Practice Management

With the number of hospitalists rising, office-based physicians are (gratefully or begrudgingly) getting accustomed to using them.

The best defense is a good offense, say these CPAs.

Our group employs an anesthesiologist. Sometimes he'll perform the pre-anesthesia service in our ambulatory surgery center, only to have the surgery cancelled because of a particular medical reason. Can we get paid for his work?

I occasionally encounter a Spanish-speaking patient who has a complex problem that requires an extensive explanation, and I spend a great deal of time making certain he comprehends what I'm telling him. Can I get compensated for the extra time I spend during these visits?

A couple of colleagues have told me that there's no true doctor-patient relationship in a workers' compensation exam because it's conducted at the request of the employer, not the patient. Do I still have to worry about malpractice liability?

With an EHR, doctors no longer have to worry about long-term off-site storage of thousands of paper charts. Is storage as simple as backing up the records onto discs or cartridges and keeping them in a bank vault?

Sometimes I get held up in the exam room by someone who just wants to chat. How can I end the visit without offending the patient?

I recently dismissed a patient from my pediatric practice. When the child's father asked why we let his son go, we explained that his wife had been abusive to my staff. Now she claims we had no right to release this information to her husband without her consent. Did we violate HIPAA or any other privacy rule?

We decided to have a certified coder review our charts to help us straighten out any coding and documentation problems. The auditor used the 1995 evaluation and management guidelines. She told me that when I documented the exam portion of a visit, I included both body areas and organ systems in the note and that's inappropriate. I can't see why that's a problem. Is she right?

Hospitals can help you buy this software

You'll applaud some changes, but have trouble with others.

More than 80 percent of California primary care doctors-excluding those in the Kaiser Permanente system-rarely communicate with patients online.

My employer reneged on his promise to offer me a partnership after three years as an associate. Instead, he offered me a productivity bonus, and I accepted it. For the next four years I stayed with the practice, and now I want to find a new job. Am I still bound by the original noncompete agreement I signed when I joined the practice? It says I can't work in the area for two years after I leave.

Generic dispensers can boost patient compliance, but they may not help your bottom line.

Many of the claims we submit for Medicare patients who have Medigap insurance are being rejected. Since we aren't doing anything differently with these crossover claims, what's changed?

Many of the claims we submit for Medicare patients who have Medigap insurance are being rejected. Since we aren't doing anything differently with these crossover claims, what's changed?

In an effort to catch more HIPAA violations, the government has engaged a private consulting firm, PriceWaterhouseCoopers, to conduct security audits of covered entities, including hospitals, pharmacies, health plans, and private practices.

Can the government demand access to health records usually protected under HIPAA to investigate healthcare fraud?

For the past 32 years I've been the only specialist in my field in the region. How can I break the news of my upcoming retirement without alarming my patients about the lack of care in the community?

My employer reneged on his promise to offer me a partnership after three years as an associate. Instead, he offered me a productivity bonus, and I accepted it. For the next four years I stayed with the practice, and now I want to find a new job. Am I still bound by the original noncompete agreement I signed when I joined the practice? It says I can't work in the area for two years after I leave.

Weigh the pros and cons of four major scheduling strategies, and see what could work best for you.

Some doctors are doing it successfully, but costs and logistics can make it a challenge. Here's what to watch for.

Despite state laws and class-action settlements, many insurers still force doctors to take plans they don't want.

You think you're doing great-but does your boss agree? Here's how to know what the practice leader expects of you.

We're confused about billing chemotherapy hydration. Many times a patient will present in a very dehydrated state and require hydration therapy before we can begin infusion therapy. Other times, the hydration is part of the protocol for the infusion therapy. Is the coding different for these two scenarios?

A member of my group is fed up with Medicare. He has his Medicare patients sign an Advance Beneficiary Notice prior to rendering services, then the patients pay him and he tells the billing department not to file claims for those services. I'm concerned that what he's doing isn't correct, and that his actions will negatively affect the group. Am I overreacting?

A local hospital notifies us when they've admitted some of our patients by faxing a list of names (normally three or four names at a time) to our office. We make a copy of the page for each patient's chart and then use a marker to black out the other names on the list before filing it. Does this practice violate privacy rules?

I plan to start my own strictly fee-for-service practice but continue to work part time for my present employer. In that position, I belong to several health plans. Does being on the panels of these plans obligate me to accept their members in my own practice?

Our community hospital recently opened some offices staffed by newly-recruited family physicians. Now, some of my patients who received care at the hospital's ED say that doctors there tried to refer them to these new physicians for follow-up care. Aren't there laws against poaching another doctor's patients?

Our ten-physician multispecialty clinic is negotiating a contract with a new management company to oversee office functions, including billing and collections. Our previous management company charged 10 percent of net collections for such services. What's the going rate?