Why Basic Training Isn’t Enough
When you hire a virtual assistant, even from a reputable medical virtual assistant agency, expect to put in a LOT of effort to train them, even though they come with some basic training.
That’s the thing: it’s really basic training. More than that may actually not even be feasible for the agency to execute, because every practice has their own processes. What helps more than the training they receive through the agency, is their prior work experience. So, for example, if they have done Eligibility Verifications for a practice they worked with before, they will know how to do that. Any tweaks they may have to make do it “your” way, will be relatively easy.
Bottomline, expect it to take several weeks to fully train your virtual assistant. Naturally, the more tasks they have to do for you, the longer the training will take.
Custom Training My Virtual Assistant
Prior to hiring my first-ever virtual assistant, I was doing it all, a la micropractice-style. So, I had to pretty much download my brain onto paper all the processes and how I execute them in order for me to teach someone else how to do it.
Downloading My Brain aka Policies and Procedures Manual
I started writing a document on my google drive that became what is now our Policies and Procedures Manual.
It goes into every detail of how things are done around here.
For example, phone calls. The document states, “When the phone rings, take a deep breath and smile. The person at the other end can “hear” your smile.
Answer the phone with “Hello, I’m first name-last name from Ace Kidney, nephrologist, Dr Sadhu’s office. How may I help you today?”
Here are some processes outlined in our Policies and Procedures manual:
- Compliance with HIPAA
- Inbound Phone Calls
- Outbound phone calls
- SpruceHealth Inbox
- New Patient Appointments
- Patient Reminders
- Preparation of office notes for upcoming office visits
- Respond to Medical Record Requests
- Follow up insurance claim denials
The document is currently 38 pages long is perpetually changing, like a living, breathing thing. Like the practice, it strives to be better, leaner, more efficient every day. It did not start out in such depth. When you’re teaching someone, you might gloss over parts that seem trivial or obvious to you- and then you find out that it was not so obvious to the other person. Then you change how you teach it, going forward.
My Own Camcorder Method
Recently, I was reading Dan’s Martell’s excellent book Buy Back Your Time. In it, he describes what he calls the Camcorder Method, to train others to do something exactly the way he does- by recording himself do the process, while explaining it- and then having someone write out the procedure based on the recording. Turns out, I had done a version of that while training my virtual assistant.
To train my virtual assistant, I gave her access to thePolicies and Procedures manual and then went over it with her while on a videocall, via zoom. The good thing is, zoom and many of the other videoconferencing platforms lets us record the call. This helps in two ways. First, it is a resource they can go back to, whenever they need to. And second, it is a resource for us- when we need to train someone else for the same processes- either because we’re expanding our team or because a team member needs to be replaced.
I started off with talking to my new V.A. about the culture of my practice. The big picture. The current state of affairs in medicine in this country and my reason, my WHY for doing this. I believed that if she got this bit, the rest would be a cakewalk.
Then came the mundane but important things, like staying HIPAA compliant.
I’ve mentioned this before: my virtual assistant is pretty much an extension of me, handling all tasks that does not require my MD degree. That’s a LOT of processes to train someone on. And therefore, it took me a LOT of time to fully train her. Three months, pretty much on the dot.
I did not hand over all tasks right from the get go. I offloaded tasks, in order of priority. Things that I disliked most or were most disruptive/time consuming for me. Phone calls were one of the first to go, not surprisingly!
Phone Calls: A Patient’s First Interaction with Your Practice
Phone calls with a medical practice are one of the most vital parts of the patient experience and for new patients, their first taste of your practice. Without a face in front of you, it is often easier to fall into apathy or disinterest. So, it is important to train well in this regard. Phone calls are also how new patients make their first appointment with your practice. So, that needs to be a seamless process- easy for them but thorough enough for us that we will ultimately get paid for the work of seeing the patient.
I already had a system in place of all the questions to ask a new patient requesting an appointment. Those were the same questions I would ask when I was doing this job. So, that was an easy transition.
EMR Training
EMR training came right along with the phone calls. That took a few days- along with the questions that came after, here and there. I screenshared while on video calls with my V.A. to show her the ropes of both the EMR as well as the integrated practice management system. At that early stage, her role was simple. Gathering patient demographics for new patients, entering them into the practice management system and getting them on the calendar.
Eligibility Verification: Not an Easy One
Eligibility Verification was next and that’s a doozy. If you’ve done it, you know what I’m talking about. In fact, I like what someone I know at a billing company once told me: Eligibility Verification is only 80% accurate. I love that insurers have a disclaimer right alongside the information for Eligibility Verification. “Verification of benefits is not a guarantee of payment”. Yeah, you bet it’s not.
The process itself is not hard. There are many places that can give you the information. Nowadays, many EMR/Practice Management Systems are set up to do Eligibility Verification. You can also do it via the insurer’s portal or on a platform like Availity.
The problem is, not all the information is clear or accurate. And apart from the insurer’s portal, all the other platforms are only as good as the information being fed to them by the insurer.
