|5 Tips for Avoiding Cash-Flow Problems 09/17/2014|
The rising cost of doing business alongside declining reimbursements means a much leaner cash flow. A problem with claims and major payers can reduce or eliminate revenue for a few weeks. To maintain reserves, you must remain alert to financial fluctuations. Here are five things you can do to reduce cash-flow problems.
|9 Tips for Making the Big Purchase at the AAO 2014 Exhibition 09/17/2014|
Simply navigating the world's largest ophthalmic exhibition can be overwhelming. With more than 600 booths to explore, it’s home to almost every product and service in the industry. Don’t feel daunted though — this month, members of the YO Info editorial board and the YO Committee provide tips on deciding what gadgets to buy at AAO 2014 in Chicago.
|Will I Succeed in Practice? 9 Questions for Robert E. Wiggins, MD, MHA 07/15/2014|
With medical school, residency and possible fellowship training, ophthalmologists’ education hardly lacks rigor. Yet many young physicians starting practice soon discover alarming gaps in their education as to the business side of practice. To help young ophthalmologists succeed in their careers, the Academy’s YO Committee recently developed a practice management work group to help address YOs’ needs in this area. The team recently interviewed Robert E. Wiggins, MD, MHA, the Academy’s senior secretary for ophthalmic practice.
|5 Tips for Avoiding Malpractice Hypertension 07/15/2014|
Unfortunately, we live in a litigious society. It’s impossible to eliminate the possibility of a malpractice claim as a result of performing your duties, but you can minimize the problem. Here are five tips and several resources for reducing your risk.
|Human Resources 101: 6 Tips for Avoiding Labor Law Hypertension 06/17/2014|
As a physician, your primary role is medical. In addition to providing patient care, however, every practice must also perform certain duties as an employer. While you probably pay close attention to the federal regulations that govern patient care, someone in your practice should give equal attention to the laws pertaining to you as employer. Here are six tips for improving compliance and reducing stress around the human-resources aspect of your practice.
|5 Tips for Avoiding OSHA and HIPAA Hypertension 05/13/2014|
Two areas of the practice that sometimes fail to get the attention and training required are OSHA and HIPAA. These federal regulations require annual staff training, and staff must constantly be aware of the dangers that exist if they are not purposeful and careful in their actions and words. Here are five tips to effectively train employees and monitor activity within your practice.
|5 Tips for Avoiding Medicare Fraud and Abuse Hypertension 04/17/2014|
Many aspects of running a practice are stressful. If you’re an ophthalmologist seeing patients in the United States, you most likely treat Medicare patients. Getting paid for those patients means complying with a complicated set of regulations that change regularly – and with recent payment disclosures, Medicare reimbursements are receiving new public scrutiny. What’s a new doc to do?
|9 Tips for Avoiding Contracts, Mergers or Acquisition Hypertension 03/18/2014|
Many aspects of running a practice are stressful. If you’re a new physician trying to negotiate your first job, the stress can began with the contract. To help you avoid business-contract “hypertension,” here are nine tips for navigating stressors associated with contract negotiation, mergers and acquisitions.
|5 Tips for Avoiding Health Care Reform Hypertension 02/10/2014|
Many aspects of running a practice are stressful. To help you avoid practice management hypertension, here are five tips for navigating stressors associated with the Affordable Care Act’s implementation.
|7 Tips for Avoiding EHR Implementation Hypertension 01/14/2014|
New for 2014, YO Info launches a series of practice management articles. Each month we'll give you some practical tips on a specific topic, followed by relevant Academy resources and member benefits to help you tackle this area of practice management. This month we address the major stressors associated with electronic health record implementation.
|Using Technology to Improve Your Practice Flow and Efficiency 12/03/2013|
The use of technology in ophthalmology is widespread when it comes to the medical side of the practice. But in other areas of your practice, technology lags behind. This article introduces you to the technology your practice could use to improve patient flow — particularly patient access and interoffice communication.
|Settle Your Debt! A Look at Public-Service Loan Forgiveness and Repayment 10/15/2013|
Due to the extremely high level of student debt that most physicians hold, many are eligible for several types of forbearance and debt-reduction programs. The difficulty lies in choosing among them all. This article focuses on one of the more common debt programs for U.S.-based physicians, the federal 10-Year Public Service Loan Forgiveness (PSLF) program, and the differing repayment options involved.
