The Heart of Healthcare: Exploring Community and Compensation

Wondering how to survive and thrive in the challenging world of medicine? Come and join our lively conversation with Juli Quinn, the passionate President of GoSource. We dive into the frequently overlooked but critical topic of Revenue Cycle Management (RCM) and discuss why it's crucial for physicians to be fairly and efficiently compensated. Our conversation isn't only about money, but also about the heart of healthcare – community. So, get ready to see how interconnectedness impacts all layers of the healthcare ecosystem.

Our lively discussion with Julie sheds light on the multi-faceted aspects of the healthcare community - from front office staff, medical assistants, and nurses to the billing department. We unravel the complex relationship between clinical and financial aspects, underlining why we chose this noble profession. Discover how RCM affects not just physician's income, but the very fabric of our healthcare community and why it's essential to keep hospitals open. So, tune in, and let's explore how we can create a healthier, better, and fairer medical community together.

What You'll Learn:

• The importance of community in business and medicine.
• How profitability is not a bad word.
• How to get paid for what you already do.
• Structure your mindset to capture the invisible work.
• Billing for time.

Connect with Juli:
GoSource
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Connect with Dr. Sapna Shah-Haque:

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Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.


Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books

Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker

Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads

Battle of the Boxes

21 Day Self Focus Journal

Transcript

Dr. Shah-Haque: 0:00

Welcome to another episode of the Worthy Physician. I'm your host, Sapna Shah-Haque reigniting your humanity and your passion for medicine. So this is number two of our multi-part series partnering with GoSource, and we have President Juli Quinn again today. And honestly, Juli, I know we've had multiple conversations over the last several months and I know I said that on the last episode, but the truth is, I feel very energized when I talk to you and it's just. I think the message and your dedication to making life better for physicians and for practices and hospitals really shines through and is very consistent throughout our conversations we've had. So I just wanna share that with a listener and with you. So thank you.

Juli Quinn: 0:54

Oh, thank you very much. That's very nice. I love our conversations. I am passionate about medicine. I love the field of medicine. It is something very unique to any other industry out there and I thank you and your listeners for being such a valued part of our community as our physicians.

Dr. Shah-Haque: 1:17

Thank you for that, and I think community is a big part of that, isn't it? And last episode we discussed the importance of RCM and really trying to make the listener understand that. Okay, yeah, physicians, we don't like to talk about money, but it's not because it's really not a taboo subject. It is going back to that. We want to stay practicing, we want to stay as a hospital that is open in the community, because that's why we went to medical school to be physicians, to be the best we can, to stay in the community and give back, make humanity healthier and better.

Dr. Shah-Haque: 1:51

But in order to do that, we need to have that mindset that we need to also get paid efficiently and effectively and fairly for what we do. To recap last episode we discussed that 20 to 30% is left on the table. We get paid for about 66% of what we do, and to me that's alarming. It makes it very difficult to stay actively, actively and efficiently and effectively practicing within the community, but then also it limits the amount of community that we can add and keep if we're not able to pay fair wages. To be honest, why is community such a big importance to you? To go source, and let's start there and then I'll share why community is a big part for me as a physician.

Juli Quinn: 2:44

Oh, absolutely. Thank you so much for asking that we see our staff as not my 300 employees, but it's 300 families. They count on us to stay in business so that they can know that they have a steady paycheck for their own budgets. And then we have a community of our clients. That is a relationship that we support them so that they can serve their in-house staff and their patients, with just two more communities and we all need each other we're all connected. Our purpose-driven is actually affecting multiple layers of community, and that is something that is very special also about medicine, because you have this compassion and this empathy. That is the basis of what medicine stands for. That is continued out through all these different layers and all these different positions, not just the doctor-patient relationship, but all of the support services that are needed and that are vital to this whole industry that we call medicine.

