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Do you understand the key processes of your business? Are these processes optimised and as efficient as possible? Do you consistently analyse how to further add value to your practice?
In this podcast episode, Joe Sanok speaks with Jeremy Zug who wants you to be LEAN .
Meet Jeremy Zug
Jeremy grew up in the Pacific Northwest where he discovered his passion for people. He decided to go to college in Chicago to further develop his skills working with people and pursue a degree in counseling. While in Chicago he worked for a group practice as a practice biller and marketing manager. This initiated his desire to pursue learning about the business of Private Practice, particularly medical billing. He now lives in Michigan with his wife of 3 years. They both are pursuing their passion of helping helpers maintain sustainable and compliant billing practices. In his free time, Jeremy loves reading, fishing, biking, hiking, and camping.
- Website: https://www.practicesol.com/
- Facebook: https://www.facebook.com/Practicesol/
- Twitter: https://twitter.com/practicesolllc
- LinkedIn: https://www.linkedin.com/company-beta/16218033
Jeremy Zug’s Story
Since the last time Jeremy Zug was on the podcast, he has been growing his business – Practice Solutions – and has added staff to his company as well.
In This Podcast
In this episode, Jeremy Zug goes into the details of what it means to make your business LEAN. This includes 5 fundamental stages, which he maps out practically. Jeremy also goes into the various LEAN methodologies. By the end of this podcast, you’re bound to know how to transform your practice to a much more efficient practice.
Michael Hyatt: Your Best Year Ever
- On stage
- Back stage
- Off stage
LEAN is cycle time reduction through waste elimination. Finding the most efficient way to do something by identifying processes and cutting the waste out. Doing only what is essential and eliminating any waste.
- Identify value (from patient’s perspective)
- Map value stream – identify processes
- Remove waste
- Implement solutions to constraints and issues
- Measure and continually improve processes
LEAN Methodology: PDCA
- Check (KPI’s)
The Application of LEAN
The application of LEAN is not meant to take forever. Ideally, it should be done in a few days to a week.
Get hold of a white board, some sticky notes and a pen. Have your key processes in mind: from a patients, marketing, billing, finance perspective. Map these out on a very granular level:
- What’s valuable to a patient?
- Expected but not asked for:
- Billing is correct
- Correct diagnosis
- Warm office
- Prompt timing
- Expected and asked for:
- Free WiFi
- Not expected / asked for (‘wow’ factor):
- Ability to pay online / autopay
- Auto-booked appointments (goes to phone / PC)
- Expected but not asked for:
- Identify key value streams / business processes
- Patient processes
- Admin processes
- Marketing processes
- Measure how long each of these processes take
- Conduct ‘value-add’ analysis
- Patient has to care about it
- Activity changes patient / changes your knowledge of patient
- Activity has to be done correctly the first time (wastes time to have to do it again)
- Identify waste
- Unnecessary repetition
- Start to finish on processes (avoid multi-tasking) – without interruption
- Implement change
- FISH: focus on only one problem at a time
- FISH: focus on only one problem at a time
- Monitor and adjust
Making Private Practice LEAN
Implementing LEAN methodology to the following processes:
- Patient processes
- Admin processes
- Marketing processes
- Practice Solutions
- PoP 235 | Insurance Billing With Kathryn And Jeremy Zug
- Sheri Fitts Says That Fortune Favors the Fast | PoP 296
Meet Joe Sanok
Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.
Thanks For Listening!
Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!
JEREMY ZUG WANTS YOU TO BE LEAN[When you’re developing a website, you want to have a very clear calls to action. You want to have landing pages that are specific and clear. That’s why Brighter Vision’s new landing page tool is amazing. It’s so helpful and it integrates right in with your email management system. It’s only available, though, for Brighter Vision clients. If you’re not a Brighter Vision client, and you want this landing page tool, it’s totally free for Brighter Vision’s clients. Hand it over to brightervision.com/joe, and you can learn more about this landing page tool and all they offer including their hosting, their IT support, their website development – everything that goes into attracting your ideal client online. They have been a sponsor for a while because they are awesome. They’re affordable. They’re $59 a month, and so many of my consulting clients use them and love them. So, hand it over to brightervision.com/joe and you can get your free first month for free.] This is Practice of the Practice podcast with Joe Sanok – Session Number 297.
