There are several different types of contracts related to the healthcare sector, and most of it needs to meet regulatory compliance. It can create a tedious and challenging operational nightmare due to various dynamic factors; organizations are often unable to complete the committed hours of services. A good scheduling platform makes handling these contracts easier, more simplified, more intuitive, meeting the contract requirements, and, more importantly, completing the committed hours of therapy. Patient care experience in the US is commonly not allocated based on patient urgency, but scheduling patient visits rarely is based on any insight. Patient calls mostly drive scheduling, availability of appointments, standard and widely used templates, or any other workarounds to fit in a reference-based patient, insurance status, etc. Many of these constraints add up to the complexity of an overburdened scheduling process designed primarily to meet the organization’s requirements, staff, and providers, often overshadowing the patient’s needs.
In this blog, we will vastly cover the provider angle to contract fulfilment.
First thing first- meet the contract compliance requirements
- You never want to breach compliance.
- You always want to be ready with documentation in case of audits.
- You want to provide the heist quality services to your patients.
Plan ahead of time
- Think of recurring sessions and long work authorization periods as opportunities rather than a headache. In the ABA space, you get this golden opportunity to commit to your patients over a long time.
- Best of the best have not met 100% fulfilment, so cut yourself a slack. We are talking about patients and mostly children; run time changes are inevitable.
- Avoid Adhoc sessions and form recurring schedules for several weeks
- Choose the pattern of recurring sessions custom to your patient’s needs. That leads to lesser cancellations.
- Use the software which tells you trends and predictions.
Use technology to prompt you
- Make use of technology to your advantage.
- Frequency of prompts and their intensity; are easily achieved using good scheduling software. Make full use of the configurations.
- Use the software which gives you reminders and provides you the guiding rails.
User alerting mechanism
- It is never too late; you have the scope of providing more hours of services every day. Make most out of your cancelled hours of the day.
- Notification engine to set the frequency of your alerts
- Set mild, moderate, and severe alerts, starting from amber flag to red flag to screaming popups to emails copied to supervisors.
Make best use of cancelled sessions
- Aptly set your cancelation policies
- Form a mechanism to consume cancelled hours for any other patient
- Always know the distance between your service locations, mostly home-based services, so that you can wisely do your reallocations.
- Let the software calculate distance between your service locations, so that you can wisely do your reallocations.
Calmanac helps scheduling, care design, and triage practices in any organization, despite the different profiles and structures. It covers organizations including ABA, a safety-net healthcare system, local and national integrated health care systems, an integrated community-owned health system, and a managed care system.
Although these organizations differ in size, populations served, and institutional constructs, these themes and the strategies described are applicable to all U.S. health care.
Calmanac pushes the boundaries of the Scheduling system to create a single source of truth that enables providers to cover and deliver the right capability to the right patient while ensuring that all expected parameters set by the Payor and Providers are being considered. The solution also provides an integrated offering with large medical billing vendors to ensure seamless flow across the board. It enables the providers to seamlessly automate and derive superior commercial value from the solution set for their internal and external value proposition.
For more details and to schedule a demo, please feel free to write to firstname.lastname@example.org