No Second Chance: How to Form a Great Doctor-Patient Relationship

The old adage that we all know is that there is never an opportunity to make a second first impression.  And to top it off, that first impression is formed in the first seconds of meeting someone new, in fact, studies show that it is in the first seven seconds.  The human mind is conditioned to make snap decisions about others and when it comes to patients meeting physicians for the first time, you are being judged for competence and friendliness.  Are you good what you do, should I trust you, and will I be comfortable speaking openly with you?

Changing first impressions takes much more time and effort, and as we each know about ourselves, it is difficult to come back from a bad first impression.

With so much riding on the first impression, some pointers, hopefully, reminders, about things that you should be doing when meeting that new patient, or meeting again with an existing patient.

ICD-10 Family Practice Codes

  1. Smile: The first thing noticed is your face, what does it say? Yours should be a welcoming smile, conveying friendliness. The arms folded is off-putting.
  1. Introduce yourself: Believe it or not, some physicians have gotten into the bad habit of immediately launching into questions about the patient’s needs and condition, evening moving to start the examination without a simple; “Hello I am Dr x.  And put offer your hand to be shaken.
  1. Make eye contact: maintain constant eye contact for the first few seconds. Don’t glance at them as if they are secondary to the test result in your hand. It shows that you are ging them your undivided attention.
  1. Ask permission: After the initial question and answers as to the patient’s condition, ask permission to examine them. “Ok, may I be examining you”, or whatever body part. This is a statement that allows the patient to feel empowered.  They control whether or not you are going to touch them.
  1. Posture: You may be rushed, you may be hurried, you may be a tense form that last phone call, but you have to train yourself to appear calm and present. Stand upright and confident.

Another old adage is “he’s a great physician but has a lousy bedside manner” is far too prevalent a description of physicians of their patient.  Yes, they are able to see through the bad first impression, but clearly, there is something missing in the patient-physician relationship.  Such a reputation is not one that attracts new patients, and actually, one that inhibits good communications.

Your job set one, is to create an environment where there are trust and an openness to communications.  The patient needs to feel that they are not an interruption of your day and that they can tell you about their needs, and fears.  Such patients are better listeners, and their listening, as well as their speaking, are important for a good outcome.

The advent of patient ratings, whether online or tied to bonus or compensation programs makes developing a good first impression increasingly important for you and your practice.

These are just three brief things you can do to make a great first impression that says you are a friendly, caring and competent physician. Even for a highly educated professional like a doctor, you cannot escape the laws of human nature and behavior, and you can have a list of publications as long as your arm — but it will come to naught if you don’t understand how to communicate.

Think about the first several seconds you meet someone.


Medical Denial Claim

Delays become denials – quickly

The American Medical Association has reported that over 17% of all denials of claims are for the simple reason the failure of the physician to file the claim in a timely manner.

The reality is that there is no reason why any claim should be lost to timely denial. If timely filing denials are among one of the reasons your revenue is leaking away, only you can stop it, and there is no reason to allow it to continue.

Unfortunate too often physicians have become victims of the staff excuse of blaming the insurance company for the denials, lumping them all together.  This denial cause, timely filing should not be occurring. To prevent this, however, EHR for small practice have come into play an attempt to streamline workflow and filing but the transition from physical practice to digital forms of administrative work is an impediment to the cause. Furthermore, the misnomer that small practices don’t require EHRs or are too costly creates a further hassle in the filing situation

A claim denied for timely filing is a self-inflicted injury to your income.  It occurs for the simple reason that your practice cannot get a claim “received” by the payer within the payer’s filing deadlines, usually 60 days.  First off it is outrageous that your practice can’t get a bill to the payer in 60 days, and equally outrageous that you are letting your income lag even that long.

The standard in your office must be to bill daily.  No excuses.  Every day the prior day’s claims must be sent out.  In most cases, this means sent electronically.  If paper claims are still being created, mailed daily. Do not allow your office to fall behind, and if it is not the standard practice in your practice to bill daily, then review the processes in your office, find out what the impediments are, and remove them.  Do not allow excuses.  Daily billing needs are the standard.  Ok if you’re a surgical practice and need to get a copy of the surgical report from the hospital to the bill, then billing within 48 hours may be the appropriate standard.  In any case, it is too easy to fall into the trap that your staff is too busy to do daily billing.  What possibly could be more important than getting you’re your earned income?

But you are not done there.  You need to keep an eye on your receivables.  Now that it’s billed, if you are not paid by day 30 from the date sent, you must go to the payer’s website and look up any claim that is still outstanding.  No this is not an overwhelming task.  If your office is billing out daily, most of your bills will be paid within 30 days, especially with daily billing.  This means that day you will have a short list, if any, claims outstanding at 30 days.  Check these on the payer’s website.  If you do not find the claim listed, and its status, then send the claim again.  Electronically or if paper, by certified mail.

The task is to assure that your claim has been received.  Sending is not the goal, receipt by the payer is.  Therefore, by checking at 30 days you are making sure that no claims have gotten lost in the process.

Once you have assured that your claims have been received, if you are not paid within 45 days of receipt, then now with a copy of the proof of receipt, a copy of the electronic receipt, or paper receipt of mailing, your clam cannot be denied for timely filing.  And you are in a position to send a complaint to the state regulatory authority, generally the Department of Health or Insurance in your state.  Nearly all states now have statues that mandate prompt payment form insurance companies.  No reason not to let these tax dollar paid staff help you get paid.

In any case, your proof that the payer has received your claim keeps your claim a legitimate claim against the payer, however, you want to pursue it.  It cannot become lost to timely filing.

Author Bio:

Alex Tate has served in various positions at leading health IT organizations for the past thirteen years. Most recently Mr. Tate served as Vice President at a leading EMR organization. He currently oversees product management and revenue cycle consulting for a number of organizations. Mr. Tate oversaw the development of many emerging products and held leadership roles across health-tech strategy, operations, service organization development, delivery, and optimization. His ongoing collaboration with startups and academic research centers are paving the way for the development and commercialization of groundbreaking technologies like artificial intelligence, augmented reality, HCI and other initiatives for a future that offers the promise of transforming care delivery through cutting-edge technology and progressive methodologies.



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