Dr. Shah-Haque: 4:02

I agree, I agree. So let's start out with there's a relationship, like you said, with the clinical part and the financial part. There's a connection with the front office staff and the medical assistant that's going to be rooming the patient. Each part, whether it's the front desk, the individuals at work in the back, hands-on with the patient, whether it be a nurse, a phobotomist, a medical assistant, the physician, and then even with the billing, there is a very key center and that's the patient.

Dr. Shah-Haque: 4:43

We have that relationship and it's not just delivering a service, it's not just delivering an office visit. A lot of times it's as healing for the patient as it is the physician. Because of that connection. That's why we went into medicine. But, like we were talking about beforehand, not only are we part of a community with the practice or the patients or the physical location, but then there's also that sense of community. Like you said, those are 300 families, the same approach in our clinic as well, and I think that really has to be appreciated and celebrated because without community, without that tribe mentality, it's really hard to exist and we know that's one key aspect of trying to fight burnout. But also we can relate that to finances and on the financial end. You're not yes, you're there to collect for the physician, but you're also there to provide for your employees, right?

Juli Quinn: 5:49

And our employees and our physicians' employees, because we're not good job, then they're not going to be able to keep their jobs. Let's face it we are connected. The doctor is taking care of patients, but it is this whole community and multiple communities that interlock to make this possible and to allow to not only sustain but to grow.

Dr. Shah-Haque: 6:21

And no, I appreciate that you be pointing that out Because again it's about. It's not about I went into medicine to make money. I went into medicine to make life better, to be a healer, but I also want to get paid fairly for what I do because, again, things are expensive and there's probably even more inflation in the world of medicine. The overhead keeps going up, reimbursement keeps going down. So let's look at ways to get paid for what we're already doing, for example, like lab reviews. Let's bring that in as an office visit or optimize telehealth. It's good for multiple reasons, because we're capturing work for work that we're doing, but it also I'm going to put it back for physicians.

Dr. Shah-Haque: 7:09

Let's think about this. We can send a letter If it's appropriate, yes, send a letter. If it's appropriate to have your medical assistant or your nurse call, yes, have them do that. I'm talking about something that, hey, this lab was abnormal. I would recommend X, y and Z treatment, and this opens up to questions. Would that be viable for telehealth or an office visit, instead of picking up the phone and calling every patient? Because, also, there are only so many hours in the day and so we have to delegate things. So I'm using the word optimization of our use of time and delegating things, but then also being able to incorporate a sustainable business model.

Juli Quinn: 7:51

Yeah, that's really an important question. What am I doing that is reimbursable, that, ethically, I should get paid for this? I find almost all positions are undercoding the value of their level of visit and giving away a great deal of free service, and that is not going to, one, help with the burnout issue and, two, the financial picture. You really should look at capturing those hidden not hidden but areas that you've been giving away for free. That is absolutely ethical to start building insurance for.

Dr. Shah-Haque: 8:39

And so some of those things would be not only what we do in the visit, but also getting ready for that visit, the time spent maybe calling a pharmacy or calling a specialist, getting that time spent before, during or after.

Juli Quinn: 8:57

So CMF, which everyone is familiar with. They set the codes and the edits of what is included in the description of each code. And your listeners, I'm sure, are aware we just had a revamping of our. So it's your office visit, so it's your 992.3, new patient or return patient, your evaluation and management codes, because they actually were listening to doctors saying hey, I do so much more than that 15-minute visit that I had the patient in the exam room and I was at the face-to-face encounter. It took reading the records prior to this visit. It's a new referral and I want to bring myself up to speed on what has already been done for this patient. And then your ordering, say, at this encounter, labs, radiology tests, and then those results are coming back. You have to review those and you might have a need to pick up the phone and talk with another doctor, one of their specialists, to collaborate on your diagnosis, and you should be paid for all of that.