Welcome to the practiceofthepractice.com. I’m Joe Sanok, your host. Duh, of course. You know that I’ll say that. We’re in the radio center, two-building, and beautiful downtown Traverse City, Michigan, the Mitten State, the Great Lake State, America’s High Five because it looks like a hand, and the upper peninsula kind of looks like a rabbit. Well, they have those weird things with their states, don’t we? I’d like to hear what your states look like. Tag me on Facebook or put it into our Practice of the Practice Facebook. I would love to know what your state look and like. Does it look like a box? What would you say Florida looks like – kind of like a sock? I don’t know. I’d love to hear what you all think.
Anyway, I’ve been listening to a bunch of audiobooks. I recently discovered, and I feel really dumb that I didn’t realize this that I don’t have to an Audible account because our public library for free offers audiobooks through an app. So, there’s this app called Hoopla, which you usually have to pay for to download audiobooks, but our library allows you to download 8 audiobooks a month.
I’ve been going to Michael Hyatt, your best, your ever – Shout out to Gordon Bruce. I know that you read that book and you got his journal. If you guys don’t know Gordon, he’s a good rate podcaster-consultant out there doing some awesome work, especially around how to use Google Suite in a hippie-compliant way.
But anyway, I’m listening to this book and I realized so much of New York Times Bestsellers of books is giving a process, is giving steps. And, I listened to audiobooks in one and a half speed to get through them faster and because sometimes the reading pace is a little slow for me. And I’ve realized how frequently authors are giving me a list of five things or three things. “In this chapter, we’re going to cover these three things, and under each of those three things, here’s five things, and here’s seven things, and here’s four ways to do this.” It’s really just a list of lists of lists. And so, when we have a process, when we have an idea, when we have a way that walks us systematically through something. We tend to achieve more. We tend to do more. We tend to be able to conceptualize really ambiguous things into very practical things.
For example, Michael Hyatt talks about – he breaks his life into on stage, back stage, and off stage. So, on stage work is his work with customers, to clients, consulting – all of that. Back stage work is sort of behind the scenes, logistical work that has to be done. Then, off stage work is the down time. I like how he frames that because everybody understands that when you’re on stage, you’re in front of the crowd, you’re going to be on. When you are back stage, nobody sees exactly how you’re doing it but you still want to do it ethically or you want to do it right. And then, off stage, you’re not performing anymore. You need to not check these social media. You need to not be doing these other things. So, that’s just one thing from the book that really stood out to me.
Today in the Practice of the Practice podcast, Jeremy Zug, who is the co-owner with his wife, Catherine of Practice Solutions – Practice Solutions does amazing medical billing. You got to head over to practiceofthepractice.com/fun. If you want to check them out, better redirect you over to their website and know that you came for me. They’re fun medical billers. I know it would seem like an oxymoron, but I would have not given them the “/fun” if it wasn’t true.
Without further ado, I give you Jeremy Zug!
INTRODUCTION TO JEREMY ZUG[JOE] Today on the Practice of the Practice Podcast, we have Jeremy Zug, he’s the co-owner of Practice Solutions with his wife, Catherine. They’re doing insurance billing, and they’re innovative thinkers. So, today we’re actually going to be talking about things outside of just insurance.
Jeremy, welcome to Practice of the Practice Podcast!
[JEREMY] Hey, thanks Joe. Thanks for having me back on again!
[JOE] Yeah, I’m really excited about this. It’s cool to see how many people have been coming your way. You guys are rocking it out with Practice Solutions.
[JEREMY] Yeah, we are. It’s been fun. It’s been a great ride so far. We’re just going rock and roll.
[JOE] Yeah, I know last time. We’ve heard your back story but how are things been going since you’re in the podcast last? Like, how many people have been joining you, guys? And, you’re taking things off people’s plates for them with insurance.
