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ClaimCare is Alive and Well

  
  
  
  
  
ClaimCare Medical Billing CompanyMark Twain is attributed with saying, “The reports of my death are greatly exaggerated.” We at ClaimCare can now relate to how he must have felt! A small company by the name of Claim Care that helped patients with denied claims (and not associated with us in any way) closed their doors in September 2010. We were not even aware of the group until someone phoned us this week to see if we were still in business. Be assured – ClaimCare is alive and well – and going strong!

Not only are we alive and well – we are continuing to keep on the cutting edge of information and key technologies to collect the maximum allowable revenue for our clients while alleviating costs and hassles for their offices. We look forward to continuing to serve all of our existing and new clients in 2011 – and beyond!

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

Medical Billing Update: Hold Medicare Claims or Submit Them?

  
  
  
  
  
medical billing medicareClaimCare, Inc - June 15, 2010 - According to various media reports from Washington, action will come too late regarding the June 6 Senate announcement that it is ready to initiate a 19-month Medicare "doc fix." This means cash-flow problems will affect doctors across the country. Senator Charles Schumer (D-N.Y.) said at a press conference that the Senate is expected to have 60 votes to pass the bill "early next week (week of June 14)." But even if the votes come then, more than likely it will take several days for the bill to be passed by the House and signed into law by the President.

On Monday, June 14th Medicare responded to this continued delay by Congress by deciding that it will extend its freeze on processing claims with June dates of service until Friday, June 18th. It is possible that Congress will reverse the massive Medicare fee reduction by that date. Given, however, the time line outlined by Senator Schumer, it is unlikely the fix will be completed by that time.

So, on Monday, June 21st, Medicare may well begin processing June 2010 claims using the 21.3% fee reduction that went into effect on June 1. However, it appears highly likely that within two weeks Congress will retroactively reverse the fee cut. This will result in Medicare claims being reprocessed, causing new "make-up payment" problems for providers. It is a situation that leaves providers to ask some important questions - and to make some important medical billing decisions.  

Question/Decision #1:  Should your medical billing department continue submitting your Medicare claims as usual - or should you hold them until Congress eliminates the 21.3% fee reduction?

If you submit your claims as usual, then you will receive payments as usual - but at the reduced fee rate. When Congress does eliminate the fee reduction, you will have a lot of work to do when Medicare reprocesses your claims. This work includes auditing to ensure Medicare has indeed made all of the make-up payments they should. It also includes responding to patients' questions and concerns about receiving two Explanation of Benefits (EOBs) from Medicare regarding their charges. The situation will be exacerbated when Medicare automatically crosses these lower-paid claims to secondary insurance payers. EOBs and payments involving secondary (and possibly tertiary) insurance payers will cause further confusion and complications for your office - and  for your patients.

If you hold your Medicare patient claims and then submit them after Congress passes the "doc fix" bill, you will not get hit with the 21.3% cut - but you will get paid later than usual. You also will have a much simpler time in terms of ensuring all payments are correct from both Medicare and secondary payers. Also, patients will receive only a single EOB for the dates of service during this "waiting" time period.

Question/Decision #2:  Should you collect co-insurance from Medicare patients under the fee schedule that was in place prior to June 1, 2010 - or under the significantly reduced fee schedule?

If you collect patients' 20% Medicare co-insurance under the reduced fee schedule and the reduction is reversed by Congress, then under Medicare rules you will need to bill patients for any extra amount they owe over $5.00. (You are not forced to try and collect balances that will cost more to pursue than will be yielded in revenue). This will lead to additional expense and patient confusion.

On the other hand, if you collect co-insurance amounts in accordance with the pre-June 1 fee schedule and Congress does not reverse the fee reduction, then you will need to reimburse patients any overpayments greater than $5.00. (The same financially reasonable principle applies to patient refunds.) Since it is unlikely that the fee reduction will stand, this is an unlikely outcome.

Question/Decision #3:  Most likely, you have already filed some June 2010 Medicare patient claims. These will start being processed on Tuesday and will generate many of the issues mentioned above. (The decisions you make now regard being able to minimize the complications rather than being able to avoid them completely.)  These already-filed claims force you to ask and decide: Should you bill patients and secondary insurance payers for the June 1 to June 14 dates of service you submitted (and for which Medicare will begin receiving payment over the coming days) or should you wait for these claims to be reprocessed and paid correctly after Congress reverses the 21.3% Medicare fee cut?

