Archive for category: Articles

The JOY of Work

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The Joy of Work - Staffing firms - The Avery DifferenceEmployees are motivated to go above and beyond while having fun

Ask any staffing firm, big or small, what its top challenge is. Not surprisingly, the answers are identical: Finding people with the right skills given the scarcity of talent. Organizations – including staffing firms – are facing one of the largest talent shortages since 2007 with the US unemployment rate at 4.1% in February. Firms are all vying for the same talent. So when staffing firms find the right internal workers, what do they do? Engage them. Here’s how.

For the ninth time, Staffing Industry Analysts surveyed employees of staffing firms to see the approach these companies are taking. The winners on this year’s “Best Staffing Firms to Work For” list are committed to creating an environment that helps their workers reach their potential, professionally and personally. Gone are the days when it was just about careers and 80-hour workweeks. Staffing firms must adopt a holistic approach that extends to the home. The successful staffing firms are those that allow employees to take off early to watch their kids’ baseball games or be there for a piano recital. Of course, it’s understood that employees meet their deadlines before taking off.

The Avery Difference

At Avery Partners, we are different in that we take all the risk. We meet each of our candidates face to face for the interview to make sure they are the best fit for the job. These candidates are also OUR employees. We manage all their paperwork, applications, check references, federal verification and tax forms, background checks, drug screenings, pay-records, taxes, etc. This takes the hassle off your company and staff so that you can do what you do best.

Please contact Jennifer Hall for more information at the office (770) 642-6100 x237 or email

No Signature Required for Credit Card Transactions

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No signature required on credit card transactionsThe card networks have agreed, starting in April 2018 MasterCard, Discover, American Express, and Visa will no longer require signatures for credit card transactions that use chip or contactless payment solutions. While the transition to EMV chip and contactless payments has not been required, those merchants who have updated their terminals to this technology can benefit by not requiring signatures from their customers. Merchants will still have the option of asking for a signature, but the requirement will no longer be in place.

The card networks have seen a decrease in fraud with the rollout of EMV-ready technology of both terminals and cards. Additionally, fraud fighting and tracking capabilities have greatly improved. These advancements and the general consensus that merchants are not actively comparing signatures on receipts to the back of the card or photo identification, have led to the removal of the signature requirement.

How will this really work?

The change may take some time for consumers and merchants to get used to. The many years of card transactions and signing the receipt is a hard habit to break, and it will take time to do so. Consumers may still feel the need to sign, and merchants may still want signatures on receipts, especially on higher sales transactions. The benefit for all is a faster checkout experience. One of the complaints about the EMV chip transactions is that they take longer to process. This process has improved, and now the removal of signing the receipt will allow transactions to be completed faster which will shorten checkout lines.

As consumers become more accustomed to not signing a receipt, the rollout of EMV chip technology will increase, as they will expect the functionality from the merchant and their card issuer. So, those merchants or card issuers who have not converted may feel pressure to complete the upgrade. Further rollout of EMV technology will further reduce fraud in the face to face environment.

Jennifer Autian is the founder of TCA Business Solutions and an independent representative of merchant services. To learn more about EMV technology or explore other payment processing options, connect with her at 678-523-8760 or by email at

Do I really need a 0% Abandonment Rate on my Appointment Calls?

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We’ve all been there…

For me, it looks like this: I’m sitting with my phone to my ear, ready to talk about my reason for calling, eagerly waiting for someone to answer.

efficient call abandon rate

And after what seems like an entire lifetime (probably 7 minutes), while I’ve started multi-tasking a few other things, I forget why I was on the line in the first place. And with much anger or at least a little consternation, I hang up.

Its critical for us to empathize and remember that behind that (1) abandoned call added to your stats today was the pain in the neck experience (and likely Twitter rant) for that one caller today- this can become a huge issue.

Luckily, you can tackle the dilemma of callers hanging up before your agents can help them by learning about your abandon rate and queue times.

We recommend your abandon rate be anywhere between 4 – 8 %. Having a 0% abandon rate is inefficient and unnecessary, and having an abandon rate over 8% will likely affect your satisfaction rating negatively.

