By now, you should be almost ready to open the doors to your new practice. It’s time to focus on setting up essential office systems and services such as telephone and transcription. You also need to set down the specific procedures your employees should follow to bill patients and insurance companies, as well as how they should handle other duties, such as ordering supplies and communicating test results.

The backbone of your practice management system–your computer hardware and software–should already be up and running. (See “Starting a practice: 5-6 months out–Office design and supplies,” June 18, 2004, available at www.memag.com.) A good computer system can handle most front- and back-office tasks, several of which we’ll discuss in this article.

Putting the proper systems in place

Telephones. Your practice can’t thrive without a first-class phone system. But before you purchase one, determine what your needs will be: Which rooms do you want phones in? Do you want a system that automatically phones patients with a recorded message to remind them of their appointments? Will any of your employees need hands-free capability? What do you want patients to hear when they’re on hold–classical music, perhaps, or information about your practice? Will you want voice mail?

After you decide on options, it’s easiest to use a local phone provider to install the lines you’ll need. In fact, because of contractual agreements, you may be limited to one provider in your area that can do the work. However, once the wiring’s finished, you’re free to purchase your phones and other hardware from another provider or from an office supplies store like Staples or Office Depot, both of which allow you to place orders through their Web sites. Likewise, carefully compare rates offered by various long-distance providers, to find the plan that best fits your calling patterns.

Ultimately, the cost of any system will depend on the features you choose and the number of lines you get. At a minimum, a solo practice should have three lines (one of which should be the doctor’s private line), plus one each for a fax machine and a computer modem. Ideally, though, you’ll want something faster than a traditional dial-up line for your computer, so ask your phone carrier if it provides either DSL or ISDN. Or ask the local cable company if it offers cable hookups to the Internet. If you can get a fast connection, that’s one fewer dedicated phone line you’ll need.

Think carefully before you opt for an automated telephone system. Most patients, especially older ones, prefer to speak with someone directly. Personal attention may make the difference if you’re building a patient base from scratch. If you feel you need an automated system, structure it so that the receptionist has adequate time to answer before the call is directed to the system.

* Answering services. A good answering service will represent your practice well and be attentive to patients. A bad one, operated by rude or disinterested personnel, could drive people away. Choose your service carefully, pay attention to how it performs, and don’t lock yourself into a long-term contract until you’re happy with the way your calls are handled. You can ask colleagues to recommend services they’re pleased with, or see if your hospital has an in-house service that you can subscribe to.

Tell the service how you want calls fielded and when you should be paged. In other words, define what you mean by “emergency.” Will that include calls from your spouse and kids? “Make sure the service gets a return phone number–two, if possible–and a specific reason for the call,” says Christopher Zaenger, president of Z Management Group in Barrington, IL. “A short message saying so-and-so called is useless.”

Under no circumstances should an answering service provide medical advice.

* Mail. As helpful as fax machines and e-mail are, you’ll still need to send plenty of things through the post office–packages and patients’ billing statements, for instance.

If you expect your new practice to start out small, purchasing stamps and bringing packages to the post office may suffice at first. But once the volume of mail swells, you’d do well to investigate other options. The US Postal Service (www.usps. gov), for example, has a service called PC Postage, which allows you to print postage from your personal computer. The Postal Service also offers postage meters that allow you to dispatch mail and packages right from your office. Money for the meter can be transferred directly from your corporate bank account automatically or via a phone call. Pitney Bowes (www.pb.com), an independent office technology and services company, also offers postage meters for small offices.

For packages, compare the Postal Service’s rates with those of a few independent carriers, such as DHL (www.dhl.com), FedEx (www. fedex.com), and UPS (www.ups.com). Use a street address as your mailing address. Private carriers aren’t permitted to deliver packages to US post office postal boxes.

* Transcription. Your colleagues can recommend worthwhile medical transcription services. They can tell you what they pay per line (10 to 14 cents is typical for a US-based service) and whether the company is accurate and reliable. Before you sign on with a service, speak with at least two physicians who use it, and ask whether it offers a no-cost or low-cost trial period.

The latest trend in transcription is to send dictation to overseas-based companies, many of which are located in India, Malaysia, the Philippines, and other developing countries. Most of these firms provide the same services as their US counterparts, with much quicker turnaround (due largely to time zone differences) and at around half the cost. The speed of your Internet connection may determine how useful an Internet-based service would be for you. Naturally, the faster your connection, the better.

