Practice Management Q&A

April 4, 2008

Coordinating physician and staff vacations; A major health-plan recredentialing project; When a patient refuses your letter

Coordinating physician and staff vacations

During the summer when the physicians in our cardiology group take three- and four-week vacations (not at the same time), our office hours are reduced. That results in a lot of down time for our staff. With reduced hours cutting revenue, we can't afford to pay people for just sitting around. How can we organize our summers to keep everybody busy?

This is a perfect opportunity to encourage staff to take their vacations at the same time as the doctors. For example, you could offer two extra hours of vacation for every day they take when a physician is out of the office during the summer "slow down." That could add up to over two additional vacation days that must be taken during the summer.

A major recredentialing project

When I resign from my current group, many of my patients plan to follow me to my new solo practice. To accommodate them, I want to maintain my current health plan affiliations-all 36 of them. The prospect of recredentialing with three dozen plans simultaneously is mind boggling. What's the best way to handle the administrative hassle?

Start early. If you're not credentialed when you start seeing patients at your new practice, some plans will refuse to pay you. You'll need at least two to three month's lead time.

You can engage an outside billing service to handle your recredentialing. Or find an experienced, capable person from another doctor's office to take on the assignment as a moonlighter. Or, if you plan to do your billing in house, hire a biller now. She can take on the recredentialing project, start training on your computer system, and possibly help deal with other start-up matters.

Whomever you hire should start by contacting the CAQH, the Council for Affordable Quality Healthcare, a not-for-profit alliance of more than 350 health plans and organizations. Their free credentialing service, the Universal Credentialing DataSource, allows you to credential with participating health plans with one standard application. You can check to see which plans participate with the UCD at http://www.caqh.org/ucd_healthparticipating.php.

When a patient refuses your letter

A patient refused delivery of my certified letter dismissing him from my practice for noncompliance. Now what?

Try calling him. If you deliver the message, document all that was said. Don't leave a voicemail if he doesn't answer.

You could also send an e-mail. Use "Personal and Confidential" as your subject and turn on the return receipt feature that lets you know when the message was opened. Save copies of your original message and the receipt in the patient's chart.

You could also try sending the letter again. Be sure to document every delivery attempt in the chart.

In this issue, the answers to our readers' questions were provided by: Judy Bee, http://www.ppgconsulting.com/, La Jolla, CA; Lee J. Johnson, JD, Mount Kisco, NY; Judy Murray, Clayton L. Scroggins Associates, Cincinnati; David C. Scroggins, CHBC, Clayton L. Scroggins Associates, Cincinnati.

Send your practice management questions to: PMQA Editor, Medical Economics, 123 Tice Blvd., Suite 300,Woodcliff Lake, NJ 07677-7664, or send an e-mail to mepractice@advanstar.com (please include your regular postal address).