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Will that new supply of coffee mugs, calendars, note pads, and pens engraved with your hospice’s name and phone number make physicians or their nurses refer to you? Probably not, according to experts.
"I don’t need another coffee mug," says M. Tray Dunaway, MD, FACS, CSP, a physician and author of Doctors are from Jupiter and Compliance is from a Galaxy Far ... Far ... Away and Pocket Guide to Clinical Coding. "I need a home health agency that will be a partner in my success and save me time and make me money. Most home health marketing people are health care people, and they don’t always look at what they are selling from the buyer’s perspective," Dunaway says.
When you are trying to establish a relationship with a physician, it is the physician who is the customer, so it is important to focus upon the issues that are important to the physician and the physician’s practice, he adds. "Saving time and making money are important," he reiterates.
Make communication easy
If your agency has a mechanism that makes referrals simple and getting orders signed easy for the physician, then you are saving time for the physician, Dunaway adds. He points out that agencies that send orders for signature through the mail with postage-paid return envelopes actually have been a financial boon for him, as he collects all of the orders, returns them in one envelope, and saves the stamps from every other envelope. It is OK, and preferable, to include more than one order for signature in an envelope, he explains.
The staff at Community Home Health & Hospice in Longview, WA, still mail orders to physicians, but have been able to greatly improve response time and have made it easier for the physician to read the orders, says Terry Skrentny, BSW, RN, clinical information systems and medical records director at the agency. "We used to have 40% of orders take 30 or more days for signature. Now, we receive 85% to 90% of the orders within two weeks," she says.
Skrentny’s agency automated with a software system that gives field nurses laptops on which they enter the visit information and transmit the data to the office. Orders and 485s are automatically printed in the office for staff members to mail to physicians. "Prior to automation, we would hand-write the orders, and we often had physicians say they couldn’t read what was written," she explains. "With automation, the orders are legible, and the physician doesn’t have to spend time trying to decipher handwriting," Skrentny adds.
Some of Skrentny’s physicians prefer to have orders faxed to them for signature, and her software has that capability, she says. "We still mail 90% of the orders," she notes. Although her agency is not yet using the capability to send and receive electronic signatures, it is a possibility for the future if enough physicians will benefit, Skrentny adds.
While home health agencies cannot bill for physician oversight of a home health patient for the physician, provide resources that can be used to make sure the physician is reimbursed for his or her time, Dunaway says. Providing booklets that explain billing codes or referring physicians to web sites that offer guidance will demonstrate that you understand the financial implications as they relate to a physician’s office, he says.
Not only does a physician expect you to provide quality care to his or her patients, but a hospice representative also should be able to describe services that differentiate your hospice from others in the area, Dunaway says. "If you tell me that you are better than other agencies, I immediately doubt it," he says. "Instead, tell me about your cardiac rehab program, your cutting-edge wound-care program, or your specialized staff for diabetes care. If I see that your agency is able to handle the tough patients, I will know that you can handle routine patients," Dunaway adds.
A home health agency is an extension of the physician’s practice in the patient’s home, he explains. Not only does the physician want to be assured that the staff is composed of quality nurses, but he or she also wants to know that the nurses will support the physician in front of the patient, he says.
"For example, if the nurse notices an error in the medication order, instead of saying that it appears the doctor made a mistake, the nurse should say that with all new, cutting-edge medications we have available, he or she just wants to double-check the dose," Dunaway suggests. "Then, the nurse can call me and point out that one of the new medications may interact with another, and I have a chance to prescribe another medication or change the dose. In this instance, the nurse enabled me to fix my mistake without compromising my patient’s trust in me," he adds.
Focus on top referral sources
"Everyone likes closing a sale, but what does it mean if you visit 100 doctors and only 10 of them are likely to refer patients to your agency?" asks Dunaway. "Know your buyer; know exactly who is sending you patients," he says. This not only means knowing who your top referral sources might be, such as specific physician practices or hospitals, but also knowing the specific people in those organizations, he explains. Be sure you focus your efforts on the people most likely to send you business, Dunaway says.
Skrentny agrees. "We have 3,000 physicians in our database for the geographic area we serve, but 75% of our referrals come from 300 of those physicians."
As you focus on your top referral sources, remember that you only get about two minutes to sell the physician on developing a relationship with your agency, Dunaway points out. "Have your positioning statement ready and explain how your services will save the physician time, provide excellent care, and make his or her life less stressful," he suggests.