Practice Management

Coding modifiers are often underused, misused, or submitted without supporting documentation. Here's how to end these costly mistakes.

When I serve on the ED call roster, I frequently see elderly patients. Recently, I've received several requests to fill out FMLA forms from adult children who accompanied their parents to the ED and then took time off from work to care for them after they left the hospital. I only cared for these patients in the ED. Do I have any obligation to fill out these forms?

One of our receptionists shows absolutely no initiative. She makes no effort to promptly answer the phone, doesn't file unless she's asked, and never offers to help the co-workers who frequently assist her. On the other hand, she has a wonderful personality and has been with us for seven years, with perfect attendance. Is there any way to rehabilitate her?

How do I handle a patient's demand for a refund for an outcome that was less than perfect?

The author realized his minor, commonplace errors were hampering patient care. See if any of them ring a bell for you.

Physicians must put patients first, but you also need to be profitable. Here's how doctors tackle the wrenching decisions about money and ethics.

Posting an ad for an associate is not enough. You need to convince job candidates that your practice is desirable.

Our practice has never billed for extended visits, but we often spend a great deal of time counseling patients. How do we go about reporting extended visit codes? What else needs to be documented besides the history, exam, and medical decision-making?

One of our physicians was called to active duty earlier this year. We've hired a substitute doctor and plan to bill his services as a locum tenens physician. Our concern is that we can only do this for 60 days. Do we need to find another replacement after that time has elapsed or can we ask for an extension?or discharge and rehire the same locum tenens doctor?

Our family practice routinely sees patients after they've been treated in the ED for lacerations, fractures, and similar injuries. We've recently seen an increase in claim denials for such services because the ED physicians are billing for complete care for procedures, even though we're doing the follow-up. What can we do?

Twenty-eight percent of medical practices still don't accept credit card payments, according to a survey by SK&A Information Services.

The number of disciplinary actions taken against doctors has dropped during the past two years, according to the Federation of State Medical Boards.

Angie's List, a website where visitors can read--and write--reviews about service providers, is adding healthcare practitioners to the mix of businesses it holds up to scrutiny.

More than eight in 10 Pennsylvania residents have failed to prepare an advance healthcare directive that would guide their family, doctors, and other clinicians in an end-of-life situation, according to The Institute for Good Medicine at the Pennsylvania Medical Society.

Health insurance costs everyone more these days, but mom-and-pop businesses feel the greatest pain, according to a newly released study from the RAND Corporation.

CMS is adding to the list of preventable injuries or conditions that Medicare won't pay higher rates for if they're acquired in the hospital, such as a transfusion of the wrong blood type.

Remember internist David Brailer, once the point man for EHRs in the Bush administration? He’s now the chairman of a private-equity firm that’s bankrolling a healthcare IT startup with its own cast of ex-public servants.

Talk about being stuck in the 19th century. Twenty-eight percent of medical practices still don’t accept credit cards, according to a survey by SK&A Information Services.

In my state's prescription monitoring database, I found that one of my patients has been getting prescriptions for the same DEA-controlled medication from several physicians. Can I report this to the other prescribers?

I'm a PA, employed by a company owning multiple skilled nursing facilities in our city. I don't have provider numbers with various insurers, but I see patients with the oversight of an MD who's not always onsite. My services are being billed with the provider numbers of the "supervising" physician. I'm new to practice, so I'm not sure whether this is a problem? Is it?

Our practice's employees often leave during the day to take care of personal matters. Although they claim they make up the lost time by working through lunch, I suspect they're not putting in the 40 hours a week we're paying them for. Should we be flexible and allow them to come and go as long as the work gets done, or should we insist they adhere to a regular 9 to 5 workday?

I'm one of several physicians employed by a hospital. None of us are supervisors. When we asked for a raise, the hospital cut off negotiations and threatened to fire us. Can we form a union to negotiate for better wages?

Want to spend more time with your patients? Consider a retainer practice.

Seeing patients when they want to be seen helps you respond to their needs and stay competitive.

A growing number of doctors are dedicated to keeping the small practice model alive. In using innovative strategies to keep solo or small group practices successful, they're stubbornly bucking a trend that's become familiar in recent years.

Clutter can impair office efficiency and even hamper revenue collection. Here's how to cure the too-much-paper bottleneck.

We've been using the NPI on our electronic claims for several months without a problem. Suddenly we've begun receiving rejections from virtually every commercial insurer. Our clearinghouse indicates that the problem is the information contained in the NPPES (NPI) files, but we've scrutinized these files for each of our providers and corrected any misinformation and are still having problems with claims. Is there an issue we're unaware of?

Our surgery practice has a satellite office in a nearby hospital. We report place of service 11 (office) for the E&M services we provide at that location, but our Medicare carrier recently notified us that because we're located in an outpatient hospital facility, we should be specifying place of service 22 (outpatient) instead. Is this correct?

I recently discharged a patient who repeatedly abused his medications by taking more than I prescribed, although I didn't state this in the termination letter. But now he insists that we give a reason, in writing, and wants to schedule an exit interview. How should we handle his demands?

Our practice has grown rapidly. Our office manager?a former biller who moved up the ladder?can't keep up with the expanded responsibilities. How do we tell a loyal employee that she's no lmedical practice,office manager,practice administration onger up to the job?