DOT Communication

Views:
 
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

Definitions:

Definitions Health Care Professional (HCP) - a person who helps in identifying or preventing or treating illness or disability. They are subject to their college requirements. Educational requirements can be anywhere between 4 and 12 years of formal education and for specialists even longer. Education does not stop with a diploma but requires a lifetime of courses and certifications to keep up with the newest techniques and advancements. Health Care Company or Professional Corporation – an individual HCP who runs a business providing only those services that they have been trained for. They can hire other HCP who they manage providing their credentialing is the same.

Definitions:

Definitions Health Care Vendor (Big Box Store) – a company that provides a variety of Health Care services across multiple disciplines which are typically public corporations with the necessary infrastructure to support it. Quality Assurance (QA) – a process by which administrative personal review a HCP report for spelling, grammar and content. QA ensures that the report answers the question that has been requested by the referral source. QA ensures that the report arrives on time.

The Dilemma:

The Dilemma

Insurers have a problem!:

Insurers have a problem! In Ontario insurers have seen their assessment costs spiral primarily due to the number of assessments being generated. This has resulted in: Limiting what is now covered under auto insurance premiums. Implementing caps on how much an assessment can cost. Limits placed on how much rehab will be offered.

HCP have a problem!:

HCP have a problem! Over the last 20 years HCP have experienced significant barriers both professionally and financially. Their professional hourly rates have been highly regulated and are now lower then they were 20 years ago. They can no longer work directly with referral sources and the intermediary companies that do work directly are just getting bigger. HCP are prohibited or at least discouraged from discussing file specifics directly with the referral source. The Big Box Stores have engrained in the industry that HCP are incapable of providing a professional report directly to the referral source without it going through their “quality assurance” process.

You have lost control:

You have lost control

The Solution …:

The Solution …

What is ?:

What is ? D octors O r T herapists for Scheduled appointment and contracted price in

What does DOT mean?:

What does DOT mean? D octor? O r T herapist?

What is DOT?:

What is DOT? D irect O nline T oolki D octors O r T herapists 4

What is DOT?:

DOT is simply a highly efficient way for referral sources to access the best Health Care Providers (HCP) directly. It is giving HCP the opportunity to build their own brands and pride in ownership. It is a model that rewards excellence and gives the responsibility and control of a referral back to the Health Care . Referral sources that believe in the concept that “You get what you pay for” will love the DOT concept. What is DOT? PROFESSIONAL

Business Clustering:

Business Clustering The concept of DOT is based on the principal of small business clustering together to achieve a goal or to take on a large threat. This is not the first time this has been tried in our industry and in fact was highly successful with the creation of the Ontario OT Alliance.

What DOT is not?:

What DOT is not? DOT is not a referral management system. It is meant to enhance the existing systems that are clients have already invested in.

Why Now?:

Why Now? Changes within our industry have reduced overall demand for assessments consequently prices for these services are under pressure. Price Quantity S Q P 1 P 2 D 1 D 2

Business Models have to Change:

Business Models have to Change Health Care Providers are being caught in this price squeeze and as a result quality of services have and are being affected.

Question of Value?:

Question of Value? What is the product that is being sold? Some believe the product is “The Report” and the differentiating factor is the “Quality Assurance” process. Quality Assurance

DOT Philosophy:

DOT Philosophy At DOT we believe that the report is simply a by-product of our true product, which are our experienced and qualified HCP that have been selected for a referral based on their experience and credentialing. If we do not have the proper HCP then we will have to decline the referral. DOT formula: BAD AX = BAD REPORT

Old World:

Old World Product No consistency in product or pricing Dealing with multitude of vendors

Current World:

Current World Product HCP are making smaller % on services that are declining in price.

Where’s the Beef?:

Where’s the Beef? PROCESS PRODUCT PROCESS In the current world most of your funds goes into process, then the product.

Where’s the Beef?:

Where’s the Beef? PROCESS PRODUCT PROCESS DOT directs more of your funds towards the product than the process!

Big Box Store Distractions:

Big Box Store Distractions

Broken Telephone:

Broken Telephone

Minor Injury Guidelines (MIG):

Within the MIG , there is the MIC or M inor I njury C ap which is $3500. MIC could also stand for M ilitary I ndustrial C omplex or in this case the M edical I ndustrial C omplex as it seems that this is what has been built up to support the Medical/Legal industry. What seems to have taken priority over providing a truly multi-disciplinary approach and maximizing the claimants funds is maximizing the funds available to keep the lights on. Minor Injury Guidelines (MIG)

Medical Industrial Complex:

Medical Industrial Complex r esults for Physiotherapy Clinics in GTA.

