Physicians Practice - January 2008 - (Page 47)

• Look line item by line item at his costs. Since you’d be working more hours, some of your expenses will be higher, so factor that into your evaluation. • Ask for documentation of productivity — patients-per-day or RVUs. Can you at least match his productivity? • What conveys with the sale? Computer equipment? Software? Patients are not required to stay with you, so you’d best make sure you get more for your money than the right to take over his lease. • Do you like his staff? Would you keep them? If not, factor in hiring costs. • If the lease seems high, do you even want that location? Is the lease They also list that a median number of 0.61 staff per FTE provider in these categories. That said, here is what Physicians Practice recommends for billing stafﬁng, by claims volume, where a biller is deﬁned as anyone who touches the process from the time a charge becomes a claim until the claim is fully paid: • Full-time billing employees per 100,000 claims: 10.45. (Claims are the basic work unit of a billing staff member, just like work RVUs are for a provider.) • Payment posting/cash management FTEs per 100,000 claims: 1.9. • Credit resolution FTEs per 100,000 claims: 0.4. • Insurance denial and follow-up FTEs per 100,000 claims: 3.1. • Patient follow-up and inquiry FTEs per 100,000 claims: 1.8. One biller per 10,000 claims may seem a bit low, but if the claims are clean, then no billing staff intervention is needed at all. Therefore, the ratio is not just a reﬂection of how good the biller is, but how good the process is. Keep these principles in mind: Busier physicians generate more claims. Some specialties have more difﬁculty than others when collecting. Some patient populations are harder to collect from than others. Good staff can pay for themselves easily if they boost collections. Technology can make staff much more efﬁcient. The best benchmarks may be your own internal performance over time. If collections are poor now and you truly believe adding staff might help, it’s generally worth the money spent to reap even more. breakable? Look concretely at other possible locations. Are they actually cheaper? • What, exactly, is he proposing he would tell his existing patients? That you are his hand-picked successor? Or just that some other body will be in his space? What he says will affect how many patients choose to stay with you. • Look at the density of physicians in your specialty in the area. Is there a need for another physician? (Hint: Try calling some of the practices as a patient and ask when the next available well-visit is. If it’s more than a month, that’s good; everyone is overbooked.) HOW MANY BILLERS DO I NEED? Q We are trying to develop a budget for our central billing department that supports 20 physicians at nine different sites. We currently have 12 full-time staff posting all of the charges and payments, sending out claims, and doing A/R follow-up. Can you give me any insight regarding the FTE per provider for billing? A The Medical Group Management Association says multispecialty practices spend a median of 2.7 percent of net medical revenue on staff related to patient accounting, general accounting, and managed-care administration. Not exactly what you needed to know, but it’s a start. WWW.PHYSICIANSPRACTICE.COM • Pamela L. Moore, PhD, CPC, senior editor of practice management for Physicians Practice, is this month’s expert. Moore has been writing for physicians on practice management issues for 10 years, and she is a recognized speaker and commentator on healthcare management. She can be reached at pmoore@physicianspractice.com. JANUARY 2008 | PHYSICIANS PRACTICE | 47 http://www.countmein.biz 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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