Practice Operations Tips

AMA practice tip: Workers' compensation, property and casualty eBilling toolkit and state-specific resource map

Learn how to automate workers' compensation claims submission and attachment processes in the AMA's workers' compensation, property and casualty eBilling toolkit. Here you can also retrieve state-specific resources, by accessing an interactive may providing information on state-specific resources on workers' compensation and medical reporting and billing requirements, state rules and regulations, how to file an appeal, and more.

Visit www.ama-assn.org/go/workerscomp to access these resources.

AMA Practice Tip: Claims Submission Toolkit

Save thousands of dollars a year while relieving your practice staff of some of its most tedious and time-consuming tasks.  Too good to be true? Not if you use electronic claims submissions.  Automating your claims submission process can:

• Minimize claim rejections and resubmissions
• Deliver your claims to health insurers in real time
• Expedite payer responses and boost your cash flow
• Free up time for revenue-enhancing functions, such as ensuring correct payment
• Reduce your claims submission costs by over 55%

The AMA’s Claims Submission Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “Claims and Claim Status Transactions: The Advantage of Going Electronic,” and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Claims Status Toolkit

Long lead times receiving payment on your claims can put a crimp in your practice’s operations. But keeping track of outstanding claims manually can be expensive and time-consuming. Determining the status of your claims electronically can:

• Substantially decrease associated costs by 90%
• Keep you informed about your outstanding claims, and about any potential snags that       need your attention
• Streamline your claims processing and cash flow
• Cut back time spent calling health insurers, waiting on hold, or searching payers’ Web      sites for updates
• Free up time for revenue-enhancing functions, such as ensuring correct payment

The AMA’s Claims Status Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “Claims and Claim Status Transactions: The Advantage of Going Electronic,” and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Eligibility Verification Toolkit

How much time and money does your practice devote to verifying patients’ insurance eligibility and policy coverage? How much time does your staff spend on the phone with payers, waiting for responses, and filling out forms? If your answer is “too much,” electronic eligibility requests and responses may be the solution. By adopting this method, your practice can:

• Save thousands of dollars per physician every year
• Submit eligibility requests and receive payer responses more quickly and accurately
• Provide faster, more convenient service for your patients
• Apply your staff’s valuable time and energy to revenue-enhancing activities
• Reduce claims rejections and avoid the collection and billing costs stemming from            verification errors

The AMA’s Eligibility Verification Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “Electronic eligibility request and response - A great deal more than ‘Yes, the patient is eligible’," and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Prior Authorization Toolkit

Prior authorization transactions can be slow and tedious.  Your practice's time is better spent providing attentive medical care and responsive customer service.  Handling your prior authorizations electronically can:

• Speed up health insurer response
• Minimize time and resources devoted to manual processes, such as waiting on hold and    compiling faxes to payers
• Free up time for revenue-enhancing functions such as ensuring correct payment
• Reduce transaction costs by over 80%

The AMA’s Prior Authorization Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “The ’underutilized‘ transaction that can streamline your referral and prior authorization processes,” And, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Referral Requests Toolkit

How much time and money does your practice devote to manually asking payers to approve referrals to other physicians, hospitals and other health facilities? How much time does your staff spend on the phone with payers, faxing referrals and filling out forms? If your answer is “too much,” electronic referrals may be the solution. By adopting this method, your practice can:

• Save thousands of dollars per physician every year
• Submit referrals and document responses more quickly and accurately
• Provide faster, more convenient service for your patients
• Apply your staff’s valuable time and energy to revenue-enhancing activities

The AMA’s Referral Requests Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “The ’underutilized‘ transaction that can streamline your referral and prior authorization processes,” and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Electronic Remittance Advice Toolkit

Want to save thousands of dollars per physician annually? Accepting electronic remittance advice (ERA) and automating your claims process can:

• Speed up payment
• Save time spent on manual processes such as opening mail, filing and phone calls to         health insurers
• Eliminate lost EOBs and expedite filing to secondary payers
• Free time for revenue-enhancing functions such as ensuring correct payment

The AMA’s ERA Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “Saving with Electronic Remittance Advice,” and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Workers' Compensation, Property and Casualty eBilling Toolkit

Claims for services covered by homeowners, automobile and business insurance—including workers’ compensation—are all categorized as property and casualty. Workers’ compensation claims can cause administrative hassles, but there’s a way to avoid these headaches. The AMA’s workers’ compensation toolkit shows how electronic billing (eBilling) for workers' compensation claims can dramatically cut your practice's billing and payment cycles, while improving your interaction with payers, by:

• Replacing paper bills and attachments with electronic health care transactions
• Minimizing bill rejections by electronically submitting claims and attachments in one        electronic submission    
• Increasing cash flows by eliminating multiple submissions via mail
• Reducing your bill (claim) submission costs by over 55%

The AMA’s Worker’s Compensation Toolkit makes adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in a workers’ compensation electronic health care transactions program, five easy steps on how to automate workers’ compensation processes, and the educational webinar, “How to automate your workers’ compensation claims”. Visit www.ama-assn.org/go/workerscomp to access these free resources and start experiencing the savings in your practice.