[JEREMY] Yeah, so we service over a hundred clinicians at this point, actually over a 150. It’s good! We’re learning a lot and servicing people we’ve hired since then. More staff, and more staff can do more things. So, we’re looking forward to that. I think since the last podcast, you got credentialing and paneling.
[JOE] Just so glad about! I was like, “You got to do this.”
[JEREMY] It’s been part of it, you know. So, now, we offer that. We’re glad to be able to offer more services. It’s rolling. It’s good!
[JOE] Well, I think I mean, so often, I was just on the call yesterday with somebody. And, they were so overwhelmed with all of their billings. They were like, “I got to hire someone and train them.” And I said, “No you don’t! But, you could literally can call Jeremy tomorrow. They can start taking things off your plate.” That transition of – within a month. “How long does it actually take?” I said, “Tomorrow they can start.”
[JEREMY] Yeah! It’s about, you know, the average transitions. It’s like 2 to 3 weeks.
[JOE] Okay, so within 3 weeks, someone can totally have all of their billings off their plate?
[JEREMY] Yeah, and it’s really affordable. That’s the biggest conception is, you know, if you hire somebody with all of this knowledge, they’re going to be way outside my budget. And, it’s just not true, right? You can get people that are really experienced and love what they do for some full-time personal benefits. That’s naturally the point of outsourcing. Well, I can save some but still have it off my plate.[JOE] I see it more as a multiplier, similar to adding an assistant. When you have an assistant that answers the phone, they’re going to get paid, say, $15 an hour. If you tried, $150 an hour, and you do one extra hour, you can pay for $10 of somebody else’s time.
[JOE] It’s like a multiplier for you, and same sort of thing with billing, or any other things that you can take off your plate. If you take IT off your plate, you would have dinked around with WordPress for 5 hours. You would probably do worse than an IT professional. With a few bucks an hour, they would have knocked that out in an hour. And so, it ends up being so much of a multiplier.
[JEREMY] Yeah, with billing, it’s even more than that, right? It’s like, let’s say, they have claims, they’re on pay on they’ve submitted, or whatever. Then, it’s like, we actually add money to the bottom line. It’s not really a cost. It’s like somebody to go get money that I would have never seen before.
[JEREMY] That’s like awesome!
WHAT IS LEAN?[JOE] Today, we’re talking about the LEAN process. It’s interesting that you brought it up when were just chatting. I think it was last week, or the week before. I didn’t know that you’re a LEAN guy. I remember when I first learned about LEAN. I was working in a community college and they had a person that her whole job is to look at the college and see how they could enact LEAN.
I was like, “this sounds awesome!” Because they had a little business sense, but I wanted to learn more. We had lunch one day. I read a bunch of books about it.
So, why don’t we just start with, what is LEAN?
[JEREMY] Very simply, LEAN is cycle time reduction through waste elimination. Now, that sentence alone is like, LEAN, in unintuitive sense, right? But basically, that’s finding the most efficient way to do something, and you cut the waste out of your processes. That’s identifying your processes and cutting the waste out. There are multiple parts to that. But essentially, you’re doing only what’s essential, and eliminating wastes in your processes.
[JOE] This started out in the manufacturing world.
[JEREMY] Yeah, most of it was in the Far East, actually.
[JOE] Is it Toyota?
[JEREMY] It was Toyota, yeah, and then, a couple of other manufacturers that found that they could produce more with a higher quality through some of these practices. They had less inventory on hand. They people wasted less time. They moved. They had bigger margins. American companies adopted all that. So, you would hear a lot of Japanese terms like kaizen, and all those things, but it’s really applicable. It’s only been for the last 10-15 years that really hit the service industries.
People thought, well, LEAN is fork that’s down the road for us. But no, you can apply it to private practice and it’s incredibly viable.
LEAN IDEAS[JOE] So, let’s talk about just some of the concepts of LEAN and we’ll definitely talk about the applications to private practice. And so, take us through. What are some of the ideas around LEAN that people should understand?
[JEREMY] LEAN, essentially, as you define… It’s really 5 stages. These 5 stages are applied across any organization really but to identify value. In healthcare, if that’s okay.
[JOE] Yeah, absolutely.
