Statement to the press by WHO Director-General Dr Margaret Chan
11 June 2009
World now at the start of 2009 influenza pandemic
Dr Margaret Chan
Director-General of the World Health Organization

Ladies and gentlemen,

In late April, WHO announced the emergence of a novel influenza A virus.

This particular H1N1 strain has not circulated previously in humans. The virus is entirely new.

The virus is contagious, spreading easily from one person to another, and from one country to another. As of today, nearly 30,000 confirmed cases have been reported in 74 countries.

This is only part of the picture. With few exceptions, countries with large numbers of cases are those with good surveillance and testing procedures in place.

Spread in several countries can no longer be traced to clearly-defined chains of human-to-human transmission. Further spread is considered inevitable.

I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose.

On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.

I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.

continue reading "Announcement From WHO: World Now at the Start of 2009 Influenza Pandemic"

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I hope that I am fortunate enough to have been missed by my readers while on an unintentional sabbatical these last several weeks. I have been moving to my new home in North Carolina and starting a new job. Our house temporarily has no television, no land line, no cell phone reception and no internet access so I’ve been cloistered from the news, my blog, Twitter, LinkedIn, email, FaceBook and listservs. It has been INTENSELY quiet, if there is such a thing.

I’ve been doing a lot of thinking about my new community, my new job and my chance for a fresh start. A television commercial I saw recently says something about being able to be more yourself where no one knows you. It’s true. Here in my new community I can be a better me as no one knows any different. A new job is always an opportunity to do things differently and I’ve made a list for myself of the things I will do differently, better, or not at all:

1. I will stop rolling my eyes. I don’t like it when someone rolls their eyes at me, yet I think I roll my eyes without even realizing it. I will become aware and stop it.
2. I will arrive to meetings on time. I have the compulsion to do “just one more…” that compels me to read one more email, squeeze in one more phone call and so I don’t arrive places on time. It’s rude and it sends the message that I think my time is more valuable than the time of others. Nope.
3. I’ll work a normal amount of hours per week, as soon as I can find out what that is. Boy, is this a can of worms. I’ve always heard that you have to put in more hours if you want to advance and that managers should be the first ones in the office in the morning and the last ones to leave. The problem is, of course, that you will be exhausted, sick, cranky, unfocused, estranged from your family and one-dimensional if all you are is a workaholic. It is a disease and I want to be on the road to recovery.

I have lots of new stuff to share.  For one thing, I just completed the best orientation I’ve ever had, and several readers have expressed an interest in creating a stronger orientation program for their practices, so I’d like to expand on this.  I also kept extensive notes on my job search process and will write about searching for a job in 2009.

As always, I thank you for coming along for the ride with me and I welcome your comments and feedback.

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What a wonderful, crazy time this is, both in healthcare and in my life.  I can hardy keep up with either!

First, some changes to my website/blog.  I’ve added a few new pages to house special resources, but I don’t have them connected to RSS or email yet, so for the time being readers will need to check out these pages on the bar at the top of the page to see what’s new:

• The Library will house links and documents.  Right now it houses links, but documents are coming soon.  If you have documents you’d like to share, or some you’d like to see posted on this page let me know.

• Webinars/Events is a page set up for webinars and events, especially free webinars and events.  I’m still adding these in manually, but will have this page automated in the next month or so.  Again, if you see things you’d like me to add here, please let me know.

• News & Notes are things I come across daily that aren’t meaty enough to write a post about, but do deserve a mention.  I’m trying to separate things so that you can customize your reading experience.  Time is short, and I want readers to be able to hone in on the information they’re looking for.

• Lexicon (will be available soon) is a collection of definitions of words used on this site and is a quick reference for readers.  It works two ways.  You can go to the page to look up a word alphabetically, and my wonderful tech guy has set it up so the definition of any word in the Lexicon shows up any time you roll over the word anywhere on the blog.

• Down the road I plan to…well, why ruin the surprise – stay tuned!