|Getting the Last 10 Percent: Fixing Billing and Collection Performance, Part 2 09/17/2013|
Last time, we took a look at the difference between mediocre and outstanding billing and collection results, identifying exactly where you should apply extra attention to increase your practice’s collection of receivables. This month, we continue discussing improvements, beginning with accounts receivable (A/R) follow-up.
|Getting the Last 10 Percent: Fixing Billing and Collection Performance, Part 1 08/13/2013|
The billing and collection process closely resembles the clinical processes used to evaluate and manage a patient’s medical eye problems. During a medical examination, all components of the history and/or exam must be completed. If even one is omitted, an incorrect diagnosis could be made and improper treatment could be initiated, usually with suboptimal results. In this article, we’ll look at the difference between mediocre and outstanding billing and collection results. We’ll also identify where applying extra attention can increase your practice’s collection of receivables from around 90 percent to 100 percent.
|How to Improve Practice Efficiency with Effective Policies and Procedures 07/15/2013|
As busy administrators, we are constantly searching for ways to maximize resources and accomplish more in less time. Clearly written policies and procedures can help us attain greater efficiency by requiring less training time and disciplinary action. While creating these policies and procedures can be time consuming, the benefits far outweigh the work required to get the initial version completed. Such documents establish uniformity, accountability and expectations to create clear lines of responsibility and allow staff to take ownership of their duties. These documents empower our staff, and they empower us as managers.
|Secrets of Financial Success for Young Ophthalmologists 06/10/2013|
Imagine you have just finished residency and are starting your medical career. You may feel relieved to finally have those years of schooling and training behind you. But then reality sets in, and you wonder how you are going to deal with the medical school debt that you’ve accrued. How can a young physician balance the financial stresses of overwhelming medical school debt with buying a first home, saving for retirement, buying a new car and, at the same time, enjoying life? Let’s approach this question with a specific plan of action and some principles that can help any young physician.
|The Five Steps of Supervision, Part 2 05/14/2013|
A system is an established, step-by-step way of processing work efficiently and effectively. Last month, we looked at how a systematic approach to managing staff can help your practice run more smoothly. However, employees also bear responsibility for their individual positions within the practice. Here, we’ll look at the five steps of employee responsibility that complement the five steps of supervision we introduced last time.
|The Five Steps of Supervision, Part 1 04/15/2013|
“Putting out brush fires – that’s all I seem to do!” lamented the office manager. “From the time I get here in the morning until I leave the office late at night, I am constantly dealing with staff problems. I can’t seem to get anything else done!” I listened carefully, then asked her a couple of questions. Her answers were excellent qualities that managers should have, but they didn’t describe a system for managing employees. A system will help you to get the most productivity from your employees by helping them develop their skills and talents. This can be accomplished by implementing the five steps of supervision.
|How to Create a Simple (But Effective) Practice Budget 03/11/2013|
In today’s ever changing marketplace, creating a meaningful practice budget is a necessity. An accurate, useful budget can be a valuable decision-making tool to analyze potential business threats and opportunities and help physician owners and practice administration make sound strategic and disciplined choices. However, too few practices actually take the time to create a budget, instead seeing the endeavor as a complex, time-consuming process that likely will not be used. This article introduces a simple approach to creating an effective practice budget.
|How to Manage a Challenging and Diverse Staff 02/12/2013|
In the eyes of most managers and administrators, one of the most difficult aspects of management is human resources. No two people are the same, but the key is not to let a difference of opinion or personalities evolve into an antagonistic relationship. How do you effectively manage diverse and sometimes difficult personnel? Here are some suggestions for optimizing your staff-management skills.
|How to Get an Effective Practice Website 01/14/2013|
Providing quality medical care is paramount to a practice’s success, but informing current and potential patients and colleagues of your practice’s offerings is equally vital. Every medical practice should have an effective Web strategy for site development and maintenance, marketing activities and metrics tracking and strategy optimization based on the results. Practices that institute and maintain a well-thought-out online presence tend to be more successful than those that lack a strategy or those that implement only a partial strategy. Here are some pointers for getting it right.
|Eight Pearls for Joining Your First Practice 10/16/2012|
You are almost there. The light at the end of the tunnel is fast approaching, and frankly, can't come soon enough. As you begin this process, the most difficult question initially might be where to start. The following pearls are a culmination of advice from a number of sources and people who have been in your situation.