AMA Practice Tip: Claims Acknowledgement Toolkit

Acknowledgements confirm that a transaction is received. However, the acknowledgement electronic health care transactions are not mandated under the Health Insurance Protection and Accountability Act (HIPAA), and therefore are not required to be used by payers or other intermediaries in the claims revenue cycle. The AMA is advocating to change this and require that all payers acknowledge receipt of electronic health care transactions, so physicians will no longer have any doubt as to whether, and when, an electronic transaction was received. Ask the clearinghouses and payers you work with whether they will provide electronic acknowledgements and urge those that haven’t yet adopted these transactions to do so as soon as it is feasible.

The AMA’s Claims Acknowledgement Toolkit helps make adopting this process simpler. The toolkit includes a summary of questions to ask before enrolling in an electronic health care transaction program, a survey to evaluate your vendor’s functionality, and the educational webinars, “The Real World of Electronic Claims Acknowledgments,” and, “Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management.” Visit www.ama-assn.org/go/htc to access these free resources and start experiencing the savings in your practice.

AMA practice tip: Save money with credit card payments—shop around

One of the best ways to ensure receipt of your patients’ payment responsibility is to offer the option of credit and debit card transactions. Learn how to maximize the benefits of accepting credit and debit card payments by contracting with a payment processor that suits your practice’s specific needs and by recognizing how you can save on fees with your current processor. The AMA Practice Management Center has developed the educational resource, “Shopping for a credit or debit card merchant agreement: Guidelines for physicians,” to help you improve your practice’s bottom line.

AMA practice tip: Save time and money in day-to-day operations

Looking for ways to improve your practice? Wondering where to start? With the American Medical Association’s (AMA) new Rapid Process Improvement Initiative, your practice can quickly identify areas for process improvement and follow the program’s easy-to-tackle steps to implement these changes. This free Web-based tool walks you through the process with an interactive practice assessment, an assessment results guidance tool and toolkits to help you implement the process improvements you have identified. Individuals who complete this program can also apply for the program’s certificate of accomplishment.

Visit www.ama-assn.org/go/rpi to take the first steps toward process improvement, and save your practice time and money in your day-to-day operations.

AMA practice tip: 2011 AMA National Health Insurer Report Card finds increasing inaccuracy in claims payment

As the cornerstone of the AMA’s “Heal the Claims Process”™ campaign, the National Health Insurer Report Card encourages a more efficient claims payment system by providing an annual check-up for the nation’s largest health insurers and benchmarking the systems they use to manage, process and pay claims. The report card, which launched in 2008, both highlights improvements in the industry and addresses areas of concern that demand attention.

The findings for 2011, issued at the AMA’s annual meeting on June 20, show that commercial health insurers have an average claims-processing error rate of 19.3 percent, an increase of 2 percent compared to last year. The increase in overall inaccuracy represents an extra 3.6 million in erroneous claims payments, and added an estimated $1.5 billion in unnecessary administrative costs to the health system. “A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually,” said AMA Board Member Barbara L. McAneny, M.D.

Visit www.ama-assn.org/go/reportcard to access the report card’s findings, including denial and accuracy rates and claims processing timeliness. You can also watch an archived webinar that details the findings and learn more about the “Heal the Claims Process”™ campaign.

AMA practice tip: Appointment scheduling and your bottom line

Something as simple as appointment scheduling can help improve a physician practice’s bottom line. For example, gathering basic patient data at the time the appointment is scheduled allows for the verification of the patient’s health insurance information before a patient’s visit. Visit the AMA Practice Management Center to access the educational resource “Appointment scheduling to improve your bottom line.” Available to AMA members as a member benefit, this resource was developed by the AMA Practice Management Center and the Kentucky Medical Association.

AMA practice tip: Don’t write off claim denials—fight for accurate payment

If your practice submits claims electronically, there’s now a free tool to help you secure accurate payment from health insurers for inappropriately denied claims. With the Claims Workflow Assistant, a free online tool from the AMA Practice Management Center, you can look up the reasons health insurers reported for denying claims on the electronic remittance advices (ERAs) you receive. Then, you can determine the best steps for your practice to reverse the denial. The Claims Workflow Assistant even helps you get started with recommended workflows for the top 80 percent of denials from the 2008 and 2009 National Health Insurer Report Card and provides numerous template appeal letters that AMA members can easily modify to use in their practices. Visit the AMA Practice Management Center to access the Claims Workflow Assistant.