What if?:

What if? What if a company found a balance between the 100% that HCP used to make and the 50% they are currently making and pay them 75% of the bill. Would this not attract the best and most experienced HCP? What if that company created a system where insurers could access the HCP more quickly and directly. What if that HCP knew that their ability to receive their next referral would be influenced automatically by the quality and timeliness of their report. What if each of these HCP knew that whatever service they were providing was building equity in their own name and company. What if, these HCP promised to always give priority to the referrals they received though your company.

DOT World:

DOT World Product (80%)

Direct Communication:

Direct Communication

DOT Process:

DOT Process The DOT process simply stated falls into two major parts. Direct on-line access Integrated with your internal system Simple to use interface HCP, appointment and contracted price in 30 minutes or less

The Referral:

The Referral Our referral process provides a system where you can have direct access to the best HCP in industry. Tell us of a HCP that you would like to see added to DOT so you can have direct access. Stringent selection process for candidates to become a DOT HCP. Seven criteria, algorithmic selection process to choose final 3 applicants on every referral. Final decision rests with referral source as to which HCP will be selected .

PowerPoint Presentation:

Export 1.Ask 2.Bids 3. Confirm 3.Confirm 2.Bid Review

PowerPoint Presentation:

John Smith (your login) REFERRER DASHBOARD

PowerPoint Presentation:

Cathy Jones (your login) HCP DASHBOARD

PowerPoint Presentation:

John Smith (your login) CLIENT

PowerPoint Presentation:

Benefits to be addressed, etc… John Smith (your login) Type ? Summary? Why? Injury?

PowerPoint Presentation:

John Smith (your login) Why? Attendant Care Who? specialist What? s ervice type Where? L4G 9E5 When? w eek of How (much)? Summary 10% Meta tags Soft Tissue Ax:Multi Type ? Summary? Yes Why? Injury?

DOT ASK:

DOT ASK

PowerPoint Presentation:

Ax:Multi John Smith (your login) Who? OT What? IHA Where? L4G 9E5 When? 06/06/12 Why? Attendant Care $850 How (much)? Therapist $85 $935 06/08/12 2:00p 212 km $950 $95 $1045 Cathy Jones Credentials: BSc.OT Graduation: 1997 Deliverables: 134 On Time %: 95% M6P 2P5 Summary 10% Meta tags Why? Soft Tissue Type ? Summary? Yes Why? Injury?

PowerPoint Presentation:

Decline Confirm Decline John Smith (your login) Why? Attendant Care Accept Confirm Why? Soft Tissue Type ? Summary? Yes Why? Injury? Ax:Multi Email will be sent to all three

A. The Ask:

A. The Ask Referrer completes 5 drop down questions and hits the ASK button. This will access our database of Health Care Providers that best meet the request. Bids Confirm Ask Export Deliverable

B. The Bid:

B. The Bid After receiving an email link, the Health Care Provider (HCP) reviews the Ask. The HCP simply submits a date and time and can revise the baseline price if they so choose. Bids Confirm Ask Export Deliverable

B. The Bid Review:

B. The Bid Review The adjuster will receive the Bids in real time. The adjuster can wait for all Bids to be received or accept a Bid as soon as it arrives. Bids Confirm Ask Export Deliverable

C. Confirmation:

C. Confirmation Once the adjuster has selected the HCP, they will submit a confirmation. This represents a contract between the referrer and the HCP. Bids Confirm Ask Export Deliverable

The Deliverable:

The Deliverable Like in a football game, in order to win we must play well throughout the game. Six factors will ensure a superior deliverable. Our selection criteria combined with free market HCP pride of ownership Superior remuneration DOT priority guarantee Direct communication Revolutionary templates

PowerPoint Presentation:

Delierable Export/HCAI Cheque $1000 Payroll - $750 HCP Invoice $1000 Complete/Incomplete Ax/Tx No Show/Late Canc

PowerPoint Presentation:

John Smith (your login) Deliverable: IHA Date : 08/06/12 Due: 15/06/12 Client: Claribel Arnette Referrer: John Smith Allstate Insurance – Markham HCP: Cathy Jones Ax Status? No Show. Do you wish to reschedule Reschedule? 06/12/12 10:00a me Adjuster? CHART NOTES :

DOT RESCHEDULE:

DOT RESCHEDULE Please click on the following link to see the rescheduling request. Dear Adjuster,

PowerPoint Presentation:

John Smith (your login) Deliverable: IHA Date : 08/06/12 Due: 15/06/12 Client: Claribel Arnette Referrer: John Smith Allstate Insurance – Markham HCP: Cathy Jones Ax Status? No Show. Do you wish to reschedule Reschedule? 06/12/12 10:00a me Approved Adjuster? CHART NOTES :

PowerPoint Presentation:

John Smith (your login) The client did not appear to be substantially disabled. Attendant Care was $0. Deliverable: IHA Date : 08/06/12 Due: 15/06/12 Client: Claribel Arnette Referrer: John Smith Allstate Insurance – Markham HCP: Cathy Jones Ax Status? Complete. Report to follow. Reschedule? date time Adjuster? CHART NOTES :