Second, yesterday my husband and I embarked on a cross-country trip from Seattle to Raleigh.  We are relocating back to North Carolina as I continue my job search.  If you’d like to hear about our travels, click on the last new page, Road Trip.

And third, Manage My Practice.com is closing in one year of blogging, 100 posts, more than 100 subscribers via email and RSS, and close to 100 visitors daily.  I sincerely thank each of you for taking the time to visit my blog.

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New employees must complete the new I-9 form (Employment Eligibility Verification) beginning Friday, April 3, 2009.   Here is the link for the new form: New I-9 Form

Managers, you do not need to to use the new form for employees whose hire date is prior to April 3.

What is the purpose of the I-9?  The form states that it “is to document that each new employee (both citizen and non-citizen) hired after November 6, 1986, is authorized to work in the United States.”

Reading the instructions, I was surprised to learn
continue reading "Managers: Start Using the New I-9 for New Employees Friday April 3, 2009"

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I am writing this post in response to seeing a lot of questions recently about making deposits.  Even if you know how to make a deposit, you could copy this post into a word document and with a few changes, use it for a protocol for your office.  So, here goes:

1. Make sure all mail and checks that you receive are for your practice.  It’s easier and less costly to return it to the sender if you catch the mistake on the front end, instead of refunding it after it has been deposited in error.
2. Open the mail and separate the checks into four piles: (a) all insurance and other non-patient checks, (b) all patient checks, (c) all correspondence from insurance companies without checks, such as denials, “no-pays”, and requests for additional information, and (d) patient credit card payments..  Run two adding machine tapes each on the insurance check pile and the patient check pile to get an accurate total.
3. Some practices receive checks for medical records, depositions, honorariums, call pay, etc. and handle these monies outside of the standard deposit protocol.  Other practices handle them as a part of the process and post everything to a patient account or a dummy account specifically for non-service related revenue.  Either way is fine if it works for your practice.
4. Give the credit card payments to the person in your office who processes credit cards, and have them add these payments to your other credit card payments from over the counter.  Once the credit card payments are successfully processed, give them to the billing clerk to post to the patient account on the computer.  Be sure to always post patient payments ASAP (over the counter and mail) so patients don’t inadvertently receive a bill from the practice that does not reflect their recent payment.
5. Give the insurance company correspondence to a billing clerk to process after stamping the date on each first page.
6. If your office is big enough, split the duties between three people of (a) opening the mail and running two matching adding machine totals on the checks, (b) preparing the deposit and running a third matching tape total, and (c) posting the checks.  Make sure all adding machines are set to count the number of items and that item numbers match on all tapes.
7. Paperclip each check to its documentation.  Recycle the envelopes.  Some detailed people keep the envelopes with the patient checks until matching the address on the check and on the envelope and on the statement stub in case the patient has moved.
8. Stamp today’s date on the paperwork and EOBs (Explanation of Benefits) that accompany the insurance checks. Give the EOBs and one tape to a billing clerk to post.
9. There are two schools of thought at this point.  One school believes that no check should be deposited without first posting it to the patient’s account in the computer.  A second school (to which I belong) believes that the money should go right into the bank, and post the payments to the accounts within 2 business days.
10. Some offices have the technology to scan all deposits and all EOBs, and some offices will choose to photocopy checks to use as reference documents.  Some banks offer online images of deposited checks.  Refer to my post on lockboxes and remote deposits for other options.
11. Separate all insurance checks from their EOBs and stamp the back of the check (on the correct end) with your bank deposit information.  Separate the patient checks from the statement stubs and stamp the back of the checks with your bank deposit information. Give the statement stubs to a billing clerk to post the patient payments, checking first that the information on the stub and the check match, including the amount paid.
12. Deposit slips are carbonless and each deposit uses a set of two slips: one goes to the bank and one stays in the book.  Look in the back of the book for the piece of cardboard that you use to slide behind the two slips to keep the writing from bleeding through.
13. Date the deposit slip.  If you happened to have received cash in the mail, add the total of the cash where indicated on the slip.  Run a third adding machine tape for the insurance checks and the patient checks, verifying the correct amounts, and fill in a total for each category (I do not recommend you list each check separately!), totaling at the bottom of the page, and filling in the number of items.  Most deposit slips also have a place to fill in the total on one side of the deposit slip.
14. Most banks charge by the number of deposits, so it is typical to make one large deposit, regardless of the number of checks in the deposit.  Tear the top copy of the deposit slip off, put it on top of the checks, paperclip or rubber band the stack together and take it to the bank.
15. Once you’ve made the deposit, bring the receipt back and tape it on the back of the deposit slip copy in the deposit book.  Enter the amount of the deposit into your accounting system (Quickbooks, Peachtree, Great Plains, etc.)
16. Rest until tomorrow’s mail arrives