AMA practice tip: Improve practice efficiencies and save money

Physician practices can save significant administrative time and expense by electronically performing routine functions, such as verifying patient eligibility and contacting the health insurer about the status of a claim. The AMA has developed the educational resource “Understanding the HIPAA standard transactions: The HIPAA Transactions and Code Set rule” to help physicians more fully understand the HIPAA electronic standard transactions, the HIPAA Transactions and Code Set rule and how this rule impacts the physician practice. This resource explains how physician practices can prepare themselves for using the electronic standard transactions and how physicians can ensure that health insurers with which they are contracted comply with the HIPAA electronic standard transactions. Available to AMA members, this resource also provides a survey that physicians can use to determine the extent to which their practice management software and billing vendors comply with the HIPAA Transaction Code Set rule.

AMA practice tip: Automate your practice and reap savings

The movement by physicians, payers and vendors to streamline health care delivery through the adoption and use of information technology solutions strives to create a more efficient claims revenue process for all involved. By eliminating significant parts of the manual processes in an office’s routine, physicians can free their practice staff to perform other revenue-enhancing functions. Visit the AMA Practice Management Center to access the educational resource “Information technology solutions: consider the potential savings.”

AMA practice tip: Improving practice efficiencies with electronic claims submissions

The AMA, in collaboration with the Connecticut State Medical Society, developed the educational resource “The benefits of electronic claims submission—improve practice efficiencies” to help physicians and their practice staff understand the electronic claim submission process and the many benefits that may be realized by submitting claims electronically to third-party payers. This resource discusses the reduction of claim submission costs and errors, and offers tips on getting started with electronic submission.

AMA practice tip: Connecting with your patients  

Online medical consultations, also known as e-visits, present opportunities for growth and increased efficiency in the physician practice. To learn more about this new patient convenience and whether it’s right for your practice, visit the AMA Practice Management Center to access the educational resource “Online medical consultations: Connecting physicians with patients.”

AMA practice tip: Selecting the best EMR/EHR system for your practice

Procuring an electronic medical record (EMR) or electronic health record (EHR) system for your practice can be an intimidating process with the many facets and the multitude of EMR/EHR vendors currently available. How do you select the one that’s best for your practice? The AMA has created the educational resource “15 questions to ask before signing an electronic medical record or electronic health record agreement” to help you assess your practice’s needs and determine which vendor will best meet those needs.

AMA practice tip: Toolkit helps maximize practice efficiency in rapidly changing health care environment

The upcoming transition to the government’s modified electronic transaction standards, coupled with the Medicare and Medicaid electronic health record incentive program, will require physician practices to upgrade or replace their current practice management software. To help you select and purchase the most appropriate software for your practice, the AMA and the Medical Group Management Association (MGMA) collaborated to develop an online toolkit. Free to members of the AMA and the MGMA, the new “Selecting a Practice Management System” toolkit provides a roadmap to make this process easier for your practice. You can use this information to establish your practice needs and take advantage of recent improvements in automation. The toolkit resources include:

• A five-step guide to practice management system software selection.
• A comprehensive checklist that helps you determine which practice management system software features and functionalities are essential to your practice and which will enhance your revenue cycle management.
• A sample “request for proposal” that you can employ in your communications with practice management system software vendors.

Visit www.ama-assn.org/go/pmsoftware to start taking advantage of this valuable toolkit today.

AMA practice tip: Experience savings with electronic funds transfer

Want to save thousands of dollars per physician annually? Accepting electronic funds transfer (EFT) payments from health insurers and automating your payment process can help you experience significant savings and: 

• Speed up payment
• Save time spent on manual processes such as depositing paper checks and making phone calls to health insurers
• Reduce the risk of lost or stolen checks
• Free time for revenue-enhancing functions such as ensuring correct payment

The AMA’s new EFT Toolkit helps make the process of accepting EFT payments hassle-free. The toolkit outlines the steps to getting started, specific considerations for physician practices, and checklists of questions to ask your bank, health insurers, and your billing service or clearinghouse before signing an EFT agreement. The toolkit also provides an archived webinar with industry experts. Visit www.ama-assn.org/go/eft to access these free resources and start experiencing the savings in your practice.

AMA practice tip: Vendor directory helps you select a practice management system

Are you looking for a new practice management system or an upgraded system that can integrate with electronic health records? Get the information your practice needs to select the right software for your practice with the help of the new Practice Management System Software (PMSS) Vendor Directory.