A bigger issue, though, may be privacy. If sending patient information over the Internet concerns you, you may want to use a local service instead. Verify, though, that it isn’t subcontracting to an overseas service.

“Also, make sure that the service signs a business-associate agreement,” advises Keith Kamperschroer, a Milwaukee CPA and practice management consultant with Kolb+Co. This contract, which any healthcare lawyer should be able to draw up, imposes many of the same HIPAA privacy requirements on the transcription company that you’re bound to as a private practitioner. The service should also assure you that its subcontractors, if it uses any, are following the same security standards.

* Laundry, janitorial, and security systems. The best way to find good services in these areas is to ask similar medical practices in your area which companies they use for regular and biomedical waste. Also find out what problems, if any, they’ve had.

For each type of service, get the name of a company contact. Ask this person how employees are screened and for proof that they’re “bonded.” (In short, bonding allows the company to make good if something in your office is broken or stolen.) Moreover, get a copy of a sample contract and read it before you go ahead and hammer out the details of your own contract.

* Getting paid for what you do

Health plan contracts. Unless you plan to open a cash-only practice, you’ll have to sign contracts with multiple health plans. Your practice management consultant should be familiar with the plans that offer the best fee schedules for physicians in your specialty, but your local or state medical society may have this information, too. At the very least, your medical society should be able to tell you which carriers do most of the business in your state. And, of course, your colleagues are a good resource, as they’re likely to have the name of a specific representative at each insurer, whom you can call to start the ball rolling.

One-year contracts are the most common, although some can be for as long as three years. A shorter time frame works to your advantage if you later find you’re being underpaid or that the contract’s terms are too restrictive. Most one-year contracts, however, renew automatically, so if you want to address something prior to renewal, be sure to do it during the negotiation period or you’ll be locked into the same agreement. The negotiation period is usually one to four months before the anniversary date.

The most important thing to look at in a contract is the insurer’s fee schedule. Never sign a contract that doesn’t specify what your reimbursement will be based on. Understand, too, what adjustments the plan may make to your charges. These adjustments are also known as “negotiated discounts,” and as the name suggests, you may be able to negotiate them with the payer.

Be sure you consider what the contract allows you to bill patients for directly. Copays and deductibles are generally okay, but charges for educational materials or for telephone or e-mail consults may not be. You also should familiarize yourself with how to handle disputes with the plan; some provide for arbitration.

It’s smart to have an experienced healthcare attorney review all insurance contracts and modifications before you sign them.

* Your fee schedule. Your practice’s fee schedule should list all of the commonly billed services in your specialty, along with your fees, which should be comparable to those of similar practices in the area.

Putting together a fee schedule can be difficult, especially if you’ve had no experience with billing insurance companies, so it’s best to entrust a management consultant with this task. He or she may advise you to base your charges on some percentage of Medicare’s fee schedule, since most third-party payers work off that….

Collin Crawford Consultant’s Office Solution

Netcomm Services was founded in 2008 by it’s founder Mr. Alvin Chia. Mr. Chia has been working in the IT industry for 20 years implementing and maintaining numerous Lan/Wan systems in Asia Pacific region working with partners on various projects and will be the main contact person for any queries and handling of project tasks.

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Lan

Setup & Migrate Windows based servers (2003 & 2007 server edition)

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Setup & configure Windows XP, Windows 7, MS Office 2003/2007 softwares in new Client pc to connect domain and servers for printing and shared folders

Installing, trouble shooting Windows XP, Win 2000; Vista clients. Repairing, OS and replacing hardware.

Setup of Pabx system (Avaya, NEC, Fujitsu), digital call master, IP Phones and configuring the PABX

2WIRE integrated ADSL and home wireless installation & configuration

Wan

Implement ADSL, Mega pop line for connection to remote sites offices by setting up router, switches (Cisco & Nortel), modem

Video conferencing equipment (Polycom) using ISDN line

Voice over IP system (VOIP)
 
Security System

Using Symantec, MacAfee, Nokia on client pc and Trend Micro, PCTools, and Norton products in servers
SSL certificated on Web servers.

Storage Systems

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Web Server

Setting up Web server and creating home page for Web hosting
 
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Author: Adrian Collin Png http://www.collincrawford.com/about/