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Mobile and Paperless
Setting up in private practice is easier for anaesthetists than it is for most other medical specialists because we don’t need to hire consulting rooms and staff. Unfortunately working in theatre all-day and trying at the same time to keep up with billing and administration can be difficult or even impossible.
The important thing is that there is probably an exponential relationship with late billing and the time it takes to be paid. If your accounts are late, you will be throwing away money in interest and bad debts. The aim should be to process accounts on the same day of the anaesthetic and dispatch them as soon as possible. There is no place for month end billing. The sooner accounts are out, the sooner they will be paid.
Anaesthetists need to plan what is best for their particular practice. If your practice is small you could do your own billing, but you need to have the time and discipline. If you cannot get your new accounts out every week, you should probably employ part-time help.
Most anaesthetists employ someone to help with follow up and credit control and many outsource everything to a billing bureau. Whatever you do, you have to be in control and manage your practice. It is your responsibility to decide what to bill for and the rates used for each patient. With the huge difference between BHF and SAMA rates, you might want to use discount in-between rates for some patients in order to avoid complaints that could damage your practice. If you use a bureau you need an efficient way to communicate what you want done and the bureau in turn must give you back the data you need to monitor your practice.
We can’t work efficiently without IT and Internet communication. Most medical aids use Internet banking to pay accounts. We have to use Internet banking to check the payments deposited into the practice account without waiting for month-end bank statements. And many patients expect to be able to communicate using e-mail and to have receipts e-mailed to forward on to their medical schemes. E-mail is becoming indispensable.
Here are a few ways to use the Internet and e-mail for practice administration. All anaesthetists have some unscheduled free time during the week that makes it worthwhile to carry a laptop computer.
- You can connect your computer to the Internet using your cell phone and GPRS. This gives you a low cost mobile Internet connection anywhere and you can still use you cell phone for calls.
- Alternatively you can use a 3G card for a faster connection.
- E-mail has a lot of advantages: It does not demand immediate attention and you can set rules for filing the e-mail messages automatically as they arrive. With a little planning, you can have your messages neatly filed for you to attend to in order.
- You can send and receive file attachments with e-mail. This allows you exchange information with a bureau to check accounts before they are mailed or to import and export accounts if you use ‘turbomed’ for practice management.
- You can e-mail Invoices and receipts as ‘.JPG’ images instead of mailing paper accounts. Many patients, medical aids, and hospital administrators prefer email to paper. With e-mail, you can request confirmation of receipt, which makes it like Post Office Registered Mail.
- You can send and receive faxes though e-mail by subscribing to the ‘faxwhiz’ service.
- You can use e-mail-to-fax to print an account on any fax machine. If a patient wants to pay immediately and you don’t have a printer to print an account, you can fax the account to the theatre or ward receptionist.
- You can use SMS messaging through e-mail by subscribing to ‘clickatell’.
- ‘Mail-manager Plus’ is a Telkom service that allows you to redirect faxes and recorded voice message from a normal telephone on to your e-mail address. Voice messages arrive as e-mail ‘.WAV’ attachments. You use Windows Media Player to listen to them and you can replay just the part of the message you want to replay, e.g. the telephone number, using a scroll bar.
- You could use a portable scanner like a ‘docupen’ to copy hospital stickers, admission forms and handwritten instructions and then e-mail the scans to your billing bureau.
Anaesthetists are perfectly placed to make use of mobile computing for clinical applications as well as practice management. Mobile network connections are still new so we are likely to see a lot of new applications in the future including powerful applications that run on networked PDA devices, Tablet PC’s and laptop computers.
Tony Manicom
Links:
www.clickatell.com
www.docupen.com
www.faxwhiz.com
www.turbomed.co.za
| MESSAGES FROM SISYPHUS |
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The Art of Practice Management
The waitress, stretched over me, right breast in my left eye, poured
the Chardonnay. A good time to test Poor Old Tom’s theory that a
woman could, in ten seconds make an assessment of a man’s net worth
more accurately than the Deceiver of Revenue and his entire Audit
team can do in five years.
“Could you tell me,” I said to her, “the Net Worth of the gentlemen
sitting around this table?”
“The Gentleman on my left is a company expense account. Suburbia,
two kids, and eventually a seat on the board. In the rat race, he
will finish in the money. He is a solid investment. The Gentleman on
my right in the Pringle cool autumn colors and the Rolex Oyster
perpetual Day-Date in 18k Yellow Gold with Diamond Bezel and
President Bracelet, probably valued at $30,000.00 is an all time
star winner of the rat race. And you Sir,” smiling sweetly at me
“are still trying to find the start gate. But don’t worry; you can
always blame it on a poor career choice.”
I looked at my companions carefully. Michael the Accountant in his
Edgar’s suit was conservative but careful with the money.
Poor Old Tom on the other hand was elegant in an understated way and
there was a very large yellow watch on his left wrist. $30,000?
“It is perfectly obvious Booitjie” said Poor Old Tom. “Women marry a
life time investment and eke out the economics of the future
generation on that investment. Not for them the flighty economics of
the risky own business or inventing the theory of relativity. Men
have a problem, too many options; from clown to king. No, women have
emotions, people count more than things. They invest their time and
effort in people, in the here and now, the short term because they
know the long term is an uncertain destination!”
