10 Tips to Improve Your Influence on Providers
Here’s some food for thought to help you carry more weight with your doctors.
In the coding and auditing world, the provider is in the driver’s seat. Coding and auditing professionals must have the soft skills to share their expertise, collaborate with providers, and in some cases influence providers to change behaviors to improve documentation and coding accuracy.
Here are 10 tips to consider when communicating with healthcare providers.
1. Use Facts and Data
Providers are highly educated, data-driven individuals. They have been trained to make decisions based on data, not opinions or feelings. Would a healthcare provider change a patient’s cholesterol medication without reviewing their lab values? Probably not. Why would they change their documentation practices based on a coder’s or an auditor’s feelings or opinions?
Before you approach your provider regarding a needed change, do your research. To support your position, refer to and site relevant resources, such as:
- National or local coverage determinations
- The Centers for Medicare & Medicaid Services (CMS) or your local Medicare administrative contractor
- National Correct Coding Initiative (NCCI) policy manual
- Commercial payer policies
- A recommendation backed by credible, nationally recognized sources will carry much more weight.
2. Be Respectful
Providers, by virtue of their role in clinical practice, are accustomed to being the leader in the room. They are often the person someone calls when they need an answer or advice; so it can often be disarming and uncomfortable for them to not know the answer to a question.
When approaching your provider about an issue or question, be sure your communication is respectful. Avoid sounding condescending, critical, or “teachy.” Approaching providers in a respectful manner shows you’re trying to help and support them. This will make it safe for them to accept your recommendations, and help to diffuse potential defensiveness.
3. Time Your Conversations
At the end of a rough day or right before lunch might not be the best time to launch into a long dissertation about your provider’s documentation and coding shortcomings. If possible, schedule these discussions for a time when your provider is mentally fresh, has had breakfast or lunch, and can engage without distractions.
Even with careful planning, you may find your provider is running an hour behind, or perhaps just heard about the passing of a patient. If you discover the timing isn’t ideal for a productive conversation with your provider, offer to reschedule.
Make sure the timing is conducive to your own success, as well. If you’re fighting the flu, distracted by a personal situation, or upset about an issue with a co-worker, it might be more of a challenge to remain supportive, objective, and collaborative with your provider. Everyone has a job to do, even when circumstances aren’t perfect, but by being selective about when you discuss issues with your provider, you can improve the likelihood of a positive outcome.
4. Be Concise
If there’s one thing providers wish they had more of, it’s time. Unfortunately, we all get the same number of hours in the day, so be intentional about how you spend yours and theirs.
When meeting with your provider, be prepared and get to the point. They really do have a million other things to do — and so do you. If you’re scheduled to meet for one hour and you can finish in 30 minutes, do so. The providers will appreciate this, and they’ll begin to trust that you won’t ask for their time unless it’s truly needed.
When meeting during patient care or on-call time, prioritize the issues you wish to discuss and address the most important ones first. Even with careful scheduling, you never know when the provider might run long with a patient and arrive to your meeting late or get called out for an emergency, leaving less time than planned for your discussion. Always begin with the issues that will make the most impact; that way, if you run out of time and can’t address all of your agenda items, at least you covered the most important ones.
5. Connect Recommendations with Goals
Is your provider patient-centered? Show you understand by explaining how your recommendations will help keep her coding on track, so she can focus on her patients. If your provider is looking for a work/life balance, show how implementing your recommendations will reduce the number of coding queries she receives and help her get home earlier. If your provider is motivated by money, show that by coding correctly she can improve collections, reduce costly denials, and avoid paying interest, fines, and penalties. Showing how your recommendations align with your provider’s goals will make her more likely to buy in and implement the recommendations long term.
6. Focus on the Problem, Not the Person
We’ve all heard the old saying, “It’s not what you say, but how you say it.” When raising a concern with your provider, be sure your statements focus on the problem, not the person. Use “I” statements rather than “you” statements. For example, “I wasn’t able to find the order for this service,” rather than “You didn’t document the order.” Although both statements identify the issue of the missing order, the first states the problem factually, while the second assigns blame and could be perceived as an accusation instead of an attempt to solve a problem.
Another great technique is to focus on the documentation, rather than the person. For example, “The documentation was missing a signature” may be better received than “You didn’t sign your notes.”
7. Offer a Solution, Not Just a Problem
Presenting a problem without a recommendation is not productive, it is just complaining. Offer practical solutions whenever possible. Better yet: Provide options. For example, if you’re proposing an update to the provider’s documentation template, you might come up with two different solutions and propose, “We could do either A or B. Do you have a preference?”
By offering specific recommendations, you’re not only showing the provider you’re interested in helping to solve the problem, but you’re also increasing the likelihood of arriving at a solution you can live with.
8. Understand First, Be Understood Second
It’s difficult to address a problem without understanding its root. When attempting to collaborate with your provider on an issue, ask questions to gather more information about why a particular problem, workflow, or behavior exists. For example, when discussing an error identified in an evaluation and management (E/M) audit regarding the level of service selected, you could say, “Dr. Smith, help me understand why you felt the decision making was higher for this encounter.” By understanding the provider’s thought process, you can often identify where the misunderstanding occurred and address it. You might even find the misunderstanding was on your part. Either way, the provider will likely appreciate you seeking to understand her point of view before jumping to conclusions.
9. Recognize the Positive
Believe it or not, healthcare providers often get little thanks for the work they do, and receive quite a lot of scrutiny. Occasionally, take the time to let your providers know what they are doing well. Be sure that your feedback is genuine and sincere. They’ll appreciate the kudos, and will begin to see you as being “in their corner,” which can build rapport and make them more open to your recommendations in the future.
10. Evaluate Your Own Image
Politicians are really good at making appearances. They constantly evaluate how their actions and words will affect how voters perceive them. You may find it helpful to do the same.
Think about the way you dress, speak, and interact with others in your workplace. Do not gossip or joke inappropriately in the break room and then expect to be taken seriously in meetings. If you overreact when errors are discovered, change your behavior by responding with composure and reason to ensure they are corrected.
Remember: Your influence isn’t limited to the conference room or meeting area. In a sense, you are marketing yourself in every email, every meeting, and every discussion to which you contribute. You are ultimately in control of elevating or diminishing your ability to influence others in the workplace. Be sure the image you build is consistent with the level of influence you wish to have.
Marea Aspillaga, BS, CHC, CPC, COC, CPMA, has more than 13 years of management and compliance experience in both private and employed professional practices. She serves as the system director of compliance and privacy of professional practices for the Baptist Health System in Kentucky. Aspillaga is a member of the Lexington and Louisville, Ky., local chapters.