When you drop a health plan; The cost of hiring an accountant; How to tell when a worker is earning too much; Background checks for waste haulers; If an exiting doctor takes your charts.
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Q: Our group has decided not to renew a contract with a low-paying health plan. Are we responsible for notifying this insurer's patients? What should we tell them when they call for an appointment?
A: Your contract with the insurer will tell you whether you're obligated to inform its beneficiaries. Regardless, if a covered patient calls for an appointment, your receptionist should explain that you'd be happy to see him, but he'll have to make new payment arrangements since you no longer accept his insurance. She also should tell him which plans you do still participate in, so he can consider switching.
Q:How much should my practice be spending on account services?
A: The typical charge should be 1 to 2 percent of gross receipts.
Q:How will I know when an employee's salary has maxed out? What should I do when that happens?
A: A truly valuable employee's salary is never maxed out.
If you think that you're paying a staffer more than the going wage for her position, you need to examine why. Have you awarded appropriate annual raises? Has she brought expertise, loyalty, and stability to the practice that warrants premium pay? If the answers are Yes, then she's worth every penny. Conversely, if you freeze her salary now, she might go looking for a job at another practice.
If you're facing a revenue shortfall that will make it difficult to award raises, explain the predicament to your staff. Just make sure that you at least offer a cost-of-living increase to everyone.
Q:Our internal medicine practice received a cold call from a medical waste hauler that offers a better rate than the company we've been using. Obviously, we're interested in cutting expenses. But no one in our office is familiar with this vendor. What research should we do before considering a switch?
A: First, contact the agency in your state that regulates hazardous waste disposal (usually, it's the health or environmental protection department). Ask whether the company has ever been the subject of a complaint or violated disposal laws.
In addition, contact your state medical society or hospital association. Either may have an opinion or recommendation.
Finally, ask the company for references.
Q:After 18 months, my new associate left to start his own practice five miles away. The day after he quit, he showed up at my office and took several hundred chartsmany of patients we'd both treated. We weren't legal partners or incorporated. Do I have any recourse?
A: If you had an expense-sharing arrangement, there may not be much you can do. Presumably, the other doctor's practice owns about half the charts. But if this doctor was your employee, contact your attorney immediately to explore legal ways to have the stolen charts returned to you.
Do you have a practice management question that may be stumping other doctors, too? Write: PMQA Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742, or send an e-mail to firstname.lastname@example.org (please include your regular postal address). Sorry, but we're not able to answer readers individually.
Kristie Perry. Practice Management. Medical Economics Jul. 11, 2003;80:100.