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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.
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.”