The pros and cons outlined for the questions/decisions in #1 and #2 also apply to #3. If you proceed with billing patients (and secondary insurances that do not automatically cross over), you will have confused patients who receive an initial statement from you and then receive a second statement from you for additional money after Congress retroactively reverses the fee cut.   

On the other hand, not billing patients and secondary insurances until after Congress acts will delay your collections - but will lead to much less patient and office confusion.

My Recommendation:  Every practice must make its own decision about these issues, but a decision must indeed be made. If you can handle the temporary cash flow reduction, then my recommendation is:

  1. Hold your claims until Congress retroactively reverses the Medicare fee cut;
  2. Collect patient co-insurance under the pre-June 2010 fee schedule;
  3. Do not bill patients or secondary insurance for the June 1, 2010 to June 18, 2010 dates of service for which you will start receiving payments over the coming days. Instead, bill the patients and secondary insurances after these dates of service are reprocessed when Congress reverses the Medicare fee cut.

This approach will minimize confusion in the practice and among your patients. It will also minimize the chance you are underpaid for your claims.

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

Medical Billing Update: July 6 PECOS catastrophe fast approaching

  
  
  
  
  
medical billing pecosUntil recently physicians believed that they had until January 3, 2011 to comply with Medicare's PECOS enrollment requirement. This is no longer the case. In May Medicare announced that a new mandate from the health system reform law forced the deadline to be moved up by 6 months. Starting July 6, 2010 if the physicians that refer to your practice are not properly enrolled in the Provider Enrollment Chain and Ownership System (PECOS) then your cashflow will be interrupted. If a claim is submitted to Medicare after July 6th with a referring physician that is not enrolled in PECOS, then Medicare can reject the claim. This means that your practice needs to work with your referring provider base and ensure that your referring providers are enrolled in PECOS. This is a much higher burden than the more typical medical billing situation where a provider only needs to ensure the he or she is enrolled with a payer.

In order to mitigate any risk to your practice's cashflow you need to:

  • Generate a report of your top referring providers,
  • Call and check the PECOS system to confirm that your practice's key referrers are properly enrolled (you will need basic information about the providers such as name, tax ID or provider ID),
  • Contact any referring providers that are not properly enrolled with PECOS and make certain they know: 1) they are not enrolled with PECOS, 2) why it is critical that they enroll with PECOS, and 3) how to quickly enroll with PECOS (to eliminate any delays on their part in finalizing their enrollment), and
  • Send thank you notes to all of the providers that are enrolled with PECOS (this is a great way of showing them how much you value their referrals).

With all of the healthcare bills and Medicare cuts taking up mind share and discussion time, it would be easy to miss the critical PECOS medical billing deadline and find that the 21% Medicare fee cut is one of two big reimbursement problems. Take action TODAY to ensure your practice's cashflow.

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

The June 1 Medicare Fee Cut - The Medical Billing Dance Continues

  
  
  
  
  

Medicare Fee cutPhysicians continue to see their collections, cashflow and emotions whipped around like a rag doll in the mouth of a rottweiler. Congress failed to act before the June 1, 2010 deadline. Once again physicians are "officially" under a new Medicare fee schedule that has an average reduction of over 21%. In reaction, Medicare will once more hold claims for the first 10 business days of the month (for June dates of service).

Physicians are being told that this 10 business day hold will have a minimal impact on their collections. This is not accurate, however, since Medicare is not holding the payments for 10 business days; rather they are holding the processing of the claims for 10 business days. It makes sense to hold the processing since if Congress negates the 21% pay cut then Medicare would need to reprocess the claims. This approach means, however, that at the end of the ten business day hold, Medicare will drop the full amount of held claims into the processing hopper and then the normal time line will begin (in other words, do not expect a big Medicare check on June 15th - which is the 11th business day of June). The bottom line is that unless Congress acts swiftly and thus Medicare begins to swiftly process claims, most physicians will see a big dip in their Medicare collections in June (since the payments typically seen in the last two weeks of a month are from dates of service in the first part of the month).

