Welcome to our Spring newsletter after the warmest winter in a long time.
It’s been a busy few months for us at Synapse out and about spreading the app word at conferences and events across the country and we have plenty of other ‘appenings to report.
We have news on the recent Medibank Private and Ramsay Health negotiations, Appointmaid updates and there’s an exciting opportunity to join a specialist practice in Melbourne.
The MBS mire continues to be perplexing. Have you ever wondered whether you can ‘take over’ a referral that wasn’t addressed to you or whether you can provide specialist telehealth support to a rural emergency department patient? We’ve answered those questions for you and you can read about them here.
And finally, we’re sharing with you a snapshot of our in house statistics for the month of August as well as a quick review of informed financial consent requirements and some tips about helping us to get you paid.
Next time I write I’m sure I’ll be including information about the Christmas closures which is a terrifying thought!
Until then, happy reading…
Synapse Medical Services
Medibank Private & Australian Health Management (MBP) and Ramsay Health – do we have a winner?
Some of you may have read recent media coverage concerning a dispute between MBP and Ramsay.
MBP and Ramsay had reached an impasse in their negotiations in the context of a pending 31 August deadline, when their existing agreement was due to expire. The dispute related to hospital costs not medical costs and, as such, was never going to adversely affect the payments made by MBP to doctors under no-gap and known gap arrangements.
Late last week we received a call from MBP who advised that agreement had been reached and a new three year agreement signed ensuring no out of pocket hospital (bed) costs for private patients admitted to Ramsay Hospitals.
The AMA conference, the Health informatics Conference and the Geriatrics conference
It’s been a busy boothing winter for us having a presence at many and varied conferences including the AMA national conference, The ANZSGM – Society of Geriatric Medicine meeting in Adelaide and more recently at Australia’s premier health informatics event, HIC 2013, where we were showcasing “Synapps”.
HIC 2013 had an impressive keynote speaker line up, including the Hon Tanya Plibersek MP and Martin Laverty the CEO of Catholic Health Australia who delivered an inspirational presentation examining the factors that contribute adversely to the health of Australians starting with the education of our kids. There was a strong focus on telehealth with an international array of presenters sharing their experiences, but out in the exhibition hall it was digital health all the way. A mind boggling array of innovative and exciting technical solutions for the delivery of healthcare services were on display, including of course – us! Paper was positively shameful as a concept, we almost wanted to hide our brochures…
The MediMind quiz was a huge hit at all conferences as always. Everyone wants to be in it to win the daily iPad give away but we do make them think for their prize.
The Prime Minister question stumps even the most knowledgeable participants with an average of only four entrants out of sometimes 100 getting a correct answer. But Professor Maria Crotty is no slouch and nailed it at HIC Adelaide, walking away with the iPad loaded with Synapps and of course, she’s now a dedicated app user for all of her billings.
What’s the Prime Minister question? You’ll just have to come along when next the quiz is on.
Secretary wants holidays? – no one to cover – try Appointmaid
Only a few months old, Appointmaid is proving popular already. Much more than just appointment scheduling, Appointmaid is a complete virtual receptionist service. You just forward a number to our 1300 number and we do the rest. One of our doctors simply threw us his mobile and said he’d be back in a fortnight… It started ringing the moment we caught it – literally!
We’re doing everything you would expect your practice support staff to do including managing appointments and reminders, organising theatre bookings, managing IFC, fielding calls, scheduling drug reps and squeezing urgent patients in at the 11th hour. And it’s fun!
And with a shared calendar it means we are all looking at the same thing. You can make and change appointments at anytime, as can we, and the calendar is updated immediately. And it’s always there for you on your phone.
But to make it even better, we’re currently programming our own software to further customise the service ensuring we provide a tailored, flexible and user friendly interface.
So now with Synapse offering billing, transcription and virtual reception, there’s not much you really need other than someone to meet and greet your patients on the day and we’ve even got some helpful ideas about that.
Give us a call on 1300 510 114 to find out more or email email@example.com.
The Private Practice (TPP)
At one of the recent conferences I was chatting with a physician about the requirements for valid referrals and, well, one thing led to another and before I knew it we were chatting about The Private Practice magazine, courses and events. Completely unprompted she said this:
‘I was on a flight recently and I got chatting to the person sitting next to me who turned out to be a geriatrician. She said that she had recently been to one of The Private Practice courses and it had transformed her life. She couldn’t stop raving about it. It’s even made me think about starting in private practice.’
So I thought I would include an unashamed plug for TPP in this edition of our newsletter, as the comment really came as no surprise to me and now, more than three years in, our partnership with TPP remains a source of great pride. With Steven Macarounas at the helm, the quality of the speakers and integrity of the educational program is in safe hands. Steven is uncompromising when it comes to the required deliverable – educate!
Our brief as speakers is that we are not to mention our products or services during our presentations, just focus on the education. I have seen presenters come and go over the years as those who have not understood this requirement have not been invited back. So those of us who are left standing can talk for hours about whatever our ‘thing’ is, completely forgetting we are actually addressing potential clients.
And it goes without saying that the TPP product has matured and improved over the past three years as we have consistently refined, tweaked and tailored what we do in response to participant feedback. So I recommend TPP to you, your colleges, your departments, your practices. Steven can tailor a program that will not disappoint and as you know, Synapse clients get a 25% discount on all courses.
