Practice Management

CMS recently alerted us that we need to start billing Medicare using our National Provider Identifier. We're already doing this because we've been under the impression that this has been a requirement for some time. Can you clarify?

Recently our hospital underwent a Comprehensive Error Rate Testing audit. I have since been notified that because there were no records found for 25 percent of my billed visits, I owe Medicare an enormous amount of money. I have no control over how the hospital manages its records or which ones were requested and produced. Does CMS have the authority to do this and, if so, what should I do?

These doctors boosted their income and increased patient satisfaction by tailoring their practice to the local population.

This determined ER physician taught himself a second language so he could communicate with all his patients.

Here's how to progress from gentle to firmer methods-and when to resort to a collection agency.

We perform diagnostic testing in our office. One member of our group looks at the results while the patient's still in the office, uses that information to help determine the plan of care, but doesn't dictate the results until weeks later. We submit the claim for the testing immediately after we see the patient, but should we hold all claims until the findings are documented?

Much as I don't wish to, I may have to stop providing my patients with injections. The reimbursement doesn't cover the cost of the drug, much less the cost to administer it. Any tips on how to deal with this problem?

Our group owns an ambulatory surgery center. We heard that Medicare changed the ASC payment system effective Jan. 1, as well as the list of ASC-approved procedures. Will these changes affect our bottom line?

With the number of hospitalists rising, office-based physicians are (gratefully or begrudgingly) getting accustomed to using them.

The best defense is a good offense, say these CPAs.

Our group employs an anesthesiologist. Sometimes he'll perform the pre-anesthesia service in our ambulatory surgery center, only to have the surgery cancelled because of a particular medical reason. Can we get paid for his work?

I occasionally encounter a Spanish-speaking patient who has a complex problem that requires an extensive explanation, and I spend a great deal of time making certain he comprehends what I'm telling him. Can I get compensated for the extra time I spend during these visits?

A couple of colleagues have told me that there's no true doctor-patient relationship in a workers' compensation exam because it's conducted at the request of the employer, not the patient. Do I still have to worry about malpractice liability?

With an EHR, doctors no longer have to worry about long-term off-site storage of thousands of paper charts. Is storage as simple as backing up the records onto discs or cartridges and keeping them in a bank vault?

Sometimes I get held up in the exam room by someone who just wants to chat. How can I end the visit without offending the patient?

I recently dismissed a patient from my pediatric practice. When the child's father asked why we let his son go, we explained that his wife had been abusive to my staff. Now she claims we had no right to release this information to her husband without her consent. Did we violate HIPAA or any other privacy rule?

We decided to have a certified coder review our charts to help us straighten out any coding and documentation problems. The auditor used the 1995 evaluation and management guidelines. She told me that when I documented the exam portion of a visit, I included both body areas and organ systems in the note and that's inappropriate. I can't see why that's a problem. Is she right?

Hospitals can help you buy this software

You'll applaud some changes, but have trouble with others.

More than 80 percent of California primary care doctors-excluding those in the Kaiser Permanente system-rarely communicate with patients online.

My employer reneged on his promise to offer me a partnership after three years as an associate. Instead, he offered me a productivity bonus, and I accepted it. For the next four years I stayed with the practice, and now I want to find a new job. Am I still bound by the original noncompete agreement I signed when I joined the practice? It says I can't work in the area for two years after I leave.

Generic dispensers can boost patient compliance, but they may not help your bottom line.

Many of the claims we submit for Medicare patients who have Medigap insurance are being rejected. Since we aren't doing anything differently with these crossover claims, what's changed?

Many of the claims we submit for Medicare patients who have Medigap insurance are being rejected. Since we aren't doing anything differently with these crossover claims, what's changed?

In an effort to catch more HIPAA violations, the government has engaged a private consulting firm, PriceWaterhouseCoopers, to conduct security audits of covered entities, including hospitals, pharmacies, health plans, and private practices.

Can the government demand access to health records usually protected under HIPAA to investigate healthcare fraud?

For the past 32 years I've been the only specialist in my field in the region. How can I break the news of my upcoming retirement without alarming my patients about the lack of care in the community?

My employer reneged on his promise to offer me a partnership after three years as an associate. Instead, he offered me a productivity bonus, and I accepted it. For the next four years I stayed with the practice, and now I want to find a new job. Am I still bound by the original noncompete agreement I signed when I joined the practice? It says I can't work in the area for two years after I leave.

Weigh the pros and cons of four major scheduling strategies, and see what could work best for you.

Some doctors are doing it successfully, but costs and logistics can make it a challenge. Here's what to watch for.