The key value proposition of Patient Relationship Management (PRM, also known as CRM, for Customer Relationship Management outside of healthcare) is its ability to enhance financial performance of the clinic by helping retain current and attract new patients. PRM helps providing timely, patient centered, and efficient care, emphasizing preventive instead of reactive care. PRM is a data-driven and patient-focused methodology to strategic practice building and effective patient relationship development.

PRM helps identifying new service needs and then designing care programs and processes for front office and billing functions to meet the needs. PRM system captures patient information during entire period of each care plan in terms of functional health improvement, care plan implementation, and billing.

Patient Relationship Management Concept

PRM is based on a simple concept of monitoring and responding to practice workflow data. Effective PRM integrates key data structures, including patient travel card (SOAP notes), financial care plan, and billing (charges, payments, and balance).

A PRM system tracks changes in the key data structures and generates "alert" reports to office management about patients reaching critical thresholds. The office manager and the doctor review such reports and respond according to practice development strategy, using call centers, Internet, direct mail, or personal conversations during office visits.

Financial Care Plan

Financial care plan is an effective tool for patient loyalty development because it helps the patient to afford the care while establishing a guaranteed cash flow to the provider. Patient loyalty is enhanced because of a financial incentive offered to the patient.

The concept of financial care plan is based on a relative cost difference for the same service during the plan period and outside of it. The patient guarantees certain number of free service encounters by committing to a care plan.

A financial care plan improves the perception of service cost-benefit, because without the plan, the cost for the same number of service encounters would be higher. Therefore, it is important to track the plan for each patient and, upon reaching the end of the plan, begin charging the regular fee.

1. End-Of-Day Report

   End-Of-Day report displays New patients, Visits, Cash, Insurance, Free, Insurance (Billed, Collected), Cash Collected, Missed Appointments, Recalls, Patient Visit Average. End-Of-Day report is the main report of PRM because it allows the manager to reconcile revenues with patient visits, eliminating no-charge visits and unbillable appointments.

   End-Of-Day report also provides an interactive "drill-in" ability to reach Electronic Travel Card and Financial Care Plan.

2. Electronic Travel Card

   An electronic equivalent of a paper travel card (Electronic Travel Card, or ETC) contains complete information about patient's health and care history. It is similar to electronic medical record and subject to same HIPAA compliance regulations. ETC includes:

   • Numbers and dates of visits
   • SOAP notes for each visit
   • ICD-9 and CPT codes
   • Care frequency recommendation summary
   • X-rays and posture images
   
   
3. Financial Care Plan Status Report

   Chiropractic office management system must be able to show status of the financial care plan, including

   • Visits
   • Charges
   • Payments
   • Write-offs
   • Balance

   Note that both the provider and the Front Desk person use the Care Plan Status Report, since the front Desk person must be able to discuss any outstanding balance with the patient upon arrival to the office. Colored display of relevant information helps the Front Desk person to react quickly and effectively to situations that require correction, e.g., bad plan definition dates, missing visit data, or unpaid balance.

4. Care Plan Tracking

   To begin charging patients regular fees or define a new care plan upon care plan expiration, the office must track care plan end dates. Such care plan expiration tracking function is accomplished in two ways:

   • Today's appointment list shows patients with expired care plans
   • Separate report lists patients with expired care plans within a given date range.

Summary

Patient Relationship Management is a catalyst for building successful and competitive chiropractic clinics. Integrated systems, combining data about patient's health, care plans, and billing, are cornerstone for Patient Relationship Management. A disciplined practice manager reviews End-Of-Day and Financial Care Tracking reports daily to monitor and reconcile average patient visits, missed appointments, recalls, new patients, charges, and collections.