Practice Management Q&A

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Billing for wasted time; HMO advice; beach house raffle

Billing for wasted time and supplies

For certain procedures that require an extensive setup, we prep the room in advance of the patient's appointment. If the patient doesn't show up, some of the items have to be discarded or sterilized and repacked. Is there any way we can bill for our preparation/clean-up time or the lost supplies?

No, sorry. No carrier will reimburse you for expenses you incur when a patient misses an appointment. To solve problems like the one you cite, establish a cancellation policy: Inform patients that they'll be charged a no-show fee for any appointment missed or cancelled without 24-hour notification.

One of my partners owns a beach house. We've been tossing around the idea of awarding one week at the house to an employee and spouse. We'd draw the winner's name out of a hat at our year-end party. Will this boost morale or cause problems?

This exciting prize will no doubt boost morale around contest time, but our consultants see a potential for trouble. How comfortable is your colleague with giving employees full rein at his vacation home for a week? For example, if something gets damaged or lost, or if someone is injured, would that affect his relationship with them at work? Moreover, from a legal point of view, it sounds like a business use of the premises. Will your partner's homeowners' insurance policy cover any losses or injuries that occur under this arrangement?


Also, our consultants think the prize might unintentionally emphasize the lifestyle difference and salary disparity between the doctors and employees-and only make things more difficult when time comes to pare down annual raises or trim back office spending.

In general, it's wise to keep your private lives separate from your employees'. Consider a weekend stay at a beachside hotel, instead.

Should you help patients pick an HMO?

Occasionally, a patient asks for advice on picking a Medicare HMO and I've always obliged. Should I continue to do this?

Yes, if your experience with a certain Medicare HMO has been favorable and you have other patients who are satisfied customers, by all means tell him that. Make sure he understands, however, that joining an HMO means that his primary care doctor will be making the referral decisions, and that he may have to give up some of the specialists he's currently seeing if they're not in the plan.

Edited by Liz O'Brien,
Associate Editor

In this issue, the answers to our readers' questions were provided by: Mary Ann Bauman, MD, Integris Family Care Central, Oklahoma City; Michael Brown, CHBC, Health Care Economics, Indianapolis, IN; Kathryn Moghadas, CHBC, Associated Healthcare Advisors & TopCat, Fern Park, FL.

Do you have a practice management question that may be stumping other doctors, too? Write PMQA Editor, Medical Economics, 123 Tice Blvd., Suite 300, Woodcliff Lake, NJ 07677-7664, or send an e-mail to (please include your regular postal address). Sorry, but we're not able to answer readers individually.