[JEREMY] You want to define value from the patient’s perspective. You want to map the value stream with the key processes and along with that, identifying issues and constraints in your process. Then, you remove wastes. That’s the third piece. The fourth is that you would implement solutions to those constraints and issues. And then, five, you would measure and continually improve your processes.
[JOE] What was number two?
[JEREMY] Number two is you would map value stream and identify key issues and constraints.
[JOE] It was first, value. Then, map it out, remove wastes, solutions, and then, measure.
[JOE] Okay, cool.
[JEREMY] You want to make sure you’re effective.
[JOE] Yeah, yeah. Well, I know at the college. They had kind of taken all those ideas and they did this thing called “Plan, do, check, adjust.” First, you plan out. What do you want to do with your project? Then, you do it. You give it a whirl. Then, you check your certain KPIs or Key Performance Indicators. And then, you adjust. For me, that idea of adjusting and feedbacking part of the loop has been essential especially for my virtual assistants. And so, with Emily, my director, Samantha, who was in South Africa, we meet every week and we talk briefly about what do we need to do, and here’s some feedback and things. Rather than be like, we need to sit down and have a meeting about what you’re doing wrong. It’s just like, let’s adjust as we go because we’re not going to nail it the first time. We’re going to get better, rather than trying to make it perfect from the first get-go.
[JEREMY] That’s right. And yeah, PDCA right there. That’s really fundamental in the LEAN. There’s like 10 or 11 LEAN methodologies that people have adapted. It seems like every year; some consulting comes out with a new LEAN.
[JOE] It’s even leaner.
[JEREMY] It’s even leaner, right? The beach body LEAN. So, that’s exactly right. PDCA, and now, it works. To be honest, it’s just very pragmatic. That tends to work for people. Anywhere from Ford and GM to your small private practice, or even on your group practice. That can be applied.
[JOE] So, what are kind of things that people need to know about LEAN before we talk about kind of why it’s valuable?
[JEREMY] Well, you know, people need to learn that this doesn’t… it’s not meant to take forever. This is meant to be a quick… it can be done in a week. Briefly, I worked for a manufacturing company where we get a lot of LEAN activities. We had a consultant come in and then, they came. We rented the LEAN process in 4 days. After 4 days, we saw massive improvements. I think that’s the big thing. This doesn’t take a year or a year and a half to develop, and then, implement, and adjust. Right? It’s not that long. Three or four days where I look at stuff, and then, we make these changes. And then, we measure and adjust. It’s not meant to take forever. And I think, that’s important.
LEAN APPLICATIONS[JOE] One practice owner said, “I love that. What do I do? I want to spend 3 or 4 days focused in on my practice and having a be LEAN.” Maybe they had a Friday, Saturday, Sunday that they set aside. They go to coffee shop. They go to hotel. Whatever they get away that really kind of sort through this. What could that look like if they were going to say, “I’m going to dive into LEAN over 3 or 4 days.”
[JEREMY] I think this is exactly where we would talk about the application of LEAN, right? I think you need… I would get a whiteboard and those big sheets of paper with extra markers and sticky notes. I would get a bunch of materials like that. And then, I would have already prepared what your key processes. What are your key business processes from the patient’s perspective, from a marketing perspective, from a billing perspective, from a finance or APAR perspective? What are your 5, or 6, or 8 key business processes?
[JOE] What’s APAR in case someone doesn’t know?
[JEREMY] Accounts Payable and Receivable. How do you know how to pay your bills? Simple stuff. You want to have those already in mind when you get there because if you get to your hotel in your weekend, or whatever, and you don’t know what your key processes are because usually you have 5 to 8 every business, then, it’s going to take a lot longer. But, when you already have those documented and you have your key business process already in mind, that becomes a lot easier to do this kind of thing.
[JOE] Okay, so you get all the information, and you show up. And then, what would that look like to, then, decide what your LEAN process is actually going to be once you have all that information?
[JEREMY] First of all, just to go through some of the basic processes of LEAN from an outline perspective, if you want to identify… Once you have your key business processes, you want to map them out. You want to know, what are my processes on a very granular level?
