Transcript of the Conversation
RJ:
Welcome to the IPROV made podcast where we help you build a better, more profitable healthcare practice. I’m with my co-host Jordan Smith. Hey Jordan!
Jordan:
Hey everybody. How are you RJ?
Interviewer:
I’m doing great. I’m excited about our guests today. Do you want to do a little introduction of Mr Jim Edwardson?
Jordan:
Yeah, today we’ve got Jim Edwardson with vital signs, physician resources. If you guys are out there and you haven’t heard of his company, then you might be living in the desert because; we’ve seen Jim stuff for a while. We ran into him randomly and we’re super excited to have him. He is the owner and lead consultant for the S P R. How are you, Jim?
Jim:
I’m doing well. Are you all doing the day? I appreciate you having me on.
Jordan:
We’re doing well. We’re excited to have you on. First of all, before we get going, RJ talks about, remind the listeners out there about the structure and how we usually kind of set these up.
RJ:
Yeah. And, Jim we usually kind of tell a little bit about our framework. We’ve kind of got these eight easy steps for how we think, and you build a profitable practice; then we want to talk about where we think you fit in. And, you know, the first thing is often we’re meeting with physicians, and dentists, and healthcare businesses, and they tell us all about their symptoms. And it’s just like the tables are turned where we get to listen to their problems, but inevitably they’re just random symptoms. We then make sure that we’re talking to someone who is going to take complete accountability for the problem. You know, a lot of times we’re too busy as business owners. We just want to throw money at something and say, fix it, and we’ve learned that you can’t do that. You’ve got to be completely accountable to solve the problem.
Thirdly, we kind of triage and make sure that the physician has a vision for what they’re trying to build. And your clients that you work with right now have a vision for what the future looks like. It’s usually our job as consultants, our job being me and yours, Jim, to build a strategy, to help them meet their vision. And right now Corona, COVID-19 has just changed everybody’s future. It’s just changed the world; and so, you know, when they bring us in to build a strategy, usually it’s looking at different ways to build their practice more profitably. Today it’s a little different, today the strategy is; “Hey, my volumes are way down. People can’t come in here safely. Can you help me kind of turn things back on, or can you help me figure out how to do these remote practices and that’s our job? And usually after we get done with building a strategy, we turn it back over to their team so that they handle the tactics so that they measure the performance so that they can make sure that they’re successful at whatever strategy we’re implementing. And so Jim, that’s kind of what I see VSPR doing for their clients, building a strategy for them, not necessarily doing all the tactical work, but building a strategy. Is that what your consulting does?
Jim:
Yes, RJ, that is. That’s a very good, excellent framework to go by. And, especially, uh, this time when everything seems to be changing it’s a good thing to be able to bring provider and clients some, uh, items that are very relative to this whole new world we live in.
RJ:
So for the viewers or the listeners who don’t know about VSPR, why don’t you give kind of an elevator pitch on what you do for your clients?
Jim:
Well, thank you for the opportunity to give a background, vital signs of physician resources. I’ve been in a group practice management for probably 35 plus years, and I’ve worked for group practices and medical management companies doing all sorts of various things from CEO to COO, to revenue cycle department manager, doing the payer contracts and negotiating with payers and et cetera, et cetera. So, I started a consulting company about 10 years ago when into it full blast and I’ve got about a dozen employees. And we don’t really advertise as a billing service, but we do a lot of revenue cycle management and oversee billing departments or smaller practices that may not have a billing department manager or certified coders.
We do some audits just to see if the billing service is doing their job and or the billing department. We will go in there remotely and look at some claims that are not paid and make sure they’ve been worked. And that makes quite candidly, it makes positions, owners and practice managers sleep better at night, knowing there’s a third party, independent party, given an honest opinion of how their billing department is. Or if they lose their billing manager, we can come in there and offer temporary services and help train a new billing person.
We offer complete credentialing services. And, that’s a lot of people, might add, a lot of practices might add a provider every couple of years, and they don’t really keep up with the changes and what it takes to get a Medicare number for your practice. Get on all the payers fill out the online. Fill out the CAQ H1 and keep it maintained. And we can do a lot of that remotely. We use DocuSign and a lot of other project management tools, so no matter where they are can see where they are on their credentialing for hospitals and insurance companies.
