With declining reimbursement and rising costs, efficiency is paramount in any allergy practice. Here are tips for improving efficiency from J. Kelly Davis, BS, CMPE, Practice Manager of Covenant Allergy & Asthma Care in Chattanooga, Tennessee, and member of the Practice Management Committee.
A portal can improve efficiency in a couple of ways. When new patients complete their demographic information, list of medications and past medical, social and environmental histories online, this information is imported into your electronic health record to speed up check-in and triage. Patients may also use the portal to request prescription refills and communicate with the clinical staff. This should decrease the number of phone calls throughout the day.
Pre-authorize credit cards
With high deductible insurance plans the norm these days, it is imperative to check insurance eligibility and benefits before the visit. When new patients are called to confirm their appointment give them an estimated out-of-pocket cost. Inform them they will need to bring a credit card and that it will be pre-authorized for an amount equal to the estimated out-of-pocket cost. Credit card merchant service vendors have the ability to capture credit card information and pre-authorize a pre-determined amount. Once the insurance remittance has been received detailing the patient responsibility portion, the card is processed for that outstanding balance amount. No need for statements.
There are multiple ways to cross train front desk, shot room, and clinical staff to help with bottlenecks throughout the day. For example, clinical staff should be able to schedule returns or check-in/check-out patients as needed. They should also be able to help if the shot room gets busy. According to Kevin McGrath, MD, FACAAI, vice-chair of the Practice Management Committee, “Instead of a receptionist, we have hired medical assistants to rotate between front desk and medical assisting duties. They are cross-trained in both positions and can help out if we have problems that necessitate an extra medical assistant.”
Card scanner check-in for shot room
Some practice management and/or electronic health record software has the ability to use bar code scanners for shot patient check-in. This keeps your shot nurse focused on efficiently giving shots and not manually checking in patients. Stanley Fineman, MD, MBA, FACAAI, chair of the Practice Management Committee, advises, “We have been using bar codes for our patients receiving allergen immunotherapy injections for several years. It not only improves efficiency but also accuracy and therefore safety.”
Schedule Xolair/Nucala injections
Schedule potential bottlenecks such as Xolair injections. This helps to keep patient wait time to a minimum and allows clinical staff to better plan their clinic.
Identical exam rooms
Make sure all exam rooms are laid out and stocked the same. Exam tables should be in the same place in each room and medical supplies should be as well.
Huddle before morning/afternoon clinic
Clinic can run behind because staff isn’t prepared. Everyone needs to be in place on time. Have a brief huddle before each clinic to review the patient schedule; check to see if needed labs/scans/test results are in; prep testing trays, if needed, etc.
Nothing makes an office operate more efficiently than teamwork. An attitude of “it’s not my job” by staff should not be tolerated. Hire the right people with the right attitude and get them on the right seat on the bus.
There is no one silver bullet that will improve efficiency. It comes through a series of small steps – but when combined they can result in giant leaps in efficiency.