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Author: Jeff Tormey

Health Insurance Verification Process

How The Health Insurance Verification Process Works

Written by Jeff Tormey on . Posted in Connect.

One thing that no medical professional likes to deal with is insurance. Insurance is a hassle, it’s not always easy to comply with, and they have so many different requirements. What’s worse is that it can seem quite mysterious to those who don’t go through the process day after day.

We’re here to tell you how the health insurance verification process works, what goes into it, and what makes it operate.

What Is The Health Insurance Verification Process?

The health insurance verification process is a series of steps that checks whether or not the patient admitted has the ability to make a reimbursable claim to their health insurance provider. The process is complicated and goes through many different people at both the healthcare provider and the insurance provider.

Steps In The Health Insurance Verification Process

Patient Scheduling

The patient makes an appointment with the doctor and the doctor schedules the patient in. The registration can be done through self-scheduling to make the process quick and streamlined. New patients are entered into the healthcare provider’s database. In case of emergencies, the registration may be performed at the hospital where intake happens.

Patient Enrollment

The patient’s demographic data and medical history are recorded or referenced by the healthcare provider. This is to identify the patient accurately and make sure that insurance has the right patient.

Eligibility and Verification

This is generally the ugly part. Insurance claim details are then cross-referenced by the healthcare provider to make sure that the patient is, in fact, eligible to make a claim. Since insurance fraud is common, this is a necessary step that healthcare providers have to do. This is where health insurance verification services come in, offering patient conversion solutions that can save a considerable amount of time.

Authorization

Insurance verification establishes the eligibility of a patient’s insurance claim, but not the requirement of the insurance provider to actually reimburse the patient. The authorization process binds the insurance payer to authorize the claim through a legally binding promise to pay a specified amount. This step should be given careful scrutiny as to prevent denied claims, which can cause a great deal of stress. Here, the Role of a Medical Insurance Verification Specialist becomes pivotal in managing the process effectively.

Updating Patient

If there are any changes to the claim, the healthcare provider must notify the patient of said changes. This process is important as patients should not end up with a surprise bill at the end of the whole ordeal.

Updating Medical Billing System

Healthcare providers must update the billing system to make sure that correct charges were recorded. Otherwise, this can have a drastic effect on the organization’s accounting.

Claims transmission

At last, the claim submission request is sent to the insurance provider. This is the final step in the health insurance verification process. For assistance with any part of this process, Reach Out to us for expert support and guidance.

Why Communication Is Important in Healthcare

Why Communication Is Important in Healthcare

Written by Jeff Tormey on . Posted in Connect.

It’s no secret that one of the biggest barriers to providing good healthcare is communication between doctor and patient. Without adequate communication, the ability to deliver quality patient care is hampered severely.

But why exactly is communication so important, and where do the most common communication issues come from?

Common Barriers to Communication In Healthcare

Language and Culture

It’s pretty obvious that if two people are unable to communicate in the same language, they will not be able to convey complex ideas. But how else does language and culture play into communication? A big part is on the healthcare professional: it’s not uncommon for a healthcare professional to assume that a patient from a different cultural, social, or economic background is less health literate than another patient that’s more similar to them. As a result, they’re not given the chance to take an active role in their own healthcare.

The best way to remedy that is to hire staff that are culturally similar to the ethic minority populations of the area, but that might not always be possible. Another way is to train staff on cultural differences.

Health Literacy

Many patients are not health literate; that is, they do not understand and cannot communicate basic health concepts. It doesn’t mean that they’re not medically trained, as it’s possible to be health literate without being a medical professional. It means that they don’t understand how to take care of their own health properly, how disease and injury happens, or how the healthcare system works.

Because most patients are not going to tell a professional that they lack health literacy, an assessment must be done to gauge how health literate a patient is. Unfortunately, these assessments tend to be subjective because of the difficulty of implementing official empirically-based health literacy tests.

Improving health literacy in patients requires providing them with multi-purpose education, but that would also require them to absorb said information which is never a guarantee.