PowerPoint Presentation:

John Smith (your login) The client did not appear to be substantially disabled. Attendant Care was $0. Deliverable: IHA Date : 08/06/12 Due: 15/06/12 Client: Claribel Arnette Referrer: John Smith Allstate Insurance – Markham HCP: Cathy Jones Ax Status? Complete. Report to follow. Upload report(s) 06/15/12 1234567 Arnette IHA.doc Browse Reschedule? date time Adjuster? CHART NOTES :

PowerPoint Presentation:

John Smith (your login) Deliverable: FAE Date : 08/06/12 Due: 15/06/12 Client: Claribel Arnette Referrer: John Smith Allstate Insurance – Markham HCP: Ed Harris Ax Status? Complete. Report to follow. Upload report(s) 06/15/12 1234567 Arnette IHA.doc 06/15/12 1234567 Arnette FAE.doc Reschedule? date time Adjuster? CHART NOTES : Browse

D. Deliverable:

D. Deliverable Once the Ax/Tx has been completed the HCP notifies DOT of the file status. The HCP will then complete whatever deliverable is required and then upload this to the DOT server. Bids Confirm Ask Export Deliverable

D. Deliverable (Billing):

D. Deliverable (Billing) DOT admin team will generate the invoices* for the HCP based on the status of the file. If the file was a NS/LC the bill will be adjusted accordingly. Bids Confirm Ask Export Deliverable * HCAI

E. Export:

E. Export The report will be exported to the referral source with the invoice if required. An HCAI invoice will also be generated on behalf of the HCP by the DOT admin staff. Cheques are payable to DOT Health acting as the agent for the HCP. Bids Confirm Ask Export Deliverable

Payroll/Receivables:

Payroll/Receivables DOT will manage receivables for the first sixty days for the HCP. Once cheques have been received by referral source, HCP will be paid bi-weekly. DOT will deduct 25% from amount received on behalf of HCP from referral source. Bids Confirm Ask Export Deliverable

Majority Of Doctors Will Use iPads On The Job By 2013:

Majority Of Doctors Will Use iPads On The Job By 2013 Doctors' iPad use growing faster than expected

Adapt or Die:

Adapt or Die In the 2011 movie “ Moneyball ” Oakland A’s manager Billy Beane challenged and entire industry and proved just because something has been done a certain way forever does not make it right. The Boston Red Sox adopted Billie Bean’s system and went on to win the World Series in 2004 and 2007. The last time they won was in 1918.

Templates:

Templates It is DOT’s goal to bring the process of using healthcare templates into the new millennium by designing them to work on mobile devices such as the Phone and iPad . This h as the added benefit of the dictation software that is built right in. Our templates are being designed by HCP following an analytic process that will optimize efficiency and consistency.

Protecting Fees and Standards:

Protecting Fees and Standards In an ever competitive economy, where health care dollars are being rationed, going direct to the customer will be the only way Health Care Providers will be able to protect their fees and their professional standards.

Ask yourself these 3 questions?:

Ask yourself these 3 questions? Do you want to build your own brand or the brand of the Big Box Stores? Do you want the market to reward you according to your experience, professionalism and ability to deliver. Do you want to be in better control of your career?

Ask yourself these 3 questions?:

Ask yourself these 3 questions? Are you differentiating your company from your competitors by using the big box stores? Do you believe the big box stores provide enough value to justify taking 50 to 70% of the bill? Do you believe in the concept of “You get what you pay for”?

What do you think?:

What do you think? Stay tuned!

PowerPoint Presentation:

DOT

Ask yourself these 3 questions?:

Ask yourself these 3 questions? Are you good enough to build your own brand or do you want to continue building someone else’s brand? Are you tired of negotiating prices with an intermediary to make 50 % or do you want to deal directly with the client and make 75% + of the bill? Are my reports good enough to go directly to a customer or must they go through a quality assurance process? Is the QA process worth 25% of your money?

Database Design/Integration:

Database Design/Integration Custom Existing

Referral Process:

Referral Process Cross reference against Export to determine new or existing referral

Databases:

Databases Referrals Interventions (Ax/ Tx ) HCP Clinics Referral Contact Referral Source

User Interfaces:

User Interfaces System : Types; Classes; Pricing etc… HCP: profile update. Adjuster: Ask/Bid: process. Collaboration. Uploading.

Challenges:

Challenges FAEs Multi Timing JSA

DOT Workflow:

DOT Workflow

RMS:

RMS

PowerPoint Presentation:

Bids Confirm Ask Export Deliverable

Presentations:

Presentations Introduction User Interface

PowerPoint Presentation:

Best HCP; Best paid Coverage Multi-Disciplinary Competitive and consistent pricing