Note: smaller or larger offices may use a simplified or a more sophistocated version of this process.  Feel free to comment and let me know how you do it!

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I just participated in my first webinar and really enjoyed discussing the 2008 MGMA Annual Conference with colleague Marshall Maglothin and FierceHealthcare.com Editor-in-Chief Anne Zieger.  Click here to register with FierceHealthcare and launch the webinar.  My part starts at about 16 minutes.

Let me know what you thought about the conference.

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It seems that my most popular post to date has been the one I wrote on the difference between its and it’s.  This tells me that managers are looking for ways to improve their writing and communication skills.  Not being one to overlook the obvious, I thought I would write a post about the difference between your and you’re.

I’ve been reading blogs and blog comments so much lately that my eyes are almost crossed, but one thing that does jump out at me is the tendency for many writers to confuse the two words your and you’re.

Remember the rule for its and it’s?  This one is almost the same.

If you can substitute the words “you are” in the sentence, use the apostrophe.  For example, “You’re reading my blog” can also be expressed as “You are reading my blog.”

If the words “you are” make no sense whatsoever as a substitution, do not use the apostrophe.  For example, “You’re blog is fascinating,” sounds fine, but makes no sense when you substitute it with  “You are blog is fascinating.”  This is the place to use “your”, as in “Your blog is fascinating.”

Your choice of words makes all the difference, and you’re the one to make that choice.

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Maybe I’m out of the loop, but this story really caught my eye because a patient is suing the doctor, the practice, and the office manager.  This is the first time I’ve been aware of an office manager being sued for a practice policy.

Having worked at a practice that utilized medication contracts, I can see both sides of this story.  The patient needs care, the physician has to protect himself and the practice.  This is a no-win situation, in my opinion, because physicians have the right to dismiss patients from their practice, and patients have a right to seek medication for illness and pain without discrimination.

The patient is seeking to be re-admitted to the practice as a patient, and is asking that no derogatory comments be placed in his medical record.

Read the story here at StopTheDrugWar.org.

What are your thoughts?

(PTSD is Post Traumatic Stress Disorder)

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©Stephen Coburn/Dreamstime.com

I’ve always advised my children that if they can use its and it’s appropriately, if they can balance their checkbooks and can fry an egg, then they can be wildly successful in the world.  In other words, if they paid attention briefly in English, Math and Home Economics, success is within reach.

Now most people balance their checkbooks online and there are hundreds of websites to guide you in the cooking of a fried egg, but it is still clear to me that many people don’t know the difference between its and it’s.

Here’s how I remember which one to use, because it doesn’t come naturally to me either.

If you can substitute the words “it is” in the sentence, use the apostrophe.  For example: “It’s my blog” can also be expressed as “It is my blog.”

If the words “it is” make no sense whatsoever as a substitution, do not use the apostrophe.  For example: “The kitten licked its paw,” cannot be expressed as ‘The kitten licked it is paw.”

In this instance, you have my permission to forget the rule that “’s” means “belongs to.”

Okay, I feel much better having gotten this off my chest.

Oh, and p.s. I also taught my kids to look people in the eye when they give them a firm handshake. Maybe I should have taught them the fist bump instead – it’s (it is) more sanitary.

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