For example, a lot of the time, it will not specify whether you are in-network with the patient’s plan. You need to know that independently. And it’s not as simple as, “I know I’m in network with BCBS, I should be good”. You need to know if you’re in-network with that particular plan. So, for every insurance umbrella, you need to know which of their “trade lines” you’re contracted with.
And errors are common, too. For some reason, the UnitedHealth portal lists me as out of network for everything. But I am in-network. I have a contract to prove it and I get paid an in-network doc (I’m not sure if that’s a blessing!). But in the beginning, I had a hard time figuring this out for myself and made many a phone call to hash it out before I figured that the portal was just wrong.
So, training a virtual assistant on Eligibility Verification is a little fraught. I showed her the process of getting the information and then we interpreted the information together for several weeks before I let her independently assess it.
Actually, many of the processes work this way. It’s not that the steps involved are particularly difficult but since the devil is in the detail, the training goes on while on the job- and you can expect to be pretty hands-on during that initial time period.
Comprehensive Support: Key Tasks My Virtual Assistant Handles
At this point, my virtual assistant handles the following tasks for my practice:
Answering inbound phone calls
Making most of the outbound phone calls: to patients, to insurance companies, to referral co-ordinators of other practices, medical records departments of different organizations
Scheduling new and established patient appointments
This one was hard for me to let go since I am really particular about my time but I have since mostly delegated this. As far as tasks go, this one is pretty straightforward. I do keep my thumb on the scale, though.
Eligibility Verification
Doing Eligibility Verification for new patients and for established patients in a new calendar year or if a patient’s insurance changes. She attaches the Eligibility Verification to the chart and adds an alert telling me what the patient responsibility is, that pops up at check out. That helps me get the right amount from the patient before they leave the office.
Prepping Notes
Preparing office note for patient visits based on templates for HPI/physical examination and also inputs lab results into the note: (my EMR is fairly basic and will not automatically input lab results into notes). I go over the lab results myself prior to a visit to make sure there are no transcription errors.
Faxes
Makes outbound faxes. We use an electronic fax- so there is no paper involved, unless a document requires my wet signature in which case I have to take care of it. My virtual assistant makes all the faxes- whether it is my office notes to the primary care or referring physicians, medical records requests and everything in between.
Inbound faxes: we tag-team. If she sees them first in our shared inbox, she does the needful (like scanning the lab result into the chart or calling the patient if it is a new referral) and tags me saying either that I need to do something [like refill a prescription or take a clinical decision] or that she took care of the task [for eg., “attached to chart and added to note; appt 10/25/24”]. After that, I look at the content of the fax at some point- sometimes right away, if I’m working on practice matters- or within a few hours, if I’m either seeing patients in the office or engaged in other shenanigans (like writing a blog post or relentlessly promoting Link Medical Spaces on social media!).
If I see a fax before she does, as often happens during evenings and weekends, I look at the fax contents and tag her. With routine things, no further direction is needed at this point- but sometimes I will write her a note asking her to do something specific.
Patient Calls and Messages
Patient calls and messages: We deal with patient messages the same way. We tag each other, if needed- but if it is some simple issue, like a patient asking when their upcoming appointment is, the virtual assistant answers right away without my input. For clinical questions, she tags me and then I decide how to respond.
New Patient Registration Forms
My new patient intake forms are online and 95% of patients will complete them online, prior to their appointment. If a patient is unable to do so, my virtual assistant lets me know which patients need to fill out their forms in the office.
She also attaches the forms to the patient’s chart.
Revenue Cycle Management
Revenue Cycle Management (RCM): This was the latest thing I have outsourced to my virtual assistant. I do all my billing in-house- which meant, I was doing all the billing myself. I still like to stay on top of all things RCM, so again, my virtual assistant and I tag-team for these tasks. Every day that I see patients, I close my notes for the patients seen that day and create a “visit” for each note (a click of a button on the note itself). The V.A. makes sure there is a “visit” created for each patient on the schedule and proceeds to “create a claim” and subsequently “submit the claim” for each patient encounter (both being one click each on the Practice Management system).
She also posts each patient payment into the system.
When payment ERAs are received in the practice management system, I cross-check them with the bank account and make sure each payment was indeed received by us. Then the V.A. posts each payment to the right patient encounter and also attaches the ERA to the chart for future reference.
My virtual assistant also makes calls to the insurance companies to fight denials. I trained her extensively, giving her the script to talk to the insurers, staying very polite but persistent. For every denial that she calls for, I give her the background on what is going on, what the insurer says the denial is for, on the ERA and what questions to ask. Most of these denials take more than one phone call, so she follows up on them as per a schedule we draw up.
In Summary: The Essential Tasks a Virtual Assistant Can Handle
This is a glimpse into how my virtual assistant helps with multiple different tasks in the practice. It gives you an idea of exactly how much can be remotely handled. Unless a process requires you to actually touch a patient, it can be done by a person sitting in their own space, in their own time zone, anywhere in the world and it will be done just as well.
Have you utilized virtual assistants in your practice? What roles do they play? What tasks do you have them handle? Tell us below so we can all learn from each other!