Patient-Staff Communication

It’s not just language, culture, and health literacy that can affect communication in healthcare. If staff aren’t making sure they’re understood when communicating to the patient, then that could cause serious issues in understanding especially if the patient is not health literate.

It’s important to train staff on how to properly convey information to patients at all steps of the process.

Most importantly, staff must have a way to confirm that the patient understands what is being told to them. The patient must understand their diagnosis and their treatment plan.

In Summary

  1. Language and culture differences present both obvious and subtle communication issues.
  2. Patients with low health literacy are less likely to understand what is being told to them, and work must be done to assess how health literate a patient is.
  3. Communication is a two-way street: staff must work to make themselves understood.
Online Medical Marketing Strategies

Online Medical Marketing Strategies For Attracting Quality Patients

Written by Jeff Tormey on . Posted in Connect, Convert.

Online medical marketing sounds like it can be confusing. There’s SEO, there’s ads, there’s social media, and all of these things need to be combined to form a cohesive marketing strategy. That’s a lot of different tactics to consider!

But healthcare marketing is not about tactics, it’s about strategy. While tactics play a role, they’re not the end of the conversation. Do the first things first.

Figure out who you want to reach

The first thing all businesses need to do before they start marketing is figure out who they need to be marketing to. Marketing doesn’t work if it’s to the wrong people.

Can’t decide what kind of people who want to reach? Start with your services. What services do you currently offer, and what kind of people come in for those services? What are their problems? What are their demographics? Define these things, and you’ll have a good idea of who you should be reaching with your marketing.

Then take a look at your local market’s needs. Do research on your local market’s demographics, and take a look at their behavior.

For example, a bariatric surgeon may be looking for women aged 30-45 who are struggling with their weight and have not found success with diet and exercise. Figure these things out for your practice!

Decide what medical topics you want to speak about

Now that you know who you want to speak to, you need to figure out what you need to say. Medical topics that relate to your practice are the best topics to discuss, as they give prospective patients information that could lead them to book an appointment.

It’s not enough to have something to say: you have to have a reason to say it. Why should prospective clients listen to you?

Ultimately, you want to talk about issues near and dear to your target audience, while also providing interesting and highly informative content for them to read.

What kind of topics should you discuss? Whatever is highly relevant to your audience! Going back to our bariatric surgeon example, you may want to discuss things like the post-op diet that all patients have to go through, or how they should be preparing for surgery. Figure out what your market wants!

Read More: Ways to Promote Your Medical Practice

Test different digital online medical marketing tactics

There are many different medical marketing tactics. You will want to invest in many, or all, of them and see which ones are moving the needle the most. Search engine marketing, social media marketing, paid search, paid social, PR… all of these things should be tested. Invest small amounts of money and time into them, and see the results.

You’ll notice that not all of them bear fruit, but given enough time and tests, some of them should. Then, you’ll know what you’ll need to invest in further.

Last Words: Make Sure To Track The Results Of Your Marketing!

Many businesses, clinics included, fail to measure the true impact of their marketing. When you measure this, you’re not going to get a 100% accurate picture, but you will get a good idea of what’s working and what’s not. However, you can’t get this idea if you don’t collect the data and analyze it!

You should be collecting information about where your website traffic is coming from, what people are doing on your website, and how many people are requesting an appointment (either by phone or through your secure web form).

A Person Holding A Tablet

Keys To A HIPAA Compliant Website

Written by Jeff Tormey on . Posted in Connect.

You want to have a strong web presence so prospective patients can find you online. You may even want to have people send you information online so you can give them recommendations. Both of these things are great!

But there’s one thing standing in the way: HIPAA compliance. If your website is not compliant, you risk a hefty fine… or worse, a lawsuit. So what do you do to make your site HIPAA compliant?

Keep PHI In Mind

Protected health information (PHI), and its transmission or storage, is the key to figuring out if what you’re doing is HIPAA compliant or not. If you’re transmitting or storing PHI, which you almost certainly are if you’re using web forms to collect prospective patient information, you need to make sure everything is HIPAA compliant.