The AMA and MGMA offer this free resource for their members as a complement to the recently released “Selecting a Practice Management System” toolkit. Built on specific responses to survey questions posed to vendors, this directory can make your search for practice management system software easier. AMA and MGMA members can query, filter options and print out detailed vendor responses to all survey questions.

Visit www.ama-assn.org/go/pmsoftware to access the vendor directory and its related toolkit resources today.

AMA practice tip: Considering cloud computing for your practice  

Could your practice be saving time and money by adopting ASP or cloud computing software? Check out the AMA’s educational resource “Is an application service provider software or cloud computing service right for your practice?” to learn more about the advantages, challenges and requirements of online software applications. This resource discusses various operation models, as well as how to determine if one of the models may fit your practice’s needs and capabilities. It also provides a handy checklist of questions to consider.

After selecting the most suitable delivery model, you must still identify the specific software which offers the best value to your practice. Consult the AMA MGMA toolkit “Selecting a Practice Management System” for additional information which can assist you in making your decision.   

Visit www.ama-assn.org/go/pmc to access these resources.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Eliminating unfair discounts

Physicians are regularly solicited to participate in preferred provider networks (PPNs) via participating provider agreements. But how does a physician know if the agreement is beneficial for the practice? In today’s market of rental networks, it is imperative to understand which organizations physicians are contracting with and what the agreements should contain. View the webinar, “Eliminating unfair discounts” to learn how preferred provider networks work, what the difference is between a primary and secondary provider network and what should be contained in an agreement. This webinar also provides an update on the AMA’s related legislative activities.

You can learn more with the AMA and the American Association of Preferred Provider Organization (AAPPO) toolkit, “Physician and other health care provider contracting toolkit.” 

AMA practice tip: Evaluating business models—understand which alternative suits your practice best

Are you seeking ways to simplify your practice and reduce administrative overhead? The AMA Practice Management Center has created the educational resource “Cash practice alternatives: Considerations for physicians” to assist you in evaluating whether limiting your practice’s financial dependence upon health insurer contracts might be a viable option for your practice. This resource walks through the various cash practice alternatives and helps you assess which business model suits your practice’s particular situation best.

AMA practice tip: Achieving medical home recognition

In 2008, the AMA voted to adopt the "Joint Principles of the Patient-Centered Medical Home," joining the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association in endorsing the principles. The principles include guidelines for the coordination of care to improve the patient-physician relationship, quality and safety, access to care, and the payment model for coordinated services. Along with public and private payers launching Medical Home pilots, Bridges to Excellence (BTE) partnered with the National Committee for Quality Assurance (NCQA) to offer an incentive program for physicians that is based on the Medical Home model.  AMA's Private Sector Advocacy presents the document, “Achieving Medical Home recognition,” to educate physicians on the concepts behind the NCQA and BTE models.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: How to keep your practice competitive and compliant

In a shifting environment in which physicians are under pressure to collect, track and report data about the quality of the care they provide, how can small physician practices develop the infrastructure needed to compete in today’s marketplace? An increasing number of physicians are opting to collaborate with other independent—even competing—colleagues to respond to these pressures. In some cases, physician collaboration may allow physicians to jointly contract with health insurance companies and other third-party payers. AMA’s Private Sector Advocacy has created the booklet, “Competing in the Marketplace: How physicians can improve quality and increase their value in the health care market through medical practice integration, second edition,” to provide guidance on integration issues. Outlining various strategies for physician practice integration—including physician practice mergers, financial integration and clinical integration—this resource can help physician practices stay competitive while complying with antitrust laws. This second edition includes a new preface and appendixes that highlight the AMA’s antitrust activities.

AMA practice tip: Make sure your practice is compliant with the new health privacy and security requirements

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the American Recovery and Reinvestment Act of 2009 (ARRA), physicians are required to control the ways in which they use and disclose patients' protected health information. The resource “What you need to know about the new health privacy and security requirements” outlines the newly expanded requirements for protection of patient health information, patient rights to this information and administrative protections physicians must have in place. Learn about the compliance deadlines and where you can find more information to ensure your practice is fully protecting your patients' health information.