So, with an abandon rate between 4 – 8%, you can still have a high satisfaction rating without inefficient and costly over-staffing of your team.

By tracking and investigating your average abandon queue time you can solve just about any abandon rate issues your team might have.

It’s easier to solve an abandon rate that’s lower than 4%. Look at your abandon queue time (the time before a caller hangs up) and make sure to answer any calls right before the majority of your callers have hung up historically. In this situation, it is likely that your team is answering the line sooner before your callers are tired of waiting and hang up.

Keeping those callers on hold just a little bit longer will probably not lower your satisfaction rating. And more importantly, you will have an efficient, perfectly-staffed team.

The harder part is solving the issue of an abandon rate that’s higher than 8% where callers are hanging up before anyone is available to engage. The short answer to this is to hire (and train) more staff.
While you’re getting your new agents up to speed, you’ll likely still have callers who hang up before your team can assist or callers who end up waiting around for ages looking like this.

Sometimes a more creative route is to find ways to keep callers waiting on the line longer. You can do this by changing up what customers hear while they wait for your team to answer.

For example, some organizations will play automated messages (a health insurance line reminding callers to get vaccinated during flu season).

So, if your team is experiencing abandon rate issues and doesn’t know where to start- here’s the breakdown.

First, identify whether your abandon rate is lower than 4% or higher than 8%. Then, use your abandon queue time to decide whether you need to allow your team to work more efficiently, hire and train more staff, or making changes to what your callers hear while they’re on hold.

After these changes, you’ll be on a path for happier customers and more efficient employees.

Paul Mancini
Clear Choice Telephones, National Accounts

Lease Renewal – An Opportunity Not Always Taken

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HealthOne Realty

Opportunities present themselves in many forms. A lease renewal represents a perfect opportunity for a practice to analyze the operation of an office and to reduce occupancy costs, which generally represents the second largest practice expense next to personnel. Such a large number on your income and expense statement should be an inviting target but many practices do not take the time and they do they treat a lease renewal with the attention it deserves.

Like most practice managers and doctors, your time is precious. You may not feel that you have the time nor the requisite market knowledge to adequately address these issues on your own. Knowledge is key to any successful negotiation, and generally the side with the most knowledge wins the day.

For this reason, I would suggest that you engage a real estate professional who specializes in healthcare to assist with your office assessment and lease negotiation. Be sure to begin your assessment far enough ahead of the lease expiration so that you preserve all of your options. Depending on the size of your office, you should start thinking about the process at least twelve months prior to lease expiration. Remember, you can always slow down the process if it moves along too quickly, however you can’t create time if it moves along slower than expected.

Use the upcoming renewal as an opportunity to take a fresh look at your office space. It does not have to signal an intent to move. Rather it offers the chance to obtain the feedback necessary to make an objective assessment of that office prior to executing a long term lease commitment.

In your assessment, the following questions should be asked:

Does your current office space still efficiently accommodate your needs?
Efficiency has never been more important than it is in today’s healthcare environment. A physician can not be his or her most efficient if the space he or she occupies does not provide an efficient platform for patient flow. The fact that it may have been efficient at lease commencement does not mean it is still the case at the end of the lease.

Does your location still fit your patient base?
With a lease renewal you are looking at making a long term commitment. During the term of a new lease will the location continue to fit your patient base? Have the demographics of the area changed? Do you see signs or trends that will render the space geographically undesirable?

Is your current lease survivable?
The vast majority of any lease document describes events which may never occur during the lease term. Partial destruction, eminent domain and interruption of services, to name just a few, are landmines which lay dormant in leases. Many of these provisions have the same chance of occurrence as winning the lottery. But just like the lottery, someone is going to be a winner, despite the odds, or in this case the loser falling victim one or more of these lease provisions, with results that can be disastrous. These events are often detrimental to both landlord and tenant, but they need to be negotiated in such a way as to minimize their effect on your practice, allowing your practice to survive them.

