How to power up your software

There's enormous untapped potential in many practices. Potential that lies not in fancy marketing programs or new services—but in the wellness care and preventive medicine veterinarians recommend every day. Participants in Benchmarks 2008: A Study of Well-Managed Practices told me that the most effective way to improve client compliance is for all doctors and staff members to present a consistent message.

High-compliance practices use their written medical standards to define the message, and they discuss the standards regularly during practice-wide meetings. Yet I've learned that doctors and team members fail to follow the standards much of the time—so client compliance still lags.

It probably happens more often than you think: The doctors in your practice charge for 30 minutes of surgery time when they actually spent an hour in surgery with the patient. Or team members don't note all lab charges, and dollars slip through the cracks. These aren't intentional misses; it's just that there's no mechanism built into your employees' routine to help them be as accurate as possible. Remember, doctors' and team members' compliance with the practice's standards of care and fee schedule is key to your bottom line. Here's where your practice management software enters the picture.

The bottom line

Take Dr. Christine Stevenson's practice, for example: Pinnacle Peak Animal Hospital is a five-doctor practice in Scottsdale, Ariz., and a participant in the 2008 Well-Managed Practice study. Pinnacle Peak has grown dramatically more profitable since Dr. Stevenson began using her practice management software to its fullest capabilities. She's been using this current system for eight years, and even now, she's still learning new tricks. Her very first challenge—successfully met—was to learn how to increase her team's speed and accuracy with everyday tasks like invoicing, creating estimates, and improving the accuracy of accounts receivable.

Recently Dr. Stevenson has begun tracking her practice's daily transactions and missed charges. And this is where she's seen big improvements. Since she began auditing her transactions, missed lab charges have shrunk by 66 percent. She's also seen an increase in charges for surgical and anesthetic time. Because of the audits, the doctors are more accountable for accurately reflecting how much time they spend in surgery, so they charge appropriately. And the accuracy has paid off: Surgery and anesthesia charges have increased 25 percent.

On the web

Dr. Stevenson says the daily audits have made a huge difference in her practice's day-to-day operations and have helped reduce the pressure on her to raise fees. "We don't conduct the audits with the intention of backcharging clients," she says. "We do audits so we can evaluate our processes, find the holes, and patch them."

Here's how the auditing process works with her practice management software: At the end of the day, a staff member prints an audit trail report that includes all the daily transactions by client, a list of procedures completed that day, and the doctor who performed each procedure. The report ensures that the proper doctor is credited for his or her work, surgical and anesthesia time was properly charged, and the medical history for each patient is correct. If there's a mistake, it's corrected.

By the numbers

At the end of the month, the hospital administrator reviews all hospital invoices for lab fees, cremation fees, and specialty referral fees to make sure each client was charged for the services provided. This monthly report is then cross-referenced with individual client transactions to make sure the team charged for the services appropriately.

Making any adjustments as a result of issues uncovered during the audit process and plugging those holes is an ongoing process for Dr. Stevenson and her team. When a problem pops up, they take a few weeks to consider the issue and then sit down as a group to determine whether adjustments to the process are necessary. "It's definitely a test of my patience," Dr. Stevenson says. "But you've got to work through the issues slowly, determine what's best for your business, and not rush into any changes."

While it may feel like slow going, don't forget that your management software can be a huge time-saver in the end—and make hitting your compliance goals a snap. When you're using it to its fullest, you'll see how big of a difference software makes. You'll start working through mundane daily tasks in a flash. This means you'll have more client contact time, which translates to better care. But, Dr. Stevenson warns, don't try to do it all at once. Ease into using your system. "It truly is a journey," she says. "It's a constant work in progress toward improving how we practice and how we use our software." So get started now, but take your time and get comfortable with your system in stages.

Putting it into action

As Dr. Stevenson's experience shows, your practice management software is an invaluable tool to help you raise compliance—both internal practice compliance and client compliance with practice recommendations. Set compliance targets and use your software to track the results; you can even set up an audit system similar to Dr. Stevenson's. Paying attention helps you hit your targets. Not sure where to begin? Try these tips:

1. Offer training. To help your whole team get a solid grasp on what your software can really do, schedule training with your software provider. Your staff likely has an excellent understanding of software basics already, but there might be a whole lot more you could do to enhance efficiency and productivity and monitor compliance.

Hire a trainer to spend a day at your hospital teaching the entire team how to better use your software. The benefits of learning the advanced features will be well worth the cost of the training session. Some of the software companies will even send a trainer to your practice for free. "Training can make a huge difference in the team's comfort level," Dr. Stevenson says. "For our team, the learning curve was small—just a couple of days."

Some staff members who weren't as technically inclined hesitated to jump on board, she continues, but younger team members adapted immediately. And with a little training, the older team members saw how much more efficiently they could function. Within a few days, they were raring to go.

2. Go paperless. Tired of searching for misplaced or misfiled medical records? Computerize them to enhance efficiency and productivity. Once a team member enters the provided care in the medical record, the software ensures that the charges are automatically billed, declined care is noted, and reminders are set up for the next necessary care. What a great opportunity to reduce duplicate efforts, protect yourself from liability, reduce missed charges, and better track compliance with recommended care. Plus, you'll no longer struggle to decipher illegible handwriting.

While going paperless has its benefits, your practice doesn't have to be paperless in order for you to effectively leverage your software. Dr. Stevenson and her team put the use of paperless medical records on hold until improvements are made to her system and she gets an even better grasp of all the things software can do for her practice.

3. Use codes. Create group codes—diagnostic and treatment codes that are linked to billing codes—within your software to ensure more accurate estimates. This strategy allows a doctor to ask a technician to prepare an estimate that includes specific fees—all the fees for that particular diagnosis or treatment protocol.

The veterinarian can then review the estimate and add any patient-specific charges. As a result, there are fewer missed charges—and fewer client surprises between estimate and invoice. Here's a helpful hint: At Pinnacle Peak Animal Hospital, Dr. Stevenson created a provider code specifically for technicians. This way technicians can create their own appointments for things like nail trims and anal gland expression without taking up the doctors' time or affecting the doctors' average client transaction numbers.

4. Beat the drum. Why should you continually instill the value of consistency and compliance in your team? First, and most importantly, consistency and compliance are in the best interest of your patients. I share my home with three kitties and one energetic beagle-spaniel mix, and I rely on my veterinarian to proactively and consistently communicate my pets' healthcare needs to me. Your clients rely on you for the same thing. Secondly, as a consultant, I know that the medicine must drive the business. And when it does, the dollars follow.

Many practice owners I work with understand this on one level, but they don't always make the connection between the medicine and the money. If you're having trouble seeing the synergy between the two, see "Want to Boost Compliance? Here's Where to Look First" for an example of how you can impact your practice's bottom line.

By the numbers

5. Gather your resources. Use the tips in this article and the management materials and tools found in Benchmarks 2008: A Study of Well-Managed Practices to guide your practice down the path to enhanced client compliance. These resources will help you identify your improvement targets, develop an implementation plan, and get started.

Your patients and clients will appreciate your efforts—and so will your practice's bottom line. So what are you waiting for?

Veterinary Economics Editorial Advisory Board Member Denise Tumblin, CPA, is owner of Wutchiett Tumblin and Associates in Columbus, Ohio. Send comments to ve@advanstar.com or post your thoughts on our message boards at dvm360.com.