Physician's Practice - November 2008 - (Page 49)

ASK THE EXPERTS YOUR TOP QUESTIONS ANSWERED INCENTIVES; MODIFIER -25; PATIENT KEEPING CHARTS; PRACTICE COLLECTION RATES; INTERPRACTICE CONSULT STAFF INCENTIVES Q I would like to learn about incentive pay programs for nursing staff, billing staff, and receptionists for a large pediatric practice. A Well, here’s a model I saw recently that I really like: It’s a two-part system: First, staff members receive a revenue bonus if the practice collects a preset dollar amount (or more), which goes up over time. Twelve percent of any amount over the goal goes back to receive extra cash or a proﬁt share if collections are up. Beware: You will get what you pay for. I’ve seen practices give their billers incentives to work faster. As a result, more claims went out, but so did more errors, causing total accounts receivable to drop — not what you want. Reward your employees only for what they can control. For example, in the proﬁt-sharing program mentioned above, the practice divides I’ve seen practices give their billers incentives to work faster. As a result, more claims went out, but so did more errors, causing total accounts receivable to drop. YOU’LL GET WHAT YOU PAY FOR the employees. Of that 12 percent, half is divided equally among staff, and the other half is distributed based on staff members’ anonymous evaluations of each other. You can see how this approach keeps your staff focused on revenue collection and encourages a team environment. The second part is based on patient satisfaction survey results. Each staff member receives $50 if all patients surveyed in a given period say they would recommend the practice to others. I like this because it builds teamwork. Other programs are geared to reward the success of speciﬁc staff members. For example, billers may WWW.PHYSICIANSPRACTICE.COM A One quick and easy model is to do a SWOT analysis: Set up a four-column table — perhaps in Excel, but even paper is ﬁne — and list your Strengths, Weaknesses, Opportunities, and Threats. Even this can be enough to get the conversation rolling. From there, obviously, you seek speciﬁc tactics to take advantage of your biggest opportunities, shore up your weaknesses, and protect against threats — all without hurting your core strengths. You’ll ﬁnd plenty of examples and detailed explanations if you search for “SWOT” online. PROBLEM-FOCUSED AND WELL VISIT Q If a patient comes in for a routine physical but he also has a new problem or he wants to discuss a past medical problem, can we bill both 99386 and a 99213 or 99214 with modifier -25? A CPT instructions indicate that if an abnormality is encountered at the time of a preventive visit, it is appropriate to report an outpatient E&M code (99201-99215) with a -25 modiﬁer in addition to the preventive medicine service. The documentation in the medical record should support the performance of a signiﬁcant, separately identiﬁable E&M service in addition to the preventive medicine service. The diagnosis for the preventive care service is linked to the preventive visit and the diagnosis for the problem is linked to the problem visit on the claim form. The issue becomes one of the payer’s payment policies. Many payers do not cover a preventive and a problem visit on the same date regardless of the CPT instructions. NOVEMBER 2008 | PHYSICIANS PRACTICE | its top-line revenues or collections. The staff has little control over costs, so the practice doesn’t base the bonus program on net revenue. Keep it as simple as possible, and keep it as public as possible; competition works. Set the rules clearly, and then stick to them for a prescribed amount of time. You can establish temporary programs for deﬁned periods, but don’t give your staff a goal and then move the goal line mid-season. EASY STRATEGIC PLANNING Q Can you give me an outline for a simple yet comprehensive strategic plan? 49 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physician's Practice - November 2008

Physician's Practice - November 2008 Contents Death of Solo Practice Just a Myth Letters HSAy What? Noteworthy Finding Lost Revenue: The Search for Billing and Coding Gold Getting More: Our Annual Physician Compensation Survey ’Tis the Season to be Neutral Ask the Experts Evaluating Paperless Labs HR in a Box? The Guide Coding Third-Party Audits on the Rise Branding the Cash-Only Practice Intra-Office Tug-of-Wars Stickin‘ Up For Yourself Classifieds Advertiser Index

Physician's Practice - November 2008

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