So, you have your general business processes. Let’s say from a patient’s perspective. What’s valuable to a patient? That’s first and foremost. You know how a patient comes into your office, when they leave, and schedule. But, you want to identify what’s valuable to them.
In my mind, from the patient’s perspective. There are 3 LEAN bubbles of things that a patient finds valuable. They just expect. They don’t ask for. They just expect that these things – these billings are correct. They have the correct diagnosis, a warm office, prompt in and out times. They’re not waiting after check-in. They’re not waiting after checkout. Those kind of things, they didn’t ask for those, they expect them. And then, there are things that they expect but they specifically ask for: basic needs, not ask for, and expected and ask for.
Proximity – is your counseling office close to where I live and work? I don’t want to travel 2 and a half hours to get to it, that kind of thing. Reminders – text, email, voice reminders. People ask for those all the time – free Wi-Fi, parking – things like that. And then, there’s the wow factor, things that they don’t even know to ask for like the ability to pay online, or even auto-pay, so they don’t have to think about it.
[JOE] Kombucha and coconut water in the lobby.
[JEREMY] Yes, exactly! Kombucha and coconut water… wow!
[JOE] What’s really funny is just… a friend of mine is a distributor for this Kombucha company. We’ll see. Some people think Kombucha is super gross, and some people really like it. I’m one of the people who really likes it. First time I had it, I thought it was super gross, kind of like the first time you had salt and vinegar chips. And then, I brought them in, and they went faster than anything else’s gone in our fridge. People loved in and so, I said I’m going to get some more kombucha.
[JEREMY] You had to do it, and that’s exactly what I’m talking about. You know, one thing that we’ve seen recently is appointments are autoboots like in their email. It’s like you come in. Once my next appointment is done, it goes to my phone or my computer. So, I don’t really need to think about it. That’s like great. You want to identify value from a patient’s perspective and I would start there. Right? You know, you arrive. You identify what’s valuable. And then, you want to identify in the LEAN. I’ll use the term interchangeably, if that’s okay. But, you want to identify key value streams slash business processes. The LEAN methodology step is a little bit confusing.
That’s what I meant in the beginning when I’m talking about, “what are your patient’s processes, your admin processes, your marketing processes?” All these things form your private practice. I don’t know if you have anything else to add there.
[JOE] I think that if I understand the flow that someone goes through and then value what they’re looking for. That then helps you identify what’s working, what’s not working. I think that’s when you get to the step about removing wastes. So often, we just like, throw marketing up against the wall, and see what sticks. We don’t really know, or even know to ask.
[JEREMY] Why would we measure anything? It works, right? Doesn’t everything just work?
[JOE] Exactly! It’s just like, you know, okay, yes, I should put an ad in the local newspaper. How do you know that works? So, learning to cut that waste. I think one of the biggest waste that we do is even just your personal time. If your running full tilt towards your practice and what you want to do with it when you’re in the office, or kind of dinking around for a bit.
[JEREMY] Right, exactly. I think the other piece you might add is after you map your step-by-step processes… For example, your patient completes the paperwork. How long does it take to get that information in your EMR? How long does it take to do the knowledge-ability check done? Who’s doing that work? Where’s that all kept? If you map each step, and then, correspond each step into a time value, they’ll help you in the end measure what works and what doesn’t.
Let’s say, it takes you, Joe, 30 minutes to an hour to do knowledge-ability check. What could you be doing with 30 minutes to an hour of your time? How valuable is that to you? That’s actually incredibly valuable. That’s how we get to the waste perspective. First, before you even get there, you need conductive value add analysis. What’s adding any sort of meaningful value to my processes here?
With LEAN in healthcare perspective, for process to add value, there are 3 criteria it has to meet. First, the patient has to care about it. It may be anything from your website because you better believe that people care about websites. Marketing companies exist, right?
[JOE] Let me jump in. When I was in my very first office, I was subleasing it as a percentage of what I brought it. So, I paid 20% of whatever I brought in as my rent. The amount I paid is above market value. So, that office would have gone $500 a month. My ceiling was $700 a month. But, I paid 20%. For me, that made sense. Start with that, I wasn’t allowed to change the furniture. There were brass lamps. There was an accountant rolling desk. The couch was cream and blue checkered pattern with flowers that look like a picnic table cloth. It had this smell of fake floralness. So, it was not at all my ideal place.