If after careful review you can answer yes to the first two questions, then negotiate vigorously with your current landlord. Make sure that once you have negotiated good economic terms you address the other lease provisions with the intent of making them survivable.

If the answer is no to one or both of the first two questions you need to first determine if these issues can be addressed in the current space. If not you should begin a search for alternatives which will accommodate the needs of your practice.

Careful and informed negotiation in both instances will provide opportunities which will go straight to your bottom line.

Stan Sharp is president of HealthOne Realty Advisors.
He can be reached at 770-578-4996 or

MACRA and MIPS: How the New Rating System Might Impact SEO and Social Media Traffic

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(and what your practice needs to do to improve the reputation and visibility of your practice)

Medicare New Rating System Impacts SEOThe Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is the new pay-for-performance Medicare reimbursement program that was signed into law a few years ago. Focused on improving quality, value of services and accountability of medical professionals being paid by the Medicare program, it attempts to reward health care providers for better care, security and services. The new Act combines parts of the Physician Quality Reporting System, Medicare Electronic Health Record incentive program, and value-based payment modifiers into a single program called the Merit-based Incentive Payment System, or “MIPS”. The new system began on January 1, 2017 and uses a scoring methodology that creates ratings based on quality, resource usage, clinical practice improvement activities, and use of certified electronic health record technology. Ratings are then reflected in a score that ranges from 0 – 100 and can have a strong impact on the reimbursement amount authorized by Medicare each year.

While each medical entity that receives Medicare patients should be positioning itself to meet the expected guidelines required to maximize their reimbursements and improve patient experiences, there is another aspect of the new program that is getting far less attention than it deserves: the potential impact on your social media representation/reputation and search engine optimization (SEO) and related visibility as your ratings are posted in the public domain and put to use.

MACRA, MIPS, and Social Media Impact.

Under the MACRA program, all physician scores are published on the Physician Compare website ( More importantly, these scores are also being made available to the full spectrum of social media review and rating platforms and services for usage as they see fit, including (but not limited to) Google, Yelp, Facebook, and The intention of the program is to spur direct competition between providers, motivated by the consumer-facing scoring. The higher the score, the more favorably they anticipate your practice will be viewed by Medicare patients searching for a doctor. While 3rd party sites have yet to factor these new MIPS ratings into their algorithms and online rating systems, it is a safe bet to assume they will figure out how to best do so sooner rather than later, in the interest of greater accountability and patient choice. In fact, it is fair to assume that MIPS ratings for Medicare physicians and practices may reach or even exceed the importance of regular patient reviews.

To add much-needed context, we need to spend a little time qualifying and quantifying the impact of reviews and ratings on consumer decision-making. According to a major local consumer review study of more than 1,000 people conducted by BrightLocal:

  • 85% of consumers trust online reviews as much as personal recommendations
  • 73% of consumers are likely to trust a local business more if they have received positive reviews.
  • 50% of consumers require at least a 4-star rating before they will seriously consider doing business with your company.

These results confirmed what we’ve known for some time: reviews matter as they heavily influence trust, which is arguably the most important currency for online traffic and lead generation. Your online ratings and reputation have a major impact on a majority of online searches and whether they choose your practice over a competitor. With MIPS scores likely to be added to healthcare provider rating websites like and general review sites like Google and Yelp, there is every reason to assume that your MIPS rating will become one of the biggest factors (if not the single largest factor) in helping people decide if you are a top choice to be their doctor or not.

MACRA, MIPS, and Search Engine Optimization (SEO)

One unknown factor is how, when and if search engines like Google and Bing will choose to use these ratings in their search results. All major search engines are focused on providing the most relevant data possible to their users to help them make the most informed decisions possible. Over the years, that has been reflected in the creation of separate local business groupings, star-based rating systems, review snippets, and more, right in the middle of page 1 search results.