You can check out upcoming courses at this link http://theprivatepractice.com.au/programs
A new client using Synapps is a daily event here in Spring St, which is very satisfying for us. We can even boast that the majority of billings we received everyday (and that’s a lot of billings) now come to us via the app.
Synapps new release is now available for download – Android version 1.2.4 and iOS version 1.1.7. These include bug fixes, improvements and enhancements such as the ability to set default list type, default list location and the inclusion of patient-end telehealth services.
Allied health users are also making a bee line for Synapps as are telehealth practitioners who are increasingly using the specific telehealth function which automates an otherwise complex claiming dilemma.
It’s all great stuff but there’s much work yet to do. The next release is already underway with more enhancements and improvements and our major project of synching across devices is high on the agenda.
Don’t forget to email our dedicated app email firstname.lastname@example.org to report bugs, give feedback, request support or suggest enhancements.
MBS claiming conundra – referrals and telehealth
Ever wondered what constitutes a valid referral? Whether it’s OK to ‘take over’ a referral if you were not the named specialist on the referral, whether it has to be in writing and be signed and by whom? Find out by reading ‘The rules on referrals’ published in the winter edition of The Private Practice Magazine and also available on our website under our ‘news and publications’ tab.
And, more recently I was asked a few interesting questions about telehealth claiming and whether the services at both the specialist end and patient had to be claimed and whether specialist telehealth services could be provided to patients in rural public hospital emergency departments. Always up for an MBS challenge, I must confess the latter of the two questions was a tough one. But after delving deep into the labyrinth of health legislation and agreements the answer emerged and you can read it in the Spring edition of The Private Practice Magazine which is a great read. And of course we will post it on our website news blog ‘news and publications’ once it has been published in TPP in about a week’s time.
Looking for rooms in Melbourne?
We have a client currently refurbishing a large practice in Melbourne, who is interested in hearing from practitioners looking for a place to set themselves up. It’s a great opportunity to join a new specialist practice in Doncaster, without having to shoulder the overheads! There are numerous consulting rooms available and our client is happy to discuss permanent or sessional arrangements. Whilst predominantly suited to specialists, other medical and allied health professionals are most welcome. If you’d like to find out more shoot me an email email@example.com and I’ll pass your details on.
Quant methods Synapse style
We see it as our job to get you paid promptly and, as you know, we have a 5 business day turnaround on all billing batches.
To achieve this, whilst always maintaining quality and accuracy, we have developed streamlined processes and internal workflows that are closely monitored and recorded every step of the way. It’s a military operation where we record and time stamp everything that happens during the processing of every single batch as it moves through the processes of data entry, first QC, second QC , final QC and completion.
You would expect no less from us as it’s important we get it right. We have always taken this responsibility seriously.
Internal reports are generated and reviewed every month to see how we are travelling. You might be interested to view these stats from last month.
- 91.43% of all billing batches were completed within 5 business days
- 6.37% were completed within 7 working days (reason for delay – missing/incorrect information causing patient to fail online verification – usually waiting on return call or need to call fund/Medicare/referring doctors rooms for provider number)
- 2.2% were completed within 10+ working days (reason for delay – still waiting on client to provide missing details such as item number, location of service, referring doctor – unable to proceed further).
As you can see, we actually achieve our target with 100% of the claims for which we have correct and complete information. The reasons for delays are matters beyond our control but which we do everything we can to resolve without bothering you.
We only contact you if we really have to because we know you have bigger things to be worrying about. But you can help us to ensure your claims are transmitted without a hitch by providing us all necessary information. The best way to do this is to use ‘Synapps’, as most of the necessary data is collected by taking a photo of the patient sticker so it saves a ton of work entering names and numbers. But if you aren’t yet on Synapps here’s a reminder of what we need:
- Full name of the patient
- Full address of the patient (and a contact telephone number if available)
- Date of birth
- Medicare number
- Health fund name
- Health fund number
- MBS item number/s
- Referring doctor name
- Referring doctor provider number or (at very least) a location for him / her (a suburb will do)
- Referral date
- Location at which the services were provided
- If workers comp – the name of the workers comp or third party insurer and the claim number
Stand clear and mind the gap!
I’m sure you all understand that doctors in Australia are free to set their fees for their professional services. You can charge what you see fit for your services and are never locked into one particular type of claiming or fee structure – we have a constitutional guarantee to secure this right.
But when you do charge gaps there are a few important things to remember, chief among them being informed financial consent (IFC). IFC is only a legal requirement when using the health fund Known Gap schemes. At all other times, whilst not a legal requirement, providing patients with an estimate of medical fees is best practice, not to mention being plain common sense.
No-one likes fee surprises and we deal with them at Synapse too often. Patients will often say they did not know about the out of pocket costs they have suddenly been hit with and it can be a difficult situation if we have no IFC (a written and signed one ideally) to fall back on.
We want your patients to be happy and will bend over backwards to assist them whenever we can, but when it comes to talking about money, we know that talking about it before rather than after the event is desirable and a written and signed IFC is invaluable in securing your payment and reducing the incidence of bad debt.
We provide an IFC service for our clients or, if you would prefer to manage this yourself, we provide free IFC templates in the secure zone of the website. We encourage you to use them or call us on 1300 510 114 if you’d like to chat about having us manage this process for you. And finally, if you’d like to read more about managing bad debt in private practice we have the perfect article – ‘The cheques in the mail’.
And that’s all from us. See you for the summer edition when we’ll have new weather, a new political climate and we might even win some cricket.