Employee Spotlight: Kelly Giles

Meet Kelly! Kelly, the Help Desk & Quality Assurance Manager at TSI Healthcare, joined our family in October of 2011. Kelly illustrates the true essence of teamwork through her positive attitude, dedication, and commitment to excellence. She is always courteous, polite and goes above and beyond to ensure that each client request is met in a professional and timely manner. Get to know Kelly better…

Revealed: The Secrets to a Great Revenue Cycle Strategy, Part 2

Welcome to the 2nd installment of our 3 part series as we examine the key components to a great revenue cycle strategy. We learned in part 1 that there are no secrets to revenue cycle strategy. Instead, there are basic principles that, when properly followed either by your billing staff or your Revenue Cycle Management (RCM) services provider, will enable you to get better medical revenue cycle results.

The first three operational principles: Collect patient balances the same day of service Verify patient insurance eligibility Implement a triple clean claims scrubbing process (click here to review those principles in detail) The next three operational principles: Remind Patients of Appointments. No-shows are a very costly component of any practice. According to the MGMA, most medical practices average a 5-7% no-show rate. While there are many strategies for managing no-shows, including no-show penalties, overbooking and collecting advance deposits for some specialties to name a few, the best strategy is a tailored and consistent automated appointment reminder program. Place someone at your practice in charge of measuring the effectiveness of automated appointment reminders based on timing and frequency. I’d also encourage you to request confirmation from your patients for appointments and track this. Population Health and Patient Portal are two effective systems utilized by our firm. Tracking and Preventing Claim Denials. Finding why your claims are getting denied, ranking them by denial code and payer, and then systematically fixing them at the source can dramatically impact both practice cash flow and operational efficiency. As is often the case, you will likely find that 20% of the denial codes account for 80% of your denials. Most claims clearinghouse solutions have this information readily available and it is just a matter of assigning the tracking and fixing of denials to a team member. Often denials result from something as simple as an incorrect referring provider number or provider linkage errors up to more complicated improper use of modifiers, etc. No matter the reason, most denials can be fixed, often by examining why they occur and fixing them at the source of your front-end processing. Clean claims rates should be in the 94-98% range. Manage Insurance Underpayments. Loading fee schedules and producing a regular under/overpayment report will be very beneficial in identifying any insurance underpayments and making the necessary adjustments. Setting up access to payer websites will help you gain access to these fee schedules which can often be imported by your PM System. Also producing reports which identify any time you receive payment of 100% of a payer’s allowed amount will be helpful in identifying where your fee schedule may need a bit of tweaking. Measuring these vital operational components and then implementing an ongoing strategy toward their optimization can pay substantial dividends in today’s challenging world of increased provider demands and shrinking reimbursement. Check back with us soon where we complete this series with a look at the final components of optimizing your revenue cycle management.

David Dyer Vice President of RCM Group Services and Business Development

Employee Spotlight: Shawn Daugherty

Meet Shawn Shawn, the Team Lead for Technical Services Group at TSI Healthcare, has been with our family for over 3 years. Sporting zombie apocalypse public service announcements at his desk, it's never a dull moment when working with Shawn. He has proven time and time again to be a valuable asset, winning awards for Above and Beyond in Quarter 1 2013, Technical Services Group MVP in 2013, and Rookie of the Year in 2012. Get to know Shawn better…

TSI Healthcare Turns Users into Payment Experts in Just 10 Minutes with Latest Webinar

TSI Healthcare, together with TransFirst, offers a fully integrated Payment Processing through NextGen Enterprise Practice Management (EPM) and NextGen Patient Portal.  Our recent webinar provided an overview of the solution, touching on key time and money saving points for its audience of providers, practice administrators and chief operational officers. To hear the webinar and download a pdf of the presentation, visit our Events Page. Below are a few of the Frequently Asked Questions from the webinar.


What would my merchant processing rates be with this solution?
Rates are dependent on a number of factors. TransFirst will complete a unique analysis for each client. Rates are very competitive and we can often meet or beat existing rates.


What if we don’t like the solution?
With TransFirst, there are no contract terms or early cancellation fees. If you need to cancel and return to your previous solution you only need to let us know.


