Physicians Practice - January 2008 - (Page 44)

ASK THE EXPERTS YOUR TOP QUESTIONS ANSWERED INCIDENT-TO BILLING; MANAGING DENIALS; PROTOCOLS FOR NONPHYSICIAN PROVIDERS INCIDENT-TO BILLING IS NOT FOR RESIDENTS Q Some third-year resident physicians would like to moonlight at our clinic, but insurance companies have told us they will not recognize billing by residents. Is there a way around this problem? Can we bill them under me as medical director although I am usually not on premises? all the administrative work (and there is a lot)? I was interested in no-weekend call in exchange for doing the administration. Or what is a fair dollar amount? A I’ve seen groups solve this in various ways. Management compensation is most common in practices with a compensation structure built WHAT’S THE DEAL? Your proposal should take into account the value you bring to the group in your management role. That is, how is this position affecting your group’s profitability? on productivity in which a physician’s clinical productivity is hampered because of the time that physician devotes to management tasks and to serving as the only real go-to physician contact in this regard. In such a case, that physician needs to catch up and be paid reasonably. Management salaries can be paid based on actual time spent at an hourly fee, a set fee, or a percentage of the practice’s proﬁts per year. Your proposal should take into account the value you bring to the group in your management role. That is, how is this position affecting your group’s proﬁtability? Do you get more revenue from your managedcare contracts? Does the position involve managing operations only? Your answers to questions like these can help you determine the value of the position and, subsequently, its fair compensation. Some groups feel that a physician-administrator basically saves them from having to hire another administrator. In that case, compensation is based on an administrator’s going salary — in other words, the group pays the physician the amount the group is saving by not having to hire another staff person. There’s really no industry standard for this, so your group should principally look at its overall budget and negotiate. PATIENTS-PER-DAY NORMS Q I am wondering what is the average number of patients seen per day by a general/primary care internal medicine physician? I am having trouble locating this specific information. A I don’t know of published norms, but, anecdotally, I see practices treating anywhere from 25 to 45 patients a day. The “norm” is 20 to 25. It really depends on a physician’s personality type and what that physician needs to do to make ends meet. Some people are maxed out at 25. Others breeze through 60, no problem. A more nuanced and credible standard might be to measure relative value units, or RVUs. According to data from the Medical Group Management Association, the median RVUs per year for general internal medicine is 7,716, excluding technical component charges and nonphysician practitioner work. Your management software should be able to run a report for you on RVUs per year. A No, incident-to does not apply to residents, and besides, you’d need to be on premises to bill incident-to. Note that you may be able to bill Medicare. The AAMC has a summary of the rules on its Web site. Visit www.aamc.org/advocacy/ library/teachphys/phys0004.ht for details. For private insurers, they call their own shots, although it may still be worth a few more phone calls to try and negotiate a solution, depending on the volume of billing. REIMBURSEMENT FOR PHYSICIAN-MANAGERS Q I am the physician-practice administrator for a large practice. What is fair compensation for doing 44 | PHYSICIANS PRACTICE | JANUARY 2008 WWW.PHYSICIANSPRACTICE.COM http://www.aamc.org/advocacy/library/teachphys/phys0004.htm http://www.aamc.org/advocacy/library/teachphys/phys0004.htm http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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