Physicians Practice - October 2008 - (Page 36)

MANAGEMENT only when healthcare providers are providing healthcare, so when you’re wandering the halls in search of Pap kits, tongue depressors, and who-knows-what-else, you’re not treating patients (read: generating revenue). In short, every exam room should be fully stocked with everything the doctor needs, and all supplies should be in the same place in every exam room. Related to improperly stocked exam rooms is a poorly supplied practice. Take a hard look at what you’re ordering and why. Practice demographics can shift dramatically as the years pass. If your pediatric clientele has declined by 25 percent, why are you robotically ordering the same quantity of child-sized gowns? Buying in bulk to save only makes sense if you actually use the products. Get organized. Sentgeorge posts a list of needed supplies and ordering thresholds in each exam room. Once a month, she places an order, only reordering if there are ﬁve or less of an item on the shelf. Standard lists and protocols will keep you on track in other areas as well, she says. “I made lists for groceries, for marketing, and for the ofﬁce supplies.” YOU LET THE CYNICS GET TO YOU protocol and perform efﬁciently, and the longer it takes to see a positive return on investment. For pricey purchases like an EMR, negative mindsets can cost big. When you’ve got a change coming — a new process or service, a large purchase, a different work ﬂow — start the attitude adjusting early, during the research that leads to the change. Get input. Encourage physicians and staff to voice everything that’s wrong with buying some piece of technology, renovating the reception area, or the like. Write it all down and take it seriously; this is more than just giving someone an opportunity to vent. While much of it will be “I-hate-change” bluster, you’ll likely ﬁnd a gem or two of worthwhile advice as well. When it’s time to implement, you’ll have more staff on board — much more than if you wait to inform everyone that the roll-out date is this Thursday. Such careful staging worked for Hawthorn. “I even have doctors who log on and look at their denial reports,” says Nivison, and jokes, “I take great pleasure in saying, ‘I told you so.’” Well, he’s earned that right, with all the money saved. YOU’RE NOT WELL INFORMED impossible to submit claims and get them paid time after time,” says Woodcock. “You’re going to have situations every day where the rules change, or such-and-such insurance company pays differently in this state than that state. The algorithm is almost too difficult for a human being to grasp. Every time [a claim] is denied, that costs you money. If you don’t notice it, you lose the money.” Luckily, there are also a myriad of ways to stay informed: • E-Newsletters — Our own free, opt- in e-newsletters (PEARLS, Administrator’s Desk, Tech Doctor, and PEARLS on Coding) will help you stay on top of the shape-shifting world of medical management. There are many other worthwhile e-newsletters as well, including MGMA’s Washington Connexion, and many of the “Fierce” newsletters (see www.ﬁercemarkets.com), to name just a few. • RSS Feeds — Many Web sites now offer direct feeds that will automatically push information you want directly to you. • Alert services — Think of an alert as When Hawthorn Medical Associates switched to the Navicure clearinghouse, Nivison heard from a lot of change-resistant naysayers. “The staff said, ‘This will never work.’ But now, they’re very much on board.” That’s great, because every time a foot drags it leaves money behind: The slower the learning, the longer it takes to master a new system or Does anything change more often than insurance regulations? And what’s going on legislatively? Were you ahead of the learning curve for getting an NPI number, or did you ﬁnd out the day after Medicare’s long-publicized, March 1 deadline because all your fee-for-service claims to CMS bounced? The sheer volume of need-to-know info is surely daunting. “It’s virtually USE THE RIGHT CODE LEVEL OF HISTORY 99213 Expanded, problemfocused history LEVEL OF DETAIL 1 stable chronic illness OR 1 self-limiting or minor problem 2-3 stable chronic illnesses OR 3+ self-limiting problems LEVEL OF DECISION MAKING Low, such as OTC drugs, physical therapy, or medication management with minimal risk (e.g., Augmentin) Moderate, such as minor surgery with identiﬁed risk factors or medication management with moderate risk (e.g., Coumadin) a cross between an e-newsletter and an RSS feed. It only comes when it’s got something to say. For example, The Verden Group offers an alert service to apprise you of important regulatory changes with insurance companies. The alerts can be tailored to the payers you contract with (www.TheVerdenGroup.com). Or check out Modern Healthcare’s alert service, which covers a broader swath of must-know healthcare news (www.modernhealtcare.com). • Professional societies — Many medical societies these days have super Web sites that strive to keep their members informed. They also make it easier to get involved in advocacy campaigns. YOU’RE IN A 99213 RUT 99214 Detailed history CPT’s code 99213 is by far the most popular E&M code. Sometimes, it’s the right code to choose. But the higher-paying 99214 should be getting much more play. Many doctors don’t really understand the rules of WWW.PHYSICIANSPRACTICE.COM 36 | PHYSICIANS PRACTICE | OCTOBER 2008 http://www.fiercemarkets.com http://www.TheVerdenGroup.com http://www.modernhealthcare.com/ http://WWW.PHYSICIANSPRACTICE.COM

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

Physicians Practice - October 2008 Contents Another Reason to Go Cash-Only? Letters How ’Bout Them Gas Prices? Second Opinion: Oh, Canada! Noteworthy Cover Story: Fixing the Leaks: How to Tighten Your Money Spigot Navigating a Lawsuit Ask the Experts The Administrators Desk: What’s Your Mission? EMR: Help or Hindrance? Dealing with Dr. Dangerous E-Mail Abuse Primer The Road to EMR Interoperability Don’t Let Staff Costs Stifle Profits Coding Classifieds Advertiser Index

Physicians Practice - October 2008

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