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Successful Physician Practices

Successful Physician Practices . Before Start Up. Plan For The New Provider and Start Early Don’t wait until the new physician is on site Expenses (salaries) without supporting revenues are not just a “fact of life”. Before Start Up.

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Successful Physician Practices

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  1. Successful Physician Practices

  2. Before Start Up • Plan For The New Provider and Start Early • Don’t wait until the new physician is on site • Expenses (salaries) without supporting revenues are not just a “fact of life”

  3. Before Start Up • Appoint a lead or charge person for the project • Prepare a checklist and action plan matrix • Assign a responsible party to each task • Hold weekly progress meetings

  4. Hire a Practice Manager • Don’t expect your hospital B.O. Manager to oversee the office operations. They have a full time job! • In order to grow a new practice you need someone on site who can devote attention to its daily needs. • If you do not want to invest in a Practice Manager hire a consultant to oversee the operation.

  5. Location Of the Office Structure • Where are we going to place the physician • Do we need in license to operate the structure/ business • What if any remodeling is required for code standards • Wiring for phones, computer, fax etc • Install phones, computers, EMR and other equipment • Don’t forget if we plan to install an x-ray machine need additional services • Post signage • Get the benefit of free advertisement

  6. ProviderEnrollment • Make sure you’ve obtained malpractice for the physician • Provider data: DEA, State License , CV, CAQH Profile • Submit Medicare / Medicaid Provider Enrollment Applications • This is the number one killer of practices today because it will kill off cash for a long period of time.

  7. Marketing the Practice • Can be done effectively for minimal cost • CommunityAwareness • Health Fairs • Physician lunch • Clubs and organizations • Newspaper • Open House • Don’t forget to capture internal referrals!!!!

  8. Hire or Contract for Experienced Personnel • General rule for staffing 2.5-3 FTE for 1 primary care provider • Process thru Hospital HR Dept • Employee Health • Compliance training • HIPAA • Office in-service training • Job descriptions • Policies and procedures

  9. Work Flow Operations Don’t take the basics for granted. • Train staff on efficient office duties with patient care and quality measures in place • A new patient with a bad experience can undo a lot of good marketing • Start with the check in or front office person on how to answer the phone correctly • Gather patient information • She must know office policy on insurance, payment etc • Set appoint schedule hours and lock them down • Inform patient at this time if you have a patient portal

  10. Patient Registration • The process of gathering information seems simple but can cost you big dollars if not done properly • Know the insurance plans in which you participate , how will OON, bad debt and charity be treated • Train staff how to read insurance cards • Check eligibility • Collect co pays, deductibles upfront • How to handle self pay

  11. This is a great time to present the patient with a “Welcome to the Practice Letter” to set expectations on how the practice will handle med refills, missed appointments etc. (oh, and decide at start up how they will be handled)

  12. Billing • Will you do it in house or outsource? • What software will you use? • Do I have the capability to produce both 1500’s and UB if I decide to convert the practice to an RHC? • Develop your charge master and monitor it. • Billing must be done daily! • Cash balance procedure. • EDI / ERA connections and enrollment. • Payment posting: Will the office do it? How will adjustments be handled? • Patient statement printing process. (Use a bulk printer!)

  13. A/RFollow-up If it does not happen on a regular schedule the practice is doomed from the start. With timely filling issues, patient frustration over billing, and lack of private pay control the cost of for this practice will continue to be a negative and patients will leave the community for care… And it won’t be financially successful.

  14. Train, Train and Train Some More Use all the resources available such as HTHU and the vendors who can provide expertise in these areas. Do patient surveys and don’t be surprised at what you learn!!!

  15. Just when you thought you knew it all… Hold On Here comes ICD-10 with no delays on implementation. HIPAA 5010 Who wants to tell the physicians as they are still struggling with E&M codes. Are they up to speed on proper charting and documentation???

  16. Questions ??? Thank- you Helen Williams, CPC 678-367-4889 williamsh@ppmatl.com

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