Here is the full text of the Medicare announcement (from the Trailblazer Website):

"The Continuing Extension Act of 2010, enacted April 15, 2010, extended the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. CMS believes Congress is working to avert the negative update scheduled to take effect June 1, 2010. To avoid disruption in the delivery of health care services to beneficiaries and payment of claims for physicians, non-physician practitioners and other providers of services paid under the MPFS, CMS has instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of June. This hold will only affect MPFS claims with dates of service on or after June 1, 2010.   This hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt.   Be on the alert for more information about the 2010 MPFS update."

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

What is the best medical billing fee structure for old AR clean-up?

  
  
  
  
  
old AR clean-up, denial managementYou may be faced with multiple fee options if you are considering seeking help with your old AR clean-up and denial management. Many medical billing companies will charge a very high percentage of what they collect (over 35%). Others may offer a fixed fee approach. Which is best for your practice?

As is so often the case, the best answer lies between these two options. One of the weaknesses of a high percentage of collections with no fixed fee is that the medical billing company doing the old AR clean-up has no incentive to pursue smaller claims. It will cost well over $20 for each old claim worked by the medical billing company. This means that any claim under $100 will not provide much profit for the company and will likely be ignored. This is an issue because many of the older AR claims are these smaller claims.

The fixed fee option, however, has its own problems. The problem with a pure fixed fee pricing model is that the medical billing company has no real incentive to collect as much money as it can. The company is being paid a flat fee; if it can write off a claim it will cost the company less but, of course, cost the medical practice more in lost revnue. In addition, under a fixed fee model, the medical billing company has an incentive to take a long time to work the old AR - the longer they work, the more they make.

A hybrid model of a moderate fixed fee and a moderate percentage of collections provides the best of both worlds. The fixed fee component makes it economical for the medical billing company to pursue smaller claims. The percentage of collection means the medical billing company will profit from collecting every dollar that it can (and thus does not have an incentive to just write-off claims).

Proper alignment of incentives between the practice and the medical billing company cleaning up your Old AR is critical. A mixed pricing model provides the alignment of incentives that is required for the best overall results for the practice.

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

Medical billing offices need a helping hand every now and then

  
  
  
  
  
old ar clean-up denial managementMedical billing offices / Managers often find themselves in need of extra "helping hands" for a variety of reasons including:
  • The loss of a key employee (either temporarily or permanently);
  • A backlog of old AR that has become so large that no one is quite sure how to tackle the problem;
  • Growth of the Practice, but the billing staff is the same size.
  • Expanding / opening a new office location;
  • Problems with current billing system or installing new EMR/system that causes extra work.

In these types of situations it is critical that the medical billing office / Manager and the medical Practice become willing to seek help - even if it's just temporary, short-term help.  Trying to claw out from under these situations without outside help can be overwhelming.   And the strongest billing offices / Managers know there is no shame (in fact there is great wisdom) in asking for a temporary "helping hand" during crunch times.

If you are considering seeking extra / temporary help, what type of help should you pursue?   You want help that meets the following important standards:

  1. The extra help can be given quickly, but does not require a long-term commitment on your part. In other words, when you are out from under the immediate crisis, you can stop using the outside resources / medical billing company.
  2. The extra help team members are true experts in the medical billing industry and they have access to the most current billing codes and requirements. In other words, don't hire "Aunt Matilda who does medical billing part-time out of her home office now and then for a little extra cash."
  3. The "extra hands" help causes minimal interruption or risk to your current cash flow and processes. For example, it is very high risk to use "pinch hitters" to do your up-front data entry work. If they fail, then your cash flow for the Practice will stop. On the other hand, applying "extra hands" on older claims and AR minimizes risk and complications because this work requires less system access, does not jeopardize the new claims that are going out daily, and requires less familiarity with the nuances of the Practice's operations.
  4. The help provides EXTRA value beyond the immediate crisis, and gives you the best bang for your buck. True medical billing Experts bring a fresh eye and state-of-the-art knowledge about the billing industry. They can give you honest feedback and keen insights about your Practice that enable you to improve collections, test out new technology to assist your staff, and provide a general level of relief that will allow the Practice to avoid future pitfalls and crises.

