Cut costs, waste time? When a new employee feels "oversupervised;" Keep politics out of the exam room; The ins and outs of tail coverage; How to bill for an MA
Q:The publicly funded, rural clinic where I volunteer requires physicians to do their own coding and billing. Wouldn't it be more cost-effective to hire a staffer or independent contractor to do this?
A: Physicians should always do their own coding. But it's a waste of time for them to do billing at the expense of patient care. Ask the clinic's director to train an existing employee or to hire someone experienced in billing to take over that task. Another option is to use an outside billing agency. The clinic should seek competitive bids.
Q:A billing specialist we hired six weeks ago complained to me that our office manager watches her like a hawk. The staffer says she finds it insulting, and implied that she'll quit if our office manager doesn't back off. How should we handle this?
A: Talk to your office manager. If she says the new employee is making mistakes, ask her for details. If she can't cite any, tell her to ease up.
Assuming the billing specialist was well-screened, close supervision beyond a week or two should be unnecessary.
Q:I've written a citizen-action letter, aimed at the White House, that criticizes its handling of prescription drug costs for seniors.
What's the best way to spark patients' interest in reading and signing it?
A: Our consultants advise against looking for political allies among your patients. You don't want to risk offending or losing any over political differences. Seek signatures outside your office building.
Q:One of the doctors in our group is leaving. Who should pay for tail coveragethe practice or the departing physician?
A: If the individual members of your group are responsible for buying their own malpractice insurance, then the exiting physician must arrange and pay for his own tail coverage. If your practice has a group policy, you're probably already covered for any claims that could be brought against you because of actions that occurred during the departing doctor's tenure with your practice.
If the doctor refuses to pay for tail coverage, and your practice has no written agreement requiring him to, consider offering to split the cost with him. After all, tail coverage benefits both parties. Or find out whether the doctor's new employer offers "nose" coverage. If it does, you can do without tail coverage.
Q:Our doctors spend about 30 minutes a day reviewing lab results. Can we use CPT code 99371 to bill for the time our medical assistants devote to alerting patients of their test results?
A: You can bill for it, but you won't be paid by Medicare, and you probably won't be paid by private insurers, either.
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 Q&As. Medical Economics May 23, 2003;80:98.