[JEREMY] It’s like a funeral home.
[JOE] It was. Yeah. And so, it wasn’t the best place for me. I obviously have a much different style if you’re looking at this video to see my style. I have a great website, though. And the, website looked amazing. One of the most common comments I got was, “Oh, this office was different than I expected based on your website.”
It just shows that if you have a decent website, people would have expectations like the quality of your care and the quality of your space. Luckily, people overlooked that. I just said, “Oh, you know, I stayed here because we’re getting going in the first couple of years. We’ll get our own space soon.” That was, I think, emphasize how important and awesome website is that you can have a really crappy space. And the space was decent, you know. It was just a different style. You can have a space that doesn’t fit you if your website looks great.
[JEREMY] Exactly. And, the patients care about it. That’s the first criteria. There’s 3 criteria in order to evaluate value in your processes. Three criteria; patient has to care about it, fundamentally. Two, the activity that you’re doing changes the patient, or changes your knowledge about the patient. Is an eligibility process important? Well, yeah. That get changed whether or not they show up next week. It can get changed on how you get paid. It changes on a lot of things.
The last criteria is the activity has to be run correctly the first time. Often, in the manufacturing world, it’s called “rework”. You create a product, you have to go back and fix that same product. That’s a ton of waste. How often are your processes being done correctly the first time? That’s what gets to the waste.
LEAN is all about these wastes. There are essentially, you know, looking at your processes. Not all the wastes apply to private practice, so, I’ll only talk about the once that really apply because there’s not a lot of rework that has to be done except, in my word, the billing. That matters to me a lot.
Cream processing, if it has to be done again, that’s a big problem. But, if you look at your processes, as you’ve mapped them out visually step-by-step, ask yourselves some of these questions. Are you physically moving items too much? Are you physically going from one spot to another because that time can be measured? For me, maybe my office is too far away. I think that can count. Do I have to drive an hour and a half to my office? I don’t have that. What can I do with 3 hours a day.
[JEREMY] I was just talking to a consulting client, who she sees people on Wednesdays and Saturdays in a different office that’s an hour away. We looked at how busy she was at her office that’s right by her house. And then said, how many clients do you actually need there to make it work? It was amazing. I think she only needed like 2 or 3 clients at her full fee rate to make up for that time.
For her, the amount of lost money from just sitting in the car, when we actually run the numbers to see how much she was losing by going there… Yeah, great example.
[JEREMY] That matters. All of this really matters. If you’re in a situation where you have to travel, my perspective would be listen to a podcast, listen to valuable content, because that will optimize that time. There shouldn’t be any time in your work day I don’t think that’s wasted. You should always be moving towards something and doing something. You don’t have to get into that granular detail, but just to maximize your time really matters.
The other part of that is transportation. So, the waste of transportation, or waste of moving is like, “how organized is your computer or your physical notes that you’re writing on?” If you have to look for stuff on your desktop, that takes forever, right? I don’t know if you’ve ever worked for an organization, Joe, where making that data server is a mess. Things aren’t organized very well. And you have to hunt and pack, and search. It’s like, “why?” Why would you do that when you can know exactly where stuff is, pull it up, move on? That kind of thing is very important.
For us, it’s really important that people’s computers are organized. You have to transition computers from one staff person to another. You need to know where to go to find everything. You don’t ever run wastes there.
[JOE] The book, First Things First, has a really interesting idea of layering your activities. Rather than just exercising, rather than just hanging out with your family, why not go for a walk with your family so you’re layering things. For me, I kick the steps every day. I think it’s actually faster than the elevator when you’re on the fourth floor. I don’t always run up the stairs, but I try to go up and faster than I can just lowly gag up. To save time, but that little extra bit of exercise or to walk faster than I would normally would walk, doing that saves me time, but it also then gives me a little bit of exercise. Finding micro things that you can add into your day, I think over the long haul helps you make progress so much faster.