The best way to achieve these objectives is to find an outside company who will work the AR that is over 60 days old.  This will:

  • Allow the Practice's current billing staff to keep getting current claims out the door fast and clean to ensure the Practice's revenue remains steady and strong;
  • Pin-point the source of much lost cash flow and give relief to the Physician's greatest point of aggravation - old AR. No medical billing Manager ever gets in trouble with the physician because all of the AR is under 60 days!! But many a medical billing office / Manager had to face the wrath of a Physician because a large backlog of old AR has started to build up in the 120+ bucket.
  • Give the Practice / Office Manager a lot of valuable feedback on the specific issues that led to the old / high AR in the first place. Are certain codes or payers causing issues? Is there a credentialing or system set-up issue? Are there denials that are not being properly pursued? Are there denials being left on the books that will never pay and are simply creating "false AR?" The feedback from the Old AR clean-up can be invaluable in helping the Practice and the medical billing Manager make changes to prevent the old AR from ever becoming a problem again after it is cleaned up.
  • Demonstrate new reports and follow-up tools to make it easier for the billing office / Manager to do their job well. Most of the medical billing companies who provide Old AR clean-up services also utilize sophisticated reports and follow-up tools that are valuable to the Practice. Seeing firsthand how these tools work may provide insights into how the Practice could leverage them to prevent future crises.

In summary, knowing when to seek help and being strategic in the type of help you employ can turn a potential disaster in to a triumph that will delight physicians, provide immediate relief for the medical billing office / Manager and set the Practice up for on-going medical billing and collections success.

Follow this link to see an example of an AR clean-up and denial management service that can assist medical billing offices in crisis.

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

Motivation: Always try just one more time

  
  
  
  
  

motivation   Mark Twain said, "The only difference between a tax man and a taxidermist is that the taxidermist leaves the skin."  That's the way many small business owners feel nowadays, with proposed increases in taxes, along with mandates and increases in health insurance.  Just the other day, one business owner reminded me of the Will Rogers quote, "The difference between death and taxes is death doesn't get worse every time Congress meets."

   In the midst of the tax and health care "reforms" and the economic situation, I received an article earlier this week containing a survey reporting 70% of employed Americans are afraid of losing their jobs.  So, it is important during times such as these that we not only draw upon humor from great wits like Mark Twain and Will Rogers, but also draw from such quotes as Thomas Edison's, "Our greatest weakness lies in giving up.  The most certain way to succeed is always try just one more time."  Reminds me of the story of George Washington Carver...

   I vividly recall reading Carver's biography in one of those orange, hardcover books available in our elementary school library.  (I wrote a column several years ago about how much I enjoyed and benefitted from this great series of children's books.)  Carver grew up at the close of the Civil War in a one-room shanty on the property of Moses Carver, the man who owned Carver's mother.  He and his mother were abducted from Moses Carver and sold to new owners.  The boy was later found and returned to Moses Carver, but his mother was never seen again.

   Rising from slavery, George Washington Carver became one of the 20th century's greatest scientists, and his influence is still being felt today.  He devoted his life to understanding nature and the many uses for plants.  He is best known for developing crop-rotation methods for conserving nutrients in soil and discovering hundreds of new uses for crops such as the peanut and the sweet potato.  His work and the manner in which he lived his life led to his becoming one of the most respected people in U.S. history.

   However, in the beginning of his work, after he recommended farmers should plant peanuts and sweet potatoes instead of cotton, he suffered his greatest trials.  The farmers lost even more money than they were losing with cotton due to the lack of a large market for peanuts and sweet potatoes.  Carver cried out to God, "Mr. Creator, why did you even make the peanut?"  Many years later, he shared that God led him back to his lab and worked with him to discover some 300 marketable products from the peanut.  Likewise, he made over 100 discoveries from the sweet potato.  These new products created a big demand for peanuts and sweet potatoes, and they were major contributors to rejuvenating the Southern economy.

   Carver arose early each morning to walk alone and pray.  He asked God how he was to spend his day and what God wanted to teach him that day. As he progressed and developed the many products that benefitted mankind and won him renown, he also turned down many offers - such as a six-figure income opportunity from Henry Ford.  He felt he was doing what God wanted him to do and doing the thing that would most benefit the people of America and the world.  George Washington Carver was the epitome of someone who lived by the quote later uttered by Edison, "...always try just one more time." 

