Hats_Off_to_PracticeManagers_2016

to Practice
Managers
SIX TIPS TO MAKE YOUR DAY A LITTLE EASIER
HATS OFF

FIREFIGHTER: Putting Out the Fire
How to Handle Disgruntled Patients
Education is the Best Fire Extinguisher
Setting the Right Mood in the Clinic
WRANGLER: How to be a Payment Wrangler
Doing it Right, Right from the Start
Payment Wrangling the Easy Way
COACH: Put Me in Coach
Developing an All-Star Team
TABLE OF CONTENTS
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3
Introduction
Practice managers do it all–coordinating staff schedules, helping resolve staff or
patient conflicts, paying invoices and managing the budget, training staff–even fixing
computers or building issues if they come up. During the course of the day, practice
managers have to wear several hats to keep things moving along for their physicians
and staff, and improve how healthcare is delivered to their patients. That’s no small
feat. And while saying “Thank You” only scratches the surface, we want you to know
how much we appreciate everything you do.
When we asked practice managers across different practice sizes, geographical
locations and markets to name their number one need, the answer is practically the
same: help make my day easier. This eBook is designed to do that by providing
practical tips, policies and practices you can try to tighten up your practice.
Sometimes changing one or two key procedures can be the difference in surviving
and thriving.
On behalf of MedSynergies and the Practice Partner Line, we’d like to tip our hat
to all of the Practice Managers out there, for everything you do to make your
practice a better place for doctors, staff and patients.
Thank You!

4
PUTTING OUT THE FIRE
TIP 1othing sets the day into a tailspin like an unhappy patient.N
When poorly handled, an encounter with a disgruntled patient is the ultimate forest fire—quick to
spread with the potential to damage everything in its path. When emotions flare, it affects
everyone in the clinic—patients, staff, physicians and you. Far too many times, we go into survival
mode when confronted by an upset or dissatisfied person. We’re quick to fight for our side, to defend
ourselves and put our hurt feelings in the driver’s seat – often without considering what the person is
actually saying or feeling. As the face of the clinic, practice managers and front office staff have to be
able to explain the clinic’s position without fanning the flame; more importantly, they must also make
sure the end result is a satisfied patient. This isn’t always easy, but with a little bit of training and
practice, you can learn to put out the flame before it starts.
The important thing you can do right away is to get the right perspective. Keep in mind that the patient
is only in your office when they’re ill or in discomfort, so they’re already dealing with something before
they even walk through the door. That means that whatever they are upset about is at least the second
thing that has gone wrong today. It also means that nine times out of ten, the emotions aren’t about you.
The best thing you can do in this situation is let the person know, by your words and actions, that you
hear them and are there to help them.
Knowing how to handle emotional situations before they blow up not only keeps patients satisfied and
returning, but keeps your day moving smoothly
and your staff (and you) happy and sane.
2014 article in Physician’s
Practice discussed the benefits
of understanding the different
situations and personalities
involved in emotional encounters,
and used a helpful resource from
call center training to help know
what signs to look for and key
phrases to use when dealing with
the different types of disgruntled
patients. By having the staff role
play the various situations and
brainstorm on how to handle the
situation, the front office staff felt
prepared and empowered to
confidently handle the situation.
A
Today, I will play the role of firefighter.
FROM THE FIELD

5
TIP 1
ACTION ITEMS
ACKNOWLEDGE THE EMOTION Let them know that you recognize that they are upset. Here’s a sample response: “I feel like our
communication has broken down. Let’s talk about what has happened, and how we can make things right.” Starting your response
in this manner lets the patient feel that you both are partners in finding a resolution.
NO AUDIENCE PLEASE Moving the patient to a private area where they are free to talk through their situation not only keeps their
emotions more controlled; it helps the patient know they have your undivided attention. Make sure the room has chairs for both of
you to sit down. Offer the patient coffee or water if your clinic keeps it in stock.
LISTEN WITH MINIMAL INTERRUPTIONS Let the patient talk, and gather all of the facts you can so that you can get to the
heart of the matter. When the patient is finished expressing the problem, restate the problem back to the person to verify what you
heard. Be aware of what you are communicating with your face, your posture and your gestures. Don’t fidget or look around – and
most importantly, DON’T look at your phone or watch.
EMPATHIZE, APOLOGIZE AND OFFER A SOLUTION After listening to the patient’s complaint, apologize for their frustration
and let them know you will work to resolve the issue. Keeping in mind the root cause of their frustration, see what information can
be provided to help the person understand what happened. If there was an error on the clinic’s part, acknowledge it and let them
know what you will do to fix it. If there was no error, offer an explanation of what happened and a solution that takes the patient’s
needs into account. Be very clear on what you can do and what you can’t do. If you need time to research the answer, or others need
to weigh in on the solution, be sure to set clear expectations and update the patient regularly on your progress.
SAY THANK YOU Thank the person for speaking up and for their patience while you work to resolve the issue.
TIP 1

