A Psychiatry Practice That Started Off Running
Meet Brian O'Neill, PMHNP-BC
Brian O’Neill was getting his Registered
Nurse certification just before he decided to
start his own solo practice as a PMHNP in
Wyoming. Having started a practice in a rural
area, Brian O’Neill recognized that there were
not many psychiatrist in the area, and felt it
would be a great place for him to practice. He
now provides service for a number of mental
health disorders.
About the Practice
Founded in 2012, Beartooth Brainworks is
a private practice in rural Wyoming. Brian
O’ Neill serves 500-600 patients diagnosed
with a variety of mental health issues
including ADD/ADHD, sexual abuse trauma,
schizophrenia, and bipolar disorder.
The Business Challenge
Brian O’Neill became certified as PMHNP in
Wyoming before starting Beartooth Brainworks
in 2012. In his previous position at a hospital,
he was inundated in paperwork and battled a
poorly structured internal process. There almost
seemed to be “built-in inefficiencies,” he said,
like when things “could have been resolved in a
call, but nurses would still have the patient come
in.” Lamenting that there was “too much distance
between the provider and patient,” O’Neill set his
goal of “bridging the gap” to improve patient care.
When O’Neill decided to open up his own practice,
he knew that the first step to bridging the gap
between patient and provider would be to take
control of every aspect of his practice. As a solo
provider starting on his own, he needed a practice
management software that would not bog him
down with various administrative tasks, and help
keep his practice running efficiently. Soon after
opening his practice in 2012, O’Neill realized that
managing the backend tasks of his practice like
credentialing and enrollment were taking months
for him. He also had to catch up on billing at the
end of every week. Worst of all, these tasks were
getting in the way of quality patient care. That’s
when he turned to DrChrono’s RCM team for help
The Solution
DrChrono’s all-in-one integrated EHR and Billing
Platform provided O’Neill with practice management
tools and advanced clinical charting features to
help manage everything from patient care to billing.
As for his billing challenges, O’Neill has partnered
with DrChrono’s RCM team who manages his entire
backend needs. Since then, his practice has been
able to maintain a higher net collections rate, and he
enjoys a great work-life balance. He has effectively
closed the gap between provider and patient,
and he’s happy to spend the majority of his work
hours visiting clients. He now enjoys the flexible
work schedule that rarely comes with running an
independent business, and is still able to make more
time for patients when they need him.
How O’ Neill Set Up DrChrono To Run an Entirely Independent Practice with No Staff Support
Workflow Optimization
With customizable clinical forms and tools, DrChrono
EHR was an easy choice for Brian to integrate into his
practice. He has been able to utilize speech-to-text
and copy from previous notes, “because in psychiatry
there’s a lot of stuff that continues to flow through”.
At the end of the day, he spends minimal amounts of
time polishing his notes and wraps up his work.
Sending notes when needed was incredibly easy
and saved him lots of time wasted running back
and forth. Being in a field that deals with sensitive
circumstances, O’Neill has been in a few depositions.
“The notes fit all the requirements for the legal side
of what we need to do, and it’s been really nice,
how it’s set up it’s really easy for the attorneys to
go through which makes my life easy because then
they don’t have to do much questioning … easy for
them to read, easy for me to testify....”, the tools
available make it easier for him to help patients in
circumstances that many providers are not
familiar with.
Providing Higher Quality Care
Other tools that help O’ Neill bridge the gap between
patient and provider are the secure messaging,
mobile EHR and e-prescribing features.
Secure messaging enables him to work with patients outside of the office, allowing patients to
reach him at
any time which is particularly important for the types
of patients he treats, who commonly suffer from
anxiety or bipolar disorder.
O’Neill has also been able to create a comfortable,
welcoming patient experience using only an iPad. He
simply sits down on the couch with the patient while
charting on his iPad, sometimes without the patient
even realizing it. The conversations flows naturally,
and feels not only personal, but also safe, which is
especially important for O’Neill’s patients.
In addition, e-prescribing accessible by mobile
devices enhanced his patient care. From refill
requests to pharmacy lookup, he can even help
patients when they head out of town.
“One of the coolest things about
[e-prescribing] is say a patient goes and
travels, forgets their medication, they call
me from California... I say give me [the]
address… we go to search… 3 blocks
down, 2 blocks over, I sent your prescription
there, so you’re good to go. Boom.”
“Hands Off” Billing Management
For the first several months after starting his practice,
O’Neill had been managing his billing in-house,
which became increasingly difficult to maintain as his
practice began to take on more patients. Frustration
began to surface as he went through the certification
process. He did not have time to spend on menial
tasks, once he implemented RCM into his practice,
his problems were taken care of for him. In his own
words, “I was trying to get it done for three or four
months … I was like, these guys are the bomb, which
is fantastic because this was a freakin’ nightmare!”.
The DrChrono RCM team implemented processes
that allowed him to submit claims with a fast
turnaround. In a matter of weeks, his billing cycle
had become fully implemented. O’Neill upgraded to
the DrChrono RCM plan to have the ability to see
more patients and provide higher quality care. His
billing performance compared to industry averages
reinforces his believe that DrChrono RCM was the
best decision for his practice.
Days in AR: 26.36 days (average 35-45 days)¹ Conclusion
Claims get submitted by his team twice a day, and
billing statuses are effective for minimizing back and
forth, getting O’Neill paid sooner than most practices
in his specialty.
Clean Claim Rate 99% (average 95%)¹
Dedicated claim scrubbing for each claim ensures
that claims are submitted accurately and are pushed
through as quickly as possible, giving O’ Neill an
excellent CCR that beats out his colleagues.
NCR: 96% in 2016, 94% in 2017 (average 94-97%)1
O’Neill’s RCM team has maximized his adjusted
collections consecutively every year. Every claim
is reviewed by coding specialists and claims are
submitted with the highest tier codes possible to
ensure maximum reimbursement.
Cloud-Based Accessibility
O’ Neill loves having the ability to be accessible to his
patients anywhere around the world. With DrChrono’s
full featured mobile EHR, all he needs is his iPhone
or iPad and cell service. He is able to stay ahead of
his workload even as a solo provider because he can
access his patients’ medical record, document a full
patient encounter, sign off on it and lock the note
wherever he is. DrChrono’s RCM team then simply
bills right to the insurance company.
Conclusion
Since partnering with DrChrono nearly six years
ago, O’ Neill has barely had to make any changes
to his scheduling, charting, or billing profiles. His
encounters feel completely natural, his charting
is complete, and billing succeeds with hardly any
intervention on his part. By streamlining these internal
workflows he has succeeded in “bridging the gap”
between provider and patient, and offers quality
patient care he can be proud of. DrChrono EHR has
proven to be the virtually “hands-off” solution O’
Neill needed to manage his administrative and billing
work as a completely solo psychiatry practice, now
handling over 500 active patients spanning over three
locations with only a four day work week.
“I’m really busy [seeing patients], I’m
completely solo, and I can do all this stuff
on my own and I’m still surviving. I’m not
buried under paperwork… I basically only
work four days a week, and travel when I
need to and want to, and DrChrono enables
me to do that.”