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About our guest Blogger:

© Carl Mays, father of ClaimCare CEO Carl Mays II, is an author and speaker at over 3,500 events.  Contact Carl at carlmays@carlmays.com or 865-436-7478.  His motivational speaking and book information can be found on http://www.carlmays.com/.  The Student Mentoring site MyMerlin.Net for students and others is based on his book and program, "A Strategy For Winning."

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Medical billing collections will suffer no matter what Congress does

  
  
  
  
  

medical billing companiesEveryone in the medical billing field is hopeful that Congress will act to defer (and ultimately eliminate) the proposed 21% fee reduction for Medicare.  Keep in mind, however, that March 2010 collections will likely suffer a delay even if the fee cut is deferred.  The coming months will be a challenging time for medical practices and medical billing companies.

In January 2010 Medicare had a 2 to 3 week delay in processing claims because they needed to update their system after Congress deferred the 21% Medicare fee reduction.  As of today, Medicare is still catching up in their claims processing (a fact that have not officially acknowledged).  ClaimCare found that as of February 23, 2010, Medicare was still at least a week behind in their typical claim processing time frame.  And this level of a delay happened when Medicare had plenty of advance warning concerning the deferral, so you can imagine what delays could result when they have less advance notice.  In addition to this delay, Medicare had a system problem that resulted in multiple weeks worth of secondary claims not crossing over properly.  This Medicare system problem has compounded the delay in collections.

There is every reason to expect another delay in Medicare payments in March 2010 if Congress issues a last-minute deferral of the 21% fee reduction.  Based upon past evidence and experience, if Congress does issue a deferment, we anticipate a 2 to 3 week delay in the Medicare claims processing and payments.  Therefore, when thinking about your cash flow for March 2010, you should plan for at least an additional 2 to 3 week delay for Medicare payments.

If Congress decides to delay the fee reduction for only 30 to 45 days (as they are considering), then this problem will be repeated and exacerbated in April if they pass yet another last-minute deferral.  Practices and medical billing companies need to plan on Medicare collections being less predicable and fairly erratic over the next few months.  As I stated earlier, this is a challenging time to be a medical practice or a medical billing company.

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Copyright 2010 by Carl Mays II. Carl is President and CEO of ClaimCare Medical Billing Service, one of the largest medical billing companies in the United States.

Motivation: Renew Your Spirit and Make the Climb

  
  
  
  
  

Motivation   Former University of Florida quarterback Tim Tebow became a hot discussion topic when Denver Broncos coach Josh McDaniels selected him in the NFL draft. Many of the comments have been of a very sarcastic, critical nature, such as one sportswriter demanding, "Fire Josh McDaniels for drafting a team chaplain in the first round." Only time will reveal the outcome of the selection, but the entire situation led me to think about hearing the late Dallas Cowboys coach Tom Landry say, "We're looking for character, not characters."

Regardless of any other talents and qualities one may possess, character often means the difference between life and death - of an organization or a person. I recall a "character segment" from the classic Lawrence of Arabia film. T.E. Lawrence, a British Army lieutenant during World War I, is leading a group of men across the Nefud Desert, considered impassable even by the Bedouins. Traveling day and night during the final stretch to reach water, they find an oasis. As the men celebrate and splash in the water, Lawrence discovers a riderless camel. The man apparently had fallen off during the night.

   Lawrence says, "We must go back and find him." But no one agrees to join Lawrence. They plead with him not to go, saying it is God's will he did not make it, that his fate was written by God. "We must not interfere," they declare.

   Lawrence climbs on a camel and heads back into the desert alone. The men shake their heads and say, "Now we have lost him, too." Two days later, a shimmering image emerges from the heat wave stretched across the sand dunes. The men stare, wipe their eyes, and stare again. Finally, someone yells, "It's Lawrence! He has found him!" They run toward Lawrence. He hands the unconscious survivor to them, looks into their faces and hoarsely whispers, "Remember this: Nothing ‘is written' unless you write it."    

   Has today's whole economic, social and political turmoil slapped you down? Is it now trying to "write you off?"

   J.C. Penney is a name well-known to most of us. He launched his chain of "The Golden Rule" department stores in 1907. His first wife died in 1910. He incorporated as the J.C. Penney Company in 1913. His second wife died giving birth to a son in 1923. The stock market crashed in 1929, and he lost $40 million.

