Friday, October 12, 2018

Announcing: "Tweets, Likes, and Liabilities: Online and Electronic Risks to the Healthcare Professional," by Michael Sacopulos and Susan Gay

Electronic medical records, websites, cellphones, email, and social media have created tricky new legal problems for healthcare practices. The digital world, namely social media, offers healthcare practices a vehicle to attract patients and potential employees but also presents risk to healthcare providers. This book will give practices the knowledge and tools to reduce liabilities and provide a “roadmap” to that world.
Although physicians, practice managers, administrators, and risk managers of practices and health systems know these issues are important, there is a dizzying array of issues (and interpretation) on the Web. Staff member have difficulty in identifying areas of potential risk, lack of a strategy to address electronic risks, and lack of tools to address electronic risks.
This essential book will give you peace of mind by flagging areas of risk – and then provide guidance and templates to address the risk.
Find out what’s important, and what’s not, in this easy-to-use guide. Selected topics include:
  • No more guessing: a Social Media Policy for Your Employees
  • Reviewing the social media profiles of employment candidates? We'll give you state by state guidelines.
  • Train Your Employees on Cyber Security Basics
  • Don't Let Your Website Turn Into a Law Suit
  • The only Mobile Device Policy you'll need
  • How you can be hacked through your website, “Contact Us” feature.
  • I know the perfect guy for you. He put together the website for our church.” How to select a website designer
  • The skinny on SSL Certificates and why you need one
  • Who Owns the Content in our website?
  • Patient photos on your site
  • Astroturfing – Fake Reviews, Real Consequences
  • Are generic HIPAA training models enough?
  • Focus on the Biggest Cyber Risks First – we'll give you the roadmap
  • BONUS! Templates for your mobile device policy, social media policy, business associate agreement, photo and video release, plus others!
Table of Contents
Section I
Introduction: Patients, Physicians, and Social Media: The State of the State
  • Social Media and the Hiring Process
  • Social Media Use and Policies in the Healthcare Practice
  • Cybersecurity
  • Your Practice Website
  • Online Reviews and Ratings
Section II
Social Media and the Ghost of Employees, Present and Future
  • Equal Employment Opportunity Commission and Federal Antidiscrimination Laws
  • State Laws on Social Media Policy in the Hiring Context
  • Best Practice Advice for Using Social Media When Hiring
  • Best Practices for Employers When Conducting Online Social Media Searches
  • Social Media Policies for Employees: The Illusion of Control
Section III
The Content You Create – Internal Risks and Management
1. Don't Let Your Website Turn Into a Law Suit
  • How to Minimize Risk and Improve Compliance
  • Hacking is Not Limited to Networks
  • Cents and Sensibility
  • Where Oh Where Can I Find a Good Web Developer?
  • Conduct a Risk Assessment with Vendors
  • Contract Terms
  • The Business Associate Agreement (BAA)
  • Disclosures, Consents, and Terms...Oh My
  • Website Content and the Role of the Federation of State Medical Boards
  • Site Security, HIPAA Compliance, and You
  • Specialty Vendors Requesting Access to Your Website
  • Accessibility for All
  • Risk Assessment Questions for Web Developers
  • Checklist
2. Licensing Boards: Ethical Duties in the Cyber World
  • HIPAA Considerations and Best Practices to Avoid Breaches
  • Case Studies: Misguided Mistakes and Egregious Errors
  • Overview of the Federation of State Medical Boards’ Model Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice
3. Practical Cybersecurity for Physicians: How to Develop Policies, Procedures, and Effective Training
  • Why Preparedness is Worth the Effort
  • Focus on the Biggest Risks First
  • Develop/Update Policies
  • Security Policy
  • Social Media Policy
  • Mobile Device Policy
  • Written Procedures Are a Must
  • Design an Effective Training Program
  • Ongoing Training and Monitoring are Critical
Section IV
Patient Satisfaction and Online Reviews—Managing Risk and Your Online Presence
  • Patient Satisfaction is a Vital Metric
  • Taking Charge of Your Online Presence
  • Embracing Online Ratings
  • Monitor Yes. Respond? Maybe, Maybe Not
  • Economics of Good Reviews
  • Correlation with Clinical Outcomes
  • Patient Satisfaction Tips
Section V
Template Gallery/Resources
1. Business Associate Agreement
2. Pop-Up Notice on Website Prior to a Patient Communicating with Your Office
3. Terms of Use for Your Website
4. Healthcare Practice Security Policy
5. Photograph and Video Release
6. Social Media Policy for the Healthcare Practice
7. Mobile Device Policy
8. Data and Electronic Sanitation and Disposal Policy