Why are ACH (electronic checks) less expensive than a credit card transaction?
An ACH transaction is moving money through the banking system so the fees are typically $.25 – $.35 each. A credit card transaction has the fees assigned by that card association (ie Visa, Mastercard, etc.) and those costs are higher.


How do I learn more about TransFirst?
Call us at (800) 354-4205.


Be sure to visit our Events Page to register for additional upcoming webinars.

Employee Spotlight: Marcellus Atkins

Meet Marcellus! Marcellus, an EHR Support Specialist at TSI Healthcare, consistently makes the transition to a new EHR as smooth as possible for our customers. He truly cares about how the customer feels and puts forward a real sense of urgency to solve any problems. His coworkers commend his positive and upbeat attitude, making him a pleasure to work with. Get to know Marcellus better…

REPOST: The Boom Continues: Dissecting HIMSS14

Health information technologies have attracted plenty of healthcare reforms that they are now a staple in every medical institution's digital services, citing the vital role they play in care coordination, patient engagement, and analytics. More insights into the rapidly evolving healthcare industry can be read here:

Image source: ehealthreporter.com

If attendance at the annual Health Information Management Systems Society (HIMSS) conference is a barometer of the state of the health IT industry, then the sector continues to grow at a rapid pace, but is starting to converge. HIMSS 2014 set a new record for attendance, with close to 38,000 participants. If that’s not significant enough, over 1,200 health related IT companies exhibited in the cavernous 50,000 square foot exhibit hall. Even some of the relatively new companies to enter the market claimed large spaces in the exhibition hall, validating the willingness of venture capital and angel investor money to both launch and fund these ventures.

This event is choreographed to display the grandeur of the health information technology revolution driving healthcare reform in America and the massive formation of the digital tools responsible for transforming the healthcare industry, all under one big top. While it could be argued that this year’s HIMSS event lacked a new dominant theme, and that the message across nearly every booth was population health management and analytics, it was clear that despite political haggling and partisan politics, health IT continues to be one of the clear winners in the transformation of healthcare.

If you think of the main exhibit hall as an ecosystem, at the apex of the food chain stood the dominant EHR providers: Epic, Cerner, Allscripts and McKesson. Emerging quickly in numbers to challenge this hierarchy are the many and adaptable population health management (PHM) companies. Deep in the peripheral tributaries of the exhibit hall were emerging raptors, small in stature this year, but positioned to evolve quickly (or die), including healthcare analytics companies, optimization consultants and care coordination platforms. The idea-to-market timeline continues to shrink for new and innovative solutions – a far cry from the decades of application theory and beta testing for electronic health records. We see this all too critical acceleration in product development as a very strong driver for continued health IT business initiatives and company launches, as well as future 3rd party investments.

What sense can we make from the maze of exhibitors, EHR vendors, PHM technology companies, health IT start-ups, clinical management technologies, and volume-driven to value-based conversion entities? Now more than ever before, there are unique and compelling opportunities for health IT business development for the immediate and long term time frames. Growth in the opportunities to apply technology and to change the business of care delivery exist, with plenty of room for expansion, which will come as the healthcare industry pivots and explores new approaches to provide comprehensive care to defined populations.

Additionally, we see a coming “applification” of healthcare; a dawning of an insatiable need for functionality, with more companies bringing forth application development programs for care coordination, patient engagement and analytics. There is a natural adaptation that will seize upon this need and work tirelessly to find that “sweet spot” for providers and payers to digitally link to patients, thus creating an umbilicus for shared health information that flows in near real-time, bi-directionally and is secure. This is on the horizon, and we can expect steps toward this reality in the very near future.

The collective message, strategy or axiom to learn from HIMSS14 is one of appreciation for the forces at work to bring about change. Make no mistake, there are many and they are of significant power to push the industry forward, rapidly. Government agencies such as CMS and the Office of the National Coordinator (ONC) are scrambling to stimulate, harness, guide and govern this phenomenon.

The question post-HIMSS14 is: In a world of declining growth in revenues from traditional RVU-based sources, how will organizations continue to pay for these needed IT support solutions that are becoming required elements of survival for healthcare providers? Early adopters of the ACO model are already seeing that the level of investment required to create the infrastructure needed to support the care collaboration is higher than expected and ongoing. Meanwhile, targets will likely become harder to hit, revenues will become more and more restrained, and simple gains in efficiencies could become harder to find.