Juli Quinn: 10:16

What's exciting is that you now will get credit you meaning the doctor and your level of care. You will get credit for all of those extra services. You just have to know how to ask for it and it seems daunting when CMS comes out with oh, we have a whole new way of doing things and everyone says, oh no, I got to learn this. But it's actually pretty simple. You can go the easy route of just billing by time-based and it is your face-to-face, that's only your face-to-face encounter and if that is all that was involved in the visit, then that is absolutely appropriate to use that. It's easy to defend if the insurance company is asking for chart notes to justify your level of visit, which is on the rise. So you have to be prepared that your medical record is going to justify.

Juli Quinn: 11:11

The other reason that time-based is really good is you get that patient every now and then. That just needed a great deal of your time and you should get paid for it. You're now running 30 minutes, 45 minutes, behind on your whole schedule, but you couldn't leave them at that moment. They needed to have your ear for an additional 30 minutes and you gave them that you should get paid for that. They were not more complicated. So on the other way, which is the medical decision-making, mdm way of determining a visit, they would not qualify for a high level, but they took your time. So you can go back and forth and decide today for this patient time-based is the most appropriate, or the next patient on your schedule. The medical decision-making is the most appropriate, and that is where you can now get credit for not just what you did, but the time your MA spent and those other things the pre and post review of records, the talking with other doctors all can be added to your chart note and bump up the level of your visit.

Juli Quinn: 12:29

I'm not talking about let's just take advantage and get how. What do I need to do to get more money out of this visit? Let's get you paid for what you did. You're spending the money, the time, the resources to see this patient. If it's more difficult, you should get paid more. That is now able to be done.

Dr. Shah-Haque: 12:50

Thank you for that, because before it was not such that we're doing all this invisible work after hours and now there's a way to capture that. Would it be helpful maybe, like when we're going back to those work on your templates. I find them very easy to create and you can really whittle them down to where they are efficient. But when we're working on those or there's something that we could add, would it be worth putting the amount of time, like 20 minutes speaking with Dr Jones regarding a patient I'm just giving them throwing out a name there. Or 15 minutes on hold for pharmacy or the insurance company.

Juli Quinn: 13:26

If I'm the one actually doing that, should I putting that in my note as far as time chunks, it doesn't hurt, just because there are so many chart reviews now requested by these insurance companies, and we want to give them every reason to justify paying the claim, because they're going to look for that one reason not to, and we want to be able to give them every reason to pay you. And so absolutely to add that if it's easy enough for you to do, it only supports the chart visit.

Dr. Shah-Haque: 13:59

I appreciate that because, again, we're already doing it. I think we all do our due diligence to deliver excellent, high quality care to our patients. That's the reason why we're still in clinical medicine, and even if you're not in clinical medicine, that's okay, because now this is a learning point. But the thing is, let's get paid for what we're already doing and other professions they embrace this type of topic, so let's start embracing that and normalize these type of conversations.

Juli Quinn: 14:27

Yes, If you have anything you need fixed, diagnosed it fixed in your home. Let's say you call out a plumber, they're going to charge you for each time they come and they're going to charge you for how long they were there and they're going to charge you for each part that was used in the treatment of your problem. We absolutely accept that and expect that in every other industry. It's time to start having those same expectations for medicine.

Dr. Shah-Haque: 15:01

All right. Thank you so much for that and again, just thank you for showing us the importance, because before working with GoSource, you actually would go into a practice and consult on many of these things as well as others. Is that correct?

Juli Quinn: 15:19

That is correct. I've been a practice management consultant for 23 years and I've owned a medical billing service for 23 years, so it's been a journey of really finding where we can make protocol fixes to help the practice be more successful. I'm not changing the practice. I'm discovering what they do and how we can get those paid by the insurance.

Dr. Shah-Haque: 15:52

Thank you for that, julie, and again we can reach you at GoSourcein, is that correct?

Juli Quinn: 15:59

That is correct.

Dr. Shah-Haque: 16:01

All right, so that'll be in the show notes and again, just thank you for everything you're doing and we'll stay tuned for the next episode. If you have found this helpful, like, share with a friend and click on the link in the show notes. We can all use some camaraderie.