“What you are saying then is that women are like characters in a
Thomas Hardy novel, capable of achieving a state of grace but they
screw it all up because of emotions”
“Booitjie, if you think about it, all those books you read on
evolution are written by men and the key they seek is the origin of
intelligence – the brain. A woman would frame the quest as a search
for love – the heart. You just have to read the novels by Jean Auel.”
“So then, Tom, how are your investments doing.”
“Terrible. I bought 10 Mercedes Benz at 79 Euros. Now they are at a
127 Euros and to think I sold at a 109.”
“Well you made 300 Euros; what’s so shabby about that?”
“Not 10, 10thousand shares. I could be sitting on 480,000 Euros.
Instead I only made 300,000 Euros but that is the problem with the
long-term, it’s damned uncertain.”
That is Poor Old Tom in a nutshell; the hard luck story with a
silver lining.
“On what basis do you make your bad investments?”
I always try to minimize my risk so I invest where the Illuminati
invest and it usually pays off except I always get my timing wrong!”
“What is it with this conspiracy theory crap you’re always on
about?”
Michael the accountant chips in with; “he means the vested interests
like the Government. I.e. Telkom or Sasol, except Tom plays on an
international stage.”
“Exactly right, Booitjie. How a Government can control and tell you
where you can invest your after tax money has always to me made a
monkey of the Bill of Rights and the Constitution. That’s why I
prefer to live elsewhere and visit you in the summer. But tell me
how is medical politics?”
“Like the curates egg I said; ok in spots. The foundation refresher
course had its good moments and its sad moments and also its funny
moments.”
“The funny moment was the lawyer from the HPCSA and his background
in crime. The good moment was the talk on the Value and Worth of the
Anesthetist and it has born fruit in that the NHPRL rates are going
up by 20% and the sad moment was the Van Hassalt prize. I really
thought The Godfather was at last getting deserved recognition, but
it was not to be. In the end some obscure fellow with no visible
contribution to the fellowship of the profession was awarded
recognition.”
“Exactly” said Tom; “the Illuminati!”
“What Tom means” said Michael “is the same self-serving behavior we
saw with the old Nat. Party Cabinet standing around in a circle
awarding each other honors for service to the country. What about
you Sisyphus? How is Anesthesia treating you?”
”I am in Practice heaven” I said. I found these lady practice
administrators who do it all for 15% of banked money. I have no
other costs than that and in addition they bill at private rates and
discount as I feel appropriate, or they know the medical aids so
well they bill at above NHRPL rates where a charity case has medical
aid backing at a higher rate. They do my vat and my Tax and for the
past few months I am doing about as well as the SASA hotshots and
their R2 million practices but I am only working three days a week.”
“Now Sisyphus, that’s impossible! What gods are these?”
“Not gods, but Goddesses Michael.”
“Besides discipline, good house keeping and a work ethic, what
permits them to charge this premium?”
“For a start they act more like Agents than they act as Practice
Administrators. Secondly they know their trade backwards, they code
for me, ICD 10, procedures codes the lot and they do a medico –
legal check on my fees besides optimizing them and always report a
query back to me for clearance. My documents are organized and filed
and a patient query is settled on first contact. Most importantly,
there is a separation of the caring doctor from the money side. I am
no longer squeezed by the Patient demanding a discount because I
should practice for love of the patient but neglect the needs of my
family. They operate on a principal to principal basis and give
transparent month end reports. They also insist that my accounts be
clear and lucid and should always be able to withstand scrutiny by
the HPCSA and the Receiver at any time. No longer do I have bad
debts, hassles from medical aids, patients and other odd bods. To
make their life easy they even provide me with a PC and an internet
connection!”
“Ok ok, cut the Eulogies. In point form what do they do for you?”
To summarize then.
- They are agents rather than practice managers.
- They do ALL the administrative work and keep accurate transparent
records.
- They eliminate all my bad debts.
- They protect me from the patient the medical aid the HPCSA and
the receiver.
- I can concentrate on what I do best – anesthesia.
- They bill out only on what is banked in my account, so I have no
risk.
- They are very discrete.
- They are very tolerant of my vast ignorance of law, accounting
the medical schemes act and other business maters.
- The biggest bonus is that they have made my practice carefree and
profitable!
“No more cash and no more privacy for you,” said Michael the
accountant, smiling with is regulation orthodontically correct
smile.
“The goddesses stress that one does not tangle with the biggest and
meanest Sob’s in the valley unless you are suicidal, this means your
Spouse the State as in the IRS, HPCSA or your patients or colleagues
in that order. If you do decide to be a little deceitful be
discrete, tell no one, not your wife, dearest friend or your
accountant. Notice where the cash counting machines are like at
Hi-fi Corporation. Frequent casinos and other places where cash
businesses congregate. Eschew high living and buying registered
assets with cash and yes the receiver can and does prowl around in
your credit card! Your accounts and lifestyle should be
transparently simple and clearly understandable. They should excite
no interest or comment. The goddesses help me to keep my accounts a
non event and my private life private.
“You have the Illuminati on your side. Perhaps you have a small
investment in mind that a Poor Old Loser could make a few bob on?”
said Poor Old Tom mournfully.
“Indeed I have just such an investment for the festive season. Some
quality time with family and friends over the next few days should
pay rich dividends in 2006, a merry Christmas to you all and a
prosperous new year1”
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