What counts as PHI? Anything that can be used to identify a person.

Security Is Paramount

If you’re dealing with PHI, your healthcare website needs to be using SSL (HTTPS) encryption. This is non-negotiable.

You also need to be using encrypted web forms. If the information is being submitted through a web form, then there needs to be no way that an intruder can get access to that information. Encryption helps there.

Email notifications for your web form can’t transmit PHI to another user. That means, those notifications cannot have any PHI in them whatsoever.

All data needs to be time-stamped on the date and time of collection, and it needs to be accessible on request.

PHI collected by your website cannot be accessible to just anyone. You need designated staff members with designated secure logins, otherwise it’s not compliant. The point is to make sure no unauthorized user can gain access to PHI transmitted, collected, or stored on your servers.

Got any questions at all about HIPAA security requirements? Give us a call at 888-986-3638. It’s better safe than sorry.

Getting Help With Your HIPAA Compliant Website? Get a Business Associate Agreement (BAA)!

There are plenty of service providers that are well equipped to handle PHI. If you’re going to work with one, make sure to get a BAA from them. This certifies that the vendor has checked your technology solutions HIPAA compliance regulation.

This includes HIPAA compliant web forms, web hosting services, servers for storing patient information, and much more. Ask us about HIPAA compliance if you have any other questions.

Healthcare Marketing After Coronavirus

Changing Your Healthcare Marketing After Coronavirus

Written by Jeff Tormey on . Posted in Convert, Manage.

The COVID-19 pandemic has had a huge impact on the global economy. But the reverberations are most felt in the healthcare world. Focus on healthcare investment has shifted greatly toward dealing with the virus. Many healthcare businesses that weren’t directly involved with dealing with the virus have seen a drastic decrease in revenue.

If you’re thinking about reducing your marketing budget, we highly encourage you to think in different terms. Instead of just cutting back on your marketing budget, where else can you put that spend to work? What other strategies can you use to prepare for when businesses open up again? Here are our recommendations.

Why Now Is the Time to Prioritize Digital Marketing

If you haven’t already been putting digital marketing initiatives first, then now is the time to do it. Investing in digital marketing has always been a solid investment, but for the near term with everyone in quarantine, digital marketing has never been more important.

Invest in search engine optimization, where you’re producing content and optimizing your site and copy to be found by people on Google. Invest in social media marketing, where you post shareable content to social media and interact with your followers. You may even want to invest in paid search and paid social.

Best of all, starting now will also have some ripple effects in the long term. Your search engine rankings will increase, your social media following will grow, and you’ll have much more data if you’re investing in advertising. Why? Because digital investments are a long term play, especially with SEO and SMM.

Build Authority and Stay Connected During Lockdown

Now that everything is under lockdown, your business can use this time to create content and make your brand an authority in your space by producing helpful, interesting content that’s better than anything else out there.

Write content. Create videos. Do live workshops and webinars. But that’s not all.

After you do all of these, use the opportunity to get people’s info and stay connected. Talk directly to your prospects, and use email marketing to keep in touch with them after the shutdown’s end. By doing this, you’ll have access to them when they’re much more prepared to buy.

Read more: Healthcare Email Marketing: Why it’s Powerful and Popular 

You can even use this opportunity to give back to your community. Let your local Chamber of Commerce or Board of Trade know that you’ll be giving workshops on important health topics, and they may be able to help get the word out in your community.

Prepare Now to Thrive in a Post-Lockdown World

It’s tough if your business’s financial situation isn’t all that great. But the lockdowns will end, and people will be back to normal. If you’re able to invest the time and effort into crafting strategies for the post-shutdown world, you’ll be able to thrive even greater than before.

Stay safe, and be prepared for when businesses open again!

 

Hospital Marketing Strategies

The Five Keys to Effective Hospital Marketing Strategies in 2020

Written by Jeff Tormey on . Posted in Connect.