(800) 933-3711 

Authors Mike Sacopolus and Susan Gay

Tuesday, September 25, 2018

Good Documentation and a “Clean” Firing can Help Protect your Practice

Without being mean and cold-hearted, a manager needs to keep communications with the terminated employee short and simple. The more you talk, the more trouble you can stir up. Firing an employee is never easy. You have to be careful and thorough to make sure you haven’t said or done something that could be used against the practice in a wrongful-termination lawsuit. It’s important that you clearly document the history that led up to the termination, and it’s critical that the record shows that you have treated the terminated employee the same as you treat everyone. Lawyers look for evidence of discrimination—especially if the worker is part of a “protected” class. 

In trying to make a firing easier on the employee, many managers and physicians trip themselves up with legally clumsy mistakes. Here are five pointers for avoiding some of the common errors:

1. Keep the discussion short and direct. It’s tempting to unload on the failing staffer with a history of underperformance and mistakes. Each problem you raise gives the employee a chance to argue each point. If the worker tries to draw out the conversation, tell him or her that “there’s nothing left to talk about.”

2. Be clear that this is a termination. Trying to soften the blow can relay a mixed message—a firing sounds more like a last-chance warning. Leave no room for misinterpretation.

3. Tell the truth about your reason to fire the employee. If you’re firing the staffer “for cause,” don’t call it a layoff. Calling it a layoff (or eliminating a position) can affect unemployment claims. Worse, you can get in legal hot water if you then turn around and hire a replacement. Similarly, don’t call an economic elimination a performance-based firing. You likely won’t have the records to back up your claim.

4. Calm the remaining employees afterward. Don’t lie, but don’t divulge too much information either. Tell remaining staffers only what they need to know to assure them that the decision was fair and that their own jobs are not necessarily in jeopardy.

5. Take the former employee to the door immediately. Don’t let a terminated employee talk with other staff members. Have someone (probably yourself) accompany the worker back to his or her desk to collect personal items. While this can feel like you don’t trust the employee, it also protects him or her from being wrongfully accused of unprofessional conduct or theft.

Once you’ve made the decision, though, make sure the employee understands that there’s no room for discussion or negotiation. If you allow him or her to talk you into allowing one more chance, you will only extend the process and delay the inevitable firing. You’ll lose credibility with the under-performer and with other members of your staff.

Good documentation, fair practices, and a “clean” firing will help protect your practice and will remind the rest of your staff that you mean what you say about performing up to standard.   The Journal of Medical Practice Management   Fast Practice 

Thursday, September 20, 2018

Nothing in Your Revenue Cycle Takes Care of Itself. Five Mistakes Providers Make.

Healthcare providers with sub-performing accounts receivable will do well to take a close look at these five broad areas. This advice is especially important to high-volume billing offices affiliated with hospitals and healthcare systems. It’s not uncommon for institutional departments to falter in any of these five areas.

1. Not staying current with payer requirements. Payers often develop new tools and processes that can help you avoid slow payments and rejected claims. 
Make sure you have the latest technology (system updates), manuals, and contact information in place.

2. Failure to monitor the entire claims process: Without thorough monitoring of each step, staffers will waste countless hours analyzing denials and delays. The bottleneck that’s choking your cash flow may hide in a process you’ve inadvertently ignored.

3. Not resubmitting rejected claims: If you don’t feel you have access to data to support your claim, you might be reluctant to resubmit the rejects.

