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Issue #21 — March 28, 2012

AAPC BillingInsider e-Newsletter

F R O M   T H E   F I E L D

Don’t Let Missed Appointments Reduce Your Bottom Line
By Deli Parham, CPC

Missed appointments—no-shows and last minute cancellations—plague every practice. Some practices charge to recoup revenue for missed appointments while using the threat to motivate patients to keep appointments. Others don't. Here are some tips:


Charge for Missed Appointments
Implement a well-publicized policy charging a reasonable, fair fee for missed appointments. Simply hanging the threat of a charge out there may get the patients through the door. Or, if a patient misses one appointment but shows up the next time, issue a warning and waive the fee.

Charges often range from a flat fee of $10 to $25, or half the cost of the scheduled procedure. Before implementing a new policy, check with those health plans you contract with in order to make sure it is allowed.

Institute a Telephone Reminder System
The Automated Phone System vs. Personal Touch

Automated Phone System: Beware of using only the automated phone system even if your practice has few employees or many patients. Although using an automated phone system seems more attractive to cut back on expenditures, some patients—especially the Medicare population—may not check or understand messages, or they may simply ignore voice mail messages.

Personal Touch: Studies show most patients take person-to-person contact more seriously. People are more reluctant to miss an appointment, especially established patients who are familiar with the staff, if called directly. Personal calls are easier to understand, especially for the elderly.

Use of Both Automated and Personal Touch: Analyze patterns of no-show days and make the personal reminder calls for those days likely to have missed appointments. For example, make personal calls on Fridays for appointments on Mondays. Personal calls on days where there is an increase in no-shows and automated calls the remainder of the time may be most effective, depending on the size of your office.


Double-Book Appointments
This could lead to more missed appointments because patients become irritated with waiting a long time to see the doctor.

Require Up-front Deposit
This risks alienating patients and increasing clerical bookkeeping time.

Only Use An Automated Telephone Reminder System
This may not decrease stubborn no-shows.

G O O D   T I P S

5 Steps Toward HIPAA Security

Ensuring security of electronic personal health information (PHI) is tough. A more stringent HIPAA Security Rule and news of PHI breaches raises anxiety in billing offices.

Healthcare IT News recently interviewed Mahmood Sher-Jan, vice president at ID Experts. In a copyrighted story, "5 Best Practices for HIPAA Security", he shares these tips:

  1. Take a PHI inventory. Sher-Jan told Healthcare IT News an accounting of every element of PHI an organization holds proves a valuable starting point. This helps to identify all the information that needs to be secured.
  2. Perform a HIPAA security evaluation. Sher-Jan recommends evaluating your organization’s security policies and procedures to assure they’re up-to-date. This means reviewing them for security in anticipation of external and internal events and changes.
  3. Conduct a HIPAA risk analysis. He suggests assessing the risks and vulnerabilities to the integrity of electronic PHI. Identify the threats, including those of emerging electronic media such as social media.
  4. Have a mitigation plan in place. Determine preventive measures to protect your electronic PHI. Have a compliance and mitigation plan that includes all aspects of the HIPAA Security Rule.
  5. Create an Incident Response Plan (IRP). Sher-Jan says this is the best way to meet HIPAA and HITECH requirements.

F E A T U R E D   S T O R Y

CMS Redesigns the MSN

The Centers for Medicare & Medicaid Services (CMS) recently redesigned the Medicare Summary Notice (MSN). The new MSN, now available online at, will be mailed quarterly to beneficiaries starting in 2013. CMS Acting Administrator Marilyn Tavenner said the redesign is part of a new initiative, "Your Medicare information: clearer, simpler, at your fingertips."

Tavenner also said the statement is easier to understand and navigate, and it makes clear what information to check and how to report potential fraud. The new MSN reads, "If we determine that your tip led to uncovering fraud, you may qualify for a reward." And, unlike the old statement, the new MSN provides a phone number that beneficiaries can call to report suspected fraud. The new MSN also includes an additional page explaining in more detail how beneficiaries can handle denied claims, or file an appeal.

CMS has created a side-by-side comparison of the former and redesigned MSNs. The new MSN is more direct, telling recipients "Your Deductible Status," "Your Claims and Costs this Period" and "Providers with Claims this Period," as opposed to "Assigned Claims" and "Customer Services Information."

FROM THE FIELD is thoughts and experiences from you the reader. If you have any tips, ideas, case studies, or just anecdotes please submit them to us for future editions.

In This Issue
Missed Appointments
HIPAA Security
CMS Redesigns the MSN

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