Practice Management Tool Kit

1. Practice Management Tool Kit 2006 Georgia Medical Fair September 8 & 9, 2006

2. The Georgia Practice Management Initiative is a technical assistance service to recruit and aid in the retention of primary care providers in rural Georgia. Primary care scope of practice includes: family practice, obstetrics and gynecology, pediatrics and general internal medicine. Practice Management Initiative

3. Practice Management History This initiative was originally funded in 2001, by a joint effort among the Georgia Department of Community Health, Office of Rural Health Services, the Robert Wood Johnson Foundation, Southern Rural Access Program support of Rural Enrichment and Access Program for Health (REAP) and the Georgia Statewide AHEC Network. Due to sustainability of the program, our service implemented a fee-for-service with discounts based upon geographic and provider payor mix factors.

4. Practice Market Research • Market Research Checklist • Guidance on first step research of a specific area. • Industry Data Sheet • Assist to log and retain data for a specific location. • Used for comparative studies of pros / cons. • Competitive Analysis Form • Recap summary of competitors information. • Medical Agency Research Form • Local, State and Federal Agencies that provide medical data about a specific location, medical need and surveys.

5. Practice Start Up Checklist • Areas to consider about the facility that you may choose. • Financial matters such as tax ID number, business license, etc. • Business Development – marketing, business cards, business plan, open house, etc. • Technology – computer systems for patient registration, accounts receivable management, financial management and medical equipment. • Staff – Payroll service, employee policies, hiring of staff, etc. • Processes - Federal compliance programs required in a medical practice. • Clinical supplies.

6. HPSA - PSA • Health Professional Shortage Area • Definition • Qualifying factors • Financial benefits • Physician Scarcity Area • Definition • Financial benefits

7. Third Party Credentialing • Credentialing File Checklist • Insurance Definitions • Insurance Matrix (sample) • Insurance Matrix (blank) • 15 Questions to Ask Before Signing a Managed Care Contract • Reasons to Say “No” to a Contract • Uniform Credentialing Application Form • NCQA Standards

8. Personnel Management & Staffing • Employment Categories • Setting Up Personnel Files • Job Descriptions (sample – Medical Assistant) • Orientation Checklist • Office Security Forms • Employee Handbook

9. Patient Satisfaction • Patient Satisfaction Surveys • Ask questions about what makes the patient a satisfied patient. • Both front office (financial) and back office (clinical) areas must be addressed in a patient satisfaction survey. • Sample Patient Survey

10. Appointment Scheduling & Patient Flow • Points to consider when thinking through the patient appointment process. • Outline of Schedule Types • Open Access – Strict appointment templates • 6 Stages of Patient Flow • Interim Work Tasks • Waiting Room & Receptionist Area Checklist • Patient Flow Checklist • Sample Work Schedules

11. Medical Records • Managing the Medical Record • Chart set-up, documentation requirement/forms, safe/secure, confidentiality, retention and destruction of records. • Policies for Medical Records • Office protocol for record maintenance. • Medical record documentation/maintenance. • Confidentiality of Medical Records (HIPAA)

12. Financial Management • Controlling Practice Financial Health • Improve NET income: increase revenue/cut cost • Improve GROSS income: increase patient service, review and set fees appropriately, and improve collections • Determining Profitability • Analysis Form • Sample Practice Budget • Sample Income & Expense Statement

13. Billing & Collections • Accounts Receivable Follow-Up Form • Insurance/Self-pay follow up • Claims Denial Tracking Form • Monitor type of denial, reason and responsible party to support education/income • Financial Policy & Procedure (sample) • Returned Check Log (sample) • Notice of Demand Payment Letter (sample)

14. Benchmarks • Benchmarking Summary • What are benchmarks and how to use them • Benchmarks & Calculations • Sample benchmarks with individual calculation methods • Using Benchmarking to Improve the Collections Process • Example – reduction in denied claim using the “Denial Tracking Log.”

15. Record Keeping • Federal Regulations & Requirements • Retention schedule • Employment size • Types of documents: • Banking documents • Employment records • Payroll reports • Accounts payable reports • Federal/state program documents

16. Marketing • Medical Practice Marketing Overview • Strategies • Analysis • Market Survey Chart • Goals & Strategy • Budget Estimate • Income & Expense • Calendar • Goals & Strategy – Assessment

17. Evaluation & Management Coding • Summary of Evaluation &Management (E & M) Coding • New Patient Coding • Office Visits (3 of 3) • Established Patient Coding • Office Visits (2 of 3) • Office Visit Chart Audit • E&M Documentation & Guidelines • ICD-9-CM vs. ICD-10-CM Code Structure

18. Loan Repayment & Financial Information • Medical Education Scholarships • State Medical Education Board Scholarships • National Health Service Corps • United States Armed Forces Health Professions Scholarships and Financial Assistance Programs • Citizens of Polish Decent and Hispanic Students

19. Loan Repayment & Financial Information (continued) • Loan Repayment Programs • NHSC State Loan Repayment Program (SMEB) • National Health Service Corps Loan Repayment • Physicians for Rural Areas Assistance Program (SMEB) • Georgia Revolving Loan Fund • Specialized Loan Programs

20. Websites of Interest • National Links • Georgia Links

21. Practice Management Team Peggy LaMee, CPAM Office: (706) 660-2736 plamee@threeriversahec.org