It would certainly not be surprising to one day see a MIPS rating score listed in large print right next to a physician’s name as it appears in a Google or Bing search, which should be a very sobering thought for any physicians who are currently doing a poor job or the bare minimum amount of reporting. Adding MIPS scores has to be an attractive proposition for search engine services, as few singular pieces of information will be as comprehensive and easy to digest as a MIPS rating. If MIPS ratings are implemented by search engines and treated similarly to how consumer reviews are treated, we anticipate an impact on your local visibility with higher scoring medical practices ranking consistently higher than lower scoring ones and enjoying objectively better visibility.

What Your Practice Can Do to Prepare

In our opinion, it is a matter of when not if we see MIPS scoring reflected in both social media and search engine results. To that end, our recommendations are clear:

  • Physicians should focus on mitigating any reputation damage and negative search engine visibility impact by reporting as much data as possible to the MIPS program and make as many recommended changes as you can. The more data you submit and clinical improvement you make, the higher your rating score and payment incentive can be. A low score, secondary to either poor performance or simply failing to do more than the minimum amount of work required to avoid penalty, will end up looking the same to someone considering your practice, potentially doing damage to your bottom line.
  • We recommend active rating management and encouraging patients to leave reviews. The more positive reviews you have on essential review systems and platforms (Yelp, Facebook and Google are rated as the most trusted platforms), the more trust potential patients will have in your services. Encourage patients to leave them and thank them for doing so when they take their time out to do so on your behalf.

The best thing any physician can do here is to get out ahead of it now. Do your best to maximize your MIPS score, not just for the improved ratings, but to maximize patient care and experiences. Encourage past and current patients to leave a review. In doing so, you will not only see a highly competitive MIPS rating, but also a higher number of positive reviews from satisfied patients; both of which are tried and true methods to improve your social media reputation, search engine visibility, and ultimately the size of your patient base.

Todd C. Withrow
NicheLabs, LLC

Marketing Your Healthcare Practice with Promotional Products

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healthcare office promotional productsStarting a new medical practice or growing an existing practice can be a stressful experience.  Competition is high in all areas of the medical field.  Small practices are popping up all over the place. Most doctors leave medical school with years of education on medicine, not marketing.  Finding ways to maximize your marketing or advertising budget is key to achieving success in practice marketing.

Promotional products are a marketing medium that will help you achieve maximum ROI.  The reason??  Promotional products are used over and over again, which keeps your practice name and information top-of-mind with the recipient, and also gives your practice exposure to all who come in contact with the product.  Think how many looks an average tote bag receives each day.  Promotional products are also often passed from one recipient to another, continuing to maximize your brand exposure.

The most frequently looked at promo product of all, not just for a medical practice but for any type of business? A calendar. It gets looked at just about every single day!

Make sure you include your practice name, your telephone number and your web site address. Keep your contact information front and center so there is no excuse not to get in touch.

Attend health fairs at local businesses. Many local businesses hold yearly health fairs for their employees. This is a great way to get your name out and interact with potential patients.  Set up a booth with information about your practice.  Give out pedometers, custom-shaped stress relievers, anti-bacterial gel or tote bags to all in attendance.

Implement a customer referral program. Learning about a new health practice from a trusted source is important in the patient decision making process.  Encourage your patients to refer a friend to your office.  Give each customer who refers a friend a travel mug with a gift card to a local coffee shop inserted inside.

Article written and submitted by Sheila Fox-Lovell, President of Shandy Creative Solutions.
Questions? Contact Sheila at 770.951.0305 or

The U.S. healthcare system needs more skills for paying bills, study shows

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paying healthcare billsArticle from LA Times
By Karen Kaplan
FEB 20, 2018

Healthcare in the United States is really expensive, and one of the reasons is that managing healthcare bills is really, really expensive.

Just how expensive? At one large academic medical center, the cost of collecting payments for a single primary-care doctor is upward of $99,000 a year.

And billing for primary-care visits is a bargain compared with billing for trips to the emergency room, a hospital stay or a surgical procedure, according to a report published Tuesday in the Journal of the American Medical Assn.

Researchers from Duke University and Harvard Business School figured this out by reconstructing the entire life cycle of a medical bill — from the time a patient makes an appointment until the time the health system pockets the money for the services rendered. They applied their analysis to five types of “patient encounters,” as they put it.