|Protect Your Online Reputation and Grow Your Patient Base 10/16/2012|
Whether or not you consider yourself Internet savvy, the reality is that patients are increasingly turning to the Web to assess potential health care providers. Online reviews have a major impact on your business and that frightens a lot of practice owners. But online reviews cut both ways: they can drive patients away or they can serve as a powerful and free advertising tool. Below are some general principles for making sure your practice’s online reviews work for you rather than against you.
|Doctors in Dialogue: Three Experts on ACOs and Ophthalmology’s Future 09/10/2012|
As a follow-up to last month’s introduction to accountable care organizations, we asked three physician experts to weigh in on ACOs. David Asch, MD, is an expert on physician incentives; Margaret Paroski, MD, is chief medical officer for a large health care organization managing several hospitals and associated with numerous specialist groups in western New York; and Stephen Kamenetzky, MD, is the Academy adviser to the AMA’s Relative Value-Scale Update Committee (the “RUC”), which advises CMS on physician-payment rates.
|A Primer on Accountable Care Organizations 08/14/2012|
Over the past three decades, we have seen enormous advances in medical care as doctors have developed better ways to diagnose and treat patients. During the same time, there have been many changes in how that care is paid for and where it is delivered. Those of us who have lived through various iterations can be forgiven for our skepticism about any new “system” purported to revolutionize the delivery of health care. However, the newest acronym — ACO — stands for a concept that could represent a sea change in the very complex system of medical care that we have in our country.
|Trouble with Your EHR? When to Convert to Another System 07/16/2012|
Buying and implementing an electronic health record (EHR) system is the biggest decision a practice will ever make. EHR systems can have both positive and negative impacts on a practice’s operations depending on the vendor’s qualifications and how the system is implemented. Keep in mind that vendors are not responsible for all failures, however. Some practices find it extremely difficult to implement change, while others have buyer’s remorse and regret their decision to purchase an EHR system altogether. Practices can also find it difficult to adjust to an EHR system when it does not meet their own unique needs and requirements. This is especially true for ophthalmology practices, given their specific complexities.
|Applying the Science of Quality Improvement to the Ophthalmology Practice 06/11/2012|
Concerns about health care quality and cost containment have moved to the forefront in political debates about health care and federal and state budget deficits. Despite the U.S. health system’s proven ability to treat complex, serious illnesses, studies have shown that patients are not receiving basic, cost-effective care known to reduce death and disability, such as cancer screenings and diabetic eye exams.
|10 Ways to Improve Medical Collections 05/14/2012|
It’s a problem faced by virtually every medical practice — dealing with patients who pay their bills late, or not at all. Accounts not paid within specified terms can severely impact the overall cash flow of a practice. A clearly defined, carefully communicated, yet diplomatic payment policy may help avoid difficult collection situations. These 10 simple steps can dramatically improve collection results.
|When Physicians Leave a Practice: Seven Keys to a Smooth Transition 04/16/2012|
Physicians leave practices for many reasons, including illness, changes in employment status and personal or family needs. Both the individual ophthalmologist and the practice need to take steps in order to promote continuity of care, prevent allegations of abandonment and ensure that all involved physicians have access to the medical records in the event the care is ever called into question. Taking these steps will also ensure compliance with provisions of contracts and with requirements of state medical boards. Here are several keys to handling the transition appropriately.
|Hiring a New Physician — Answers to Some Key Questions 03/12/2012|
Most practices eventually need to add a new physician, whether to meet increasing demand or to maintain practice capacity. If you’re considering the addition of a new associate, here are answers to some of the critical questions involved.
|Team Building: An Essential Management Skill 02/13/2012|
The passage of health-care reform and the change in workforce expectations after a prolonged recession will challenge any ophthalmology practice. To achieve operational success, you will need to become even better at creating and maintaining effective teams in the office.
|HIPAA and Social Networking Sites: A Legal Minefield for Employers 01/18/2012|
As recent statistics demonstrate, social networking sites are more than just popular, they are changing the way people communicate and maintain connectivity, as well as being used in the hiring process. With employees’ use of social networking sites growing daily, employers have reason for some serious concerns. Not only could this activity negatively affect employees’ workplace productivity, but the content of postings could potentially create legal risks for employers. To mitigate these risks, it is critical that employers identify and design appropriate policies and procedures governing employees’ use of social networking sites.
