Creating systems makes managing your business easier!
Published on April 20th, 2012 @ 03:20:00 pm , using 1179 words, 3895 views
An Excerpt from Playing the Game:A Step-by-Step Approach to Accepting Insurance as an Acupuncturists
by Dr. Greg Sperber and Tiffany Andersen-Hefner
Many acupuncturists tell me they will never choose to bill insurance, and that is a common enough choice. Still, whether or not you choose to accept insurance, systems are vital to the organized functioning of your practice. Below are some recommended forms to ensure your office has the necessary structure and remains organized. Some of these are insurance related; some are not:
1. Patient sign-in sheet (yes, they are still legal under HIPAA).
2. Daysheet summary—hopefully with whatever software used to enter patient data and visit information, a daysheet or equivalent which summarizes each day’s transactions can be printed. A day sheet summary cover sheet should be created. This recaps the day and incorporates data from the daysheet print-out, the sign-in sheet (to ensure that the amount of people who signed in that day match the total amount of visit charge entries made into your practice software) and balances the monies collected in the format received, i.e., cash, checks, credit cards, payer payments. The summary should also include any reminders to do at the end of the day, such as: make change in your change box with smaller cash monies received, send welcome postcards or thank you cards for referring patients, send patient statements to any who left without paying that day, log data into stat log, etc.
3. Statistics log—to create statistics for the practice’s growth. Three separate logs should be kept: one for each day in a month, one for each month within a year, and one for annual tracking between years. The log should include: patient visits, total charges, total collections, and total new patients at a minimum. One can add additional, important items to this log. Filling these fields in, after you have reviewed a daysheet also ensures that you haven’t misplaced any of them…or the money that goes with them. There have been times when a day’s stats were missing on the stat sheet which made this author have to look for the information. I had misplaced the daysheet and hadn’t yet checked it or deposited those monies. It’s just another way to check operations and prevent errors. Currently in business, using a dashboard for these statistics has become standard. A dashboard takes these stats and creates graphs from many of them and places them on one page so that many different areas of a business can be seen in one place. Using graphs makes it easier to pop out trends, but loses some of the specifics, but those can always be looked up. A sample dashboard is available on our website, www.acu-insurance.com.
4. Patient intake forms—these should include: patient demographics, fee schedule acknowledgement by the patient, financial responsibility agreed to by the patient, HIPAA forms, arbitration agreement (if necessary by your malpractice insurance), and health history information. If the patient does have insurance, you should also make sure they sign an assignment of benefits form; this is a common form used to authorize the patient’s insurance company to pay the provider directly. Copies of the patient’s driver’s license should be kept in the file in the event collections needs to be pursued and to guard against identity theft. Plus, it is nice to have a face to go with the file.
5. Insurance verification forms—this form should include patient’s name, date of birth, insurance company name, phone number, and patient’s ID number as well as your Tax ID and NPI for easy reference.
It should address the following:
• Are there acupuncture benefits?
• If so, are they in- or out-of-network benefits? (If unsure about your network affiliation, ask them to check your Tax ID)
• Is there a deductible, if so, how much has been met?
• Does their plan go by calendar year or other?
• How many visits do they have per year, have any been used?
• Or is there a dollar limit per year, if so, has any been used?
• Is there a set copay or is it a coinsurance?
• Address to submit claims, and are there any special submission requirements with the claim(s)?
• Always document with whom you spoke, the date, and get a reference number for the call.
• The person who completed the form should initial and date it.
Verification forms should also be made for workers compensation and personal injury (PI)/med-pay cases since each requires slightly different information. The workers comp verification form should include the claim number, date of injury, insurance company name and address for claims, the adjuster’s name, phone and fax along with the utilization review (UR) phone and fax. The same information should also be determined for the nurse case manager, if one is assigned to the claim. Ensuring the claim is open and active should be verified as well.