4. Failure to verify patient eligibility: Fully one quarter of practices never verify patient eligibility and copayment amounts. With constantly rising copayments, this can cost a practice dearly.

5. Not recognizing trends: Focusing on one claim at a time without stepping back to look at the
bigger picture will prevent you from seeing correctible errors in your processes.

Without a specific assignment, no one has time to analyze charges going out to make sure billing requirements have been met, and no one has time to analyze payments and adjustments coming in the door. The problems described in this article require analyzing trends and identifying where you’re missing out on revenue opportunities. 

The take-home lesson: Nothing in your revenue cycle “takes care of itself.” You must deliberately plan to analyze and evaluate your processes so that it becomes part of your routine. Otherwise, you could have a significant “leak” draining potential income from your practice.

Visit us at for The Journal of Medical Practice Management or our Abstracts and Commentary Newsletter, Fast Practice. 

Friday, September 14, 2018

Optimizing Your Reception Area (Waiting Room) – Time for a Reality Check

Patient satisfaction depends on more than how well you perform as a physician. The entire “patient experience” affects how patients feel about your practice. What they see, feel, hear, and even smell in the reception area has a significant impact on how they evaluate your practice’s performance. Often referred to as “the waiting room,” patients can spend a good deal of time there. We prefer to use the term, “reception area.” A well designed area can actually shorten patients’ perceptions of passing time—and the opposite of that is likewise true.

There are several weak points in reception area environments that could be improved. Areas needing attention include:

• Waiting times. Patients who experience long waiting times have a greater tendency to be dissatisfied with the actual doctor consultation. Practice operations must be streamlined to minimize wait times, but every effort must also be made to help patients feel that time passes quickly, too. A comfortable environment is key, as is an attentive, compassionate staff.

 • Welcome companions. When calculating seating requirements, be generous enough to
accommodate patients’ companions comfortably. Companions affect patient perceptions as well, so various amenities, decorative details, and a pleasant atmosphere elevate everyone’s impressions. The he presence of anatomic pictures, illness information, and medical “educational” materials in the reception area has a tendency to elevate anxiety levels.

 • Patient confidentiality and respect. Patients have been sensitized to their right to privacy. Make every effort not only to guard personal health information, but to make sure patients feel protected. Details such as bathrooms that do not open directly into the reception area help patients feel more comfortable on a personal level. 

Regardless of your best efforts on the phone or in the exam room, patients are deeply affected by their impression of your reception area. Conducting an objective investigation at your own practice is an excellent first step to elevate patient satisfaction. Just about every medical management professional already knows this: An optimized waiting area raises patient satisfaction and can even boost practice efficiency. But sometimes we can be blinded by common wisdom. 

It’s very difficult to step back and take a fresh look at the things with which we are most familiar. We don’t even notice the worn furniture in the reception area, but new patients scowl at the “dingy décor.” Patients stare at the water-stained ceiling, the cracked bathroom tile, and the scuff marks on the reception counter. We walk right past them. The conversation between a nurse and patient at the clinic entrance bounces off our ears—but patients in the waiting room squirm to hear about Mrs. Jones’ urinary tract infection. Familiarity really does breed contempt. 

So how do we gain the objectivity we need? We suggest a three-pronged approach:

 • Ask. Forget about what you “already know” for a moment. Find out what patients really want in a reception area. Google “patient reception area” for a couple million hits with general advice and design tips. Better yet, design your own patient survey with specific questions about their impressions and preferences. Consider forming a focus group of several patients to meet one evening and discuss their impressions and experiences in your reception area. Ask them how you can improve.
 • Assign. Hire someone from outside the industry to assess your reception area. Provide an evaluation guide that directs them to look at everything from décor to cleanliness and maintenance, from staff attitudes and performance to patient confidentiality. 
• Assume the patients’ point of view. Spend some time in your reception area. Take some simple work—and go sit with your patients for about an hour. Be aware of what’s going on. Look around at the furniture, the artwork, the floor, and the windows. Listen to conversations—especially at the reception desk. You can learn a lot. 

Until you make a conscious effort to overcome familiarity, your practice will not likely make the improvements your patients want.