|The Technology Adoption Life Cycle 12/05/2011|
Ophthalmology has been viewed as one of the more technologically advanced medical and surgical specialties. But not all of us have the same technology-adoption habits. By identifying where you fall under the technology adoption curve and where your partners/residents are along the curve, you can use those insights to find ways to work with your colleagues to make informed tech-related decisions for your practice/department.
|Get Hip to HIPAA 5010: What It Is and What You Need to Know 08/15/2011|
As federal regulations push the health care industry toward e-medicine, an important change is scheduled for Jan. 1. That’s the date all practices must begin submitting claims by HIPAA 5010 standards, instead of the HIPAA 4010 standards now in use. The bad news: As of Jan. 1, any and all non-compliant claims will be rejected (with the exception of Workers Comp) and practices won’t get paid. The good news is that, unless you’re a very small practice or solo practitioner, most of the transition process will be handled by various practice vendors and IT staff.
|Understanding Financial Statements 06/13/2011|
This article is an excerpt from AAOE’s financial module series, The Profitable Practice. This excerpt is designed to introduce and describe to young ophthalmologists, administrators and physician owners the practical uses of the financial statements that are commonly prepared in connection with the operation of ophthalmology practices.
|Developing Your Documentation and Corresponding Coding Program 04/18/2011|
Practice managers and clinical managers often call documentation and coding “the silent monster.” The outcomes of documentation and coding, which are important billing components, are hidden away in the patient’s medical record. They only raise their ugly head when some event such as a chart audit by Medicare, Medicaid, a vision-insurance plan, a third-party medical insurance or a lawsuit requires us to copy the chart and send it for review.
|Is Your Practice Embracing Wellness Eye Care? 04/18/2011|
Coping with changes in an extremely dynamic practice environment is the major challenge ophthalmology practices currently face. An important component of running an efficient practice is providing excellent patient-wellness care beyond in-clinic visits. Reimbursement for wellness eye care has created a new model for ophthalmology practices. Practice managers have the unique opportunity to generate new revenue sources for tomorrow’s changing ophthalmology landscape.
|Charging Interest to Past-Due Medicare Patients 03/14/2011|
I am frequently asked about the appropriateness of charging Medicare patients interest on past-due amounts. Here's the bottom line from CMS regarding charging interest, etc., to Medicare beneficiaries. This issue has been brought up to CMS for several reasons but, basically, if a provider is a participating doctor and signs an agreement that he/she will accept assignment on his/her claims, the only amount that provider can collect from the patient is any deductible and the 20 percent co-payment.
|Combining Resources to Purchase an EHR System 01/18/2011|
A few years ago, one of our physicians attended the Academy’s Annual Meeting, and upon his return, he announced that we were going to convert to electronic health records (EHRs). He then laid a software brochure on my desk and said, “Go ahead and get that one. What do you think — we should go live in a few months, right?” After the initial shock wore off and we had a realistic discussion of the many factors and steps involved in a project of this nature, I began the process of considering EHR use in our practice.
|Four Tips for Hiring and Keeping Great Staff 12/06/2010|
Your staff is one of the most costly and important investments your practice will make. You must not only pay competitive wages and offer attractive benefits to attract qualified staff, but also provide a nurturing environment to retain great staff. By doing so, employees will be less tempted to change jobs for a nominal raise after you have invested precious time and money in on-the-job training.
|Six Tips for Surviving a Medicare Fee Cut 10/18/2010|
Ophthalmologists across the country recently had a little taste of what life might be like if the ever-threatened cuts in Medicare reimbursements were to be put into place. Because Congress was unable to agree on legislation prior to June 1 to delay the cuts due to the flawed sustainable growth rate (SGR) formula, Medicare ordered carriers to hold payments for three weeks, causing cash-flow problems in many practies.
|Job-Seeker’s Guide to the Joint Meeting 07/13/2010|
Few things are more stressful than leaving the safety of higher education and joining the work force. Equally stressful is making the decision to switch jobs or move from private practice to academia, academia to a large practice, or any variation in between. The Academy knows this and is prepared to help you navigate your way through the process of finding a job. During this year’s Joint Meeting in Chicago (Oct. 16 to 19), you’ll find a myriad of courses, resources, and programs to help you find (and land!) the job of your dreams.
|Using the Local Media to Promote Your Practice 06/14/2010|
Unless you are in a very, very small town, your eye clinic is likely not the only option for patients in need of care. That means people have a choice, and in our competitive world, you have to do what you can to make sure your clinic is their preferred choice. One way of establishing awareness and credibility for your practice is through your local media.
