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18 posts from March 2006

March 31, 2006

Free special report on HIPAA final enforcement rule

The HIPAA final enforcement rule took effect March 16. Organizations looking for help in interpreting the new rule now have a free resource available to them.

HCPro, Inc., is providing a free, 10-page special report that includes

  • analysis of the rule’s provisions
  • tips for avoiding enforcement activity
  • clarification from experts on the Department of Justice’s opinion on enforcement
  • latest statistics on patient complaints from Rick Campanelli, former director of the Office for Civil Rights
  • advice on how to respond to complaints and avoid an investigation

To get your free special report, "HIPAA’s Final Enforcement Rule: Understand Changes and Avoid Penalties," HCPro asks that you participate in a short five-question survey. Once you complete the survey, you’ll be provided a link to instantly download your informative special report.

Click here to take the survey and receive your copy of the special report.

March 30, 2006

Think your practice is embezzlement-proof?

An office manager steals $120,000 from a Florida pulmonologist who claimed that his bookkeeping system was "foolproof." A trusted bookkeeper embezzles $330,000 from a Connecticut surgeon by forging his signature on checks and depositing them in her own account. Think your practice has a foolproof financial system? It may not be good enough to stop a determined thief.

Read this excellent article; this link may be available for only a limited time:

Rice, Berkeley. "Practice pointers: 10 ways to foil an embezzler," Medical Economics, March 17, 2006. Read the article.

Also, you can find articles on the same subject in the MGMA Knowledge Center by searching the Article Archive under "theft."

March 29, 2006

Four words sum up physician administrator incentive plans: To each its own

From the Medical Group Management Association:

Although 73.2 percent of medical practices that responded to an informal questionnaire reported that they have administrator incentive plans, the types of incentives varied significantly. According to the MGMA Information Exchange "Administrator Incentive Plans":

  • 51.2 percent offer a bonus based on practice profit;
  • 47.9 percent offer a raise based on merit;
  • 45.5 percent offer a discretionary cash award for exemplary performance;
  • 36.4 percent offer profit sharing; and
  • 4.1 percent offer a discretionary noncash award for exemplary performance.

The MGMA Information Exchanges depend on voluntary participation and may not be representative of the industry. Readers are urged to review the entire questionnaire report when making conclusions regarding trends or other observations.

Purchase "Administrator Incentive Plans." from the MGMA.

March 28, 2006

OIG Posts New Advisory Opinion 3/27 Home Health Agency Free Preoperative Home Safety Assessment

To access the Advisory Opinion document, 06-01 (concerning a home health agency's practice of providing prospective customers with a free preoperative home safety assessment) go here:


For the index of recent OIG Advisory Opinions, follow this link:


To see "Frequently Asked Question (FAQs) on the OIG Advisory Opinion process, go here:


March 27, 2006

Four steps toward worthwhile physician-candidate interviews

Keep your physician-recruit interviews on track by focusing on the main objective: assessing the applicant's intellect, medical competence and people skills. Further, look for good chemistry between you and the potential new associate. During the actual interview, follow a four-part outline to make sure you cover all the bases. Structure the interview along these lines:

1. Break the ice. Set the meeting's tone right away by doing your best to make the candidate comfortable.

2. Explore the candidate's background. Carefully study the doctor's curriculum vitae before going to the interview. Jot down questions to ask based on the résumé. As candidates recount their own background it reveals personal opinions, self-assessment of strengths and weaknesses, values and motivations.

3. Explore the candidate's medical skills. This is not time to conduct a technical oral exam. Rather, ask questions like,;What do you do if . . . and describe a patient problem or symptoms. Listen carefully for technical know-how (diagnostic and procedure skills) and for how the recruit approaches patient care in general.

4. Discuss business issues. If you still have strong interest in the interviewee, present him/her with a written, non-binding outline proposing the employment arrangements. Keep the outline simple, but make sure it covers the offer's main components.

March 25, 2006

Physician leaders should bring your data when pitching expenditures to partners

If you want the doctors in your group to make a major financial commitment next year, bring data when you make your pitch.

Passionate opinion drives most shareholder meetings (annual or otherwise). However, as we all know, you'll face stiff resistance when battling that opinion. Switching the debate to;clarity of argument supported through data; provides your best chance to sway skeptics' opinions.

Gathering that data and preparing the presentation for the meeting becomes the challenge of the leader doctor and top manager. Usually, there's a problem or challenge the group must address -- sometimes, hopefully, an opportunity. Don't begin discussing the issue at the meeting; the leaders should come into the meeting with a proposed solution or plan for what action the group ought to take.

