Have you ever wondered why some individuals with average talent achieve great success while others with exceptional talent see their careers derail? In sports we witness this all the time. Players with great talent often find themselves on the bench orout of the game. It may be a lack of commitment, desire or emotional intelligence.I have always appreciated the dedication and commitment of New York Yankee shortstop Derek Jeter. He clearly has talent, but his desire to continuously improve, his love of the sport, and his respect for all is why he will always be admired for his achievements.
What about the world of business? Do you feel that you have reached your full potential? If not, why not?
The following are a fewsuggestions to assist you to reach your full potential:
To get our readers ready for National Nurses Week, we wanted to share a great new video from the Robert Wood Johnson Foundation that asks the question “What is a Nurse?”
The traditional view of the nurse as direct caregiver and bedside attendant to patients is really a limited view of the expansive and critical role nurses play in our healthcare system. As more and more change arrives in our system, nurses have taken on a myriad of other roles in the care process: research, community outreach, education, counseling – all of these represent departures from a “stereotypical” view of the role of nursing, and the video highlights the growth in these and other areas.
At Manage My Practice, we would like to thank all of our readers in nursing for delivering quality patient care in so many of our healthcare settings. Happy National Nurses day on May 6th, 2013!
Some organizations will use the terms essential and non-essential workers as a way to distinguish between who needs to be on site in the event of an emergency, and who does not. I do understand the purpose of this distinction, however, it’s very important that businesses not give the impression that some employees are more important or valuable than others. (more…)
There’s a lot of talk today about how physicians (and other care entities) are paid. This slide deck discusses how the system used predominantly today (RBRVS) to pay physicians came to be and how Medicare and other payers calculate a payment. Download this Slide Deck and learn about Relative Value Units.
Click Here to Download.
NOTE: this series will be repeated in the near future – click on the Webinars tab above for the latest information.
“We’ll start with the money.”
We say that a lot in client meetings at Manage My Practice. Whatever issues might exist in the practices that contact us looking for advice – financial problems will typically need to be addressed first before anything else can be corrected. No matter the size, specialty or type of practice – private, non-profit, and everything in between – the financial foundation of the organization must be built (or remodeled) before choosing strategic partners, determining new service lines, or recruiting physicians.
With no money, there is no mission – or at least no reason for hanging the shingle.
Former Secretary of State Hillary Clinton has stated that she plans on spending a lot of time getting rest and relaxation. She had an extensive travel schedule and was feeling burnt out from a very demanding role.
How are you feeling right now? Do you feel that your work is controlling you or you are in control of your work?
You spoke and we listened – you asked for a comprehensive course on Revenue Cycle Management and we brought it to you!
This series is for anyone who wants to understand the medical practice revenue cycle from the very beginning to the very end: physicians, physician assistants, nurse practitioners, advanced practice registered nurses, practice administrators, office managers, consultants, vendors, students, coders, billers and those who want a RCM foundation to enter the healthcare field. Anyone who wants to know more about how reimbursement in healthcare works in the medical practice will find this comprehensive series indispensable.
You won’t find this comprehensive course anywhere else except at Manage My Practice. Webinar leader Mary Pat Whaley, FACMPE, CPC has developed this program from 25+ years of experience in medical practice management and from requests she gets weekly for education on the revenue cycle management process.
The Complete Guide to Revenue Cycle Management – a Five Module Comprehensive Curriculum
Module I. The Foundation
- Payer Contracting
- Payer Matrix
- Setting a Fee Schedule
- Understanding Medicare Part B
Module II. The Data Build
- Practice Management System Set-up
- Patient Demographics & Insurance Information
- Eligibility & Benefits
- CPTs, HCPCS, ICD-9
Module III. The Pre-Claim Process
- Collecting at TOS
- Documentation: Paper vs Electronic Medical Records (EMR)
- Physician Coding vs. Abstraction Coding
- The Superbill vs. Using the EMR to Bill
- Claim Scrubbing: The Three Gates
Module IV. The Post-Claim Process
- Write-offs, Denials and Appeals
- Daily Reconciliation Process
- Patient Collections and Payment Plans
Module V. Monitoring
- Monthly Reports
- The Practice Dashboard/Snapshot Report
- Strategies for Improving Revenue
- Benchmarks for Staffing
- Revenue Cycle Compliance and Auditing
Also Included! Action Pack – Handouts in Word/Excel
- Contract Reference Matrix
- Contract Review Template
- Fee Schedule Worksheet
- Medicare Resources
- Allowable Cheat Sheet
- Write-off Approval Form
- Daily Reconciliation Form
- Refund Request
- Monthly Report List
- Sample Snapshot Report
- Sample Revenue Cycle Compliance Plan
Here’s what one attendee wrote about a recent Manage My Practice Webinar “Information was right on! Great examples and real life experiences.”
