Create a ‘Wow!’ experience for your patients

Providing unforgettable “second-mile” service for your patients will have them referring family and friends to your practice.

Identify key patients in your practice needing something extra from you and your staff. What can you do to impress them with your caring, commitment, and service? If you can surprise them with outstanding experiences, you'll become know as the office who makes patients say “Wow!”

MEDICARE PAYMENTS MAY BE REDUCED IF YOU OWE OVERDUE TAXES

Beginning October 1, 2008, your Medicare Payments could be reduced if the Internal Revenue Service (IRS) needs to collect overdue taxes that you owe. The Taxpayer Relief Act of 1997, Section 1024, authorizes the IRS to reduce certain federal payments, including Medicare payments, to allow collection of overdue taxes. Should you owe such taxes and your payments are reduced, your remittance advice will reflect a provider level adjustment code (PLB) of "WU" in the PLB03-1 data field. For more information, please see MLN Matters Article MM 6125 available at:
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6125.pdf.

Rightsizing your staff improves productivity

Without the right staff numbers and skill mix, your practice's daily needs go unmet. Productivity, profitability, and patient care all suffer.

“Rightsizing” your practice involves calculating the best number and mix of staff to meet your practice goals. It does not necessarily translate to downsizing, staff layoffs, or cost savings, but it does provide major productivity advantages, including

• becoming as productive as possible
• increasing profits
• making providers available to patients while serving them well
• hiring and keeping the best employees
• giving providers the best possible support

Are you a "better performing" physician practice?

The Medical Group Management Association (www.mgma.com) annually releases a report profiling the characteristics of the nation's better-performing medical groups. The better-performing groups tended to post higher overall profits, employ larger support staffs, and bring in higher revenue than other groups.

Characteristics of the better-performing groups iare usually the following:

• Investment in information technology (IT). IT costs per full-time-equivalent physician are higher for better-performing groups, suggesting an "investment" in major capital investments
• Higher productivity. The top groups conduct many more procedures per year than their counterparts
• Improved cash flow. Better-performing groups consistently lowered their gross fee-for-services charges in accounts receivable (A/R). They also post significantly lower A/R days than others, had higher collection percentages, and had substantially lower levels of debt

Long waits top patient complaints

Patients' top complaint about physicians is the amount of time doctors make them wait for treatment, whereas physicians' top complaint about patients is their failure to follow prescribed treatments, according to a Consumer Reports survey that examined both physicians' and patients' attitudes.

Patients also complained that physicians

• couldn't schedule an appointment within a week—19%
• spent too little time with the patient—9%
• didn't provide test results promptly—7%
• didn't respond to phone calls promptly—6%

Doctors' other complaints about patients include that they

• wait too long before making an appointment—41%
• are reluctant to discuss their symptoms—32%
• request unnecessary tests—31%
• request unnecessary prescriptions—28%

Leverage tax breaks for disability insurance

In the tax world, you usually can’t have your cake and eat it too.

Example: If physician practice employers provide disability insurance coverage to employees (including physician employees) on a pretax basis, any actual disability benefits paid out are taxable to the employee. On the other hand, if employees pay for coverage with after-tax dollars, any future benefits they receive would be tax-free.

Strategy: Physician practices can give their employees a choice. The practice can set up a disability insurance plan so that employees can choose their tax poison. Either they are taxed up front on the coverage or they can choose to elect to avoid tax until the benefits are paid out.

Are employers allowed to give employees the choice? The IRS recently approved this type of setup. (IRS Revenue Ruling 2004-55) The ruling says that it’s OK for employees to switch their positions in a subsequent year. Employees might choose to pay tax up front as they near the end of their working careers, especially if their health is beginning to fail. That way, any actual disability payments will be tax-free. Conversely, younger employees might generally opt for tax-free coverage, figuring it’s unlikely they will receive any disability payments.

Interviewing is not an easy task

"The closest we ever come to perfection is when we write our resumes"

I heard this saying yesterday and it reminded my again why all physician practices should be diligent regarding the interview process and checking up on new hire references. I'm a big fan of situational interviewing - asking the applicant specific questions/scenarios related to their applied-for job duty and see if they know what they are talking about. You can tell pretty quick if someone is a good applicant or not.  For example, I asked a billing candidate to explain to me what CPT and ICD codes are and she had no clue even though she showed billing experience on her resume - good grief!

So always remember the saying above as you are interviewing employee candidates and think - have you ever seen a really bad resume? They are out there as you know and it is your job to weed out the bad ones and find the good ones. A difficult task at best.

Consider what type of scheduling may work best for your practice

There are many types of scheduling so sometimes it is hard to know where to begin. The first places to look are to your patients, your practice, and the surrounding community's needs. Consider the two following types of scheduling:

1. Open access model. In the open access model, patients are seen within 24 hours for urgent needs, within seven days for routine care, and within 28 days for well visits. This is an extremely efficient method. It succeeds in tandem with a well-designed telephone system that enables patient access and a robust front-desk that resolves care on the first call.
2. The wave system. The wave system allows appointments to follow a steady, repetitive patient flow within a period of time throughout the day. For example, each hour contains one physicial exam, one follow up, and one urgent appointment. Make sure you take into account everyday logistics such as walk-in patients, lab courier timing, other departmental requirements, and of course, flu season.

Government and Provider Enter Into First-Ever HIPAA Privacy and Security Resolution Agreement

The HHS entered into a resolution agreement with Providence Health & Services (Providence) to settle potential violations of the HIPAA privacy and security rules. Pursuant to the resolution agreement, Providence agreed to pay the government $100,000, and develop and implement a Corrective Action Plan to ensure that it appropriately safeguards electronic patient information. This marks the first time that HHS has entered into a resolution agreement with a covered entity for possible violations of HIPAA, as no violations were admitted. The agreement stems from lost and stolen backup tapes, disks and laptops that contained the health information of approximately 400,000 patients. HHS had received more than 30 complaints about the missing tapes and laptops. Although the government has not been overly aggressive in enforcing HIPAA violations, this agreement shows that the federal government will step up HIPAA enforcement in cases in which unauthorized disclosure involves multiple patients and where HHS receives many complaints about the same incident. To view the settlement agreement, go here:

http://www.hhs.gov/ocr/privacy/enforcement/agreement.pdf

Congress Approves Bill to Expand the ADA's Definition of 'Disability'

Congress gave final approval yesterday to legislation that will bring more Americans under the umbrella of “disabled” under the Americans with Disabilities Act (ADA). President Bush said he’d sign the bill (S. 3406).

The ADA Amendments Act of 2008 reverses several court rulings from recent years that had limited the scope of ADA protections. It directs U.S. courts to apply a broader definition when deciding what truly qualifies as an ADA-covered disability.

The biggest change: The bill makes clear that courts (and employers) should not take into consideration any “mitigating measures” that reduce the impact of an impairment—such as medication, hearing aids or other assistive technology—in determining whether an employee is “disabled” under the ADA.