6
Education is the best Fire Extinguisher
TIP 2
isit any clinic, and you’ll find that one of the top reasons patients
become frustrated is billing related.
Underneath most of the screaming, tears and frustration, one thing becomes crystal clear: Most
patients do not understand the charges. But would it surprise you to know that a good number of
healthcare professionals don’t understand the billing charges either?
It’s no wonder. Look at any Explanation of Benefits sent by an insurance provider, and you’ll notice
quickly that these aren’t patient friendly documents. These things are harder to crack than Liz Keen and
Red Reddington’s relationship in NBC’s The Blacklist.
According to an article by Lisa Zamosky, a typical Explanation of Benefits, or EOB, lays out how much
of the doctor bill your insurance will cover, and how much you’re expected to cover. It is not a bill. The
actual bill comes from the clinic or health system that the clinic belongs to. The best use of the EOB is
to compare the treatment listed on the doctor or hospital bill and the treatment on record by insurance.
Making sure your staff has the information they need to speak confidently about
charges and bills is a great way to help steer the conversation toward happy and
informed patients, and keep tempers at a minimum.
Take a few minutes to train
each of your front office staff
on how to read an EOB. Make
and laminate a cheat sheet that
can be kept by the front desk.
We’ve included an EOB guide
that you can laminate on the
next two pages, or for a more
detailed reference, check out
this reference tool on
patientadvocate.org.
QUICK TIP
V

7
TIP 2
One example of an EOB had 42 pieces of information listed—42! That’s a lot to take in, even on
a good day. But even a poorly designed document is easy to understand and explain if you look
for the four basic categories of information:
1
Account information
This includes the
patient’s name, account
number, plan information,
insured person’s name
and customer service
information.
n EOB can be simple or complex, depending on how the insurance company has
designed it.
A
2
Visit information
This includes the date of
the visit, the clinic or
hospital visited (usually a
numeric code), the type of
service (s) performed –
either described verbally or
using the CPT code, and
what the clinic charged for
each of the services
(usually labeled as
“Amount Billed” or
“Submitted Charges”).
3
What the insurance paid
This is how much of the
charges will be covered by
insurance. This amount
includes Plan Discounts,
Negotiated or Allowed
Amounts, or columns
labeled “Your Plan Paid”.
There may also be a line
stating a total payment
amount that the insurance
company sent to the clinic
or doctor.

8
TIP 2
You can avoid
incorrect billing by
making sure that the
services performed
by the doctor (in their
notes) match with the
CPT codes used in
billing.
QUICK TIP
4
What the patient owes
The amount that is the
patient’s responsibility –
this is usually totaled and
listed as “Total amount
you owe” or “Patient
Responsibility,” and it’s
made up from the
amounts listed in each of
the following sections:
A. Not Covered:
These are charges that the patient’s plan
won’t cover – these typically have a note
attached explaining why.
B. Copay:
A flat fee the patient pays whenever they use
a particular type of healthcare service, such
as a doctor visit or a prescription. Based on
the services done, there may be additional
charges, but if a patient has a copay, it’s
charged no matter what the visit is for.
C. Deductible:
The amount you pay for medical services before
insurance begins to pay. Just like car insurance
deductible, a patient is responsible for 100% of the
costs until the deductible is reached. Once a
patient has met the deductible, insurance kicks in
to help pay the costs.
D. Coinsurance:
Once a patient meets their deductible, their health
insurance pays a percentage of the remaining
costs, according to their benefit plan. Coinsurance
is the percentage of remaining costs that is the
patient’s responsibility. The patient pays the
percentage until they reach their out-of-pocket
maximum. So if a patient’s policy has a 20%
coinsurance, their insurance pays 80% of the
costs once they have met their deductible.
The amount owed by the patient should be close (if not the same) as what was billed to them by your clinic.