AMA practice tip: What you need to know about the Red Flags Rule

In November 2007, the Federal Trade Commission (FTC) issued a set of regulations, known as the “Red Flags Rule,” requiring that certain entities develop and implement written identity theft prevention and detection programs to protect consumers from identity theft. In response to FTC staff indications that the rule will apply to physician practices, the AMA expressed its concerns and successfully delayed implementation of the rule until June 1, 2010. The AMA is continuing its efforts to persuade the FTC that physicians are not “creditors,” and therefore should not be subject to the Red Flags Rule. In the interim, the AMA has prepared a guidance document, along with sample policies, so that members can incorporate a simple identity theft prevention and detection program into their existing compliance and HIPAA security and privacy policies. Visit www.ama-assn.org/go/pmc and select “Data Security” to access the AMA resource, “Protect your patients, protect your practice: What you need to know about the Red Flags Rule,” and a sample practice policy.

AMA practice tip: How to protect yourself if in danger of identity theft

Identity theft has become increasingly common as the prevalence of Internet and other non-face-to-face transactions have proliferated. The AMA has developed the educational resource “Steps physicians should take if in danger of identity theft” to help physicians protect themselves if they believe their identity may have been stolen. This resource offers steps physicians should consider taking if they learn that their credit card, checkbook, Social Security number (SSN) or other confidential information that could enable impersonation has been lost or stolen.

AMA practice tip: Ensure your compliance with HIPAA security rules

All physicians and practice staff covered by the Health Insurance Portability and Accountability Act (HIPAA) are required to notify patients if breaches in the security of their medical information occur. The AMA has prepared the educational resource “What You Need to Know About the New HIPAA Breach Notification Rule” to ensure that providers are fully aware of their responsibilities under the law.

AMA practice tip: Protecting patients’ personal health information with data encryption

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, has made several important changes to the HIPAA Security Rule. These changes have raised a number of questions among physicians and other HIPAA-covered entities and their business associates about how to protect personal health information. The AMA created the physician resource “HIPAA Security Rule: Frequently asked questions regarding encryption of personal health information” to answer the most common of these questions. This resource explains the importance of encrypting personal health information in the physician practice, helps you determine what information your practice should encrypt and provides points you should consider when selecting an encryption method for your practice.

AMA practice tip: Enhance care and lower practice costs with Web-based tool that measures patient satisfaction

Want to measure your patients’ satisfaction with your practice? The AMA and Press Ganey Associates, Inc. now offer a Web-based tool called RealTime, which collects and evaluates patient feedback and provides information to help you improve your practices and better meet the needs of your patients.

By providing patients with a proactive outlet for feedback on their office experiences in an electronic survey format, RealTime delivers instant information that your practice can use to reduce wait times, improve patient communication, enhance the appearance of your practice, and manage the courtesy and friendliness of staff. RealTime generates survey reports and helps participating physicians identify drivers of satisfaction, analyze profiles of their most satisfied patients and create blinded comparisons to other physician practices.

Visit www.ama-assn.org/go/patientexperience to learn more or purchase RealTime for your practice. AMA members receive discounts and get a special introductory rate!

AMA practice tip: Implementing HIPAA security requirements in your practice

Physicians who electronically submit claims and conduct other transactions named in the Health Insurance Portability and Accountability Act (HIPAA) must meet a number of requirements. The Centers for Medicare and Medicaid Services (CMS), the federal agency charged with oversight of these requirements, has published a rule that outlines how to meet the HIPAA requirements, which are separate from the commonly discussed HIPAA privacy requirements. The AMA has compiled excerpts from the Handbook for HIPAA Security Implementation, a 256-AMPress publication, into an interactive online resource to help physicians and their practice staff understand what HIPAA requires with respect to keeping their patients’ medical information secure.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Learn the benefits, risks of participating in a health information exchange (HIE)

As organizations that facilitate the electronic exchange of patient health information, HIEs hold the promise of improving the quality, safety and efficiency of health care. But each organization can have a very different structure, data exchange model and selection of services, making it critical for physicians to be fully informed before they sign a contract to participate in an HIE.

To help physicians navigate this emerging field within health information technology, the AMA has created two new resources. The first resource; answers common questions about HIEs and the implications of physician participation, while the second resource; lists the questions and topics that a physician should research before signing a contract with an HIE. For additional insight on HIE issues, view; a recorded webinar provided by representatives from the Healthcare Information and Management Systems Society (HIMSS). The presentation offers an overview on HIEs and addresses some common areas of physician concern regarding HIE participation.

AMA practice tip: Thinking about signing a participating provider agreement?