PI/med-pay verification forms include much of the same information as workers compensation. Since there is an adjuster assigned to these types of claims as well, the adjuster’s information should be recorded along with the claim number and date of injury. The insurance company’s name and claims submission address should also be obtained. Verifying the patient has straight med-pay versus excess is also important. Remember that if the patient does have excess med-pay, their health insurance must also be verified since it will be the primary insurance billed prior to the med-pay. If the patient has no health insurance, have them sign a quick statement to that affect. Although you should ask what the med-pay limit is on the patient’s policy during the verification, they often will not tell you. Ask the patient if they know. They will receive a letter in the mail after opening their claim that reiterates the benefits and limitations of their med-pay policy, so they should know within a couple of weeks of opening the claim what the limit is, if they don’t already.
6. Policies and procedures manual – A manual that contains instructions on how to do every task in your office, the correct way, is an excellent reference for employees. This manual should include original forms for copying, with what insurance companies the providers are contracted, any discount programs with which you participate and their rates, how to verify insurance, worker compensation, and personal injury cases, and finally, opening procedures in the morning, closing procedures at night, etc. Putting this manual together will help you to get and stay organized.
There are other systems not discussed here that can help you manage many aspects of your business. Inventory management systems for ordering supplies can be helpful. End-of-day outbound call routines, scheduled marketing times, orgainzed patient record maintenance, banking and bookkeeping routines, all these should become part of your daily and weekly systems. For me, an end-of-the-week practice that keeps me on track is to make a list of the next weeks projects so that I don't have to "take the list home." Once written down, I can leave my work at the office. It will be there waiting for me on Monday morning!
Dr. Greg Sperber is also the author of Integrated Pharmacology: Combining Modern Pharmcology with Chinese Medicine
Permalink10 Ways to Re-vitalize, Re-energize, and Kick Your Practice Up Another Notch
Published on May 11th, 2012 @ 05:00:00 pm , using 1370 words, 89 views
by Honora Lee Wolfe
Remember when you were a student or a brand new practitioner? Chinese medicine was endlessly fascinating and working with each new patient was an exciting challenge that propelled you to your office with a combination of joy and curiosity each day. After a few years in practice however, the bloom may be off the rose. Practice may feel repetitive and not very interesting. You may feel tired of listening to other people’s complaints and daydream about being a NASCAR driver, a photographer for National Geographic, or a rock star. Maybe your practice is full and you are making a decent living, but cannot find a way to grow your practice or your income any further. In recent weeks, I’ve spoken to several successful practitioners with these types of problems asking me to help them re-energize their interest in their work, get their groove back, or just figure out how to change their current practice situation so that it brings them more satisfaction. I’ve been giving these issues some thought and here are my ideas for those of you in the doldrums for one reason or another.
- Practice fewer hours or fewer days per week. If your practice is full and the load is getting you down, change your schedule. Let go of one day per week for six months and see if that refreshes your psyche and allows you to be more present for the patients that you do see. You might consider hiring someone else to take over the day or days that you are not there. Charge a little less for appointments with the new practitioner, and pay them a flat salary for standing in for you one or two days per week. You are giving a younger practitioner a job and much needed experience, you can still make a little money on this person’s work, and you have time to rest your bodymind. Then….
- Take up a new hobby or learn a new skill. This might be dance classes, large metal sculpture in the afternoons, learning to sing, speak a new language, or do amateur NASCAR style racing! You could also work for a political cause that’s near and dear to your heart. Whatever it is, it may allow you the variety in your life to feel that your work is interesting to you while you are there.
- Take up a new in depth subject within Chinese medicine. Have you felt that one or more areas of study eluded you when you were in school? Did you feel that you could learn herbs again from the beginning? Is there a teacher out there whose work has fascinated you but you have yet to attend any of their classes? Would you like really become good at one specialty? Do you have an interest in one of the new doctoral programs? Do you want to learn Chinese so that you can access the medical literature in its original tongue? If so, then do it now. Take that time you have gained back from practicing less and use it to increase your skill and knowledge. You may be surprised at what you learn and how much it energizes you.