Thursday, September 6, 2018

Before You Invite Colleagues to a Staff Meeting, Ask This One Question

No matter how many times we read management articles suggesting that we cut down on meetings, they still seem to, well, happen before we know it. That’s in part because there’s something reassuring about seeing the faces of your colleagues and reading their body language and tone when discussing key issues. That doesn’t make holding needless gatherings a good idea, though.

It’s worth bearing in mind the maxim cited in one of our favorite articles in The Economist, to wit: “80% of the time of 80% of the people in meetings is wasted.” Very few organizations can afford to waste that much of their staff and management time.

The question is, it’s time to have a face-to-face discussion on an issue, how do you decide who should participate? Are the people that must be included as a matter of course? Is it possible that by leaving a lower status person out, you’re missing a vital perspective?

One way to process this is to start by asking yourself “who has the best understanding of this issue?” rather than “who needs to be in the meeting?” When you ask who needs to be there you may be obeying unwritten rules that don’t really serve your organization. But if you ask yourself who understands the issue you might draw on knowledge sources that are otherwise neglected.
Another way to think your meeting strategy through is to ask yourself whether the key issue to be discussed is related to company policy or company operations. While the two overlap, as well the people who should be present to address them, it helps figure who has the biggest stake in the matter.
For example, if you make a major policy decision it’s likely that all of the executives or leadership members should attend. On the other extreme, if you’re deciding how to organize your sales team, that’s a purely operational issue.
You may even want to mix it up to some degree, holding one meeting to solicit feedback from your executive team and another to learn what your staff has to say on an issue. Then, everyone is in synch with little time wasted.

Few office workers like to attend meetings. Reasons for this include their inefficiency, the tendency to run to groupthink and the likelihood that many who attend public have little to contribute. These meetings can drag on for hours.

In some cases, involving people in a meeting can be important, including when significant events such as a change of leadership or strategy, or with the announcement of job losses. Also, it may be beneficial to hold a very brief team meeting each morning to share progress updates. However, if a meeting is meandering and ineffective it’s probably not worth holding.
To improve meetings, experts say, it’s important to see that everyone involved as well prepared and has seen the agenda. People can react badly if they don’t know what to expect and get caught off guard. A good agenda will put the most difficult items at the beginning of the meeting and tackle them right away.  It also helps to decide whether the meeting is designed to gain buy-in for a management decision to collect feedback from workers.

Meetings that push a management objective should be rare in a well-run firm, but if such a meeting must be held it’s best if allies of the meeting leader speak first and drive the agenda.
Meanwhile, the meeting’s goal is to learn what people think, it’s best to start with low status employees and encourage them to speak. For best results, enforce a “no interruption rule” to be sure they are not intimidated. It’s also an option to let people submit their views anonymously in advance.
Once a meeting has been held and decisions made, it’s important that everyone else finds out what has been decided. Sometimes even people who are present leave the room without being sure what has been agreed upon.

Finally, if you can avoid a meeting avoid it. When possible, use electronic messaging groups or private message exchange tools to keep management and employees in touch. These venues allow everyone to impart messages in succinct form. They also make it easy for those who aren’t involved to ignore the messages and keep working.

Thursday, August 30, 2018

Get and Stay on Track with MIPS 2018

Now available!
Our 60-minute timely webinar recording on MIPS with Joy Rios. PDF handout, audio recording and a terrific Q&A session with Joy Rios.
Call (800) 933-3711 or

Need multiple copies?  Send an email to for discounted pricing.

Thursday, August 23, 2018

Happy 35th Birthday to The Journal of Medical Practice Management

In celebration of The Journal of Medical Practice Management's 35th birthday, I post the visionary "Letter from the Editor," by Marcel Frenkel, MD, MBA, from the inaugural issue of JMPM.  In many ways, this letter could be written today. The mission of JMPM is still the same. Thank you too to our authors and subscribers!
Nancy Collins
President & Publisher

"A Journal for a Time of Change"
from July 1985, Vol. 1, No. 1

It is now commonplace to state that the healthcare system of the United States is in the midst of a major change. This restructuring will greatly alter the substance, character, and style of the practice of medicine. The concept of this publication grew out of the desire to present in one journal a comprehensive approach to these changes, directed specifically to the practicing physician.