Physicians are constantly solicited to participate in preferred provider networks (PPNs) via participating provider agreements. But how do you know if the agreement is beneficial for your practice? In today’s market of rental networks, understanding who you are contracting with and what the agreement should contain is imperative. These agreements often include provisions that allow the PPN to sublease the network to other PPNs that you haven’t contracted with. While subleasing can lead to a greater number of patients, it can also make tracking the health insurance payer difficult and create administrative confusion for your practice. Learn what a PPN should include in the agreement, what kinds of questions you should ask and how to determine whether signing is in the best interest of your practice. The AMA and the American Association of Preferred Provider Organizations (AAPPO) have created an educational toolkit for physicians and PPNs, “Physician and other health care provider contracting toolkit,” to equip both physicians and PPNs to ensure fair participating provider agreements. Additionally, some states have laws regulating PPNs. Contact your state medical association for the specific laws in your state.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Helping patients understand their payment responsibilities

Physicians and office staff are encouraged to involve and educate patients about medical treatment decisions, as well as payer payment policies and procedures. Industry trends indicate that both payers and employers are shifting more of the responsibility and cost of health care treatment and payment to the patient. In response to this shift, physicians and office staff need to consider proactively establishing or revising their practice’s payment and collection policies accordingly. Visit the AMA Practice Management Center to access educational resources, such as “Helping your patients understand their billing and payment responsibilities” and “Understanding your health insurance policy and payment practices.” These resources were developed by the AMA Practice Management Center and the Kentucky Medical Association.

AMA practice tip: Educating patients about unfair/inaccurate physician profiling practices

While pay for performance (PFP) and other programs that use physician profiling can be a plus when they promote effective, safe health care and adhere to the AMA Principles and Guidelines for Pay for Performance Programs, patients should be aware that many profiling programs are poorly constructed and often focus primarily on finding ways to save money—not on improving care. The AMA, co-branding with a number of state medical associations and national specialty societies, created a poster that physicians can post in their offices to raise patient awareness of the many problems inherent in physician profiling programs. Visit the AMA’s Private Sector Advocacy to view related educational resources.

AMA practice tip: Patient education on differences between Medicare and Medicare Advantage

The AMA has created two new educational resources for current and potential Medicare Advantage beneficiaries. AMA members can use these patient educational resources to help educate their patients and staff on the benefits and problems associated with participation in Medicare Advantage plans. The first resource, “What you need to know about Medicare Advantage,” provides basic information on the program, including what to expect in terms of benefits, enrollment and health insurer marketing of these plans. The second resource, “Which plan is right for you,” provides a brief overview of the different types of Medicare Advantage plans, including HMOs, PPOs and private-fee-for-service plans.

AMA practice tip: Helping patients understand their payment responsibilities

Physicians and office staff are encouraged to involve and educate patients about medical treatment decisions, as well as payer payment policies and procedures. Industry trends indicate that both payers and employers are shifting more of the responsibility and cost of health care treatment and payment to the patient. In response to this shift, physicians and office staff need to consider proactively establishing or revising their practice’s payment and collection policies accordingly. Visit the AMA Practice Management Center to access educational resources, such as “Helping your patients understand their billing and payment responsibilities” and “Understanding your health insurance policy and payment practices.” These resources were developed by the AMA Practice Management Center and the Kentucky Medical Association.

AMA practice tip: Educating patients about unfair/inaccurate physician profiling practices

While pay for performance (PFP) and other programs that use physician profiling can be a plus when they promote effective, safe health care and adhere to the AMA Principles and Guidelines for Pay for Performance Programs, patients should be aware that many profiling programs are poorly constructed and often focus primarily on finding ways to save money—not on improving care. The AMA, co-branding with a number of state medical associations and national specialty societies, created a poster that physicians can post in their offices to raise patient awareness of the many problems inherent in physician profiling programs. Visit the AMA’s Private Sector Advocacy to view related educational resources.

AMA practice tip: Patient education on differences between Medicare and Medicare Advantage

The AMA has created two new educational resources for current and potential Medicare Advantage beneficiaries. AMA members can use these patient educational resources to help educate their patients and staff on the benefits and problems associated with participation in Medicare Advantage plans. The first resource, “What you need to know about Medicare Advantage,” provides basic information on the program, including what to expect in terms of benefits, enrollment and health insurer marketing of these plans. The second resource, “Which plan is right for you,” provides a brief overview of the different types of Medicare Advantage plans, including HMOs, PPOs and private-fee-for-service plans.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA new Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA’s Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Improve communication with your patients

Studies show that effective communication with patients has a beneficial effect on medical outcomes and significantly influences patients' satisfaction with their case.  The AMA resource, "Improve communications with your patients," provides you with six easy steps to improve your interpersonal communication with patients, as well some simple alternatives to common medical jargon that will help patients understand their medical conditions, care and follow-up instructions.

