Practice Management

I recently provided care for a patient visiting from another state. He filed an out-of-network claim for my services, but his insurer refused to pay, and he hasn't responded to the bill I sent him. What should I do?

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After May 23, only this identifier will get your Medicare claims paid.

Trading e-mails with patients is easier than playing phone tag, and you may even get paid for it.

A physician left our group recently and we hired a locum tenens until a replacement can be found. Can we use the previous physician's provider number with the Q6 modifier for billing purposes until then?

Our practice has been using immunization codes 90465-90468 for patients who are 8 or younger and 90471-90474 for older patients, but we were recently told that this is incorrect. Can you tell us what's wrong and how to fix it?

I'm employed by a large group practice in a resort community that participates in Medicare. Several resort owners have asked me to provide weekend and evening care to vacationers. They'll inform anyone who wishes to use my services that I take cash only and will not bill third-party payers. They also suggested that I set my fees to "adequately compensate" me for being on call. Is this is too good to be true?

The push for e-prescribing is heating up, with bills in the House and Senate that would penalize providers who don't abandon paper scripts for Medicare patients by 2011.

To cope with the surge in skimpy health insurance policies, adjust your billing and payment procedures. Here's how.

When I resign from my current group, I want to maintain my current health plan affiliations. The prospect of recredentialing with three dozen plans simultaneously is mind boggling. What's the best way to handle the administrative hassle?

During the summer when the physicians in our cardiology group take three- and four-week vacations (not at the same time), our office hours are reduced. That results in a lot of down time for our staff. With reduced hours cutting revenue, we can't afford to pay people for just sitting around. How can we organize our summers to keep everybody busy?

A senior partner has announced his plan to retire from our single-specialty group practice. We have a buy-out in place and expect his departure will be amicable. However, we have no experience with managing the details of a doctor's departure. For example, when should he tell his patients and referring doctors that he's leaving? What else do we need to do?

A physician we hired didn't work out, so we had to let him go after a few weeks. At that point, his credentialing with Medicare still wasn't complete. How can we get reimbursed for the Medicare patients he saw?

What can you do when an insurance carrier continues to deny clean claims?

The hospital where I have privileges provides a free answering service. If a patient or physician needs to speak to me after hours, he calls the hospital, and the operator there forwards the call to my cell phone or pager. Am I violating antikickback laws by accepting this service?

I sometimes waive coinsurance for patients struggling to make ends meet. I tell them to ignore the bills and collection letters I send because I'll just write off their balances as bad debt. Is this legal?

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The author built up her practice and became a local celebrity by writing a newspaper column.

These key questions can encourage patients to change their eating habits and shed pounds.

This doctor learned that reading others' chart notes is not enough.

You can't always count on getting top dollar, but there are still ways to get the best deal possible.

Patients with multiple health problems and multiple meds often ask-in many cases, repeatedly-why they take so many pills or why they need a particular drug. A time-consuming review of the function of each medication generally follows, along with a discussion of the benefit to the patient, indications and contraindications, and possible alternatives. Since this typically occurs after I've completed a physical exam, can I use code 90862 "Pharmacologic Management" in addition to the level of service for these patients?

While reviewing old accounts, we discovered numerous payment errors involving patients with primary and secondary coverage. Often, when the primary insurer issued a payment, our staff made an adjustment based on the allowed amount indicated on the EOB. Then the secondary insurer paid a portion of the write-off. The question now: Who should get the refund--the insurer or the patient?

One of my associates is treating the father of the senior partner in our corporation and billing Medicare for his services. It's my understanding that CMS doesn't permit a physician to bill for medical services provided to his own family members or those of other doctors in his group, but others in our practice disagree. Who's right?

When you practice medicine in the palm of your hand, you'll want a smartphone and cutting-edge programs. Here are the best.

We didn't participate in the Physician Quality Reporting Initiative for 2007, but would like to do so this year. Where can we find reliable information about the changes in codes and reporting measures that took effect in January 2008, and how to use them?

One of my patients has sued the hospital where I attended him. His lawyer wants to ask me some questions about the case. I haven't been named as a defendant. Should I talk with the attorney?

Several of my patients have said they'd follow me to my new practice. However, there's one I'd prefer not to continue to see because he's extremely hostile and verbally abusive. Since I've been his physician in the past, am I obligated to see him at my new office?

I declined to renew my provider contract with an insurer whose reimbursements are too low. Who should notify the affected patients--the health plan or me? If it's up to me, what should I say?