9
TIP 3here’s a lot of talk these days about patient satisfaction.T
The physicians in your clinic probably talk regularly about the new ways to measure and improve their
satisfaction scores. So it’s easy to see why many people in the clinic have labeled patient satisfaction as a
doctor’s job. Truthfully, while the bulk of patient satisfaction relies on the doctor-patient interaction, there is
a portion of it that is built (or torn down) outside of the exam room.
Here’s a true example: a 40-year-old woman goes to her OBGYN and finds out she is pregnant for the first
time. She is thrilled. She happily daydreams about names, little fingers and toes, and itty bitty baby clothes
while waiting to pay her bill and schedule the next appointment. The receptionist, trying to make
conversation, starts talking about how glad she is to have had her kids early in life, and saying how hard it
will be to raise kids as an older person. By the time the appointment is scheduled, the patient walks out
defensive about her happy news, and angry at the doctor’s office. In this case, the patient’s dissatisfaction
had nothing to do with the doctor. In fact, it was only because the woman liked her doctor so much that she
gave the clinic another chance, but not without lodging a complaint first. It’s clear to see that everyone has
a part in creating the ideal patient experience.
It only takes 23 seconds to build a
connection, but a lifetime to
repair a bad connection. If we all
do our part in making patients
feel valued, respected and heard,
patient satisfaction falls into
place.
QUICK TIP
The patient’s dissatisfaction had nothing to do with the doctor. In fact, it was only because the
woman liked her doctor so much that she gave the clinic another chance, but not without
lodging a complaint first. It’s clear to see that everyone has a part in creating the ideal patient
experience.

10
TIP 3
arlier this year, an article in
Physician’s Practice featured
a video by Sue Larsen, chief
operating Officer of Astute
Doctor Education, where she
shared the top way to improve
patient satisfaction. And while
her tips are geared towards
doctors, there are great
takeaways that can be applied
by all of the clinic staff,
beginning even before the
patient walks through the
door.
E
FROM THE FIELD
he number one contributor to patient satisfaction is (drumroll please)…T
Good Communication. When done correctly, communication makes a patient feel valued and builds trust
between the patient and the clinic. So what can you do in your patient interactions to set the stage for good
communication? Here are three tips to build a strong patient experience.
1
2
3
Sometimes you want to go where everybody knows your name. The old TV theme song isn’t just
catchy—it’s true. We like being places where we are treated with a personal touch. When a patient
walks in the door, smile, make eye contact and greet the patient by name. When you’re on the phone
with the patient, be sure to acknowledge them by name throughout the call, and be mindful of how
long you put someone on hold.
Keep patients in the loop. An informed patient is a happy patient. A doctor’s office is generally not
the place where someone wants to be surprised. Help control unexpected news by doing a thorough
verification of benefits the minute you get the insurance information and letting the patient know what
they will owe even before they come in for the appointment (or during check in). And make sure to
deliver billing information in a way that’s easy to understand—no acronyms or jargon please.
Sensitivity counts. Most of the time, if a person is coming into the clinic, they’re not feeling their
best. Show sensitivity to their situation by keeping a calm voice and giving them your undivided
attention. As you check a person in and out, make sure that you protect their confidentiality.
Comments about treatments or outcomes are NOT welcome, no matter how supportive you are trying
to be. If a patient comes in with a front office concern or problem, politely listen to their concern and
work with them to find a solution. Show them by your words and actions that you are there to help.

TIP 1obody likes billing mistakesN
HOW TO BE A PAYMENT WRANGLER
When you’re overcharged, it can throw all of your financial planning out of whack. If you’re undercharged,
getting a refund might be no big deal if you’re receiving the refund, but in the healthcare setting, it’s not only a
hassle for the practice; if done too many times, billing errors can give a practice an incorrect picture of their
financial state. Billing errors also eat up valuable staff time in having to rebill patients or resubmit claims to
insurances. The good news is that most billing errors can be prevented if staff members pay closer attention to
one specific procedure: Verification of Benefits (VOB).
When you verify benefits, you are checking to see what benefits and services are covered under insurance, and
what will be the patient’s responsibility. It’s important that benefits are verified correctly before any care is
provided to avoid unpaid claims or unpaid bills. On a busy day, the VOB process is often delayed or postponed
to get the day back on track, but it does more harm than good. Although VOB is time consuming, spending the
time upfront to complete a thorough and accurate VOB will save a lot of time and stress for both you and your
patients in the long run.
11
Today, I will play
the role of
payment
wrangler.
To quote a hit song from the 80s, “If you’re gonna do it, do it right.” Enforcing a well
organized procedure to collect patient information and verify benefits will not only
help the claims and billing process, but it helps keep patients informed and aware, and
ultimately happy with the clinic.
When the patient comes in, be
prepared to make a copy of
their photo ID and insurance
card, and talk through their
verification and payment
responsibility during check-in.
Conducting scripted
role-playing exercises with
your staff will go far in
providing the confidence they
need to have the conversation.
QUICK TIP