We have a complete finance department. We don’t do tax returns, but we do anything from partial monthly reporting to full finance of accounts payable, payroll processing, and QuickBooks, balance sheet, and a profit-loss statement. So if that’s ever needed for any physicians that run into problems or, their tax CPAs may be getting a little behind once in a while and need somebody to do this on-going. So that’s a little bit about what we do.
Jordan:
So you’ve got her doing a lot. I mean, everything from assessment and planning to implementation to, you know, helping improve efficiencies, right? I mean kind of touching a lot of parts of the practice.
Jim:
Oh yeah, yeah, I know we are. We’re not in the box type deal. Every client is different, every practice is different, every practice has its own needs. I just got back from a client that didn’t have a lot of leadership and they needed a lot of help. I kind of interjected as a CEO to help him through all of these stainless packages and the P.P.P plan, and the telehealth build-up. And, that was a pretty exciting time for me there, but we want to propose the services that the client needs for their framework.
Jordan:
I love that, and while we’re talking about kind of big picture, because what you just said was every practice, depending on where they are, they definitely need different types of tactics, but it always starts with that strategy and vision and where the organization is. So I know RJ and I both want to talk about some very specific tactical stuff that we think the listeners can pay attention to. But first let’s kind of talk about the vision and those practices that you work the best with. So kind of talk us through your most successful clients. What do they look like? If there’s a listener out there that’s looking at their own practice, what are some things that they should look at?
Jim:
Well, it’s like I said, every practice seems to be different. They have their own needs. They might have a very strong Billy manager, but very weak on the finance side. They may have somebody that practice just doesn’t have anybody internally to do credentialing for them. And they’re going to add two or three payers. They don’t know how to get them, their Medicare numbers and whatnot. So, those are the things that, and then, of course, there’s hot topics like right now the word on the street is telehealth and what’s going on there. But the clients that I look for are those that number one appreciate our services and what we can do for them.
I have been around long enough that I know physicians don’t like paying consultants, especially if there’s no assurance on the return on investment. And, I always look for low hanging fruit when I first go into a place and do a little free analysis, just to find them some things, to see if I can help them. And then as I go through my question and answer and look at a few basic reports and talk to the physician about their needs, I can usually as a general rule, give him some very valuable, things, and items that are basically free that will pay for at least get a good head, start on what I’m gonna offer him.
RJ:
That’s a great point. And, you know, I like to kind of stoke the brain fire of our audience and tell them some of the things that pop out to me and ways that they can utilize someone like Jim. And Jim, you’re going to hate me for saying this, but you know, often Jim’s recommendations are almost free. He will come in and he will do a review of different parts of your business, ask you questions and will often identify problems that you already know exist, but we’ll also lay out a strategy on how he’s going to fix it. So you can kind of just on an annual basis, it’s like spring cleaning time where you can just say, okay, come in, let’s see what opportunities are there that need to be fixed. Some of the things that pop up almost immediately from the listeners that I’ve spoken to are often, you’ve got a small team; and that small team is incredibly close, even literally family sometimes.
And sometimes family is great to do business with, but sometimes it’s hard to hold them accountable. So the audit services have just almost verifying and validating billing, not on a 24, seven basis, but almost spot-checking and making sure that you feel good and you can go to sleep knowing that things are being handled correctly. That sleep at night is so valuable; and, you know, I think if I’m one of Jim’s clients, that’s the most value that he provides is just allowing the sleep. But on the other side, sometimes they’re great at billing, but the financial side, I don’t get my profit loss or my balance sheets on a timely basis. Jim, you’re saying you guys provide financial and all accounting services for them too, is that right?
Jim:
Oh, yes, it is. And you’re exactly right. Either the office manager, they get behind on that or not be experienced with QuickBooks, or they outsource that to their tax account, and the tax accountant always has deadlines. There’s always a return coming up. The personal returns, the quarterly reports, the franchise returns, and they provide a service, but they’d rather do taxes and top top-level type advisement, financial planning, or whatever it is.
And so, we’ve had a lot of clients now and a lot in the past that thought of our finance. You know, we’ll get them, we’ll get the bank statement, we’ll reconcile it. We’ll do anything they want. If they’ve already paid the bills internally, we’ll just do the quick books for them. And even the tax accountants seem to appreciate our services; because the P and L and the balance sheet are very clean. And it doesn’t matter if you’re a restaurant owner, a dentist’s practice or whatever your financials, that’s what you have to have, and you have to have them the following month, and they need to be clean, and they need to be accurate, and that guides you down the path. Even getting a month in return, you know, uh, reports out of your practice management system monthly and summarize a good idea.