- Take a “vacation” and volunteer for a free acupuncture program. There are more and more opportunities these days for expanding your horizons about what this medicine can do. There is the Guatemala Acupuncture Project, Acupuncturists Without Borders, the Yayasan Bumi Sehat Clinic in Bali with a satellite clinic in Banda Aceh, or numerous small local volunteer efforts around the country. If you cannot find an organization like this that suits your interests, then create one! How about a Native American reservation? Or a free public clinic in Uganda? You may find that being a volunteer for a few weeks for people who really, really need your services may give you incredible inspiration and be something you want to do every year.
- Steer your practice toward a very specialized niche that you enjoy. It is always true that being a specialist allows you to get really good at something. The confidence that comes from going really deeply into one group of diseases or one type of treatment has many benefits. Confidence is seductive; people can feel it radiate from you and they will respond to it. Also, everyone knows that specialists charge more than GPs for their time.
- Raise your prices. It may be that you feel completely different about your work when you are making more per increment of time spent. You may lose a few patients, but most people experience that they end up with the same number or even more when they take this step. When was the last time you raised your rates? If it was more than three years ago, it really is time to do it.
- Repaint your clinic with some bright, bold colors, buy some new artwork, fountains, carpets, window coverings, or a new treatment table. You will be surprised by how much changing the look of your clinic can alter your state of mind. Do this especially if you have white, grey, tan, or cream colored walls surrounding you every day. Remember that rich colors and beautiful surroundings are healing both to your patients and to you!
- Go buy some beautiful new pieces for your wardrobe. Have you ever watched one of those “make-over” TV shows?? Did you ever notice how the “after” person is usually more attractive, more powerful, and more effective than the “before” person? You can experience this phenomenon, too, by getting a few really beautiful and probably expensive items to wear to work. I am not saying that clothes will make you a better acupuncturist, but I do know from experience that when I am dressed like a million bucks, I not only feel more beautiful, but more powerful, more energized, even more intelligent! While I don’t suggest shopping therapy on a regular basis, I do know that we should wear our most beautiful clothes to the office. Why should they stay in your closet? What are you waiting for? Again, remember that beauty is healing.
- Hire an intern. If you have been in successful private practice for some time, you probably have a lot to share with a student or new practitioner, whether you know it or not. By hiring a part time employee, you serve the community by creating a job, take off some of the load of work in your practice, and you also do a great service by helping a young practitioner learn what it really takes to run a practice. When we what we know by teaching by teaching it to others, even in an informal way, we find out the depth and breadth of our knowledge as nothing else can show us. Who knows, you may be inspired enough to hire an advanced student or young practitioner each year to help them toward their own success. Bringing in other people adds energy and a new element to your practice, so sit down and make a list of all the things such a person could do to lift responsibilities from your shoulders.
- Work on a list of long-term goals. What would you like to be doing in 10 years? What will it take to get there? Who do you need to contact for help to reach these goals? What are your absolutely wildest dreams? If they don’t include the practice of this medicine, then how will you plan your departure for the least chaos and the most success? If they do include the practice of this medicine, how would you want it to be different from what it looks like today?
Remember, a good relationship with your work is not unlike a marriage. It requires a little work and TLC every day to keep that spark of interest alive. If you have other ideas on how to keep your interest in your practice alive and energized, please send them to me at honora@bluepoppy.com
Honora Lee Wolfe, Dipl.Ac., lives in Boulder, CO and is the author of Points for Profit: The Essential Guide to Practice Success for Acupuncturists and The Successful Chinese Herbalist. For other books and free articles by Honora, visit www.bluepoppy.com.
Nine Tips on Better Time Management for Practitioners
Published on May 8th, 2012 @ 09:05:00 pm , using 908 words, 103 views
by Honora Wolfe
As we get older, time becomes our most precious commodity. There is never enough and every piece of our work, every patient, every errand can become a burden on what seems to be our stretched-too-thin schedules. Our personal lives, our relationships, and our health may suffer the consequences. So, here are a few tips to help you keep yourself organized and your time managed in such a way that a bike ride, time with your family, a manicure, or a trip to your own massage therapist or acupuncturist (imagine that!) fits into your schedule with more ease. If you really get good at this, your schedule will feel more like easy, free-flowing qi than a rigid, “scheduled”, life.