12
TIP 1obody likes billing mistakesN
Here are a few tips to create a successful VOB process for your clinic:
1
2
3
Always maintain accurate records. Make sure that any patient information you have is up-to-date.
Every time a patient returns to your office, have them verify their personal information (address,
contact information, insurance information, etc). The key is to RECONCILE DAILY.
Keep patients in the know. When a new patient calls to make an appointment, take the time to discuss
your practice’s payment policy and insurance coverage with them. Although you will give them new patient
paperwork to complete when they come in (or online), collect the information needed over the phone to
complete the verification of benefits ahead of the appointment. If a returning patient has a change in
insurance, collect the new card information and verify benefits right away.
Verify, verify, verify. When verifying benefits, make sure to confirm the following:
a. Patient is covered by the insurance
b. Insurance coverage is effective at time of visit
c. In-network or out-of-network coverage
d. Any extra steps needed for coverage (referrals, pre-authorization, etc.)
e. Amount of co-pay for services, if any
f. If deductible amount has been met for the year
Before you hang up the phone,
collect the following pieces of
information:
a. Patient’s name and date of
birth
b. Name of the primary insured
c. Social security number of
primary insured
d. Insurance carrier
e. ID number
f. Group number
g. All of the information needed to
contact the insurance company
including phone number,
website and address for
submitting claims
When the patient comes in, let
them know upfront what they will
need to pay at the time of service.
QUICK TIP
4
Make sure to coordinate. If a patient has multiple insurance policies, make sure to select
Coordination of Benefits correctly in the PMS and make a note of the correct billing order to avoid
errors and claim rejections.

13
TIP 2ne of the biggest challenges you face is collecting payments at the time of service.O
Payment Wrangling the Easy Way
When we talked to some of our Practice Managers, we find that one of the biggest challenges you face is
collecting payments at the time of service. The front office staff shies away from asking for money because
they don’t want to draw unwanted attention to a patient’s difficult circumstance and make the patient
uncomfortable. So they just quietly send a bill, not realizing that this often leads to billing confusion and
anger. This doesn’t have to be the case. With preparation, training and some helpful tips, you can help your
front office staff turn the patient payment encounter into a successful one.
o help give a better
estimation of patient
payment responsibility, one
of our client’s practices
developed a guide they call
the Front End User Guide – a
chart with all of the common
CPT codes, and the
allowable for each CPT code
for each of the major
insurances accepted in the
clinic.
T
FROM THE FIELD
1
Be clear
Manage expectations for
payments before the patient
walks through the door. Do a
thorough verification of
benefits when the person
makes the appointment
—take the information over
the phone and verify
benefits. Let the patient
know ahead of time how
much will be expected.
Have your clinic’s payment
policy clearly visible and
communicated to all
patients.
2
Talk the talk
Most front office staff say that asking for payment is difficult
when the patient says they don’t have it. Preparing scripts
for the different scenarios that your staff can face when
trying to collect payments and having the staff role play
several times helps the office stay consistent in their
payment policy. The American Medical Association has a
great script online to use as a starting point.
3
Attitude is everything
Be confident in asking for
the money. Look patients
in the eye, smile and
communicate clearly.
4
Get techy with it
Take advantage of technological solutions,
such as keeping a credit card on file through
the payment portal. That way, you can lead
with the option of using the card on file.
Instead of…
Can you pay that today?
(If patient can’t pay)
“That’s ok. We’ll send
you a bill.”
You owe $X.
Try Saying…
How will you be paying for that today?
We accept cash or credit cards.
I understand, Mrs. X. How much are you
able to pay today?
According to your insurance benefits,
your portion for today’s visit is $X. How
would you like to pay for that?