[JEREMY] I absolutely agree. That’s the waste of transportation. This is about rework or doing things but are you repeating anything that can just be done in one step. I’ll give you an example for our line of work. So, we submit secondary claims for people all the time. And, secondary claims can be complicated because you have to get an explanation of benefits from the original payor. So, as your prep process, can you get every ERA or every explanation of benefit for your secondary claims? That’s the first thing.
Secondly, you have to print amount, you have to match them, you have to expense them, you have the document that you sent them, you have to scan them in, and then you have to actually fold them, and then, mail them. That process is multi-layered.
We did this exact exercise with this process, and we took it from 15 steps to 9. In almost half of processing, we got everything needed to be done because we realized we’re repeating steps. And then, we realized that the actual mailing of those claims, there’s a lot of wastes there. We have to, like, go get the envelopes over there. And then, they have to go get postage from this store. And then, we have to compile it right on our desk. And then, oh, we’ve printed off so we have to walk to the printer. That kind of thing was bad. So, we moved the printer onto the desk. We moved all of our mystery materials to within reach. And then, we have a prescribed way that you lay everything on to your desk, so you go from computer. The claim, fold it up, stamp it, and then, right in the mailbox it goes. And now, it saves us a bunch of time. Actually, it’s like incredible.
[JOE] Yeah. So, you guys, can take on more clients. You can hire more staff. You can… those little bits of time. I think people forget about those 5 minutes. This morning, for example, I had a meeting change and so I worked on the podcast. Now, I have the next month of podcast completed. I will find what I have those 5 minutes before a meeting, I’ll jump onto a Facebook Live. I’ll do something in that time, rather than sit around. Then, you can work less days because you get so much done but I worked crazy for those 3 days.
VALUE OF LEAN PROCESSES[JEREMY] You’re hinting at the value of LEAN processes but that’s exactly right. I think in the contents of a private practice, that’s where you can see more patience, more time. And, this is something you harp on a lot. Your time is a huge asset. People don’t realize that or there’s starting to realize that, I think, as I read more literature and articles.
More patience gives you more revenue. That’s another piece of waste, but then, the other waste is are you going from start to finish your processes? So, I like the idea of layering, but I don’t like the idea of multitasking within a work day. Multitasking costs you to work against your own schedule because you think you’re getting more done but you’re actually limiting the potency of whatever your working on, so it takes you twice as long.
So, are your processes going from start to finish without interruption? That’s really important. There’s a lot of tools to avoid them. You can pause your emails. You can manipulate your processes. For us, claims go from start to finish. Nothing interrupts those processes. That way we ensure that a hundred percent of the time, things are gotten submitted, money’s coming in. We’re getting the response back because of our process.
[JOE] That just speaks to the idea of batching things. The amount of time we spent getting into a project and then getting into a new project, that’s all lost time. For me, I’ll batch record the in-show and out-show for all of my podcast. I’ll get the mic out. You know, that’s a couple of minutes to get it out. You get the setup to make sure all the sound is good. I had to do that every time. I did it versus I’m going to do four or five podcasts in a row. You just get so much more done when you do that batching.
[JEREMY] That’s what’s important. When you start this process to map everything out, and I sign a time value because then, you can extrapolate that time out for a year, half a year. That’s really important, at the end, to really look at things. So, then, you’ve identified all your wastes, you have identified where you can do better. Now, you can get to implement a change. I think this is one of the hardest parts. I think we’re afraid of change. I think the change is scary, but this kind of change is really great.
[JOE] I think people also don’t necessarily know where to start. Okay, I see this waste. How do I change it?
[JEREMY] The best acumen I’ve heard in LEAN is think fish. Focus on only one problem at a time. You’re not focusing on the whole process all at once, or all of the business processes. Focus on one area. Pick an area, Joe, of private practice we can think about as far as the business process is.
[JOE] Maybe keeping track of your accounting.
