Physician's Practice - November 2008 - (Page 53)

Do they use a superbill to designate ICD-9s? If they update there, they can go back to the chart later. Do they follow a template for documentation? If there is a printed document that has a ﬁeld for the problem list, they may be prompted to ﬁll it in. If you are using EMR, of course, the system can prompt them to review the current list and do updates. Take a look at your current process to ﬁgure out where the speed-bump is. WITHHOLDING CARE Q Can a doctor refuse to see an established patient until he pays his account balance? Would this be considered withholding treatment? A You can set a written policy, communicated to patients in advance, that you will refuse to see established patients who have not met their financial obligations. You’ll want to define this very clearly — any bill left unpaid after three months? Account balances exceeding $500? This isn’t about forcing her to continue as your patient, although you sure hope she will. It’s about liability, continuity of care, and so on. MAKE IT CLEAR INTER-PRACTICE CONSULT Q Can a family physician refer a patient to an internist in the same practice for a complex medical case? If so, would the internist bill that service as a consult? A You can get consults from other physicians within the same practice in different specialties, yes. What’s less clear to me is whether you really are asking for a consult — which means a written report and advice that comes back to you, and you continue holding primary responsibility for this patient’s problem. Or perhaps you want the internist to take care of this problem for the patient, which is a transfer of care. These are two different animals. Transferring care is ﬁne, too, but the IM would bill a new-patient visit E&M, not a consult. Visit PhysiciansPractice.com and type “consult” into the Search Articles box for many articles clarifying this point. WWW.PHYSICIANSPRACTICE.COM You’ll also want to deﬁne what you’ll do when the patient is reinstated. Do they need to pay for all services in advance, for example? Are they dropped from the practice if they go into arrears again? If so, promise to see the patient for the next 30 days, on a cash basis, until they can ﬁnd another physician or arrange a payment plan/pay in full. There is a sample dismissal letter in the Tools section of PhysiciansPractice.com. You might also want to conﬁrm that your malpractice carrier agrees with this advice. • Pamela Moore, CPC, editorial director 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. NOVEMBER 2008 | PHYSICIANS PRACTICE | 53 http://practicesalesusa.com http://www.PhysiciansPractice.com http://www.PhysiciansPractice.com http://practicesalesusa.com 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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