RJ:
Well, our audience knows exactly what you’re talking about. And often you want your billing, your accounting person, you’re your bookkeeper. You want them to be all of the things needed for accounting. And unfortunately, a bookkeeper is a different personality type than a CFO. Your CFO might be looking 10 years down the road. Your bookkeeper is looking at exactly what’s in front of her; it doesn’t make one better than the other, but the reality is you’re going to need different team members on your team; and identifying who those are or where the weak spots is, is sometimes hard for us as business owners because we don’t have time to do it. So again, Jim, I see a lot of value from our audience, taking advantage of you is just coming in and helping them identify, sets out the problems, and get to the core of what the problems are.
And so, you know, that brings me up to the next point on as a consultant. Right now, we are in the midst of this, COVID pandemic, and the strategy of open up at eight, fill up the book has changed. And so I was excited to bring you on because I wanted to discuss what you’re seeing with regards to telehealth. You had said it earlier; it’s the big, hot topic right now. Tell us what you’re seeing from your clients and your friends on the telemedicine side?
Jim:
Well, I’ve been, obviously thrust into this, my clients have been begging, starving for help and advice, and I happened to know network with some couple of national people that stay in tune and hear directly from CMS. But, the commercial payers are there that, what I’m seeing with telehealth is it’s just constant changes. This has happened since the 1st of March, and I think Medicare alone had four revisions and even came out of the end of March 31st; and then again, a couple of weeks ago with more changes and more updates, and added more services and codes that a physician could provide via telehealth.
And my company has been watching the links. The commercial payers have even been more of a challenge because they have also initially thought that telehealth 15:38 [Inaudible] adapted to it. And some of their policies are even more liberal than Medicare are. For example, a lot of the payers, if you can’t connect visually and audio and all you can do is connect audio, they’ll still let you bill an office visit instead of an audio call.
But two weeks ago, for example, the CMS increase their reimbursement for audio-only calls up to that of an office visit. And, they, uh, also come up with a couple of new codes for practices that click COVOD swap testing, and send it to reference labs. And, for example, you can get reimbursed about $43 for collecting that swab test, and putting it in a kit, send it to the reference lab.
So we watch, I’ve got a lady that every week or two, will go into all the links of all of the major payers and she’ll copy and paste those links, and she’ll look at the rules. A lot of the commercial payers waive copays, and a lot of the commercial payers, as I said, will allow you to bill office visits for even an audio-only call, but they change all the time and the way you bill for and changes too. So we keep a grid and we keep our clients informed of all those changes on an on-going basis.
RJ:
Well, you brought up the changes and it’s incredible. What we’re hearing from our friends is you know, just to put it bluntly. And you tell me if we’re a subset, but just telehealth billing is a nightmare. Is that across the board or are we just hearing it from a few people?
Jim:
No, it’s across the board. The first thing I’d like to say is you just don’t get up one day and decided I’m going to do telehealth on a boat, it doesn’t work that way. These codes have been around forever, but they haven’t been reimbursed unless certain role shortage areas that have very few providers. They have been reimbursed in certain situations in rural areas, but for the most part, these aren’t generally covered as a reimbursable service.
And so, the first thing they have to do obviously is, what software they’re going to use? Is it going to be zoom for their video conferencing? Most of the EMR now partner with a third party vendor, that will tie the visit into the electronic medical record package and initiate the call, and the visual audio of the call. But on the front end, you know, with all these payers keeping changing, it’s always been kind of standard for the providers to pick the level of service. What level of the office visit is it going to be? And so, they have to have that grid of all the different payers, Medicare is going to do one thing, and the payers are going to do another.
And for them to select that level, they need to have an updated, as these changes with the payers and updated grid to go by, and it’s been very frustrating for them. And then, of course, the claim scrubbers, they have to look at those, all those telehealth visits, and actually make sure that the provider did pick the right one. Because in any practice, you know, there’s some providers better than others. And so they also have to put the place of service and the modifier on there, according to the payer rules.
The back end is the worst when the claim comes back, what I’ve been seeing everywhere, and talking to all my network, administrators, and friends across the country, and locally is that the payers were not paying these claims correctly, these telehealth visits, they didn’t have their software built the way their links said that they would process claims.