TSI Healthcare is a leading provider of top-notch technology solutions for its partners in the healthcare industry. Visit this website to know more about its services.

Revealed: The Secrets to a Great Revenue Cycle Strategy, Part 1

As in all businesses, there are many challenges to effectively delivering services; Revenue Cycle Management services are no different.  Revenue Cycle Management (RCM) includes everything from verifying patient eligibility and up-front payment collection to coding, claims processing and tracking, and payment posting. There are no secrets to revenue cycle strategy, only basic principles that, when properly followed either by your billing staff or your RCM services provider, will enable you to get better medical revenue cycle results.  This will be the first in a multi-part series which will examine these principles. 

1. Collect Patient Balances the Same Day of Service. 
    
   All specialties are unique, and each requires its own tailoring, yet the fact remains that the best receivables strategy is not to have any.  Colleting co-pays, patient balances, upfront payment plans, etc., at the time of service (or at least as much as possible), minimizes what many practices have difficulty collecting afterward.  Collect up front.  Most businesses do.
    
2. Verify Patient Insurance Eligibility.
    
   Even some of the most advanced practices are not using this function.  Because we are a provider of services based on collections, much of which comes from insurance companies, it is important for us that we have our clients verify patient eligibility whenever possible. This can be done either before their scheduled visit or at check-in.  Follow up efforts (and costly staff resources) greatly increase when a patient’s insurance eligibility is not verified at the time of service.  
    
3. Implement a Triple Clean Claims Scrubbing
    
   Just like quality control on a factory assembly line, it is more productive to build your claims properly the first time.  The most effective claims scrubbing involves multiple review processes, often as follows:

1. The first scrub is performed manually by charge entry staff with comprehensive coding knowledge. The team looks at the claim to make sure proper codes are being used, the proper procedures have been ordered, and that the proper modifiers have been included, if necessary. This should be done prior to electronically submitting claims to the clearinghouse.
2. The second scrub is performed by your Enterprise Practice Management (EPM) software.  The strongest EPM software solutions can check your claims against the similar practices in the healthcare community for potential errors before the claims are electronically submitted to the clearinghouse.  As more and more edits are accumulated, clean claim rates should continue to improve.  Any errors from this scrub should then be manually reviewed.
3. The third scrub is performed at the clearinghouse level where claims can be cleaned up post-submission but before reaching their final destination with the payer. As with the second scrub, any errors should be manually reviewed.
    
   Implementation of these revenue cycle management principles should be followed up by inspection to ensure that they are being done properly.  The investment in time taken to make sure these processes are properly in place are well worth it.
    
   Check back soon when we pick this back up with a look at proper claims denial management processes.  

David Dyer

Vice President of

TSI Healthcare Employee Spotlight: Allie Henderson

Meet Allie!

Allie, a Special Projects Coordinator and Meaningful Use Specialist at TSI Healthcare, joined our family in May of 2012. Allie is extremely knowledgeable and her southern charm has become famous among those she assists. Her dedication and work ethic is contagious among her fellow employees. Allie was recently awarded the TSI Healthcare’s Above and Beyond Award for the 2014 first quarter! Get to know Allie better…

What’s currently playing on her ipod?
“Bruno Mars”

Her favorite hobby?
“Playing a game of pick up volleyball”

Her personal motto?
“Dream Big”

She’s happiest when…?
“Spending time with friends and family”

Why Allie  <3‘s TSI Healthcare:
“It’s a great organization where everyone works together as a team to get things accomplished!”

 

TSI Healthcare Employee Spotlight: David Dyer

TSI Healthcare Employee Spotlight on David Dyer

Meet David!
David is our Vice President of Revenue Cycle Services Group and Business Development. He joined the TSI Healthcare Family in October 2013. David can always be counted on for a kind word, a helping hand, or if you are lucky, a soulful tune. Get to know David a little better…

 

What are you most proud of?
“My two daughters”

 

What is your favorite hobby?
“Creating and performing music”

 

What is your personal mantra?
“Think positive, treat people like you would like to be treated, and fix things at the source.”