Have you been brainstorming hospital marketing strategies, but couldn’t come up with any novel ideas to support your current initiatives?

You’re not alone. Most hospitals in the US stick to the tried-and-true marketing tactics that they always have. They’ve recently added digital to the mix: much later than most businesses. Why? Because it takes time and effort which is often spent taking care of the hospital’s immediate needs.

There are, however, ways that you can come up with good hospital marketing strategies that work for you. Here are the keys to doing so.

Satisfy the needs of your local market.

Every market has different needs, and your market is no different.

You already have much of the data needed to satisfy your local market’s needs. Data such as the median age of the population, ethnic backgrounds, patterns in patient behavior, all of these will help you understand what the unmet needs are.

For example, if your area has a high proportion of Medicare enrollees, you may want to invest in services that a geriatric population will benefit from (that a younger population might not). Or, as another example, you may find that your local area’s Chinese population is growing. You might want to invest in more Chinese-language services and marketing materials in order to communicate with them.

Only you can truly understand what your local market needs out of a hospital and their messaging.

Create high quality interesting content.

Good content wins on the Internet. There’s so much content out there, especially medical content, and in order to stand out, the content that you decide to promote and produce needs to be better than what’s currently out there.

This means satisfying a need that isn’t currently met, giving information that isn’t expressed, or simply giving them a friendlier, more familiar person to listen to.

Your content, though, is NOT the time to toot your hospital’s horn. However, it is perfect for conveying information in a way that’s relevant to the people in your market, giving you an edge on the competition.

Reach out to your patients.

You have patient data (not derived from medical records) that you can use to market to them. Now, that doesn’t mean being annoying and spammy: there are rules against that.

What you need to do is make sure your patients know when they need to come in for follow ups, annual checkups, and give them whatever information they need in order to get the most out of the care you’ve given.

You can also use this opportunity to get feedback. Ask your patients how their experience was, and get them to answer questions that could help improve your hospital’s operations.

Leverage the true power of social media.

Why would a person follow a hospital on social media? There are many reasons. One reason is to stay up to date with information regarding the hospital’s openings, closings, and events. Another reason is to get important health information relevant to your local market.

A big reason, though, is to get information that is relevant specifically to them from people they trust. They’d rather hear information from a physician they can meet and speak to, especially if it’s going to be their physician. Local authorities build trust first by being local, and then by being an authority.

Remember, though, when using social media, you will need to remain HIPAA compliant and make sure that no PHI is being transmitted in any way on a social media platform!

Measure everything.

It’s not good enough to be everywhere. You need to put effort in making sure that every initiative your hospital takes part in is measured.

How should you measure the effects of content strategy and social media marketing? Blog viewership, social media following, and related upticks in hospital performance metrics.

By measuring your initiatives, you can figure out what’s working and needs more investment, and what isn’t working and should be pruned back.

Patient Engagement Importance In Healthcare

Why Patient Engagement Is Important In Healthcare

Written by Jeff Tormey on . Posted in Connect.

Healthcare professionals tend to regard patient engagement as a high priority. It’s considered an essential indicator of quality care and correlates well with positive business outcomes.

However, patient engagement is not a guarantee. Ultimately, it’s up to the patient to decide which healthcare options he or she would like to pursue. As a healthcare professional, you can only hope to provide the patient with the information necessary to make a decision.

So what can be done about patient engagement, and why is it so important yet so difficult to achieve?

What Is Patient Engagement?

Patient engagement represents how patients, caregivers, and healthcare providers interact to make good healthcare decisions on behalf of the patient. Ultimately, the onus is on the patient to make the decision based on the information given. Patients who take an active role in their healthcare and utilize the services provided by caregivers and healthcare professionals to the utmost can be said to be highly engaged patients.

Patient engagement has become a strategy to help achieve better health outcomes for patients while lowering the cost of administering healthcare services.

Why Is Patient Engagement Important?

Patients have options available to them.

It’s not hard for a patient to go to another practice. They can search for doctors and practices online quickly, and they have access to customer reviews online. Thanks to the Internet and global interconnectedness, patients are no longer limited to their immediate area, either.