Some of them are reduced, payers may apply at co-share when their link says, are waving the co-share, and the copays for patients. And, I think I find the payment posters at the offices. They either can’t keep up, or the manager or the doctor has not filtered information that is available, they don’t have the expertise to look at the links and the websites. So when they come in short paid, you know, they don’t know whether they’re, they’re just taken for granted, they got paid right, but worse yet, there’s something called auto-post. It speeds up the processing of payments, and posting payments in the billing system. And, so basically the payment is allowed to be posted and then there’s a contractual adjustment that just writes the rest of the claim off as contractual. And so, if you don’t look at those ELBs, and you’re not educated enough to know that they’re short paid, then that money may be getting written off forever, and nobody that practice owners, manager, the billers, they don’t know that that money got written off.
RJ:
Yeah.
Jim:
And you can’t even appeal it.
Jordan:
Just automatically, they don’t even have no, they don’t, you know, RJ talks about symptoms earlier of a problem. There’s no, they don’t even know that this is occurring, right?
RJ:
Yeah!
Jim:
Exactly, exactly.
Jordan:
That’s tough.
RJ:
Well, let me summarize what I think I heard because there’s a lot of our physicians who, had the aha moment and said, “Oh, COVID! I do want to go and work from a boat”. In fact, almost everyone has thought, you know, “I bet I could do this remotely, telehealth is the future”.
Jordan:
Or even an office manager or a practice manager out there, that’s saying, “Hey, my doc, they’ve been doing it the same way for 20 years. They’re just going to open up as usual”. And, I’ve got to convince him that he can’t do this from, or this is even something that they need to do.
RJ:
And learning everything that has to happen take time, energy, and effort; there’s going to be irons or kinks that need to be ironed out. And so if your volume is down now is the time to figure out telemedicine. And so I know we’re talking about being a nightmare, I know talking about it as being painful, but knowing I’ve got a guy like you, I’ve got a little additional time in my day. This is the time to really look and focus on telehealth. Would you agree or disagree?
Jim:
Oh, yes. Yeah. And the other thing about it from the patient perspective is, “Oh, I don’t want to do this. I, I don’t know how to look at my smartphone and my daughter didn’t want to come over and help me with it”. I mean, it’s just not this provider, technology is being forced on all of the individuals of the United States. So Physician practices shouldn’t just think that, well, my patients don’t want it. I mean, you know, you can’t order a meal without paying for it in advance and just picking it up off the curb. And, any other physicians are doing the same thing, and everybody is video chatting, zoom or messenger. And so now is the time while it’s already being forced to fond everybody in the United States. Now is the time to go ahead and just jump on the bandwagon with it.
Jordan:
Yeah, for sure. And I will tell you, even from a consumer standpoint, you know, we talk to practices all the time that you have to think of yourself as a consumer good. And, uh, yeah, it’s being forced on some people, but you know, a lot of patients, they are not going to rush back into the doctor’s office. I will tell you, I’m the first person to tell you that my arm has to be hanging off before I go see my doctor right now. So, so even giving, giving the patient a little bit easier, access to you is going to be something that can help differentiate your brand from another brand; and that is how you have to think about your practice is like a brand.
RJ:
Okay, so going back, now’s a great time to look at it. The first step I heard was figuring out what software we’re going to use. And, you know, if I were consulting one of my friends, I would say, “What software are you using now”? Because they’ve probably got a partner, a toolset that they can kind of connect into. Is that flawed thinking on my part or is that good guidance to tell them to start there?
Jim:
No, that’s good guidance. I will tell you this happened so fast. There’s a, you know, HIPAA that doesn’t allow certain functions that they don’t really think a certain software and, videoing is a HIPAA compliant, like a Face Time, but they have given an extension for now that you can do Skype, and you can do Face Time, but most people, most doctors that are jumping right into it before they can evaluate their EMR, what partner to use with their EMR, they’re using zoom. And, that is HIPAA compliant, it’s easy for the patient; and they’re starting off with that because as all these EMR companies partners with a vendor, those vendors are getting further behind and your backlogs on a list. And, some are doing better than other ones as far as getting everything implemented. But, the best long-term range is to look at your electronic medical record package and reach out to them and see who, see what they recommend for their telehealth services.
RJ:
Okay. So it’s committing to, I’m going to iron all the kinks out early, I’m going to find the piece of software, the hard part. The thing that no one’s going to do is just how fast everything’s been changing. And so this is where now you need to worry about training and educating, what you’re calling your friend and, and people and your backend people.
