Five Ways to Reduce Overhead

Reimbursement for medical services isn’t exactly on the rise (indeed, quite the contrary in some specialties), which makes it all the more important to watch expenses carefully. Keep in mind that every little bit of saving helps, and consider these five ideas for lowering your overhead.

1. Consider volume purchasing. If you have adequate storage space, you may be able to save a considerable sum by buying items you use in large quantities in bulk. Printing and form costs, too, are often greatly reduced as the number of copies you order increases.

2. Pay invoices promptly. Some suppliers offer a small discount to customers who pay their account balances within a certain (short) timeframe. Take advantage of this savings opportunity Read the rest of this entry »

Posted in Practice Management | No Comments »

2011 ICD-9-CM Diagnostic Code Changes

by Lori Becks, RHIA

There are approximately 129 new valid diagnosis codes that will become effective on October 1, 2010. Many of these new additions are found in Chapter 14 among the codes for congenital anomalies of female genital organs, in Chapter 16 under symptoms involving the respiratory and digestive systems, and in Chapter 17 for injuries and poisoning. Significant changes were made to the supplementary classification chapter. Fifty-five of the new diagnosis codes effective on October 1st are new V codes.

Expanded Avian and H1N1 Codes

Both avian and H1N1 influenza have been expanded into three codes each. They now include codes with pneumonia, with other respiratory manifestations, and with other manifestations.

New Congenital Anomaly Codes

The new codes for congenital anomalies of female genital organs center on unique codes for Müllerian anomalies, which encompass all congenital anomalies of the uterus, cervix, and vagina since they stem from the same embryonic origin. The American Society of Reproductive Medicine recognizes seven types Read the rest of this entry »

Posted in General, In the News | No Comments »

Battling Office Gossip

How to stop loose lips and protect patient privacy, care, and trust
By Wendy J. Meyeroff

“I was sitting in a dentist’s office when suddenly a patient storms out of an exam room and confronts the dentist in the hallway,” says Kristin Baird a practice consultant at Baird Consulting in Wisconsin and The Beryl Institute. “He said, ‘I’m sick of hearing your staffers talk about who’s dating whom, or who got drunk as a skunk last weekend. I won’t be back!’”

Indiscriminate tongue wagging — even seemingly harmless statements — can affect everything from staff morale to patient care. If you think your office is gossip-proof, you might be surprised. And if you don’t get a handle on the broad range of misstatements that could affect your practice, you could face serious consequences. Here’s how to recognize and fight gossip, rumors, and simply unwise remarks.

“Harmless” staff exchanges

Gossip is almost natural, especially in close environments. Read the rest of this entry »

Posted in General, Practice Management | No Comments »

Privacy in a Social Media World: Do networking sites like Facebook present privacy problems or are they a way to build community around your practice?

By Sara Michael

One patient at MacArthur OB/GYN had a question about moving her ovulation. Others spoke freely about their experiences with an endometrial ablation procedure. Most just wanted to say “thanks” to the physicians and show off pictures of their newborns.

These medical questions and concerns — as well as helpful information on women’s health — are all online at the practice’s Facebook page.

“We are taking this giant world we live in, and we are turning it into this small town where people are interacting,” says Jeff Livingston, one of five OB/GYNs and one nurse practitioner at MacArthur OB/GYN in Irving, Texas.

MacArthur OB/GYN’s online community of about 600 people (and counting) provides a forum for questions and information shared between physicians and patients. Livingston monitors it daily, and encourages the discussions by posting links and questions.

Livingston is among a growing number of physicians joining social media networks as a way to share information with patients or connect with their colleagues. In fact, 60 percent of physicians reported using or being interested in using online communities, according to an early 2009 survey by Manhattan Research. And all signs point to this number continuing to rise.

But as the status updating, Tweeting, and blogging increases, questions about appropriate online content and patient privacy arise. Should a physician “friend” a patient online? Read the rest of this entry »

Posted in General | No Comments »

When Every Minute Counts: Easy Ways to Save Time

An eight-hour work day is 480 minutes long. That sounds like a lot, but how often have you looked up from your desk or workstation, feeling as though you’ve accomplished about 10% of what you set out to do in a morning, only to find that it’s nearly time to break for lunch. When you’re busy (and who isn’t?), time does indeed seem to fly by. If you’d like to accomplish more each week, try to think in terms of what you can accomplish right now – today, in the next hour, over the next 15 minutes, or even in tiny 3-5 minute blocks. Here are five ideas to help you make the most of each day by making every minute count.

1. Use lists. This tried and true time management technique really does work. Each Monday, make a list of all the important tasks and goals you intend to accomplish during the week. First thing each morning, make a separate list Read the rest of this entry »

Posted in General | No Comments »

Coding Questions? We’ve Got the Answers

By Bill Dacey

Hospitalist admit billing

Q A patient presents at the emergency room with a hip fracture. The orthopedic surgeon is called and he states that he cannot be there for two hours, and he then asks the hospitalist to admit the patient. The hospitalist does so. Here’s my question: Can the hospitalist perform and bill for the admission if the patient has no other medical reason to be admitted to the hospital other than the hip fracture? Also considering that the orthopedic surgeon will be billing a global CPT code for the hip repair?

A There are a lot of variables here. First, there is no definitive answer because every payer interprets these things differently. Do you want the Medicare answer? If so, what carrier? That’s probably what you want to know.

The patient is going to get admitted anyway. In the normal course of events the orthopedic surgeon would have done an ED consult, billed it with a -57, and let the admit go as part of the global, assuming surgery was done. He later would have likely turfed medical management of the patient’s problems to the hospitalist anyway, which would have been a subsequent visit on that same day.

In this delayed scenario, if the orthopedic surgeon thinks the patient needs to be admitted and stabilized by the hospitalist, then that should be enough. The orthopedic surgeon will then show up and do the surgery — and bill globally.

Don’t try to make a science of this; you have to deal with these events as they unfold, rather than define or pigeonhole the coding for every configuration of events.
Read the rest of this entry »

Posted in Practice Management | No Comments »