1. Invest some time to plan each day.
At the end of each work day, take a few minutes to review and prioritize a to-do list for the next day’s work. Block out time for each task or set-of-tasks and put them onto/into your calendar or other planning software or system. The, when you come into work the next day, you can use your to-do list or planning calendar to keep yourself prioritized and on task.
2. Consolidate paper!
Eliminate all but one planning tool/software or calendar. Get rid of those little sticky notes, to-do lists, and scraps of paper. If you use planning or calendar software, try to integrate phone numbers into the software or into the calendar so you can reference them quickly.
3. Batch all the little tasks.
Bills to pay? Errands to run? Trying doing them all at once if you can. You might even take a ½ day per week and just do all your errands at that time, both personal and professional. Do the same for phone calls that you need to make or emails to answer, creating a block of time on your calendar to get them done. You cannot imagine how good it feels to get your most-dreaded marketing phone call out of the way by 10AM! Or, take twenty minutes at the end of each day to call patients, both checking on the new ones that just came in or contacting the old ones that you have not seen for months.
4. Keep quiet.
See what happens if, for one week, you never talk to your patients or your staff and colleagues about anything other than the care of your patients. No movies you’ve seen, gossip about the neighbors, what’s happening with your son’s soccer team, just your patient’s health and care. Most people in our profession are too friendly and, as such, we get sucked into talking to our patients about everything under the sun. Just think what it would be like if you gained back 5-15 minutes from every patient visit! You could do more marketing, see another patient if you don’t need to do any marketing, or go to that yoga class you’ve been thinking about. Learning how to control your own talking and the talking of your patients without being rude, can be a huge boon to you personally and to your practice.
5. Never handle a piece of mail more than once.
Read it and respond, pay the bill, file the report, recycle the paper, or do whatever is required, and then forget it. If you go to the office early, take time to go through and process the mail. That way it does not pile up on your desk and get lost. Create an “end-of-day or end-of-week” file for any pieces that require more time or thought. Look through the file at least once per week and decide what you want to do with that piece of information and then do it. This is another powerful tool for maintaining order on your desk and in your brain.
6. Can you say yes to this one?
Do more than a few of your emails and phone conversations begin with “I’m sorry I didn’t get back to your sooner, but...”? If so, you may really need the above suggestions!
7. Find some supplies to help you stay organized....
Take a trip to the closest Crate & Barrel, OfficeMax, or other store with supplies for helping people stay organized. Think about the ways in which you like to store and retrieve information and what your personal habits are in your office. Spend a little time and money choosing and purchasing some items to help you stay organized. Choose ones that you really like so that you will actually use them!
8. What could be automated?
These days almost everything except treating your patients can be done online! Appointment scheduling for your patients, banking (automatic monthly payments, payroll deposits), purchasing supplies, can be done by your computer with a small outlay for software or monthly payments for various functions.Even some marketing functions can be automated with regular email marketing companies. What could you set up so that you only have to think about it once a month or once a year?
9. Read up.
Really want the low down on organizational skill and time management? Get a book by Peter Gordon, one of the best time-management gurus out there.
I hope one or two of these ideas help you get more organized and give you the time you need to reach your goals, grow your practice, or just relax more often, more quickly. For more tips on growing your practice and managing it efficiently, keep you eye open for my book, Points for Profit: The Essential Guide to Practice Success for Acupuncturists by Honora Wolfe, Eric Strand, and Marilyn Allen, 4th edition!
Wrestle Your To-Do List to the Ground!
Published on May 3rd, 2012 @ 09:23:00 am , using 551 words, 151 views
I’m a big fan of lists, which I keep on my calendar and a daily planning sheet that I’ve created. For me personally, if I don’t have lists of items that have to get done, I’m more likely to be disorganized, which leads easily to a sense of overwhelm. If my required chores, work projects, errands, family requirements, etc., are all on a calendar or a list, I don’t have to keep them in my head, I just have to keep track of the calendar! The items not completed are still waiting for me when I come to work the next day. Here’s my thoughts about prioritizing my to do lists…especially for any of you new to running a business.
What items should be on it…in what priority?
•Any actual patient appointments!