TIP 1
C
Put Me in Coach
In a perfect world, practice managers would be able to observe and monitor their staff’s development and
have a training regimen that would transform them into champions. But in the real world, time is in short
supply. You constantly have to sub or replace your teammates regularly due to turnover, and you have too
many responsibilities to dive in and create individual training programs to help each staff member move to
MVP status. It’s easy to see how staff development can be put on the backburner. The good news is you
don’t have to (and shouldn’t) do it alone. Showing your staff how they can help and empower themselves
not only leads to a stronger commitment to growth, but also lightens your load so you can focus on other
priorities.
The first step is to have your staff create a list of what they feel they do well, where they could use help and
what they would like to learn. Next, you can direct them to one of the three resources below so that they can
design their own training regimen. Once they’re confident in their new skill, allow them to share their
expertise with the team, so that everyone can grow. This practice helps ensure employees are cross-trained
(which is handy when you need to pull someone from the bench to sub for an absent teammate). The office
can run with less friction, and you can know that your staff can better handle whatever curveballs the day
holds.
14
Today, I will play the role of coach.
oaching helps both the team and you
ne of the ways a practice
manager can help improve staff
performance is by finding
technology that helps make the
practice more efficient or
effective. One of the clinics we
serve was struggling to keep up
with verification of benefits. The
practice manager made
recommendations on websites
that were beneficial to the staff,
and two resources were rolled
out to all of the staff: Availity and
Payor Pass. Having access to
both of these sites has
improved the verification of
benefits process and ultimately
the patient experience.
O
FROM THE FIELD

TIP 1
Put Me in Coach
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1
Get plugged in
Do you have an Excel rookie? A soft
skills newbie? Online trainings can
help your staff go from green to guru
for virtually any skill they need to
perform their job well.
One excellent online resource for
trainings is Lynda.com. This website
offers beginner to advanced-level
trainings in a large variety of subject
areas. Best of all, the videos are
available at any time, so your early
birds and your night owls can watch
at their pace, at their time.
Individual subscription fees range
from $25-$35/month for Lynda.com,
but the knowledge you gain is
priceless.
2
Do a pub crawl
Publications, that is-trade publications
such as Physician Practice and Fierce
Practice Management, offer tips and
best practices to tone up your clinic’s
procedures while keeping you current on
what’s changing in the healthcare
landscape. Subscriptions to many of
these publications are free.
As little as fifteen minutes daily spent
reading articles from industry
publications can put best practices and
tips at your team’s fingertips, allowing
them to reach all-star status in no time.
3
United we stand
There are several organizations tailored
to practice management that have both
local and national chapters.
Membership can keep you and your
team in the know of recent industry
trends and tips, and also offer that
personal support and friendship from
people in the industry who share the
same experiences as you do.
Here’s a few organizations to consider:
MGMA, AMGA and PAHCOM. Be sure
to check in with you leadership team for
what membership fees, if any, may be
reimbursable.

References
Cloud-Moulds, P. (2014, June 28). Training Medical Staff to Deal with Angry Patients. Retrieved December 28, 2015, from
http://www.physicianspractice.com/blog/training-medical-practice-staff-deal-angry-patients
Handling the Angry Patient. (n.d.). Retrieved January 7, 2016, from http://www.hpso.com/risk-education/individuals/articles/Handling-the-Angry-Patient
Larsen, S. (2015, May 4). The One Thing that Most Improves Patient Satisfaction. Retrieved December 26, 2015, from
http://www.physicianspractice.com/patient-relations/one-thing-most-improves-patient-satisfaction
Patient Services. (n.d.). Retrieved January 7, 2016, from http://www.patientadvocate.org/index.php?p=441
Taking the Confusion Out of Medical Bills « Health Insurance. (n.d.). Retrieved January 7, 2016, from
http://blogs.webmd.com/health-reform-101/2012/01/taking-the-confusion-out-of-medical-bills.html
The right words and phrases to use with an angry customer. (n.d.). Retrieved January 7, 2016, from
http://www.callcentrehelper.com/the-right-words-and-phrases-to-use-with-an-angry-customer-30110.htm
Verify Patients' Insurance Eligibility, Coverage Before Office Visits - The Rheumatologist. (2014, March 1). Retrieved January 7, 2016, from
http://www.the-rheumatologist.org/article/verify-patients-insurance-eligibility-coverage-before-office-visits/?singlepage=
Wooldridge, M. (2014, March 11). Verifying Patient Insurance Benefits. Retrieved January 7, 2016, from
http://locktonmedicalliabilityinsurance.com/verifying-patient-insurance-benefits/
16

About Practice Partner Line
At MedSynergies, we recognize that one person can’t do it all. That’s why we’ve created the Practice Partner Line (PPL), an
on-demand practice management support service that offers help with questions or issues when you need it. The PPL
offers assistance in several different areas including batch questions, credentialing issues, policy or work flow questions,
scheduling issues and much, much more. Your dedicated practice partner is committed to helping you navigate through the
day’s complex issues, so that you can navigate your workday more smoothly and focus on the patients we serve.

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