Without actively getting patients engaged in their healthcare, they’re much more likely to have a negative experience and switch practices.

Engagement tools can help cut costs, reduce waste, and lower the burden on staff.

Technology has done wonders for improving patient engagement. Even ubiquitous tools like social media and search engines allow patients to have a much more active role in their care.

What’s even more interesting is the growing availability of tools such as wearable tech that checks health measures and patient portals for patients to access their medical records safely online. By making sure that patients know about these tools, as well as providing active support for the latest patient engagement technology, your practice can help make your clientele a much more engaged one.

Patient engagement leads to better health outcomes.

How does patient engagement improve patient health?

Engaged patients are, for example, more likely to attend regular health appointments and participate in recommended screenings. They’re more likely to understand why they’re important, too.

They’re also more likely to actively look for information about health topics relevant to them. Engaged patients are interested in their health, and healthcare professionals can help instill a greater interest in a patient’s health.

Engaged patients are more likely to be satisfied ones, and thus more likely to return.

Thanks to improved health outcomes, as well as a sense of understanding between the patient and healthcare staff, engaged patients are more likely to report positive experiences and overall satisfaction with their care.

As a result, they’re more likely to come back or recommend your practice to another. This has the effect of not only establishing a quality clientele, but also allowing that clientele to grow organically.

In Summary

  • Patient engagement is a key priority for healthcare professionals.
  • Patients who are actively engaged tend to experience better health outcomes and have more positive interactions with your practice.
  • With the advancement of healthcare engagement solutions, technology is increasingly helping patients take a more active role in their healthcare journey.
Marketing Challenges in the Healthcare Industry

The Biggest Challenges in Marketing in the Healthcare Industry

Written by Jeff Tormey on . Posted in Convert.

Marketing in the healthcare industry is unlike any other industry in the world. The healthcare industry is high-stakes, heavily regulated, and woefully misunderstood by patients.

Between staying within the law, and effectively building a connection between your business and your patients, healthcare marketing presents unique challenges not seen in other businesses. So what are they, and how should we deal with them?

 

 

 

 

 

Marketing Challenges In Healthcare

Dealing with HIPAA Compliance

You knew this was coming. HIPAA compliance is a monkey on the back of every healthcare practice looking to use new marketing methods or technology. As a result, it’s the most important challenge in healthcare marketing.

Certain forms of marketing are illegal, such as remarketing to prospects based on known health conditions, and that’s just the tip of the iceberg. So what do we do?

 

Solution: Be Diligent In Following It!

Make sure to keep claims and language within the bounds of the law. There are claims that you can and cannot make.

Most importantly, make sure your staff (and especially your marketing team) understands the HIPAA Privacy Rule. It defines what is and isn’t marketing, and what falls under the bounds of the rules.

 

Your Budget

Hospitals and practices require great amounts of resources. Since they also provide an essential service, patient acquisition is often thought of as an “if we build it, they will come” situation. These two factors result in small marketing budgets.

 

Solution: Convince Leadership Of The Value

Sell your leadership or partners on increasing marketing budget by showing how marketing can provide a measurable ROI. Marketing is not a cost center but a driver of revenue, and it’s important that leadership understands that this applies to healthcare businesses as well.

By communicating that you’re able to work with HIPAA regulations to stay above board, you’ll also convince them that investing in healthcare marketing is a sound strategy.

It’s best to work with a marketing partner that understands HIPAA and the intricacies of healthcare marketing. We at Guideway Care provide healthcare marketing systems to businesses of all sizes.

 

 

Public Perception of Healthcare

Not only do most people not understand the healthcare industry, but many people actively dislike it. Healthcare is expensive in the USA and has become highly politicized. So what can you do to put your business in the best light considering the perception

Solution: Become An Authority

Create excellent content and use content marketing strategies to promote your practice and its offerings. People like to make the choice themselves, and instead of presenting them with offers straight away, give them the information they need to make a decision themselves. This also improves your business’s reputation as an authority on your healthcare specialty.