•Marketing activities (this is where your next patients are coming from so this is second only to patients you already have!)
•Family obligations and events
•Calls to return (patients, marketing activities, other professional calls)
•Bookkeeping, patient billing, insurance paperwork
•Inventory management (needles, supplies, herbs, other)
•Clinic maintenance (cleaning, repairs, shopping)
•Self care (yoga class, writing to a friend, a glass of wine)
•Other (volunteering in the community)
When you cannot yet delegate…
At the end of each work-day, spend five minutes making your list for the next day. I like to put these items right onto my calendar book (or into calendar/planning software if you prefer)
While you are building your business, think about what could you do to take better care of the patients you already have. Have you asked them for referrals? Do you have referral request signage in your clinic? If not, that’s a good “to-do” list assignment.
Prioritize based on what’s real. If you need more ptx, marketing and outreach time is first.
Don’t dink around on Facebook unless that’s REAL marketing for you. Instead, write a blog or search for opportunities to write for other publications.
If you had the guts to do anything at all for just 30 mins a day to grow your biz, what would it be? In fact…that’s where the juice it…that’s where the new patients may be.
Once you actually have someone to delegate some items to…
•These things should be what your employee is doing when the phone is not ringing…
•Calls to return; bonding calls, reminder calls
•Bookkeeping, ptx billing, insurance paperwork
•Inventory management (needles, supplies, herbs, other)
•Clinic maintenance (cleaning, repairs, shopping)
•Ptx file maintenance
•Proofreading things you have written for promotional purposes
•Sending letters to orgs. to find speaking gigs for you; Sending letters to find publications for your written pieces
Then…
•Do what you can and let it go.
•Don’t be lazy, but don’t beat yourself up for things not completed…just put things on the next list!
•Don’t delete self-care from your list
•For things not completed, create tomorrow’s list and put them at the top
•Consider doing the things you least want to do first, so they are over with!
Teach your employee(s) a new skill so you can delegate more!
So if you are feeling scattered, overworked and overwhelmed, maybe organizing things into a realistic to-do list could help you relax at the end of the day, knowing that you’ll know exactly what is on tomorrow’s plate when tomorrow becomes today.
Best wishes!
Eric's Farewell
Published on May 2nd, 2012 @ 09:29:00 am , using 555 words, 580 views
by Eric Brand
The end of this April marks the end of a wonderful era for me at Blue Poppy, so for one of my final blogs I would like to offer a sincere thank you to Blue Poppy and our outstanding readers. I am afflicted with a constant desire to keep studying Chinese medicine, and over the past few years I have been finding it increasingly difficult to resist the desire to spend more time in Asia to take my studies to the next level. It has been a great honor to work with the team at Blue Poppy and I plan to stay closely connected to the Western world of Chinese medicine, but for now I have decided to spend more time focusing on my study of Chinese herbal pharmacy and quality discernment. I may periodically chime in with some comments or a guest blog at times, but for now, it is with a proverbial tear in my eye that I wish our readers a fond farewell.
I often feel incredibly fortunate to work in the field of Chinese medicine because our community is full of wonderful, positive, and passionate people. My time spent working at Blue Poppy has left me with an even greater appreciation of our field than ever before, partially because I’ve had the chance to meet more friendly practitioners around the country and partially because being part of the Blue Poppy team gave me the chance to experience the wonderful inside of the industry. My direct colleagues at Blue Poppy form an incredible team, and I will forever treasure my relationships with many of the great people from the wider world of Blue Poppy’s distributors and suppliers.
Over the past few years, I’ve enjoyed countless laughs and smiles with Blue Poppy’s practitioners- the radiant Honora, Shawn and Malia- and I will cherish friendships with the wider Blue Poppy team for years to come. Each Blue Poppy employee has a specialty: Rick, our guru of graphics, moonlights as Superdad and lifts the whole office with his smile. Steve, the artisanal master crafter of the external line, runs the warehouse with military precision and lurks out of the spotlight as the unsung hero that keeps Blue Poppy running smoothly. Jesse rides his mountain bike across the county through rain and snow to get the boxes safely out the door, and the customer service team tirelessly handles a deluge of calls with grace on a daily basis. Margie and Bruce, our accountant and GM, round out the team in true Colorado-style. Margie’s warm smile and fresh photos of fishing expeditions brightened every morning, and I’ll never stop cherishing my memories of traveling the hills of Guilin with Bruce and his wife during our site visits to China.
