5 Easy Wins to Minimize Physician Contract Compliance Risk
- April 3, 2018
- Posted by: dynafios
- Category: Blog, Healthcare Contract Compliance, Physician Compliance
As a former CFO of several healthcare organizations, I have scrutinized hundreds of medical director time logs and call schedules. This was not an enjoyable task, but given the substantial risk of non-compliance with a physician who was often also a referral source, the implications were significant.
The federal government has continually upped its efforts related to investigating, prosecuting and combating healthcare fraud. This focus has led to increased scrutiny on hospital-physician financial relationships and contracting issues. This interest has sharpened especially with the movement of physician providers into employment, medical directorships or other compensated relationships with local hospitals.
There have been cases of alleged improper physician compensation arrangements. These cases can and have led to significant settlements or damages. The magnitude of potential damages has placed physician arrangements in the line of sight of attorneys and private citizens with the potential to recover a portion of the damages or settlement.
This has led many hospitals and health systems to review current processes and identify vulnerabilities. Some of the biggest weaknesses are often the most simple to cure, with physician manual logs rising near the top of the list. The major challenges with manual logs include:
- Illegibility. This is a no-brainer. There is truth in that you can’t read a physician’s handwriting; however, I often can’t read my own. This is plainly a given and I don’t cast stones.
- Outdated Forms. Templates are typically included as an Exhibit in the original contract which may renew for several years. If an organization needs to revise the template, then those changes must be effectively communicated to the physician and /or his administrative staff.
- Time Sensitivity. Most, if not all, contracts include a cut-off date for the physician to submit logs to the hospital. Unless someone on either end of the contract is diligent from a calendar standpoint, key dates are often missed. I‘ve had several conversations with physicians explaining why we would not be able to pay due to failing to submit by the cut-off. These conversations were never pleasant even though this restriction is typically plainly stated in the contract. Further, as the payor, the hospital is bound by this stipulation and has no other options available.
- Paper Flow. Often there is no standard process on how physician logs are submitted. Forms are sometimes handed to a clinical director, dropped off while passing through administration, handed to someone during a meeting or scanned in and emailed. To ensure this paper flow was not mishandled by the hospital, we created a process. But, given the volumes of paperwork that is constantly in motion at a hospital, I was concerned with our ability to effectively track the paper flow from submission through multiple approvals, and eventually payment to the physician.
- Clarifications or Corrections. Although a vast majority of the items on a log are reasonable, there an issue may arise which requires additional documentation or a correction. Being able to have a timely conversation with the physician and having them make any needed edits can be a challenge.
The pace of change in healthcare and healthcare technology is advancing rapidly. Through multiple smartphone apps on our personal devices, our routine tasks are less troublesome and take less time to perform. The benefits we enjoy in our personal lives can also be achieved in our professional lives.
Utilizing an electronic process instead of manual process has several benefits and significantly reduces the risk of hospital or physician contract non-compliance. An automated physician time tracking and compliance tool can easily address these issues. Plus an end-to-end electronic audit trail would be handy, should you come under government scrutiny. Physician timekeeping and contract compliance software can provide:
- Legibility. Use of drop down menus for tasks with additional fields for details that are typed in versus written, as well as integrating talk to text features on mobile devices.
- Updated Forms. Using a web-based electronic format is typically more efficient. Updates can be performed and immediately implemented across all stakeholders.
- Time Sensitivity. Automated email reminders to providers, as well as time date stamps regarding submission helps ensure logs are submitted on time, backed by verifiable time stamping.
- Paper Flow. Transparency and a repeatable process flow is assured with electronic confirmations to physicians upon log submission, and electronic tracking throughout the entire approval process. An easy, repeatable process provides confidence in the log submission system.
- Clarifications or Corrections. An electronic process can provide a notice to a physician when there is a question about an entry, which can be corrected and re-submitted within minutes.
As hospitals and medical practices convert to electronic documentation, there is growing acceptance of using technology in lieu of paper. Physicians are becoming much more adept and supportive of automated workflows to improve compliance with protocols and clinical outcomes. Similarly, physicians have become much more receptive to automating routine administrative tasks which typically consume considerable periods time.
Technology can help mitigate contract compliance risk by automating processes, thereby eliminating human error. Often the weakest link is when the process experiences human intervention. Automating the logging and submission process eliminates human generated risk.
Stay ahead of potential compliance issues. Introducing an electronic physician logging or physician timekeeping software system can be a welcome alternative from the hassles of manual paper logging and a measure to reduce compliance risk. For hospitals, it’s a win-win. For physicians, it’s easy to do and a welcome change from paper.
Dynafios offers an easy to use electronic physician timekeeping and compliance app. Dynafios TRACE takes minutes to download on a mobile device and literally seconds to enter and submit a log. Physicians receive automated reminders to complete and submit logs ensuring timeliness, while providing complete transparency throughout the automated review and approval system from submission to invoicing.
For more information on Dynafios TRACE physician timekeeping and contract compliance software, call us at 877.858.3282 or email info(at)dynafios.com.