Cardiovascular Business - July/August 2008 - (Page 30)

Billing & Coding StrategieS › Healthy Leadership Will Carry Practices through Lean Times in complex, competitive environments where reimbursement constraints are realistic and often beyond the control of any one small practice, organizations have to look for other strategic advantages such as discipline, structure and strategy, says ronald n. riner, Md, president of the riner group, healthcare management consultants based in naples, Fla. “Historically, if you look at the healthcare organizations that reached growth plateaus in very constrained environments, the survivors had appropriately focused strategies and an organizational structure that allowed them to be competitive,” riner says. He adds that the strategy of many practices is merely to “stay above the fray” on a daily basis. “twenty years ago, it was still possible to come out of school, hang your shingle and learn on the job. that’s not true today,” he says. in fact, the margin of error for many practices is small and that’s where strong management and leadership come into play. Practices need to “take their pulse” to determine where they are and how best to move forward. it entails looking at all aspects of the practice including processes, finances, management and leadership. riner has found the biggest deficit in most practices is a failure to appreciate the importance of management, structure, leadership and governance. “if i had to pick one, i’d say the ultimate problem is with leadership: a practice’s inability to either identify the appropriate leadership or support the appropriate leadership or to have a leadership that understands its roles and responsibilities.” “twenty years ago, it was still possible to come out of school, hang your shingle and learn on the job. that’s not true today.” Ronald N. Riner, MD, president, The Riner Group, Naples, Fla. yearly audits of the coders. Occasionally, the practice will hire consultants who meet with the physicians and non-physician providers, as well as the coding and billing staff. “Our physicians are very open and easy to interact with if I or another coder has a need to speak with them regarding their dictation. We actually follow the ‘not dictated, not done’ rule of thumb,” Gott says. She adds that a good way to persuade physicians of the need for audits, consultant visits or educational initiatives is to show them the red and black ink. “You show your doctors the money trail and they start listening.” Coders are a particular breed, very detail oriented, Gott says, and they tend to have a high burnout rate. Surprisingly, Gott has a team with excellent tenure. Jennifer Miller, the business office manager, says she dreads the day when a coder leaves. “It takes years to develop good coding skills and it’s very costly to the practice to train people.” Last year, Wellmont Holston Valley Hospital was named one of the top 100 hospitals for cardiovascular care by Thomson Reuters. “Of course, I think our docs are the best because they have such great coders working for them,” Gott says, half jokingly. “Knowing that their billing is in very capable hands allows them to concentrate fully on patient care.” 30 Cardiovascular Business July/august 2008

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Cardiovascular Business - July/August 2008 Table of Contents First Word Cover Story: Planning for the Ideal Cath Lab Requires the Multidisciplinary Approach Clinical Study Digest: Cell Phone Technology Speeds Ecgs As Real-Time 3d Echo Matures, It Finds a Clinical Niche Ecg Image Management Brings Increased Productivity and Confidence Overcoming Barriers to Cath Lab Inventory Control Maximizing Reimbursement, Minimizing Penalties News & Views Calendar Reader Resources The Back Page

Cardiovascular Business - July/August 2008

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