Members of the research team conducted 27 interviews with people involved at various points in the billing process to understand every single step along the way. They also surveyed 34 doctors to understand their billing-related activities, such as submitting prior authorization requests to health insurance companies.

Once they had mapped out the entire billing process, they used salary information from the medical center to determine the cost of carrying out each step. They also added in overhead costs such as office equipment and utility bills.
These were the results:

  • It cost $20.49 to get paid for a typical primary-care visit, and took 13 minutes of processing time.
  • It cost $61.54 to get paid for a typical trip to the emergency room, and took 32 minutes of processing time.
  • It cost $124.26 to get paid for a typical hospital stay, and took 73 minutes of processing time.
  • It cost $170.40 to get paid for a typical outpatient surgical procedure, and took 75 minutes of processing time.
  • It cost $215.10 to get paid for a hospitalization that required surgery, and took 100 minutes of processing time.

If those numbers aren’t enough to make you sick, consider this: For most healthcare providers, the true costs of billing are probably higher — perhaps much higher.

Read Full Article


Submitted by:
Stephen Bradley
First Citizens Bank

5 Keys to Improving Participant Outcomes in Retirement Plans

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Capital Ideas Retirement

“I am constantly fielding questions about what improvements, beyond investment performance, can be made to a retirement plan. The attached article, provided by Capital Group, provides insight on a few simple action items that will create drastic results. While this is not an exhaustive list, it’s a terrific primer for a true retirement plan consultation.

I look forward to being a resource.”

Joshua C. Harper, CFP®, CLU®, ChFC®

Read Full Article

A Look Forward Into 2018 – A Contractor’s Perspective

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construction contractorsThrough the years I have learned that future projections typically do not come true, so this article is not about projections for 2018 but about possible trends for the construction industry.

The New Year will bring challenges in hiring quality personnel as well as retaining current staff. As commercial workloads increase, so will the need for skilled labor. Construction companies will have to pay more to attract workers to the construction industry, provide on-the-job training and encourage workers to accept responsibilities of supervision. Our more seasoned personnel will be required to train the younger employees and those employees that are willing to learn new skills. Because construction tasks require manual labor, hourly rates will have to increase above hourly rates which do not require as much manual labor. My thoughts are the difference will be about $2.00 per hour.

As labor costs increase, there will be more opportunities for prefabrication and automation. Commercial construction still has a way to go before automation reaches to job sites, but equipment is currently being developed to help reduce manpower. There will come a point when much of commercial construction projects will be built in a factory and those parts will be shipped and then assembled on the job site.

As we move farther into 2018, we should see less demand for repair and replacement in Texas and Florida due to the hurricanes of 2017. Hurricanes Harvey and Irma hit in August of 2017 and damage has been estimated to be in $200 billion-dollar range by Bloomberg. As the demand for materials and labor for repairs continues to decline in these two areas, material delivery lead times should normalize, and skilled laborers will hopefully redistribute from the hurricane damaged areas.

The events of December provide strong indications that business investment may be on the rise. Record Christmas season sales and a pro-business tax bill establish a solid foundation. Companies may be more willing to invest in new buildings to house people and product, therefore increasing commercial construction demand.

All looks positive for commercial construction in 2018. Only time will tell.

By: Eric A. Schoppman

Five Things To Remember When You Have A Lease Coming Up For Renewal

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  1. Give yourself enough TIME prior to expiration.
  2. Consider several ALTERNATIVES to your current space.
  3. THINK LONG TERM as well as short term.
  4. REVIEW the LEASE DOCUMENT even if you renew.
  5. Use the renewal or relocation as a time to RETHINK OFFICE OPERATION.