Transparency In Operations

People who are in need of healthcare services are not able to see what happens behind the curtain. As a result, they rely on reviews and information online to find out important information.

Solution: Keep People In The Loop.

Make what you do more transparent. Make it easy to see what your operating hours are, the services you provide, and how the process goes.

Also, improve the overall patient intake experience, from before the appointment is set up all the way to the moment they start the appointment. Making it easy for them to book online or by phone will definitely improve your healthcare marketing efforts, as they’ll be more likely to report a positive experience.

Making the Connection

How do you market to your customers, even considering all the HIPAA regulations? Making a connection with your customers is still very difficult, even with all the technology out there. What do you do?

Solution: Make It Easy For Them.

Be where your patients are. HIPAA regulations concerning marketing mainly deal with marketing messaging and segmentation, rather than placements.

Make it easy for your patients to find you on social media, on search engines, and in local publications by being active on them. Then, collect relevant data to figure out which of these is best serving your marketing goals.

Building Trust

Trust is at an all time low, and it seems to keep getting lower. Misinformation is abundant, and many people are starting to get more savvy to the techniques that marketers are using to mislead customers to get them to buy. Thanks to the poor reputation of the healthcare industry as a whole, this is a difficult (but not insurmountable) challenge to overcome.

Solution: Engage with transparency.

Be as transparent as possible, and showcase honest reviews. Make it easy for patients to access information about pricing, wait times, and services offered.

Also, being engaged within the community on social media and in real life is important for building trust. Your patients are just as human as your staff are, and making that human connection is the key to building and maintaining trust.

 

 

 

 

 

 

Practicing Chronic Care Management

How Practices Can Implement Chronic Care Management (CCM)

Written by Jeff Tormey on . Posted in Manage.

If you have patients that deal with chronic conditions, you know that you have to address their concerns differently than other conditions.

The Center for Disease Control (CDC) and the Centre for Medicare & Medicaid Services (CMS) both recognize the importance of approach when dealing with patients that have chronic conditions. 21% of Americans between the ages of 45 and 64, according to the CDC, deal with two or more chronic conditions, with the percentage increasing to 45% for those 65 and older.

Because these conditions cannot be cured with medical interventions, managing these patients’ care is key to maintaining positive health outcomes and high quality of life.

Chronic care management (CCM) consists of all the strategies used to educate, oversee, and manage care for chronic conditions. It entails communication between patient and healthcare workers, managing their medications, and creating and revising care plans. Nowadays, most  CCM practices are provided remotely via telephone or online.

So how can a practice implement a CCM program?

 

Steps To Implementing Chronic Care Management

Identify Who You Will Serve

Use your EHR to identify patients who may be a good fit for your CCM program. Check their eligibility with the CMS if they have Medicaid or Medicare.

Focus on specific diagnoses, such as diabetes, Alzheimer’s, or COPD.

Educate Patients on Services

In order for your CCM program to have success, your patients need to know about its benefits. Let your patients know at every opportunity that you provide CCM and that they may be eligible for reimbursement by Medicaid or Medicare.

Begin Enrolling Patients

To start enrolling patients, you’ll need to verify that they’re eligible, have a face-to-face visit to discuss the program, and get their consent.

However, it’s not enough for patients to be on board: your staff needs to know the details of the program and what it entails. Training your staff on CCM will help make implementation much easier.

 

Bill for Reimbursement

Reimbursement requires that the practice keep a clear audit trail.

As well, only one clinician can bill for CCM services for a particular patient. Since many people with chronic conditions have multiple care providers, they’ll need to understand that they can only have one clinician billing for CCM.

 

Work with a Trusted CCM Partner

This is an important consideration, as a trusted CCM partner will help ease the strain on resources that providing CCM services can cause. A good partner will take care of most of the troublesome parts.

Outsourcing CCM is one of the best ways that practices can provide quality CCM without causing too much of a burden on the practice.