Manage My Practice

• All available appointments are full.
• All staff showed up for their shifts.
• No one burns toast in the toaster oven and sets off the fire alarm.
• None of the staff show up to work wearing flip-flops or pink underwear beneath their white scrubs.
• All patients have been reminded about their appointments so they all show up.
• Patients calling for same-day appointments are able to be worked-in appropriately.
• No patients give false information at check-in.
• Established patients arrive on time with their insurance information and co-pay.
• New patients arrive on time to complete their paperwork, and give their insurance card, photo ID and co-pay to the receptionist.
• Patients with x-rays or other imaging studies bring the films or a CD.
• Patients with fasting appointments arrive having fasted.
• All patients arrive bringing their bag of medications.
• Patients in wheelchairs and with difficulty ambulating are accompanied by caregivers.
• Patients who do not speak English or are deaf have notified the office prior to the appointment and the appropriate technology or interpreters are available for the appointment.
• Patients with procedure appointments have followed their pre-procedure instructions.
• Patients with procedures have been pre-authorized by their insurance carrier and their personal financial responsibility has been discussed with them and payment arrangements have been made.
• Patient eligibility has been checked and those unable to be authorized have been called before their appointment to gain further information about their payer source.
• If computers go down, there are paper procedures in place to enable staff to continue seeing patients.
• No patients arrive saying “I forgot to tell you, this is Worker’s Comp/ an auto accident/ a liability case and I was told by my lawyer not to pay anything.”
• None of the patients pee on a waiting room chair.
• Neither JCAHO nor any state or federal officers show up.
• The copiers and faxes all work.
• No subpoenas come in the mail.

  

  Image by Smithsonian Institution via Flickr

• It’s not your very first day live on electronic medical records.
• All phone calls are answered before the third ring and no one has to leave a message.
• No patients walk in the door with severe chest pains and say “I knew the doctor would want to see me.”
• Patients remember to call the pharmacy for refills.
• Providers all run on time and seem in particularly good moods.
• Patients get their questions answered with callbacks within two hours.
• Someone delivers sandwiches, drinks and brownies to the practice for lunch.  There is enough for everyone.
• No bounced checks come in the mail.
• Providers spend so much time in the exam room listening to their patients that the patients leave feeling that every question they had (and a few they didn’t know they had) was answered.
• Providers circle the services and write the diagnosis codes numerically on the encounter form, remembering that Medicare doesn’t pay for consults any more.
• Sample medications that providers want to give patients are in the sample closet.
• Records that providers want to reference are in the chart and are highlighted.
• No one calls urgently for old medical records that are in the storage unit across town.
• There are no duplicate medical records.
• Patients checking out never say “But he was only in the room for 5 minutes!”
• The patient restrooms don’t run out of toilet paper.
• No bankruptcy notices come in the mail.
• All phlebotomists get blood on the first stick.
• No kids cry.
• The HVAC system works beautifully, keeping it cool where it needs to be cool, and warm where it needs to be warm.
• Congress announces that the SGR formula has been revoked and a new reasonable model for paying physicians has been discovered.
• Everyone goes home at 5:00 p.m., glad to have a job, glad to be of service, and happy with their paychecks.

There seem to be a lot of people searching for rules for medical offices.  I’ve never heard of such rules, but since people are looking for them, I thought I’d write some.

1. Medical offices are professional workplaces and staff need to dress, speak, and purport themselves professionally.
2. Patients are customers and customer service should be paramount.  Give all patients the utmost respect and practice compassion, compassion, compassion.
3. If it didn’t get documented (on paper or electronically), it wasn’t done.  If it didn’t get documented, you can’t charge for it.
4. HIPAA.  First of all, please spell it correctly.  One P, two As.  Secondly, know what it means and make it so!
5. Never enter an exam room without knocking.
6. Confirm patient identity (name, date of birth, etc.) before giving injections, taking specimens or performing a procedure.

   

   Image via Wikipedia

7. Remove very sick or very angry patients from the front desk immediately.  Take the sick ones to exam rooms and take the angry ones to the manager’s office.
8. Do not use medical jargon with patients.  If they don’t know what you’re talking about, they might be too intimidated to ask.
9. Wash your hands. Often.  No matter what you do in the practice.
10. The office should be CLEAN, fresh and up-to-date.  No dying plants, no magazines more than 9 months old, no dust bunnies behind the doors, no stained seating or carpets.
11. Train staff to apologize, and to apologize sincerely.
12. Complaints from patients and staff need to be addressed in 2 weeks or less.
13. Medical equipment is to be maintained and tested annually for safety and performance.
14. Once a medical record is finalized, the only changes to a paper record are single line strike-throughs with corrected information and initials, or addendums.  There are no changes to electronic records, only addendums.
15. Patients don’t understand insurance.  Be the expert.
16. Shred confidential practice paperwork and patient-identified information on-site.
17. Keep medications (including sample medications) in locked cabinets and use a good inventory system to log the use and replacement of stock.
18. Strive to meet patients at their communication level. Use graphics, translated materials and interpretive services when needed.
19. Don’t expect patients to be on time for their appointments when the provider isn’t.
20. Don’t make copies from copies.
21. Give everyone the benefit of the doubt.  There’s always more to the story. Okay, this is really a rule for life in general, but it works in medical offices too.

Leave a comment and tell me what rule you would add.