5-Week Course for $799.00 (Two Options)
Option One : Every Tuesday for Five Weeks – March 12, 19, 26, April 2, and April 9
Module I: Tuesday, March 12 @7pm ET for 90 minutes
Module II: Tuesday, March 19 @7pm ET for 90 minutes
Module III: Tuesday, March 26 @7pm ET for 90 minutes
Module IV: Tuesday, April 2 @7pm ET for 90 minutes
Module V: Tuesday, April 9 @7pm ET for 90 minutes
Option Two: Every Thursday for Five Weeks – March 14, 21, 28, April 4 and April 11
Module I: Thursday, March 14 @1pm ET for 90 minutes
Module II: Thursday, March 21 @1pm ET for 90 minutes
Module III: Thursday, March 28 @1pm ET for 90 minutes
Module IV: Thursday, April 4 @1pm ET for 90 minutes
Module V: Thursday, April 11 @1pm ET for 90 minutes
Mary Pat Whaley, FACMPE, CPC has 25+ years managing physician practices of all sizes and specialties in the private and public sectors. She is Certified Professional Coder, is Board Certified in Medical Practice Management and is a Fellow in the American College of Medical Practice Executives. Mary Pat has been providing free information and resources to physicians, care providers and medical practice executives since 2008. For questions about “The Complete Guide to Revenue Cycle Management” webinar, contact Mary Pat at (919) 370-0504.
I have not always been excited to hear patient complaints. As a younger manager I absolutely dreaded when a patient wanted to speak to me. I felt that I had little to offer a patient who expressed anger or frustration with something that had happened and I was very impatient to get past the complaint and get back to my “job.”
Now, I can’t wait to hear patients’ complaints. Complaints are the only opportunity managers have to understand the patient’s experience and hear in their own words what went wrong for them. By listening carefully, you have the potential to accomplish several goals.
- You can heal the patient’s complaint, first by making sure the patient feels heard, and second by addressing the problem if something needs to be done.
- You can gain insight into an experience in the practice and dissect it to see why the problem occurred and what can be done to fix it.
- You can model to the staff how important patient complaints are and how seriously you take them. (more…)
I have a saying about management that I try and keep front and center in my mind whenever I interact with employees.
“There are two things you should never mess with: a person’s paycheck, and a person’s time off.”
If you heard a lot of noise from your staff when they received their first paycheck of 2013 – you were not alone. This New Year’s Day, Congress passed the American Taxpayer Relief Act of 2012 seeking to avoid the so-called “Fiscal Cliff” even if only temporarily. The “Fiscal Cliff” was a combination of tax increases and spending cuts designed to force Democrats and Republicans into negotiating a longer term deal on the country’s finances. Included in the fiscal cliff spending cuts were the scheduled reduction in Medicare reimbursements that has been long-forestalled by temporary delays. The Medicare cuts were stopped with another delay (or “Doc Fix”) until January 1st, 2014, while other cuts were pushed back as little as two months as Congress continues to negotiate the outlines of a bigger deal.
Mary Pat: For the past 7 months, I’ve had the great pleasure of working as Interim Director of Coding for Marta de la Torre at Steward Medical Group, a mega group of 700 physicians and mid-level providers associated with 12 hospitals in Eastern Massachusetts. I greatly appreciate her willingness to share her fascinating story about working Abu Dhabi for two years as a Revenue Cycle Director.
NOTE: The United Arab Emirates, sometimes simply called the Emirates or the UAE, is an Arab country in the southeast of the Arabian Peninsula on the Persian Gulf, bordering Oman to the east and Saudi Arabia to the south, as well as sharing sea borders with Qatar and Iran. The UAE is a federation of seven emirates (equivalent to principalities), each governed by a hereditary emir, with a single national president. The constituent emirates are Abu Dhabi, Ajman, Dubai, Fujairah, Ras al-Khaimah, Sharjah, and Umm al-Quwain. The capital is Abu Dhabi, which is also the state’s center of political, industrial, and cultural activities. Of note, the native Emiratis are outnumbered in their own country at a ratio of 11 to 1. Emiratis now make up only 9% of the population and expatriates make up the remaining 91%.
Mary Pat: How did you learn of the position in Abu Dhabi?
Marta: I got a cold call from a recruiter. It came at a point in my life when I had reached the top of my career with the hospital I had been with for 13 years. I did some research and found out that for an Arab country, Abu Dhabi was a much more westernized country than Saudi Arabia, Qatar or Bahrain. What excited me most about working in Abu Dhabi was the chance to get in on the ground floor of building a 3rd-party payer system. Having lived through the dysfunction of the American healthcare system, I felt I could bring that experience to Abu Dhabi and help them avoid a lot of the pitfalls the American system has experienced.
Mary Pat: What was the recruitment/hiring process?