   By 1932, J.C. Penney had to sell out to satisfy creditors, leaving him virtually broke. His spirit was crushed from his losses and his health began to fail. He ended up in a sanitarium. One morning while there, he heard the distant singing of employees who gathered to start the day with a chapel service. The words were, "Be not dismayed, whatever betide, God will take care of you. Beneath His wings of love abide, God will take care of you....."

   J.C. Penney followed the music to its source and slipped into a back row. He left a short time later a changed man, his health and spirit renewed, ready to start the long climb back at age fifty-six. By 1951, there was a J.C. Penney store in every state, and for the first time sales surpassed $1 billion a year.

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About our guest Blogger:

© Carl Mays, father of ClaimCare CEO Carl Mays II, is an author and speaker at over 3,500 events.  Contact Carl at carlmays@carlmays.com or 865-436-7478.  His motivational speaking and book information can be found on http://www.carlmays.com/.  The Student Mentoring site MyMerlin.Net for students and others is based on his book and program, "A Strategy For Winning."

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The good, the bad and the ugly surround us

  
  
  
  
  

motivation communication

   The Good, the Bad and the Ugly is a 1966 epic western film starring Clint Eastwood, Lee Van Cleef and Eli Wallach in the title roles. One of the most popular and well-known westerns made, the film is regarded by many critics as a classic. It was one of Time magazine's "100 Greatest Movies of the Last Century." I explain all of this because Jean and I quite frequently refer to experiences, situations or people as The Good, the Bad and the Ugly.

   The descriptive phrase came to mind earlier this week as I was reading a sports reporter's perception of a football game. The writer described one player as doing a "good" job in fulfilling his responsibilities. He then quoted a coach who said a player made a "bad" decision. The writer went on to quote another coach who said it was an "ugly" win.

   And then yesterday, as I reclined in a hospital bed awaiting the endoscopy procedure I get the pleasure of experiencing every five years (tongue-in-cheek), a nurse who was looking at information on a form asked me what I do as CEO/president of Carl Mays' Creative Living, Inc. When I told her I am a professional writer and speaker, she asked me what I write and speak about. I explained my specialization is in human relations, motivation, leadership, teamwork, communication and performance improvement. I then added I have spoken to quite a number of healthcare groups, including hospitals.

   The nurse responded, "I've been to some meetings like that." She paused and then continued, "Do you think that type of thing really works?" I replied, "Well, do you think what you do as a nurse really works?" She looked at me with sort of a deer-caught-in-the-headlight expression, and then nodded her head and said, "Yeah." I told her, "Your job works if you are a good, professional nurse who knows what you are doing and if the patients with whom you work are cooperative and come in with the right attitude. Am I right?" She nodded and said, "I guess so." I continued, "The meetings we're talking about work if you have a good, professional speaker who knows what he or she is doing and if the people who attend the meeting come with a cooperative spirit and the right attitude." The nurse said, "I guess you're right." I replied, "Well, I've made over 3,500 presentations - so either it works or I've been able to pull the wool over many people's eyes through the years." She nodded her head and said, "Good point."

   After a pause, the nurse commented, "But, you know, it won't work if the leaders don't buy into. You've got to have support from the leaders if it's going to work." I replied, "There is always a ladder of accountability - from the top to the bottom and from the bottom to the top. Every leader on every level and every team member on every level, who is accountable for tasks and responsibilities rather than making excuses or blaming others, is a part of the solution and not a part of the problem."

   The nurse nodded her head and said, "You're right." And then, I thought of the phrase that had been brought to mind earlier during the week and told her, "But in every organization of any kind, you always have The Good, the Bad and the Ugly." She laughed and nodded her head.

   My gastroenterologist was pleased with the results of my endoscopy - and, thus, so was I. Next week, I have the opportunity to experience my five-year colonoscopy. The saga of The Good, the Bad and the Ugly continues.

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About our guest Blogger:

© Carl Mays, father of ClaimCare CEO Carl Mays II, is an author and speaker at over 3,500 events.  Contact Carl at carlmays@carlmays.com or 865-436-7478.  His motivational speaking and book information can be found on http://www.carlmays.com/.  The Student Mentoring site MyMerlin.Net for students and others is based on his book and program, "A Strategy For Winning."

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