Beyond the human relationships, there was something intangibly great about riding my bike to a wind-powered office that prioritized the planet and the people over the normal priorities of the business world. Chinese medicine is a field unlike any other, and I’m truly proud to have been a part of the Blue Poppy team for the past several years. To all the people at Blue Poppy and to all our customers and blog readers, I bow my head in a sincere thank you and wish everyone the best on the next stage of the journey. It has truly been an honor and a pleasure to write here.
Challenging topics related to ancient Chinese medicine
Published on April 29th, 2012 @ 09:43:00 pm , using 600 words, 155 views
By Eric Brand The ancient nature of Chinese medicine makes it a challenging discipline. The classics often contain statements that are ambiguous, and many concepts can be elusive to a single definition. As a translator, classical Chinese material is extremely difficult to translate because the translator must capture clarity and precision when it exists while also preserving any ambiguity present in the original. We cannot use terms that make an unclear concept artificially appear clear, and at the same time we cannot oversimplify relatively precise terms to make them appear to be more straightforward. Classical texts in Chinese medicine contain a number of terms that elude simple definition. In the past we have blogged some challenging topics, such as “zhi,” the “mind” stored by the kidney, or “sinews,” the tissue governed by the liver. Other terms are also challenging, like the difference between “source qi” (原气 yuan qi) and “original qi” (元气, also pronounced yuan qi). Occasionally, we even find examples where the ancient Chinese is clearer than the popular English colloquial term, as in the case of “fearful throbbing” (zheng chong) or “fright palpitations” (xin ji), which are more meaningful and clear than the generic English term “palpitations.” Ambiguities are problematic in the classics for a number of reasons. Often we will find a statement that is found in only a few sources, and it is not uncommon for later sources to reproduce the ancient statement verbatim without any elaboration or clarification. Many texts have been lost, and the grammatical structure of ancient Chinese leaves a lot of room for interpretation. For example, the formula Gui Zhi Tang (Cinnamon Twig Decoction) in the Shang Han Lun (On Cold Damage) is said to be contraindicated for “sick drinkers,” but the structure of the sentence leaves it unclear as to whether the passage refers to a drinker sick with Gui Zhi Tang pattern, an alcoholic patient, or a patient with a hangover. In other situations, there is ambiguity because of a missing link in our historical understanding. Consider the case of weights and measurements from the most important herbal classic, the Shang Han Lun/Jin Gui Yao Lue (On Cold Damage/Essentials of the Golden Cabinet). We basically know the metric equivalent of many ancient measurements, but the basic weight unit used in the SHL/JGYL is a subject of debate. Sources are split on whether one liang in the Shang Han Lun weighs about 3 grams or about 15 grams, which is a pretty big discrepancy. The weight of the evidence for 15 grams is stronger but the dosage in the Shang Han Lun would seem unreasonably high if that was the case. The issue of Shang Han Lun weights and measures poses questions that are difficult to resolve. For example, the formula Ban Xia Hou Po Tang (Pinellia and Officinal Magnolia Bark Decoction) measures the dose of Ban Xia in sheng, which is a volume measurement, while the other items are measured in liang, a weight measurement. If the volume of one sheng at the time of the Shang Han Lun was around 200 ml, the weight of this much Ban Xia would be the amount used. However, 200 ml of Ban Xia weighs much more than the 12 grams listed in the textbook published by the State Administration of TCM (Bensky lists 9-12 g). A similar problem exists for Wen Jing Tang (Warm the Menses Decoction), which measures the Mai Men Dong by volume, in sheng. Trying to figure out the ratio of Wu Zhu Yu to Mai Men Dong in Wen Jing Tang would be challenging even if we had access to an archaeologist’s collection of ancient measuring instruments.
XML Feeds