|Practice Building: Four Pearls for the Young Ophthalmologist 04/12/2010|
After years of hard work, many sleepless nights on call and volumes of reading and multiple rounds of anxiety-provoking standardized tests, you’ve finally finished your ophthalmology training, lined up a great job and are ready to enter practice as a full-fledged Eye M.D. Congratulations! Though the clinical learning curve will still be steep for the next few years, you’ve now got a solid set of comprehensive — and possibly subspecialty — ophthalmology skills that will serve you well. Now, there’s just one more small detail: How do you find yourself some patients?
|Practice Management Consultants — Who Needs Them? 03/15/2010|
You’ve made great accomplishments within the practice, whether by implementing electronic health records, opening up a new office or redesigning an existing one, increasing practice revenues, motivating staff, reducing A/R and improving patient flow. Yet, I would venture to guess that you are probably not completely content just to get the job done. There is a continuous drive to exceed the expectations of your patients, staff and physicians. That’s where a practice management consultant can become a great resource for your practice.
|The Federal Stimulus Package and the HITECH Act: Taking Stock of What We Know To Date 01/11/2010|
The passage of the American Recovery and Reinvestment Act of 2009 (ARRA) has left many of us seeking details on the federal plan to accelerate adoption of electronic health records (EHRs) in medical practices, as set forth in that portion of the ARRA known as the Health Information Technology for Economic and Clinical Health Act (HITECH Act). At the risk of redundancy, this article attempts to outline what we do, in fact, know about the HITECH Act thus far, and what we will likely learn in the months to come. It also discusses some of the practical first steps for ophthalmologists to consider.
|Boost Your Bottom Line 11/16/2009|
News Flash — we are in a recession. Unless you have been living under a rock for the past 18 months, it’s impossible to ignore the fact that we are living in uncertain economic times. The gloomy outlook makes headline news day in and day out. “For Sale” signs line some residential neighborhoods and “For Rent” signs line some, once busy and highly sought after commercial streets.
|Using Templates to Improve Technician Efficiency 11/15/2009|
Efficient use of a practice’s staff time = greater profitability. That’s an equation that every doctor and manager knows to be true. But awareness of that fundamental link between superior productivity and increased revenue isn’t enough. The challenge is to fully realize efficiency within your own practice. Nowhere is this more a challenge than in a practice’s technical department. Since patients and problems can gobble up precious time beyond your control, it is all the more crucial to ensure that everything within your ability to fully affect is handled as efficiently as possible.
|Employee Policies 101, or Avoiding an HR Nightmare 10/12/2009|
No one intentionally hires a bad seed, but it happens — unfortunately far too often. Take the case of a Wisconsin doctor who managed to get hired three times following a conviction for sexual assaults on patients. His record was available for anyone who cared to look. Unfortunately, none of the three practices that hired him did. The result? A string of sexual assaults on patients. While an extreme example, there is much to learn from this and other cautionary tales.
|Are You up to Code? How to Burnish Your Skills at the Joint Meeting 09/14/2009|
One of the most difficult things for a young ophthalmologist starting out in practice is the confusing world of coding. You have years of training in the science of ophthalmology, but little to none on the business side of medicine. The reality is medicine is a business, and with the recession and downturned economy, knowing that business is more important than ever. Proper coding is the key to not only receiving the full reimbursements you are entitled to, but also avoiding costly penalties. Whether you need a crash course or just a quick coding review, the Academy’s Joint Meeting has something for you.
|Job-Seeker’s Guide to the Joint Meeting 08/17/2009|
By the end of the 2010 academic year, today’s residents and fellows will be looking to join a practice in what is and will, at least in the short term, continue to be an employer’s market. The good news is, if you’re coming to the Academy’s Joint Meeting in San Francisco this fall, you can take advantage of more than just the clinical education offerings. The meeting has much to offer job seekers as well.
|EHR: Where Are You on the Continuum of Adoption? 07/13/2009|
Momentum has been building toward the adoption of electronic health record (EHR) technology. The Academy conducted a survey in 2006, which indicated that about half of the membership had or were planning the implementation of an EHR system within two years. EHR adoption was more common in larger group practices, but was also on the rise in small practices. It was greatest in multi-subspecialty groups, with 71 percent planning EHR implementation in the next two years. The latest Academy/AAOE member survey indicated that 31 percent had converted to an EHR system and 25 percent planned to convert within two years.
