DSG recently sat down with Anne M., the medical office manager of a solo family medicine practice in Oakville, Ontario, to explore how they manage uninsured services. The practice provides comprehensive care, from home visits to hospital care, but faces the ongoing challenge of balancing patient care with a growing administrative workload. Handling tasks like prescription renewals and form completions became overwhelming to manage, leading the practice to seek external support. Here’s how they’ve navigated these challenges and improved their efficiency.
DSG: Can you tell us a little bit about the practice you manage?
Anne: The practice is run by a solo practitioner who follows a traditional model of care. We provide comprehensive services including managing patients’ care while they are hospitalized. Additionally, the doctor performs house calls to a local retirement home. We currently serve approximately 950 rostered patients, along with an additional 100 to 200 un-rostered patients.
DSG: Moving on to uninsured services—what are some of the most common uninsured services that your patients request?
Anne: The most common uninsured service we provide at our office is prescription renewals by fax. Over the past decade, we’ve seen a significant increase in requests for prescription renewals without an appointment. Each renewal requires the physician to review the patient’s chart, confirm the last visit, arrange a follow-up if needed, and sign off on the prescription. Meanwhile, our staff ensures the renewal is sent back to the correct pharmacy promptly. It’s an important responsibility for the physician, but it comes without compensation.
As demand for this service grew, so did the burden it placed on both the physician and our staff. We knew we needed a solution. The Ontario Medical Association recommends that physicians charge for prescription renewals by fax, so we decided to implement a block fee system in our office. Initially, we managed the program ourselves, and it worked well for most patients.
However, over time, we noticed that some patients didn’t pay the invoices they received. Following up on these unpaid invoices created additional administrative work for our team and rarely resulted in payment. It became clear that we needed a more efficient approach.
DSG: On average, how many faxed prescription renewal requests do you get per day?
Anne: It depends on the day of the week. The office can receive 15-20 prescription renewal requests on Mondays and Tuesdays, and it is not uncommon to receive a number of urgent requests on Fridays.
DSG: Are there any other common uninsured services in your practice?
Anne: Besides prescription renewals, we often provide other uninsured services like Doctor’s Notes, School and Camp Forms, and Disability Tax Credit applications. We also get frequent requests for notes for things like orthotics, physiotherapy, and massage therapy, often without an office visit. These requests are ongoing and take up both the physician’s time and the administration’s effort to manage.
DSG: What challenges led you to seek external support for managing uninsured services?
Anne: The biggest challenge was managing a backlog of unpaid invoices and keeping track of patients who refused to honor their obligation for faxed prescriptions. It wasn’t easy because the doctor was doing the work, but the value of those services wasn’t always recognized.
We tried to be flexible and make exceptions for those in difficult situations, but it became too much to manage. So, we decided it was best to take this burden off our plate and let an external provider handle it.
DSG: When you started looking for external support, what were the key factors you were considering in a provider?
Anne: We were lucky DSG came to us. Their representative provided us with ideas and a plan we were curious to explore. We decided to sign on with DSG two years ago and have not looked back!
The service allows us to write our own annual letter to our patients and helps us review our patient list before the mailing is sent out. We feel strongly about drafting a personalized letter that demonstrates the physician’s priorities. The annual letter is an important communication tool, and we were unwilling to settle for an automated, impersonal letter. We have retained control over the process of the block fee which is crucial to us.
DSG: Were there any other aspects that made DSG stand out to you?
Anne: Absolutely. The team at DSG is responsive and incredibly easy to work with. The onboarding process was seamless. What really impressed us was how positively our patients reacted to the third-party involvement. We expected some complaints, but there weren’t any, which I think is a testament to DSG’s professional and patient-centered approach. Having them manage this service has been a great decision—it’s allowed our staff to focus entirely on our patients’ medical needs and concerns.
DSG: What tangible improvements have you seen since you started working with DSG?
Anne: The biggest improvement has been the time we’ve saved by outsourcing this task. DSG has also done a great job collecting individual fees from patients who chose not to join the block fee program. In the past, these invoices were time consuming to prepare and often ignored by patients. Now, DSG provides us with clear, concise reports detailing paid and unpaid invoices, along with address updates and other support. It’s made a noticeable difference in reducing our office workload.
DSG: How did you find DSG’s online portal?
Anne: The portal is very easy to use—straightforward and user-friendly, even for those who aren’t very tech-savvy. The onboarding process was quick and seamless, and the DSG team has always been available to assist whenever we needed support.
DSG: What is the biggest challenge that DSG has helped you solve?
Anne: Outsourcing the invoicing and payment collection for uninsured services to DSG has been a huge relief for our office. When we managed the block fee ourselves, it was a lot of work—writing the letter, printing hundreds of copies, adding address labels, stuffing envelopes, stamping them, buying postage, and taking everything to the post office. And that was just the beginning. After that came all the record-keeping, accounting, and banking tasks. DSG handles every part of the Block Fee process for us now, and it has been completely worth it!
DSG: From a financial perspective, did you find DSG’s services worth the investment?
Anne: Hiring DSG has been an excellent financial decision for our office. They’ve helped us manage invoicing for non-block fee patients and collecting payments, making the entire process much more efficient. Patients have been responsive, and we’ve noticed an increase in their awareness of the value of the services we provide. Having DSG act as a facilitator has also unexpectedly boosted our revenue, as patients seem to respond more agreeably to settling with a third party.
DSG: What advice would you give to other physicians trying to manage uninsured services?
Anne: We highly recommend reaching out to DSG. Finding ways to recapture valuable time and ease the administrative burden that comes with today’s family practice is essential. There is little or no time in a physician’s day to battle for the compensation they deserve for services provided in good faith. This kind of service is beneficial for practices of any size—whether you’re a solo practitioner like us or part of a larger group. For any office size, it’s definitely something to consider.
Uninsured Services Support from DSG
Uninsured services management requires considerable time and effort, as seen in this practice’s journey to streamline these tasks. By partnering with DSG, they successfully reduced administrative burdens and enhanced efficiency, allowing more focus on patient care. If your practice is facing similar challenges, now is the perfect time to explore how DSG can assist you. Contact our team today for a complimentary audit of your current processes and let us recommend solutions tailored to your needs.
