�  Rule 4. Verbiage is important. . . HOW would you like to pay rather than WOULD you like to pay

IRRITABLE PATIENTS

�  Patients who become irate after hearing the “bad news” about their balance need to be removed from areas where other patients are present.

� A “billing specialist” should be designated and prepared to handle these types of situations in a private space.

� Determine a minimal $ amount and print a copy of statements (previously mailed in most cases) for patients when they arrive.

�  Example: Patients with balances over $50.

�  These patients should receive an extra reminder of their balance prior to their visit (if an automated reminder has been placed)

AESTHETICS

� Make your office and your staff visually pleasing! � Clean reception area � New magazines � Educational materials and programming � Spotless treatment rooms � Living plants � Quiet music

NAMES ARE IMPORTANT � Don’t allow your staff members to become the

“shoe girl/guy” or �  “The one who takes my money”

ANSWERING FAQ’S � TEAM members should be able to

IS IT REALLY IMPORTANT TO KEEP MY BANDAGE DRY?

I DON’T REMEMBER WHAT THE DOCTOR SAID.. . DO I PUT ICE OR

HEAT ON MY HEEL?

DO I HAVE TO WEAR THAT HEAVY JACKET WHEN YOU TAKE MY X-RAY?

MY PARTS ARE TOO OLD TO PROTECT

CAN THE DOCTOR JUST CALL ME WITH MY MRI RESULTS? I KNOW SHE ONLY

WANTS TO COLLECT MY COPAY!

ISN’T IT YOUR JOB TO CALL FOR MY REFERRAL? I’M BUSY YOU KNOW!

I’M DIABETIC, IS IT BETTER TO WEAR WHITE OR BLACK SOCKS?

WHAT IF I HAVE ON BLACK SHOES??

WHY DOES MEDICARE PAY FOR THESE SHOES ONCE A YEAR? THEY DON’T LIKE

TO PAY FOR MUCH ELSE?

DEDUCTIBLE. . . CAN’T YOU JUST REBILL IT?

IS A PODIATRIST A REAL DOCTOR?

SCHEDULING CONFLICTS

� Every office has them. . .schedules and conflicts

� It’s how we handle them that makes all the difference

PATIENTS THAT ARRIVE EARLY

PATIENTS THAT ARRIVE LATE OR WHENEVER THEY CHOOSE TO. ..

HOW LATE IS TOO LATE? � Are you sticking to your policies?

� For late patients � When collecting copays � With no-shows (cancellation policy)

Are you undermining the practice policies?

DOCTOR TIME IN TREATMENT ROOMS

TABLE TURNOVER THEORY

DISPENSING IN THE TREATMENT ROOM

� Any staff member who dispenses products and devices as recommended by the DPM needs to be THOROUGHLY trained on how to properly instruct, fit and explain the benefits of utilization.

� Without staff understanding of the WHYs involved in our treatment protocols, patients are far less likely to be compliant.

�  For example: Do your back office staff members understand and can they explain. . .

� Why we recommend wearing a nightsplint following their diagnosis of plantar fasciitis?

Take some time and review the WHYs. . .. It will make a huge difference!

CLOSING THE DEAL

�  Front office team members are also instrumental in patient compliance.

�  Pick your top 5 dispensed products and see if every team member can explain:

Also do this with the most commonly dispensed DME items and make sure all staff members are adequately prepared to dispense with confidence.

EXAMPLE: CLARUS ANTIFUNGAL SOLUTION

� What it is? (A topical treatment for toenail fungus)

� How does it work? (The active ingredient Tolnaftate is delivered in an oil base penetrating the nail to reach the source of the infection)

� When do I use it/How often? (Apply the solution to the base of the nail and brush up towards the tip of the nail twice daily, when the feet are clean and dry)

� When will I see results? (Results vary depending on severity of the infection and it is important to use it consistently and keep your appointments with the doctor so she can monitor your progress. Toenails grow at a slower rate than fingernails and toenails with fungal infections may grow even slower. After a few months the doctor will be able to determine if the solution is improving your condition.)

COMBINING PRODUCTS

Also consider combining complimentary products and offering discounts to patients who follow your complete treatment plan

Example: Use Clarus Solution on the nails, Clarus Cream on the skin and Clarus Shoe Spray to treat all shoes that may be carrying the infection. Also consider incorporating a hyperhydrosis treatment.