Jim:
That’s right.
RJ:
Yeah, and is that something where to me, doctors should not be spending their time doing this. This is something that either A, they’re going to force their office managers to try to figure it out, or B bring someone in that’s already learned the ropes that have already built some of these matrices for other groups, something like that. Is that your stance on it too?
Jim:
Yeah. I’ve seen a lot of frustrated providers out there that, just the last thing they want to do is learn it and teach it to their billers, even if they had the capacity and the knowledge it’d be something that, with all the changes that happen every couple of weeks, they’ll get impatient with it pretty quickly.
RJ:
Well, and you know, I think a lot of times the office managers, they’re very smart people. I feel like I could, I’ll read up on it. I’ll figure it out. Let’s just start booking patients, we’ve got the technology in place, we’ll figure it out. When they go on that model; if they’ve already started down that path, can you come in behind and evaluate to see if they’re checking all the boxes? Are you using the proper codes, or has that ship sailed already?
Jim:
Yeah, I would highly recommend that they have some type of expert come in on the back end and look things over because, as I said, there have been a lot of claims that are short paid and written off or the copays, you know, just processed wrong. And, I think, really think there’s an opportunity for months and months to go back and see if things were written off that shouldn’t have been written off; or things could have been done differently, or can be done differently and have a look back.
Jordan:
Very cool!
Jim:
I will say, I would like to talk a little bit about the physician’s practice and the, I’d like to talk a little bit about the physicians practice, and what specialty they are. And I focus a lot on primary care and there’s a lot of opportunities I’ll talk to about a little bit, but specialists such as rheumatology or endocrinology, They don’t always have time to round to hospitals, or now they’re over indented dated with the hospital patients; and those codes, hospital visits, whether the patient’s in the ER department, long-term facility, a skilled nursing facility, hospital, inpatient hospital, they can bill out visits and consults via telehealth. So they need to look at their own specialty and how they ran and how they can use telehealth.
Also, they need some help with documentation because there are some new documentation guidelines that have already been set up that are going go to into effect in 2021. Physicians need to spend a little time on that, that’s a little different subject, but the thing that’s relevant about that is it focuses more on medical decision making and less on the history and physical. And Medicare has come out with guidelines that are what doctors have always wanted to document, that’s always what they wanted to build their level of service at medical decision making. And so, the Medicare guidelines have been relaxed, so you can start, the physicians can start using those 20, 21 guidelines and document medical decision making and not so much the history and physical. And that’s kind of a really, you know physicians perk up when I hear that.
Jordan:
Yeah. Well, that’s great, and something that I know you’ve talked about too, that’ll make, you know, there’s some practices out there, the might say, “Well, we’ve got, you know, one dog, but we’ve got a lot of, you know, nurses and MAs”, and that’s who most of our patients see. Talk about what’s changing for those groups.
Jim:
Yeah, well, the first thing, obviously, there are very few people that can bill services to Medicare; those are physicians, nurse practitioners, and physician’s assistants. There are some special indications for dieticians and other, you know, things like that, providers, but for the most part, it’s, and I have been seeing a lot of nurse practitioners and physician assistants in heavy offices bear the brunt of the follow-up visits and via telehealth, but, they did come out with that. Now, MAs and nurses, there’s been, the codes been around forever. But now, nurses and MAs can bill for their services in certain situations. Now there are some criteria around that, the patient needs to call, but all this time where patients have called in nurses and the nurses, I’d go ask the doctor a question about a medication, and they’ve had to spend time with the patient. None of that’s ever been covered or reimbursed, but now it is.
But if there’s a particular practice that is getting a lot of these calls, and they want to look into that, then I could help them with that, or I could give them the information where they could go to for that, but it’s on CMS website. And the codes are available, and you can read up on the criteria, and the conditions for when those can be built.
RJ:
Yeah, well, that’s, this is really good stuff. You know, I think a lot of times we do just think about primary care physicians that are just doing this. You’ve talked about rheumatology, endocrinology. There are nursing and MA opportunities now. So really digging into your field and figuring out if you can use telehealth. Moving into the idea that someone says, “Yeah, you know what, “I’m a primary care physician. I do want to do this”. What is the first step? Are there service types that you think would be a good fit for telehealth? And is there kind of a good way to get started?