AMA practice tip: Learn how to achieve and maintain a stellar reputation among patients and potential patients

Do you wonder what your patients say and think about your practice, and what you can do to improve and maintain its reputation? Your practice is a business, and like any business, its success depends on creating and maintaining customer (i.e. patient) satisfaction and loyalty.  You must be aware of, and responsive to, patient needs and preferences.  The AMA resource, "Managing your reputation," offers you steps to help ensure you and your practice achieves and maintains an excellent reputation among patients, their friends and family, and other potential patients.

AMA practice tip: Connecting with your patients

Online medical consultations, also known as e-visits, present opportunities for growth and increased efficiency in the physician practice. To learn more about this new patient convenience and whether it’s right for your practice, visit the AMA Practice Management Center to access the educational resource “Online medical consultations: Connecting physicians with patients.”

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Establishing a cost-based practice fee schedule

The AMA has developed the educational resource “Fee schedule analysis: Using your complete practice cost as a guide” to help physicians and their practice staff recognize the need to establish their practice fee schedule based on what it actually costs to provide a service rather than basing their fee schedule on what a third-party payer or other entity wants to pay. This resource includes a 12-step guide to help physician practices create their own unique physician practice fee schedule with an easy-to-complete spreadsheet that will allow physician practices to include additional markup percentages to account for profit, contributions to reserves and future capital expenditures.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the American Medical Association’s (AMA) new Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: AMA resources help physicians take charge of their data

Public and private health insurers are increasingly using physician data to drive their decision-making processes on new payment methodologies, network design, patient education, and health services availability and delivery.  In addition, they are using performance data to rate the quality and efficiency of physicians.  Three resources from the AMA are designed to help physicians access these data and strategically use them to improve practice efficiency and delivery of care, as well as ensure that payers and other reporting bodies are not misusing the information.

Take Charge of Your Data is a guidebook designed to help physicians understand and verify the accuracy of complex physician data reports used to profile physicians.  The guidebook was created to be used in tandem with the with the AMA’s Standardized Physician Data Report, which provides a uniform format for displaying physician data. Used together, these resources provide physicians with a roadmap to understanding how to use the payer-provided data to verify the accuracy of their profiles and assist them in providing exemplary care to their patients. Additionally, through the creation of the Guidelines for Reporting Physician Data, the AMA is working to improve the quality and utility of physician data reports.

Visit www.ama-assn.org/go/physiciandata to access these resources and find additional information on how to use these exciting tools.

AMA practice tip: Open access scheduling: Is it right for your practice?

The AMA has another resource as part of its continuing effort to help physician practices improve their patients' experiences. The member's only resource, "Open access scheduling: Could it improve your patients' experiences and your bottom line?", provides information on open access scheduling and the benefits and challenges associated with adopting this type of scheduling system.

Vist www.ama-assn.org/go/patientexperience to learn more about measuring patient satisfaction and improving your patients' experiences.

AMA practice tip: Save time and money in day-to-day operations

Looking for ways to improve your practice? Wondering where to start? With the AMA’s new Rapid Process Improvement Initiative, your practice can quickly identify areas for process improvement and follow the program’s easy-to-tackle steps to implement these changes. This free Web-based tool walks you through the process with an interactive practice assessment, an assessment results guidance tool and toolkits to help you implement the process improvements you have identified. Individuals who complete this program can also apply for the program’s certificate of accomplishment.

Visit www.ama-assn.org/go/rpi to take the first steps toward process improvement, and save your practice time and money in your day-to-day operations.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA’s Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: Succeeding in a post-health reform world

Because the post-health reform environment presents new opportunities and risks for physician practices, the AMA has created the new educational resource ACOs, CO-OPs and Other Options:  A “How-To” Manual for Physicians Navigating a Post-Health Reform World. This resource is specifically designed to help physicians maximize the likelihood of success, while minimizing the risk of failure, regardless of how they choose to navigate the new post-health reform world.

Consisting of chapters written by seasoned, expert physician practice consultants, this resource takes the learnings of the past and translates them into valuable knowledge for the future. Topics include an overview of accountable care organizations (ACOs) and issues to consider such as governance, partnerships with hospitals or health insurers, and managing antitrust risks. The resource also discusses opportunities for consumer operated and oriented plans (CO-OPs) and provides guidance on earning incentive payments for electronic health records. Visit www.ama-assn.org/go/ACO to access this resource today.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA’s Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!