|The Technician’s Role in Obtaining the Advance Beneficiary Notice 07/13/2009|
Who has the responsibility to inform patients about the possibility that the test or surgical procedure they are to undergo may or may not be covered by Medicare? Quite often, it is the ophthalmic assistant or technician. The new and improved Advance Beneficiary Notice (ABN) — renamed the Advance Beneficiary Notice of Noncoverage — became effective March 1. This Medicare form replaces the former ABN-G and the Notice of Exclusion of Medicare Benefits.
|Selecting a Medical Billing Vendor 06/15/2009|
With declining reimbursement rates and rising operating expenses, it’s no surprise the business of health care has become more complex. As a result, the practice administrator has less time to manage the myriad of practice needs. These include ongoing challenges with patient benefit plans, issues related to computer system technologies, the privacy of data stored on those systems and the multifaceted laws surrounding all aspects of human resource management. All of this leaves even less time to manage the critical billing and collections process.
|Testing Before Cataract Surgery: When to Use OCT 05/11/2009|
The American Academy of Ophthalmic Executives (AAOE) receives many coding questions concerning cataract surgery. One in particular caught our eye. It involved the use of an optical coherence tomography (OCT) on diabetic and age-related macular degeneration (AMD) patients prior to cataract surgery, to investigate and discriminate the cause of vision loss.
|Who Fits the Bill? 12 Questions to Ask When Filling a Billing Vacancy 04/13/2009|
Ophthalmologists rely on the knowledge and skills of their billing staff to help keep the office compliant and assist in appropriately maximizing reimbursement. When recruiting billing staff, some practices look for applicants with little or no billing experience — if they are then trained in-house, they won’t bring any noncompliant ideas to the practice. However, if you would prefer someone who can hit the ground running, here are 12 questions to test an applicant’s coding savvy.
|Collecting Unpaid Charges: What a Practice Can and Can’t Do 03/16/2009|
The ophthalmology practice, like any business, invariably encounters a percentage of charges that go unpaid. When an insurance company or other payor is involved, the collection process for those unpaid obligations is viewed under the law in the context of one business pursuing another in satisfaction of a contractual obligation.
However, when the unpaid debt is the obligation of a patient, both federal and state laws impose extensive requirements on the business seeking payment. These laws are designed to protect the consumer from overreaching collection practices. In addition, state and local medical societies may have procedural and ethical requirements that must be observed when it comes to collection of payment for medical care and treatment.
|Three Ways to Foster an Inviting Office Culture 02/10/2009|
Every organization has a culture unique to that organization and a doctor’s office is no exception. The culture determines how patients, staff and doctors feel when they walk in the office. The ophthalmologist plays the key role in determining the culture of his/her office. If we want our office culture to be one of excellence, competence and friendliness, we must work to set that tone. Various aspects contribute to the culture we might find in our own office.
|Getting Medicare-Secondary-Payer Claims Right the First Time 02/10/2009|
When is Medicare not responsible for primary payment for beneficiaries’ medical claim? CMS has detailed this issue in a fact sheet for physicians and administrators. Medicare secondary payer (MSP) is the term used by Medicare when Medicare is not responsible for paying a claim as primary.
|Be Prepared for an Audit 01/12/2009|
When ophthalmologists are audited and they want the best-case/worst-case scenario, they tend to call me. It is interesting to note that when a physician calls, he/she begins with, "Guess what my staff has done wrong." And when a staff person calls, the conversation tends to begin with, "Guess what the doctor has been doing incorrectly." While it is true that the physician is ultimately responsible for documentation and subsequent code and diagnosis code selection, staff must be of immediate and ongoing assistance. Here are three ways your office can be prepared for an audit.
|Record Retention and Destruction 01/12/2009|
While ideally records should be kept forever, this is not always practical. To ensure that present and future patient needs are adequately met, and that allegations of malpractice can be successfully defended, retain records according to the following guidelines. Once the retention guidelines have been met, the records may be destroyed.
|Avoiding Illegal Service Referrals: The Stark Statute Explained 11/24/2008|
At its core, the Stark statute is this basic: If you, as a physician, or a member of your immediate family has a financial relationship with an entity, then you may not refer a Medicare or Medicaid patient to that entity and that entity may not submit a bill for any item or service defined as a designated health service (DHS), unless you qualify under one of the Stark exceptions. Unlike other regulations physicians usually deal with, the Stark law is a "strict liability" law, meaning that if you bill or the entity you referred to bills for a DHS and you are not protected by an exception, you are in violation of Stark (i.e. no intent is required).