Jim:
Well, I started out in primary care and I’ve had a brother that’s a family practice physician, and, I’ve worked with a lot of primary care doctors, and they don’t have the opportunity to do the higher dollar surgeries and ancillary services that some specialties can do. And, all their practices are office-based, so the overhead is generally very high; and what I’ve seen and a lot of friends, and clients, and even ex-clients, who’ve been reaching out to me for guidance in primary care arenas. And they’ve been really, really hurt. They’re mostly all small businesses and they’ve been really hurt with the inability for patients being either scared to come in or have a lockdown situation. And even the employees for a while, not being scared about, you know, having a lobby full of patients and things like that.
So, they’ve been calling me and they have started the telehealth and that has really helped keep the lobbies from being full and reduced. Some of them still see patients throughout this whole deal, but all that, less of a degree. So they’ll have their mid-level providers, or they’ll do telehealth visits, especially on the established patients and follow-ups, and blood pressures, and things like that.
But, there are also practice certain practices that try to get to keep the revenue on – going and provide services. There are things like annual wellness visits; and Medicare came out with rulings eight, 10 years ago where, you know, physicians always just got paid, if the patient was sick, prevented stuff wasn’t covered. And so they came out with a reverse of that where in order to lower the total cost of care, fewer ER visits, fewer admissions they started approving at a hundred percent and an annual wellness visit for the patients.
And the MAs can do most of the work, cause it’s not so much the examination, it’s more of a plan. And MAs or nurses, and then the provider goes in and sees them telephonically or audio-wise and, or in-person and goes over that plan with them. And this is something that’s very great quality care, and, it’s encouraged by Medicare. The patients love it, and the bad thing about it is that physicians have not done a good job of incorporating this into their practices. They will do them probably on about 20 to 30% of their patients if they happen to catch them when they come in or if they have some sort of system, but for the most part, a majority of that goes to the wayside, or kind of fit in as an inconvenience tool or whatever.
But, right now is a perfect time to mine your database, find all those patients that qualify for our annual wellness visit and, do these tele-visits. And there are related codes that you can build with these advanced care planning and other things. And, the reimbursement on that is 250 300 bucks patient and encounter, and so it’s a good way to help with the revenue and is good quality care.
Jordan:
Well, it’s a giant revenue stream you said, because you’ve seen it with your clients, where a lot of them weren’t even taking advantage of it before you hopped in there.
Jim:
Yeah, I have a consultant in South Texas, one of my employees, and she’s really good about building templates for annual wellness visits and training physicians on mid-level providers on how to do it and working with them, working with the staff to get them. I mean, it’s one thing to give them the codes, It’s another thing to start doing eligibility and what services they qualify for. So it’s more of a follow-up and having to hold your hand to help implement these things, to make it easy on the entire practice,
Jordan:
The followup and the template stuff is great because I’ll tell you again, going back to making it easy for the consumer. If my doctor reached out to me and said, “Hey, you know, we can do your entire visit a wellness visit it’s covered by your insurance. And all you have to do is just pull out your phone at the time that we pick,” cool, I’m in, I’ll get one of those done today,
Jim:
Right!
RJ:
Well, yeah. What perfect timing to do that because a lot of us aren’t going to the doctor, not because we don’t want, but we all like maybe not going to the doctor is helping by not overburdening the healthcare system. When in fact, lots of our friends, all the volumes are down their front desk girls are slow; and so what could they be doing? This is a perfect thing for them to be doing. Starting to incorporate this annual wellness visit, figuring out the kinks on making those outbound calls or offering the service at all, this is a great opportunity that you’ve just laid out there. I think capitalizing what you said, if you are not looking at annual wellness visits as a percentage of your patient population, you should be, and telehealth is a way to do that. What a great idea!
Jim:
Yeah. I also have a few other services RJ as you’ve mentioned that when front desk ladies are looking at each other and looking for things to do and, you know, keep them employed and the volume is down. There are other services that physicians can do, but it’s just a little difficult to implement the processes. But Medicare, several years ago came out with a couple of new codes. One is transitional care management, where they actually found that if the patient were to have a face to face encounter within a week or two of discharge, most readmissions comes within 30 days, and, they’re trying to lower the readmission rate. And so, they want the patient to have an encounter and it’s called transitional care management, and get in because sometimes there are medication errors, sometimes patients are confused. They get discharged and don’t really comprehend what’s being told on the discharge orders, and that’s a really good code to bill and it’s a good opportunity. And once again, it’s good quality care that Medicare encourages.