AMA practice tip: AMA resource helps physician practices understand the impact of accepting credit card payments

The AMA has developed an educational resource, “What do I need to know about payer and patient credit cards?" to help your practice understand how accepting and processing credit card payments from patients and payers may impact your bottom line. This resource provides with information on payer and patient credit card processing, associated fees and acceptance conditions. Visit www.ama-assn.org/go/claimsrec to access this new resource. If your practice chooses not to accept corporate credit cards from payers, a "Sample letter to health insurer or other payer regarding use of an unapproved method of payment for services," is also available for you to customize and;send to any payer that is sending a payment in the form of a payment method not agreed to in the underlying contract. This template letter is available at www.ama-assn.org/go/templateletters and is free to AMA members. Your practice is also encouraged to file a complaint at www.ama-assn.org/go/clickandcomplain against payers that are requiring a payment method that has not been mutually agreed upon.

AMA practice tip: Workers' compensation eBilling vendor listing

Electronic billing (eBilling) is an effective way to avoid administrative hassles associated with workers’ compensation claims. By switching from a manual claims process to eBilling for these claims, you can decrease administrative costs, receive timely acknowledgement of your claims’ status, reduce the time it takes to submit bills, and get paid faster! Access the AMA's "Workers' compensation eBilling vendor" listing to learn about some of the many practice management system and clearinghouse vendors offering workers' compensation eBilling solutions. This resource will help physician practices adopt workers’ compensation eBilling, by introducing vendors that may assist physician practices in automating workers’ compensation claims. Visit the AMA's workers' compensation toolkit at www.ama-assn.org/go/workerscomp for additional resources, including an interactive map which provides state-specific resources on workers’ compensation medical reporting and billing requirements, state rules and regulations, how to file an appeal, and more.

AMA practice tip: Vendor directory helps you select a practice management system

Are you looking for a new practice management system or an upgraded system that can integrate with electronic health records? Get the information your practice needs to select the right software for your practice with the help of the new Practice Management System Software (PMSS) Vendor Directory.

The AMA and the MGMA offer this free resource for their members as a complement to the recently released “Selecting a Practice Management System” toolkit. Built on specific responses to survey questions posed to vendors, this directory can make your search for practice management system software easier. AMA and MGMA members can query, filter options and print out detailed vendor responses to all survey questions.

Visit www.ama-assn.org/go/pmsoftware to access the vendor directory and its related toolkit resources today.

AMA practice tip: Toolkit helps maximize practice efficiency in rapidly changing health care environment

The upcoming transition to the government’s modified electronic transaction standards, coupled with the Medicare and Medicaid electronic health record incentive program, will require physician practices to upgrade or replace their current practice management software. To help you select and purchase the most appropriate software for your practice, the AMA and the MGMA collaborated to develop an online toolkit. Free to members of the AMA and the MGMA, the new “Selecting a Practice Management System” toolkit provides a roadmap to make this process easier for your practice. You can use this information to establish your practice needs and take advantage of recent improvements in automation. The toolkit resources include:

• A five-step guide to practice management system software selection.
• A comprehensive checklist that helps you determine which practice management system software features and functionalities are essential to your practice and which will enhance your revenue cycle management.
• A sample “request for proposal” that you can employ in your communications with practice management system software vendors.

Visit www.ama-assn.org/go/pmsoftware to start taking advantage of this valuable toolkit today.

AMA practice tip: Selecting the best EMR/EHR system for your practice

Procuring an electronic medical record (EMR) or electronic health record (EHR) system for your practice can be an intimidating process with the many facets and the multitude of EMR/EHR vendors currently available. How do you select the one that’s best for your practice? The AMA has created the educational resource “15 questions to ask before signing an electronic medical record or electronic health record agreement” to help you assess your practice’s needs and determine which vendor will best meet those needs.

AMA practice tip: Collecting payment for services rendered

Collection services can play an integral role in helping physician practices improve cash flow by securing payment from hard-to-collect delinquent accounts. To offer physicians guidance in selecting a service, the AMA Practice Management Center has developed the resource “How to select a collection service.”

AMA practice tip: Save money with credit card payments—shop around

One of the best ways to ensure receipt of your patients’ payment responsibility is to offer the option of credit and debit card transactions. Learn how to maximize the benefits of accepting credit and debit card payments by contracting with a payment processor that suits your practice’s specific needs and by recognizing how you can save on fees with your current processor. The AMA Practice Management Center has developed the educational resource, “Shopping for a credit or debit card merchant agreement: Guidelines for physicians,” to help you improve your practice’s bottom line.

AMA practice tip: Save time and money with the AMA's Practice Management Alerts

Position your practice to save time and money with the AMA’s Practice Management Alerts. Free of charge to physicians and their practice staff, signing up for these timely e-mail alerts helps you stay up to date on unfair payer practices, ways to counter these practices, and practice management resources and tools. On the new Practice Management Alerts Web site, you can take action on alerts, invite friends to join and share your practice management stories. Visit www.ama-assn.org/go/pmalerts to sign up today!