In our last article we went over some of the key planning initiatives you should be doing to prepare for the long road ahead. Our goal with this article is to help you maximize your revenue potential while continuing to care for and nurture your patients. We want to help walk you through a proactive response to help your office and your patients through this crisis.

This is uncharted territory. We don’t know exactly what will happen, but we can follow the viral trajectory in other countries, learn from them, and plan for what lies ahead. We can expect that over the next few months our business will change dramatically. The question is, can we reduce the fallout with wise choices, actions and investments today? 

I can assure you, all will not go according to plan, but planning will help us to pivot and have options – it will help us be both proactive and responsive to the needs of our patients and staff. And it will ultimately save our businesses and our patient’s lives.

Rerouting Cancellations

Remember from our last article that we suggested capturing cancellations in an easy-to-sort manner so you can reschedule appointments and procedures. You should have a list of those patients ready. Now is a great time to begin triaging appointments. Sort those who can be seen with telemedicine, those who can be referred to another facility, and those who need to be rescheduled for later. 

Start with telehealth patients and move through to referrals. The goal here is to get as many patients seen as you can while balancing safety and resource needs. 


At this point you have performed your HIPAA security checks and prepared staff to begin accepting telehealth appointments. Telehealth is a very helpful tool to move through some of your patient backlog, keep patients and staff safe, and continue providing care. As noted in our previous article, OCR has relaxed rules for video conferencing with patients will not seek penalties provided you follow secure best practices.

To begin your telehealth visits, you need clear communication procedures, practice processes, and billing plans. 

Proactive Communication

  • Send a (short) note to your patients advising them that telehealth is now available. 
  • Change voicemail at the practice to advise patients they can schedule telehealth appointments.
  • Create a landing page on your website and posts on your social media pages (if applicable). 
  • Begin an outreach campaign to patients who cancelled their appointment (further details below).

Practice Processes

  • This is a new model. Be prepared for some hand-holding both with patients and staff. 
  • Send clear appointment dial-in instructions including what to expect and how to prepare. Patients and practitioners should be in a well-lit space, with no distractions. Both parties need a microphone and earphones or a headset so they can talk to each other seamlessly. 
  • Have an administrator call the patient before the appointment to test the system and ensure the patient is confident using it. This will help avoid no-shows or late appointment starts due to technology issues. 
  • Create a flowchart for scheduling staff. Ensure there is a clear method to handle different types of appointment outcomes: no-shows, standard appointments, reschedule for follow-up, and refer to emergency or other types of care. 

Billing Plan

  • Make sure you have telehealth billing codes entered in your billing system. 
  • Talk to your key insurance providers and ensure you have the complying codes. 

Security & Implementation

At this point, you can move into action. Gather your remote team to go over the rules and start working. 

  • Issue each remote team member with a VPN and instructions on how to use it. 
  • Brief team members on imperative work from home practices:
    • Use VPN or Remote desktop connections
    • Use password-protected WiFI only
    • No downloading PHI
    • Use the work-domain email provided, never personal email
    • Review the IT helpline process you set up with your remote team
  • Test systems with your team before going live with patients.
  • Double check that all vendors have their BAA agreements signed. 
  • Brief physicians and clinical staff on how to perform common telehealth visits. For example in a standard follow up, (99213 billing) the physician can observe face, demeanor, affect, and ask the patient to show and press their abdomen. 

Social Distance Doesn’t Have to Mean Total Isolation

Patient Check-In

It may not be billable or seem worthwhile today as we face a million problems – but nurturing patient relationships is important. It helps us retain humanity, connection and show we care. This is a task that you can easily cross-train to keep everyone from scheduler to surgery tech busy – and it’s easy to do remotely. 

A quick check in can also help you get information that will help you better triage patients later. Consider a few simple questions: 

  1. How are you doing/How are you feeling?
  2. Has your condition changed at all since we last spoke?
  3. Are there any barriers to rescheduling you face once quarantine lifts?
  4. How important is this procedure to you today, on a scale of 1-5? 

A two-week outreach cadence is a good standard, and you can stagger patients into groups to 

make it manageable.

Team Check-In

Continue checking in with your team as well. In addition to the ‘emotional well-being’ check we described in the previous article, it is important to keep a practice and protocol check in. 

Develop clear communication protocols for your team, especially with the changes that Telehealth will bring to your practice. 

  • Start a daily morning huddle to review the daily changes occuring
  • Start an end-of-day huddle to assess how the day went and plan adjustments for the next day. 
  • Start every huddle with a simple question: “How are you?”  There is strong data to suggest this simple question improves staff engagement. Your team is on the front lines with you. You want them to feel supported and valued – both while you’re closed and when you reopen. 

Returning to Business

We fully expect the ramp up to full business as usual to be slow. Now is the time to anticipate supply chain shortages as barriers to full capacity operations. 

  • Take inventory. What do you have today?
  • What procedures/ how many procedures can you do with that supply? 
  • Talk to your vendors and open a clear chain of communication about incoming supply. 
  • If they won’t have surgical masks or wipes for 8 weeks or more (which is likely with today’s shortages), build their projections into your scheduling plans. 
  • Leverage the cancellation list you’ve created to triage the procedures you can provide right away. 
  • Share your plan with the team and be prepared to pivot if one supply or another doesn’t show when it’s supposed to. 

This battle has already begun and we as a medical community are clearly down. But the war is not over. We’re here to help you navigate the difficult road ahead and make it easier for you. Let’s talk about some of the ways that ProSkedge can help you streamline your business during and after quarantine.