And once the discussion starts, don't stop until you address these five objectives:

1. Create a plan for the group's next step.

2. Identify resources for learning about the situation

3. Squarely address the need for time and money.

4. Agree on how you'll measure success or failure

5. Assign responsibilities and accountability.

March 23, 2006

5 practical tips on paying part-time employees in a Physician practice

From the Americian Institute of Professional Bookkeepers (www.aipb.org):

1.      Withhold FICA on part-timers (and retirees). Even if someone who works for you part-time also has a full-time job where they have had 100% of their FICA withheld for the year, you must withhold the full amount of FICA from their pay. These individuals can obtain a refund of any overpaid FICA on their 1040. Similarly, if a retiree receiving Social Security benefits works for you, say, one day a week, you must withhold FICA.

2.      Former employees who come back to work for you are most likely employees—not independent contractors.  If they do the same job they did before they left, especially in the same tax year, they are employees.

3.      Length of employment does not determine worker status. Even employees who work for only part of one day are still employees, and all employment taxes apply.

4.      Giving part-timers benefits is optional. Generally, you do not have to pay part-time or summer help for holidays and need not include temps and part-timers in health, pension and other benefits. But to exclude them, have a written plan stating which benefits are not available to these workers.

5.      Defining “part-time” v. “full-time” employees. For purposes of paying overtime under federal law, this distinction is determined by company policy, not federal law. Federal wage and hour law restricts only the number of hours worked in the workweek, when overtime must be paid (for each hour worked over 40 hours in the workweek), and the number of hours that children can work.

March 22, 2006

Physicians seeking growth turn to marketing firms

Just hours after the government approved a medicated patch for depression, an e-mail went out offering reporters the opportunity to speak with a "doc in private practice stunned at FDA approval of depression patch." While Eric Braverman was being interviewed over the phone by a reporter, another call came in: CNN was on the line. Score another one for the doctor's public-relations agent, Hope Kaplan.

A decade ago, the idea of doctors and dentists marketing themselves would have been shunned by the medical community. Now, driven by higher costs and inspired by direct-to-consumer pharmaceutical ads, doctors are hiring publicists to increase business.

But don't call it marketing – doctors call it "practice development." "There has to be this admission that being in medicine is also a business," said Rudy Svezia, president of DocGrow, a medical marketing firm in Englewood, N.J. He said his clientele increased sharply about five years ago, as remuneration from insurance companies decreased. Still, there's plenty of resistance to the idea. "If Dr. Jones is willing to at least investigate what marketing is about and deal with some professional sneering, he will see that he'll do better business than the guy down the street," Svezia said.

View the Complete Article on DocGrow

March 16, 2006

Seven tips to tackle high-deductible plans

The percentage of employers offering high-deductible plans jumped from 5% in 2003 to 20% in 2005, according to industry publications. It's reasonable to believe that the percentage will continue to rise in 2006. These plans present reimbursement challenges to your facility, so your managed care contracting professionals should learn how to revisit and rewrite contract language to ensure that the organization receives payment for its services.

Here are seven tips to prepare for the challenges of high-deductible health plans:

1. Examine your participating provider agreements with insurers, networks, and plans to ensure that you know which types of insurance products are included in the contract.

2. Negotiate contract language to exclude those enrolled in plans that may present collection problems in the future. Ask about these products in your negotiation. If an insurer includes high-deductible products, ask it how these products work. Learn what systems it has to assist you.

3. Learn in advance how to handle uncollectible deductibles without risking loss of payment from insurers.

4. Train staff to look for patients enrolled in high-deductible health plans. Give them scripts to ask about the deductible, whether a health savings account exists, and, if so, the amount of money and assets available to them to pay their bills.

5. Make sure that your policies for dealing with medical indigence and bad debt make sense for individuals who are underinsured.

6. Explore collections products and vendors to streamline your collection process and increase your collection rates. Learn from your collections vendors and second placement agencies what they need to increase their likelihood of collections, and incorporate this advice into your patient financial services best practices.

7. Track your experience with high-deductible products and other insurers. This will help you identify which plans cause collections problems.

This week's tip was excerpted from HCPro's monthly newsletter, Managed Care Contracting & Reimbursement Advisor. For more information, click here.

March 15, 2006

Silent PPOs and Physician Practices

In my recent healthcare newsletter (archives and subscription info can be found at my website at www.rtacpa.com under the resources tab), I wrote an article on Silent PPOs. In the February 17th issue of Medical Economics (www.memag.com), the Web Poll asked this question:

Have you been a victim of Silent PPOs?

The following were the responses:

5%     No, I check my contracts carefully

36%   Yes, but I can't stop it

25%   Yes, and I protest when I am

34%   I have no idea-I'm going to check now

"I HAVE NO IDEA"?   What is that all about???? Now you see why I stay so busy as a healthcare consultant!!!