How long can you hang on to your staffers? When an insurer rejects your encounter form; Allocating money and time to recruit a specialist; Ways to hold the line on employee benefits.
Q: What is the typical employee turnover rate for a small family practice group?
A: Our consultants say that most staffers leave after three to five years.
Q: I don't participate in any managed care plans. My patients pay at the time of service and then submit my bill to their insurers for reimbursement. I've used a commercially available encounter form for years with no problems. But recently, Blue Shield denied payment to one of my patients because the bill he submitted wasn't on a CMS 1500 form.
Can a private insurer legally do this?
A: Yes, if your encounter form doesn't contain all the information the carrier needs to process the claim. Ultimately, this is your patient's problem, since you have no contract with his carrier. But you should do everything you can to help him get the reimbursement he's owed.
Q: Our six-doctor multispecialty group needs a new ob/gyn. How long should we expect our search to take and how much should we spend on recruitment?
A: Allow six to 12 months. Budget $20,000 to $40,000 if you do your own search, $40,000 to $45,000 if you use a recruiting firm. What you'll pay depends on your practice's location, patient and payer mix, call coverage, hospital facilities, and the like.
Since ob/gyns require more time than other specialties to pull their weight, start saving now to finance this new doctor's first six months of practice.
Q: I'm a solo general practitioner with four employees. Health insurance premiums for my staff have been rising steadily and are due to go up again when I renew the policy in a few months. I've shopped around for less expensive plans, but haven't found anything suitable. Since three staffers are already covered by their spouses' plans, I've thought about dropping the benefit altogether. But I don't want to leave the fourth employee in the lurch.
What should I do to reduce the financial burden of health benefits?
A: You can drop the three covered by their spouses' plans. If you do, rewrite your office policy manual to exclude from group health coverage all employees covered by another plan. (While you're at it, add a statement reserving the right to change the policy at any time so that in the future you'll be able to respond to market changes.)
Here are some other options:
Switch to a higher-deductible plan.
Adopt a medical-expense reimbursement policy that fixes the amount your practice will pay per employee per month. Employees could apply this to the purchase of insurance through your group plan or a spouse's plan. Or they could use it to pay out-of-pocket expenses.
Institute a cafeteria plan, which would allow employees to buy only the benefits they want with pre-tax dollars.
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 9, 2003;80:127.