Make sure that you start the process early enough so that you will have enough time to properly evaluate alternatives. Don’t short change your practice by allowing too little time. As with anything else it is always better to have more time. If you start too early you can always slow down but if you start too late the advantage goes to the Landlord which you don’t want to do. What is enough time? To figure this out in your particular situation estimate how much time each component of the process from the initial search for alternatives, to lease negotiation and finally buildout will take. In the case of a 5,000 sf lease space you should figure on 30 days to determine what options are available. It is a good idea to find five or six options which might work. Figure another 30 days to work thru those options which would included doing test fits on the top two or three options. Efficiencies differ between different buildings and floorplates.


Take the time or hire a professional medical office broker to find a reasonable number of alternatives. After identifying five or six possibilities tour the buildings paying particular attention to such thing as visual appeal of the building ingress and egress to and from the building, the total number of parking spaces available in the building (4 spaces per 1,000 square feet of leased area is a minimum however ideally you would like 5 or 5 per 1,000. Parking is the silent killer of a practice. If there aren’t enough spaces patients will be late for their appointment, they will be upset at having to drive around looking for a space and upset because they were harassed by staff for being late to the appointment. Many times they won’t complain but just not come back. Once you have toured the options and made notes send out a request for proposal (RFP) to each option telling them what information you want. The idea behind an RFP is to get identical information from each option so that you can make an apples to apples comparison. Buildings will naturally try to give you information in a way that makes their property look good but if they are successful that makes the job of comparing them much more difficult. Once you receive the proposals from the options you will want to put the competing buildings on a spreadsheet and compare them both in terms of their economics and the more subjective issues such as appearance, ingress/egress and parking.


Concurrently with the RFPs you will want to do test fits with the best two or three options. This will tell you how each option actually lays out and how efficient they are relative to one another. In doing a test fit and looking at a long-term design for your space you will certainly want to think about the things which currently work in your space and those things that don’t. Do you have the right number of exam rooms? Does the reception area have enough seating?  Does the office still flow efficiently? What worked well for the practice five or ten years ago may not work now. Offices are generally designed along one of two ways. The “pod concept” where the exam rooms serving a particular doctor, the doctor’s office and the doctors nurse or nurses are all bunched together in a pod. The other concept “non grouped” which seems to be regaining favor in the current changing medical environment is to have all of the exams together with the nurses station and have the doctors all together apart from the exams, using charting stations interspersed among the exam rooms. This concept allows more flexibility in assigning different numbers of exam rooms to different providers which may be a function of the patient load or how a particular provider works.


A year before your lease comes up it is a good idea to get out your lease and review it to refresh your memory on what the sequence of events will be regarding the renewal of your lease. Are there any renewal options specified in the lease? This will usually be spelled out in the Special Stipulations section of the lease. If there are options how long before renewal do you need to give notice of your intent to renew. What in addition to the ability to renew does the renewal option describe such as a specific renewal rate or other items which are specified and have been pre-negotiated. An option only grants your practice the right to renew not the obligation. You will want to look at the market to determine if the renewal option is advantageous for your practice. If the renewal option is clearly advantageous then it may make sense to look at alternative spaces and begin the process of negotiating between the options to determine the best avenue for the practice.


During the process of considering a renewal it is a good idea to take a global look at the operation of the practice, and not just as it relates to the office space. Since a renewal may not involve additional square footage many practices just sign the renewal amendment and move on. However, a renewal marks three, five or even ten years since you have seriously looked at provisions in your lease. As you know there have been significant changes in the healthcare system which have had an effect on how your practice operates and possibly how your office space should function. Also with a renewal or relocation you should not just look how things effect your practice today but rather you should be looking at your needs 2, 3 or 5 years down the road.

In considering your long term needs you should consider such things as whether your phone system continues to be adequate for the operation of the practice. You might consider whether your computer system adequate for the demands of the practice in 2017 and beyond. There will be a range of issues which will be specific to your practice.

The bottom line on how to address an upcoming renewal is that you should begin early, take a careful look at whether your current space is adequate for your needs today thru the end of the renewal term, and use the anniversary to consider things that relate to your office space and maybe a few larger issues that relate to the practice. Good luck. If you don’t have the time to do an adequate job, consider hiring a real estate professional to take on some of the time consuming aspects.

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