$5 off the total price when more than 2 products are purchased together.

MEDICAL GRADE AND PHYSICIAN ONLY FORMULAS AND PRODUCTS (TWO IMPORTANT PHRASES)

Medical Grade Inserts (sample script) �  Please take your time and adjust to your devices

�  Begin by removing the liner from both shoes (if possible) and replacing them with your new medical grade inserts

� Wear your inserts for 1-2 hours the first day and increase wear time gradually for a period of one to two weeks

�  By gradually increasing wear time, your body will more easily adjust to the substantial support and control of your inserts

� Depending on activity level and the type of medical insert your physician has recommended, you can expect to feel significant relief from foot, knee, hip or back pain for months.

HELPFUL TIPS

It is completely normal to experience discomfort or mild achiness in the feet or legs while your body adjusts to wearing the devices. Remember, these are

medical grade inserts and much more substantial than over the counter or off the shelf products. With this in mind, should you have concerns, please contact

your physician.

DME DISPENSING MUST HAVES (FOR PRE-FAB AND CUSTOM AFOS)

�  1. Rx

�  2. Detailed Written Order

�  3. Patient Acknowledgement/Proof of Delivery Form

�  4. Verbiage in chart note documenting what you have dispensed and why

�  5. Copy of 30 Supplier Standards available to and posted visibly for patients

�  Samples available to you in the PEP library (and to be reviewed in more detail on a future meeting)

6 Required Documentation for Diabetic

Shoes 1. Prescription (RX) written by DPM (prescriber)

2. Statement of Therapeutic Necessity - Signed by MD/DO

4. Relevant Medical Records- Signed by MD/DO

3. Supplier in person evaluation, Exam perform prior to shoe selection (CDFE)

5. Dispensing SOAP Notes- Signed by DPM(supplier)

6. Certificate of Receipt- Signed by Patient and DPM

IF YOU ARE HAVING TROUBLE PROCURING DOCUMENTS FROM PCP

�  1. Create systems and keep organized

�  2. Double check that you are sending documents to the correct MD/DO (and that the fax number is accurate)

�  3. Attempt multiple times but do not annoy the PCP

�  4. Make sure the documents are getting to the PCP (not being held up or thrown away but reception)

�  5. When all else fails put the responsibility back on the patient and make them understand that you must follow the rules

�  6. Some PCPs are not worth chasing; know when to give up

COMMON PROCEDURES

� Create manuals for front and back office

� Document each step of common procedure set ups and items required in the treatment room at all times

�  Take pictures of ideal cabinet set up, drawers, counters

� Any staff member can duplicate from a picture

�  Examples to follow. . .

INGROWN NAIL AVULSION

•  Phenol •  Curette •  Spatula •  English Anvil •  Forceps (2) •  Lidocaine •  5cc syringe •  Needles

• 18 1½ • 25 1 ½

•  Coban • Nail pack sterile

•  4 Gauze •  3 Wood Sticks •  Rubber Band • Phenol

WARTS

•  Gauze •  Scalpel •  Blade 10 or 15 •  Wood Sticks •  Phenol •  Moleskin •  Histofreezer • Phenol

TRAIN TOGETHER AND ACCOMPLISH MORE

� Make in-services (trainings) a formal part of your schedule

� Do not try to squeeze a meeting or training in at lunch on a busy day.

�  Plan for it by adjusting your schedule.

�  Example: The last Tuesday of each month, schedule the last morning patient at 11:15 and don’t schedule your first afternoon patient until 1:15.

� Order in lunch, set an agenda, stick to it and work together for a full 60 minutes without distractions (put the phones on service, lock the door, make it mandatory for doctors and staff). Begin on a positive note and end on one as well.

USE THE PEP LIBRARY

� Make sure you are using the resources available at your fingertips and edit to fit the needs of your practice.

� Invest in your team and the future by developing

solid protocols and systems for every aspect of your practice.

YOU ARE ON THE ROAD TO IMPROVEMENT

Be proud that you have taken the initial steps towards improving the health of your practice. If there are any forms, documents or trainings that are not currently uploaded to the PEP library, please contact us and we will do our best to accommodate.

Admin@pinnaclepa.com

Thank you!