 

Why do you love TSI Healthcare?
“We are all family, we all evolved from the same source, and we provide a valuable service.”

 

What is the most random item on your desk?
“Steak Sauce”

 

To read more about TSI Healthcare's Revenue Cycle Management Services offerings, visit us at http://www.tsihealthcare.com/our-solutions/revenue-cycle-management/.

REPOST: Physician EHR Adoption Leaps 21% In 2013

The healthcare industry and EHR vendors were hugely successful last year with a 21 percent increase in the number of medical facilities adopting electronic health records (EHR) systems. InformationWeek.com has the full report.

Adoption of basic electronic health record (EHR) systems by office-based physicians increased 21% from 2012 to 2013, according to an issue brief from the National Center for Health Statistics (NCHS), a unit of the Centers for Disease Control and Prevention. Last year, 48.1% of physicians had basic EHRs, versus 39.6% in 2012.

Basic EHR systems, as the NCHS defines them, include functions for patient history and demographics, patient problem lists, physician clinical notes, comprehensive lists of patient medications and allergies, computerized orders for prescriptions, and the ability to view lab and imaging results electronically.

Last year, 78% of office-based physicians used some kind of EHR (basic or otherwise), versus almost 72% in 2012, according to the brief. That means they had some kind of electronic information system used for purposes other than billing.

The Meaningful Use EHR incentive program has been driving the big increase in adoption for the past few years. The NCHS reported that in 2013, 69% of office-based physicians planned to apply or had already applied for Meaningful Use incentives, which require them to use a certified EHR system. To participate in Stage 2 of the MU program, professionals must have a system that meets the 2014 edition criteria from the Office of the National Coordinator for Health IT (ONC).

However, the NCHS found only 13% of physicians both intended to participate in the MU program and had EHR systems with the capabilities to support 14 of the 17 Stage 2 core objectives for Meaningful Use. About 56% of respondents intended to participate in the incentive program but did not have systems that could support 14 of the Stage 2 core goals. These doctors comprised about four-fifths of those planning to participate in the program.

Percentage of office-based physicians with a basic EHR system,
by state: United States, 2013. (Source: CDC)Image Source: www.informationweek.com

The trade press has made much of these findings, but the NCHS conducted its survey from February to June of last year. Since then, ONC data shows, most leading EHR vendors have had their products certified for the 2014 edition. It's not clear how many physicians have those products, but 70% of those who attested to Meaningful Use Stage 1 use vendors that have 2014-certified systems.

"I don't think that people will necessarily struggle getting to Stage 2 because a vendor didn't provide a certified product," Rosemarie Nelson, a health IT consultant in Syracuse, N.Y., told us. "But I think there's a painful path for people to get to that vendor's certified version." Some practices will have to give up the customized templates, and there will be implementation and training issues.

Even before the recent increase in 2014 edition EHR certification, physicians were acquiring more capable systems that could meet some of the MU Stage 2 criteria, the NCHS said. From 2010 to 2013, the percentage of physicians with systems that allowed them to record patient history and demographic information increased from 74% to 83%; to order prescriptions, from 57% to 83%; to send prescriptions to pharmacies electronically, from 49% to 79%; to receive warnings of drug interactions or contraindications, from 44% to 74%; to order lab tests, from 44% to 69%; to be reminded of guideline-based interventions, from 38% to 57%; and to report to immunization registries electronically, from 27% to 39%.

The NCHS survey shows wide geographical variations in EHR adoption. In 2013, the percentage of physicians using a basic EHR system ranged from 21% in New Jersey to 83% in North Dakota. The percentage of physicians with basic systems was below the national average in Connecticut, Maryland, Nevada, New Jersey, Oklahoma, Vermont, West Virginia, and Wyoming. Adoption was above the national average in Iowa, Massachusetts, Minnesota, North Dakota, Oregon, South Dakota, Utah, Washington, and Wisconsin.

Established in 1996, TSI Healthcare provides practice management and EHR solutions to its clients. Visit this website for more information on technological healthcare systems.