There’s another one called chronic care management; and that, probably half your Medicare base will have a couple of chronic conditions that you’re managing from time to time and or on-going. And those individuals, you can get paid based on a non-provider contact throughout the month. So if you spend 20 minutes, if your office staff spends 20 minutes with their, or their home health agency or whatever it is, you can bill based on the time from your staff.
And, but once again, they’re programs that sometimes doctors think they’re too difficult to get into, or they dabbled in it, or they didn’t have the expertise internally to do it. But at these times where the clinic’s not full, it’d be a perfect time to take these opportunities and do some of these things, uh, to, to improve the care to your patients.
Jordan:
I love that, absolutely. And, it sounds like you guys can help them out with; if there are listeners out there and you’ve got any questions about these things that Jim’s been talking about. If you haven’t been able to telehealth already he is the expert on this stuff. So if you have any questions, I’d say, reach out to Jim and his group at VSPR.
Jim, for those listeners out there, just put a nice little bow on it. If they do want to get in contact with you, they have some questions. What’s a good way to kind of reach out and get in touch with you or one of your other consultants?
Jim:
Oh, my cell phone number is (817) 371-7336. So that’s also my work number and I do have a little go-to website, if you want to see a bio about myself or some of the other managers that I have at VSPR. net. And so, I’d love the opportunity. I think there’s a lot of need out there. I don’t like charging doctors if I can’t help them.
And, during this time, you know, if they do need a little extension until they get their practice back up and going, I know this time is even more difficult to pay an outsider. But, I’ve worked with providers for a long time, and if they need help and I want to be able to help them. So if they need a couple of months to get back into gear and get the revenue back up and we could probably work something out with that too.
Jordan:
No, that’s, that’s super generous, that’s great. And knowing Jim, the little bit that RJ and I do, he’s a man of his word. So if he tells you he can work with you and get a return, he’s going to work till it gets that return for you, and I don’t think it’s going to take him that long. We’ve focused on one subject, but there’s, you know, there are dozens and dozens more than Jim can go a mile deep with you and your practice on.
RJ:
Yeah, I would couple that. And just again, press you guys. If you have seen volumes fall, if you’ve been lucky enough to keep people around and not have to lay off people, I know that they’re probably not as busy as they usually are; and we don’t know how long this is going to last, and we don’t know if it’s going to come back, but we all feel pretty confident that we’re going to see it again, and that our world has changed. And as a consumer, Jordan said it, and I’ll say, too, it has changed.
Telemedicine is what I’m looking forward to using, I’m excited about it; and lots of your patients are going to be that way too. So pick up the phone. I would just call Jim and just say, “Hey, this is the practice I’m in, what recommendations would you tell me to look into. And you’d be surprised at the thing that would trigger new ideas for you, and you know, that’s what we need at this time are things just like that. So, well, I’ve really enjoyed this and thank you so much. I know our audience is just going to love this too. You have been spot on with everything you’ve said, so thank you so much for your time.
Jim:
RJ, Jordan, I have been looking at your website and the services you provide, and I’ve seen a couple of your podcasts and you offer a great service. I really appreciate the opportunity to get the word out to any providers out there that could use some help.
Jordan:
I love it. Well, hopefully, you’ll start to get some of those calls and I think you will. Jim, we appreciate you so much.
Jim:
Okay, thank you.
RJ:
Thanks, guys.
Jordan:
Alright, everybody, RJ, Jim Edwardson
RJ:
That was really good. I love, you know, it just seemed very focused on telehealth, but you know, it just gave good guidance and that’s what you look for in a good consultant.
Jordan:
Absolutely, and again, we hope that you guys enjoy this format, especially right now, we know it’s timely. And you know, very rarely do our guests give out their cell phone numbers and, you know. Jim you know, I’ll tell you he’s a man of his word. If he can’t help you, he’ll let you know. But I very seriously doubt that anybody picks up the phone and calls him and reaches out to him, that he will not find a way to help you guys, even if it’s just a 30-minute conversation to point you in the right direction.
So a long story short, reach out to Jim. We hope that you guys enjoyed this, like, comment, share. If there’s content or individuals that you want to hear from make sure and leave us a comment and let us know. As always we’re trying to provide good content and helpful information for you guys, RJ until next time,
RJ:
Jordan, thank you, audience, thank you all.
Jordan:
Alright. IPROV made podcast, out!