[JEREMY] That’s a great one. Where do all the receipts go? Do you have Quickbooks, or are you doing it all on Excel file? Do you have a CPA? Focus on that problem from start to finish. What is the best way to do that? So, we only focus on how to track your accounting and how to track all that stuff? Do not focus on, oh well, there’s taxes and accordingly payment down the road, or whatever. No. Just this one thing. And then, you improve the one focus area. Improve that one thing before moving on to the next thing. So, it’s focus, improve, and then, you’re going to sustain your improvement.
In the trainings that I’ve gone through, you have to start somewhere. Just start with what you currently do. Then, move to the next new thing. The new process after process mapping and rearranging your processes. You know that will save you time because you’ve looked at it, and you can see it, you can quantify it. And then, you sustain that improvement until you have it. And then, you reward yourself for continuing that process. And then, you want to continue improving that process.
Along with the LEAN stuff, you want to monitor and adjust. Did that work? How much time did that take? If it didn’t, well then, why it didn’t? What was the problem? That’s really a fundamental place to start.
[JOE] Wow. There’s so much here and I’m going to have Sam put together some infographics to bring it together, some checklists for people.
So, when we think about private practice, what are the few other applications of LEAN process to private practice?
[JEREMY] I would say, from my perspective, there are four. So, there’s the patient processes. You have a patient. Where are these people coming from? How did they get it entered? How are they going to pay? What’s the interface with the EHR? How does the billing work and all that?
Then, there are the admin processes. In my mind, I think billing interfaces with patients and the admin processes with revenue and all that. Then there’s marketing processes. Those three, I would say, patient, admin, and marketing. Those, in my mind, are very general global sense of a private practice. I don’t know if you would add anything there.
[JOE] I’m sure there’s lots of other processes we could do but that really kind of capture the core processes. I would start there. I think those are the applications there.
[JEREMY] Of course, in my mind, there’s a lot of applications going with billing. It’s complicated. How’s everything get tracked? And, our core competency is looking at, you know, let’s LEAN down on the billing processes. Once you get paid correctly the first time, we don’t want any claims rework. We want all of our staff to flow smoothly. That’s really where the value of outsourcing for marketing like you said. Do you want to spend 6 hours on work hours figuring this out? Or, do you want to outsource somebody who knows what they’re doing and get done in an hour.
Those are the key areas that I would say are most applicable to private practice.
[JOE] Awesome. Well, we’re going to get a lot of resources put together from all the stuff that Jeremy has shared with us today. So, if you want to go over the practiceofthepractice.com, just search for Jeremy’s name, or search for LEAN, or go just in the podcast section. There’s lots of ways that you can get information that we’re going to develop for what Jeremy covered today.
Also, Jeremy, if people want to connect with you with Practice Solutions to take billing off their plate, what’s the best way for them to connect with you?
[JEREMY] I would go to practiceofthepractice.com/fun because we make billing fun. Yeah, go to that landing page and fill out the little form. And now, you go directly to me. That will come right to me and not some sort of info, ad, whatever email. So, I’ll reach out to you.
[JOE] Well, I love what you and Catherine, and everyone over at Practice Solutions are doing. Thanks so much for being on the Practice of the Practice podcast!
[JEREMY] Thanks, Joe. Thanks for having me on.
For me, one of the big takeaways from talking to Jeremy is that you got to have systems. You have to have people. Cut the fat and figure out every little step that you can do better. One of those ways is to outsource your IT work, outsource your websites. So, if something goes wrong with your websites, you have somebody that can have your back.
Brighter Vision is one of the best website solutions out there. You’ve got to check them out if you don’t have a website on brightervision.com/joe. Also, if you have a website, and you’re just not happy with your IT people, you’re not happy with the customer service, they’re not updating, they’re not responding. You definitely got to check out the team. I was actually out in Colorado in November, and my friend, Paul, and I swung by the Brighter Vision World Headquarters. It was awesome to hangout with the team, to meet them, to see what they’re working on. And, it was just really cool to just see the full environment. They’re just regular people. They’re there to help serve their best. So, hand it over to brightervision.com/joe if you’re ready to make the switch, or if you want a website.
Thanks for letting me into your ears and into your brain. Next week, we have Robin Waite, we’re going to be diving in more info to SEO and how to rank higher.