More Services = Healthier Consumers and More Revenue

Mental health and addictions professionals require tools. For a couple decades, Terry McLeod has been a trailblazer providing those tools in the form of Electronic ...Read More

It only makes sense.

If a professional or professional healthcare team provides a consumer with two services during a visit, the consumer wins because they don’t need to delay getting the help they need and the professional’s revenue increases. I love a win-win scenario.

For the consumer this might mean that a nurse checks her blood pressure, heart rate, etc, and then after a short chat, sends her to a psychologist or other professional to discuss that or another condition. Many apparently physical symptoms like nausea or aches and pains are discovered to be in the realm of a mental health professional’s responsibility; with a root cause of something like grief. This is where an Electronic Health Record (EHR) can really show its stuff in efficiency by electronically alerting other professionals the consumer needs a service and in making sure somebody’s available to help by using the EHR’s Scheduling Module.

When this sort of thing happens, CFOs love it, process managers love it, and sometimes the treatment professionals may balk at entering a note and charge into the Electronic Health Record (EHR), simply because they’re unsure about the value of that second service and taking the time to record it (some insurance companies and states’ Medicaid won’t pay for the service). We’re all busy people, and it’s possible a second service might not get recorded as an oversight. Today’s EHRs are loaded with reminder systems to make sure scheduled services are addressed, and proper documentation and charges are filed.

Conceivably, since a counseling session can last longer (and pay more) than a short nurse’s visit, only that more profitable service may even make it into the EHR, and therefore the billing system. That could be terribly inconvenient to fostering team spirit, as a professional assigned to diagnosing the patient may want to see the note from the original person who noticed the problem and have a little chat with them before proceeding to treatment for this additional diagnosis. Oh, by the way, depending on who diagnoses the problem and other factors, we may have added to the list another service related to filing the diagnosis itself.

If it’s not in the EHR, the record believes it didn’t happen. It might not be serious, but a secondary service might affect future treatment, so it’s better to record everything.

There are a number of places that second services can be noticed in the EHR, from the front desk checking in, through visits with different professionals, and even at check-out when the consumer gets back to the desk again. A front desk person could notice a limp when a person comes in for a counseling session, or another staff member might notice a consumer with tears in their eyes or who’s behaving oddly. When all staff is mindful about a consumer’s overall health and everybody is acting like a team, more services are rendered. And in the end, even in not-for-profit environments, that can make the difference between replacing somebody who’s left for a different opportunity and giving a salary increase to other staff at the end of the year.

If an organization doesn’t have this sort of mindfulness in place, with the team looking for additional ways a consumer might need help, concentrating on the idea in a staff meeting may be a good idea. Staff education regarding what sorts of symptoms to watch out for can increase vigilance to assure the consumer gets the best care possible. As a bonus to increasing the number of services provided, the revenue of the facility can go up at a time when increasing revenue is critical.

With all that said, there are still operations out there who are stuck with “threshold” billing for some insurance payors, wherein all services provided during a single day’s visit must be included in that day’s bill for a fixed fee. No extra charge. Others will only pay for explicitly defined additional services under specific conditions. In some cases, payors may seem to make it difficult to charge for additional services. As in anything that has to do with business, you gotta be sharp and make the time it takes to optimize revenue. That may require some help from a consultant or moving a staff member into a position that’s primarily responsible for increasing revenue and assuring documentation and billing are on-track in order to provide the best care possible. With that resource in place, the EHR can be both a guide to making sure needed services are provided to the consumer, and a police officer to assure the billable record is recorded.

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