Rather than the gradual and evolutional developments which have characterized past progress, a great many organizational changes are underway. Differing systems of medical practice are now in place with competition emerging among these modes. The financing of medical care and the internal structure of the organizations of delivery present a bewildering complexity. Government regulation, fiscal constraints, local factors, and demographic trends all influence the fabric and future of medical practice.

The individual is now confronted with perplexing vistas. In past and simpler times, completion of a training program brought a modicum of assurance of the attainment of professional goals. The practitioner, individually or as member of a grouping, may now find difficulty in gauging the future and his or her new role in the new scheme of medicine. It now becomes imperative to develop an awareness of business methods socioeconomic trends in order to chart a sensible course for one's professional career.

Philosophically, the Journal is not wedded to any theory of healthcare structuring but wishes to provide an authoritative background to help physicians reach important decisions in the conduct of their affairs. This nation is large and varied, its population being diverse and requiring differing answers to its medical needs. During the transition phase that we foresee in the next decade, a variety of patterns of healthcare delivery will likely coexist and provide means for experimentation. This will allow the emergence or retention of practice patterns which are most useful in terms of economy and patient acceptance. Once can visualize the existence of fee for service alongside preferred provider organization (PPO) mechanisms and health maintenance organization (HMO) participation, all in one practice. As a private practitioner as well as an academician, I view the maintenance of a viable private sector of individual practitioners as a valid counterpoint to the emerging corporate groupings. It will provide patients with an alternate system with its own characteristics. Additionally it would allow both the individual and the corporate sectors to react to each other, refine their methods, and evolve in competition to provide better, more equitable, and economical care.

In spite of the rhetoric, it is important to remember that the art and science of healing remain the province of physicians who can also exert considerable influence on the course of events. Therein lies an opportunity. Informed physicians can help mold the future of the healthcare system in general and their own fate in particular, by participating in a dialogue within their own communities and assuming a leadership role. In instances where communications between medical leaders and the business and consumer sectors have been active, physicians have been able to maintain their traditional and pivotal role.

The purpose of “The Journal of Medical Practice Management” is to present, principally, to the medical practitioner, but also to the health administrator and others interested in this extraordinarily large system of healthcare, an overview of events and trends affecting medical practice. While there has been a proliferation of journals related to health policy, practice, and specialty issues, reading such publications with varying emphases requires the expenditure of considerable time and money. Few are directed to the practicing physician in an analytical way. Assembled in this journal, we propose to offer scholarly analyses and practical items to aid in the conduct and progress of medical practices. These will include articles on techniques of office management, computer technology, the marketing of medical services, reviews on developments in legislation, and government regulation. We will follow legal, legislative, and litigation trends affecting practitioners and also survey the constant changes in taxation that bear on practice management. Each issue will review an important facet of healthcare policy and also describe some some the varied modes of healthcare delivery, organizational structure, and the dynamics within healthcare groupings. Continuing article will consider medical education and manpower issues because of their great importance on the supply side of the medical economics equation. While our society cannot be compared with any other political entity, there is much written that we can learn from patterns of health care in nations which have already altered their systems. A regular “Letter from Abroad” will help familiarize the reader with developments throughout the world.

In addition to analyses of important issues, we will offer shorter reviews of current topics, all written by experts in their respective disciplines. These will include:
  • a review of the Washington scene
  • computers in review
  • a taxation update
  • abstracts of important medico legal decisions
  • a survey of the HMO and PPO industry
  • selected healthcare statistics
  • abstracts of the relevant literature.
Other features will profile the structure and financing of individual for-profit healthcare systems, followed by reviews of not-for-profit organizations.

Together with the regular Journal reviews, the Editorial Board hopes the continuing analyses will provide a comprehensive and practical approach to the varied factors which bear on medical practice.

Marcel Frenkel, MD, MBA
Founder and Editor
July, 1985
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