|Signs and Symptoms of the Best Practices 11/24/2008|
Since I work in ophthalmology, I tend to either accompany family to the ophthalmologist office or certainly hear details following the exam, surgery, etc. Over the past few months, several family members have had strabismus surgery, retinal detachment surgery, cataract extraction with IOL, bilateral blepharoplasty, retinal tear repair, basal cell carcinoma removal and glaucoma surgery, as well as numerous special testing services and exams. During those visits, I’ve found that, in addition to coding correctly, many of the offices I’ve visited have displayed what I consider to be signs and symptoms of the best practices. Here are a few of the highlights.
|Costly Coding Errors 10/15/2008|
The six examples presented are real. Each case presents the:
* Financial Impact
|Staying Ahead in the Digital Age of Medicine 09/15/2008|
PDAs. Online forums. Google and the Academy’s new Ophthalmic New & Education (O.N.E.™) Network. As a young ophthalmologist, you’re probably already using many of these technologies and services for problem solving, communication and research. But with Medicare’s introduction next year of bonuses for physicians who e-prescribe, electronic workflows won’t be an optional part of practicing medicine much longer. Successful participation in this changing system requires both fully interoperable systems and devices in your practice and an understanding of Medicare’s new bonuses.
|AAOE Program Offers Comprehensive Course Selection for YOs 09/15/2008|
At the Joint Meeting in Atlanta, the American Academy of Ophthalmic Executives (AAOE) will be presenting a number of CME-bearing courses to help young ophthalmologists (YOs) navigate the complexities of practice management. Whether you are still in training or have already entered practice, the comprehensive program will give you the information you need to be successful in your career.
|Maximizing Patient Referrals 08/18/2008|
Your patients present a golden opportunity to market your practice. Should you overlook or choose not to cultivate this group of credible advocates, you may be passing up a low-cost, high-return method of marketing and growing your practice.
|Common Coding Errors 08/18/2008|
To help you navigate the often-confusing world of coding, we’ve compiled several of the most common coding errors and the correct way to code these procedures. Topics include: suture removal, benign and malignant skin lesion removal, complications during the global period, exam before second eye surgery, two providers same day and A-scan coding 76519 and 92136.
|Branding on a Budget 07/16/2008|
Companies, large and small, are paying top dollar to create and promote their brand(s). They hire research firms to survey the consumer, consultants to interpret the data and marketing agencies to take the findings and develop brands, visuals, names and tag lines. The costs associated with this formal branding process can be significant. However, it is not an all-or-nothing situation. You possess numerous tools to help develop your own brand. The following three steps have been modified for the ophthalmology practice based on what professional services marketing agencies provide for their clients.
|Fraud or Abuse? You Make the Call on Coding Mistakes 06/18/2008|
As reported to the Academy, Medicare is currently auditing the following coding mistakes. Some are the result of focused medical review audits, others from whistle blowing cases. Auditors will determine if these errors are a result of coding mistakes or an intentional act.
|Improving Practice Efficiency for the Baby Boomer Generation 05/21/2008|
The “baby boom” generation, nearly 80 million strong, was born between 1946 and 1964. That means that by 2011 the first of those boomers will be 65 years old and eligible for Medicare. Additionally, by 2030, this soon-to-be over-65 population will double what it was in 2000. This equates to approximately 70 million people over the age of 65. What this “graying” of society means for ophthalmology is that we can expect to see a large influx of patients in the very near future … and we are grossly unprepared to handle them efficiently and effectively.
|How Much Do You Know? Questions You May Encounter in Your Ophthalmology Practice 05/21/2008|
How up-to-date are you with your knowledge of practical issues as well as the legal and regulatory issues that affect your practice? Take our quiz and see how up to date you are in your knowledge of some of these general questions affecting most ophthalmology practices. The answers follow the quiz.
|No File Left Behind 05/21/2008|
What three things do Martha Stewart, Frank Quattrone and Arthur Andersen have in common? All three built successful corporations whose reputation was later marred in obstruction-of-justice cases relating to the mishandling of electronic records. And in all three cases, it was discovered too late that not having a systematic practice process for electronic records management was most certainly, “Not a good thing!”