REPOST: 6 Ways To Use Social Media in Healthcare

Shannon Dauphin Lee of HITConsultant.net discusses a few ways that social media can be incorporated into healthcare to help broadcast information about healthcare professionals and their practice.

Image Source: www.hitconsultant.net

Social media has taken the world by storm and it’s much more than a way to share painfully adorable pictures of kittens — it’s also a way of finding and sharing valuable information. According to the Pew Internet and American Life Project, 72 percent of Internet users say they looked for health information online in the past year. When a serious health issue arose, patients trusted the doctors most of all, with 70 percent of them going to their doctor or other healthcare professional for answers.

That trust in doctors, hospitals and nurses extends to the virtual world. A 2012 Pricewaterhouse Coopers consumer survey found that 60 percent of respondents in all age demographics would trust information posted online by their physicians, and 55 percent would trust information posted online on behalf of their hospitals. Sharing goes both ways: Almost a quarter of all respondents would be happy to share their own take on health issues, experiences, medications and medical treatment online.

The numbers make the story clear: Hospitals, physicians and other healthcare professionals can reach more patients by becoming engaged in social media.

How to use healthcare social media

How can those new to social media make the various opportunities work for them? These six ways to use social media in healthcare can help get the word out about healthcare professionals and the services they provide.

1. Tweet it out. In a fast-paced world, messages of 140 characters or less are well-received. Keep your Twitter account active and relevant by passing on links to interesting journal articles, newsworthy tidbits and “did you know” snippets of health trivia. Remember to always respond to tweets and retweet any worthwhile information.
2. Tell it on a blog. Blogs that reach a specific target audience and deliver pertinent information can give your personal and professional brand a big boost. Popular health blogs include those that offer new updates on health issues or common-sense solutions to health problems. Capture readers with a mixture of information and humor, the way many anonymous doctors and nurses do on their blogs, and you might see your readership skyrocket.
3. Show your stuff. The Mayo Clinic currently has the most popular medical provider channel on YouTube, according to SocialMediaToday. How did they do it? By delivering videos on everything from what to expect from medical procedures to how to understand certain medical conditions. New videos are posted almost daily, which means the content is always fresh and new.
4. Make time for Facebook. One of the most popular gathering sites on the Web, a Facebook account is a must for any savvy social media initiative. Facebook can allow you to tap into a ready-made community of individuals who want to learn more about health, medical conditions and new research. Best of all, in-depth conversations can be sparked in the comments section, giving providers and patients a chance to interact in a meaningful way.
5. Talk it out with podcasts. Not everyone has the time to wade through medical journals or scholarly reports. Podcasts allow you to showcase your knowledge, answer general medical questions and focus on concerns that your target audience wants to learn more about. Podcasts are also a great way to break down complicated information so that anyone can understand it, a move that could make tired and worried minds very grateful.
6. Pin it. It’s not just a site dedicated to crafts and cute babies. Pinterest is filled with all sorts of helpful things, and one of those is the health and fitness board, complete with inspirational pictures and links to everything from new exercise routines to healthy diets to serious discourse on other health-related issues. (But be warned, busy healthcare professionals: Pinterest can be a delightful time-sucker like no other.)

Best of all, these social media outlets can all work with each other to create a cohesive online presence. By making more information about yourself available with only a few clicks, patients can get a very comprehensive picture of who you are, what you do and the kind of assistance they can receive from you.

A few cautions
Chances are you’ve already been using the Internet for networking and researching in your capacity as a healthcare professional and don’t need to be reminded that what happens on the Internet, stays on the Internet — forever. Decide on a few key points before you post, tweet or like. Are you comfortable with posting personal information, such as religious or political beliefs? Are you okay with patients being able to contact you online? If you have any qualms about mixing your personal life with your professional one, create strict rules about maintaining both a personal and professional profile online.

Finally, don’t forget about privacy laws. Discussing any patient online — even a fictional patient whose case is a bit too close to fact — can land you in hot water with employers, patients, regulatory bodies and even the law. When posting online, steer clear of anything that might appear inappropriate or flirt with any professional boundaries. In short, never share something online that you might one day regret.

TSI Healthcare is a leading information technology solutions provider for healthcare systems. Visit this website for more on the company and its services.