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Practice Management Q&A


Receptionist qualities; two same-day visits; sabbatical leave

What makes a good receptionist?

What qualities should I look for when hiring a receptionist? My last two receptionists had trouble coping with the stresses of our busy two-doctor family practice and quit after a few months.

You need a smart person with great communication skills, who can think on her feet. The office skills can be picked up on the job, if necessary.

When two visits make more sense than one

Our clinic has a nurse case manager who provides education for diabetic and asthmatic patients. We'd like to schedule patients with her immediately after their routine care visit with their doctor, but she says that insurers won't pay for education if it's provided on the same day as an office visit. We hate to inconvenience our patients by making them return to the office on another day just to see the nurse, but we have to bill for maximum reimbursement. Is she correct? What should we do?

Yes, she's right. If the patient sees both of you on the same day, the insurer will probably bundle the education into the E&M office visit code. While it's not a hard-and-fast rule, most carriers will pay for only one E&M office visit per patient per day, unless the visits are for unrelated problems; for example, a patient you treat for asthma comes back later in the day with a sprained ankle.

If your concern is maximum reimbursement, you'll have to bring the patient back on another day. It's unfortunate if that inconveniences the patient, but you and your NP deserve to be compensated fairly for your services.

Patient-satisfaction surveys

We sent out patient-satisfaction questionnaires to 1,000 active patients and got 327 responses. Is this a statistically valid sample? And is it more or less than the normal return rate for patient-satisfaction surveys?

You're right on target. A 30 to 35 percent return rate is normal for a patient-satisfaction survey. And, yes, it's a statistically valid sample.

Getting ready for a sabbatical

I'm thinking of taking a six month sabbatical next year. I practice with two partners. What steps should we take to prepare for my absence?

Consider hiring a midlevel or two now so they'll be up to speed by the time you leave. They'll bring in extra revenue before your sabbatical and should be able to keep your practice's income at its previous level while you're gone. Alternatively, hire locum tenens doctors for that period. Ask your malpractice carrier to suspend your premium during your sabbatical.

In this issue, the answers to our readers' questions were provided by: Judy Bee,, La Jolla, CA; Keith Borglum,, Santa Rosa, CA; Judy Murray, Clayton L. Scroggins Associates, Cincinnati; Betsy Nicoletti, Medical Practice Consulting, Springfield, VT; Patricia J. Roy, DO, Muskegon, MI; Mary Jean Sage, The Sage Associates, Pismo Beach, CA.

Send your practice management questions to: PMQA Editor, Medical Economics, 123 Tice Blvd., Woodcliff Lake, NJ 07677-7664, or send an e-mail to include your regular postal address).

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Jennifer N. Lee, MD, FAAFP
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