|Accounting Statements for Ophthalmology Practices 04/23/2008|
In this article, I will review some accounting principles and accounting statements that are useful to describe the financial state of your ophthalmology practice. I will also review aspects of more traditional accounting, and the reports that define the performance and financial condition of the “business” of your practice.
|Dealing with Difficult People 04/23/2008|
One of the most impressive talks that literally changed my way of thinking and interacting with others was from Lloyd D. Newell, a motivational speaker, on the subject of dealing with grumps, grouches and difficult people. In this article, I would like to share what I have learned about conflict management from a variety of sources in 24 years of ophthalmology.
|Top 10 Marketing Tips for Your Practice 03/21/2008|
Administrators and managing physicians often view marketing solely as advertising to attract new patients. Marketing is stereotyped as newspaper ads, billboards and direct mail campaigns, with LASIK surgery advertising currently being the most obvious. Marketing is in fact, however, any activity that moves your practice in a desired direction.
|Caring for Our Elderly Patients 02/22/2008|
With the typical ophthalmology practice having 65 percent or more Medicare-age patients, it is important not to draw conclusions about patients based on their age alone or their medical condition. However, elderly patients seen in the ophthalmology office have special age-related health problems and emotional needs, which ophthalmic medical assistants should consider.
|Designing Effective Ophthalmic Medical Space 02/22/2008|
Efficiency and improved performance are your main motivations behind any capital investment decision. Whether you are considering new equipment or a new or redesigned office, you need to consider how this improvement will help support the practice’s most valuable resource, the physician(s).
|2008 CPT Update 01/25/2008|
A quick overview of the six significant changes in CPT impacting ophthalmology for 2008.
|Coding Q&A 01/25/2008|
Following the morning session of the YO Program at the Annual Meeting in New Orleans, several people had some very specific coding questions. Here are the more common questions and their answers, as provided by Sue Vicchrilli, the coding executive for the American Academy of Ophthalmic Executives.
|Common Partnership Mistakes 10/12/2007|
As a practice management consultant, I have been involved in many aspects of a partnership buy-in, starting them from scratch, modifying existing buy-ins/partnerships and representing those selling as well as those buying-in. My involvement in all of these phases of a partnership have led me to the conclusion that there are a few basic mistakes often made in a number of areas.
|Ophthalmology Practice Benchmarks 10/12/2007|
As the business of ophthalmology becomes more and more difficult due to rising expenses and declining reimbursements, it will become more critical to understand and manage practice finances and patient flow. Benchmarks can help us do that—if used appropriately.
|The Art of Patient Communication 10/12/2007|
Patients may not be able to judge the quality of their treatment, but they can and do judge how well they are treated. The role of ophthalmic medical personnel (OMP) is to assist the physician in effectively communicating all aspects of the encounter so that the patient leaves the office confident in the care that is received. While perfecting technical skills, don’t forget that communication matters. Too often it is ignored. It is often poor communication in the face of a bad outcome that initiates legal action by a patient.
|Billing 101: American Academy of Ophthalmology 06/13/2007|
Ophthalmologists and administrators rely on the knowledge and skills of their billing staff to help keep the office compliant and to assist in appropriately maximizing reimbursement.
|What is AAOE? 06/13/2007|
The American Academy of Ophthalmology is committed to providing you with the information you need to be successful in practice, both the clinical and business aspects. A free membership in the American Academy of Ophthalmic Executives (AAOE)-the practice management arm of the Academy-is provided to you throughout your residency, fellowship and first year in practice. In subsequent years, the $175 membership in AAOE will more than pay for itself.
|Winning Patients and Keeping Them for Life 06/13/2007|
"I'm thinking about doing some television advertising to attract new patients," the ophthalmologist told me as we sat down to eat lunch at the Annual Meeting of the American Academy of Ophthalmology. "I feel that I need to get the word out about my offices. I'm just not getting enough new patients and we are suffering financially." "Tell me about your offices," I said, and I sat back to listen.
|Jumping Into Your First Year of Practice? 07/13/2006|
The first year of practice can be an overwhelming experience for even the most well adjusted physician. It can often mean moving to a new community, operating in a new O.R., working with new staff in a setting remarkably different than the typical university training program and making independent clinical judgments alone, perhaps for the first time. All these new experiences can make for a stressful year. However, a logical approach to entering practice may make the experience more pleasant. Here are some ways to help soften the fall.