Whether the title is manager, medical practice manager, physician practice manager, administrator, practice administrator, executive director, office manager, CEO, COO, director, division manager, department manager, or any combination thereof, with some exceptions, people who manage physician practices do some combination of the responsibilities listed here or manage people who do.
Human Resources: Hire, fire, counsel, discipline, evaluate, train, orient, coach, mentor and schedule staff. Shop, negotiate and administer benefits. Develop, maintain and administer personnel policies, wellness programs, pay scales, and job descriptions. Resolve conflicts. Maintain personnel files. Document Worker’s Compensation injuries. Address unemployment inquiries. Acknowledge joyful events and sorrowful events in the practice and the lives of employees. Stay late to listen to someone who needs to talk.
Facilities and Machines: Shop for, negotiate, recommend, and maintain buildings or suites, telephones, hand-held dictation devices, copiers, computers, pagers, furniture, scanners, postage machines, specimen refrigerators, injection refrigerators, patient refreshment refrigerators, staff lunch refrigerators, medical equipment, printers, coffee machines, alarm systems, signage and cell phones.
Ordering and Expense Management: Shop for, negotiate and recommend suppliers for medical consumables, office supplies, kitchen supplies, magazines, printed forms, business insurance, and malpractice insurance as well as services such as transcription, x-ray reads/over-reads, consultants, CPAs, lawyers, lawn and snow service, benefit administrators, answering service, water service, courier service, plant service, housekeeping, aquarium service, linen service, bio-hazardous waste removal, shredding service, off-site storage and caterers.
Legal: Comply with all local, state and federal laws and guidelines including OSHA, ADA, EOE, FMLA, CLIA, COLA, JCAHO, FACTA, HIPAA, Stark I, II & III, fire safety, crash carts and defibrillators, disaster communication, sexual harrassment, universal precautions, MSDS hazards, confidentiality, security and privacy, and provide staff with documentation and training in same. Make sure all clinical staff are current on licenses and CPR. Have downtime procedures for loss of computer accessibility. Make sure risk management policies are being followed. Alert malpractice carrier to any potential liability issues immediately. Make sure medical records are being stored and released appropriately.
Accounting: Pay bills, produce payroll, prepare compensation schedules for physicians, prepare and pay taxes, prepare budget and monthly variance reports, make deposits, reconcile bank statements, reconcile merchant accounts, prepare Profit & Loss statements, prepare refunds to payers and patients, and file lots and lots of paperwork.
Billing, Claims and Accounts Receivable: Perform eligibility searches on all scheduled patients. Ensure that all dictation is complete and all encounters (office, hospital, nursing home, ASC, satellite office, home visits and legal work (depositions, etc.) are charged and all payments, denials and adjustments are posted within pre-determined amount of time. Transmit electronic claims daily. Send patient statements daily or weekly. Negotiate payer contracts and ensure payers are complying with contract terms. Appeal denials. Have staff collect deductibles, co-pays and co-insurance and have financial counselors meet with patients scheduling surgery, those with an outstanding balance, or those patients with high deductibles or healthcare savings plans. Make sure scheduling staff know which payers the practice does not contract with. Liaison with billing service if billing is outsourced. Credential care providers with all payers. Perform internal compliance audits. Load new RBRVS values, new CPTs and new ICD-9s annually. Run monthly reports for physician production, aged accounts receivable, net collection percentage and cost and collections per RVU. Attach appropriate codes to claims for e-prescribing and PQRI. Have plan in place for receipt of Recovery Audit Contractor (RAC) letters. Make friends and meet regularly with the provider reps for your largest payers.
Marketing: Introduce new physicians, new locations and new services to the community. Recommend sponsorship of appropriate charities, sports and events in the community. Recommend sponsorship of patient support groups and keep physicians giving talks and appearing at events. Thank patients for referring other patients. Track referral sources. Recommend use of Yellow Pages, billboards, radio, television, newspaper, magazine, direct mail, newsletters, email, website, blog, and other social media. Prepare press releases on practice events and physicians awards and activities. Recommend practice physicians for television health spots.
Strategic Planning: Prepare ROIs (Return on Investment) and pro formas for new physicians, new services, and new locations. Forecast potential effect of Medicare cuts, contracts in negotiation or over-dependence on one payer. Discuss 5-year plans for capital expenditures such as EMR, ancillary services, physician recruitment, and replacement equipment. Explore outsourcing office functions or having staff telecommute. Always look for technology that can make the practice more efficient or productive.
Day-to-day Operations: Make the rounds of the practice at least twice a day to observe and be available for questions. Arrange for temporary staff or rearrange staff schedules for shortages, meet or speak with patients with complaints, and meet with vendors, physicians and staff. Open mail and recycle most of it. Unplug toilet(s).
Stay Current in Healthcare: Attend continuing education sessions via face-to-face conferences, webinars, podcasts and online classes. Maintain membership in professional organizations. Pursue certification in medical practice management. Network with community and same specialty colleagues. Participate in listservs, LinkedIn and Twitter.
What did I leave out? Take a lunch?
Read my post on “How Much Do Medical Practice Managers Make?” here.
No related posts.
gee – that sounds so easy
That nearly covers everything. I would add “Red Flag Rules” to the Legal category. But, this is the most comprehensive list I have seen thus far!
Wow Mary, pretty comprehensive list. When people ask me what I do as a practice manager, I tell them that my job is to make sure the office runs smooth. Now, I can just point them to your blog.
Thanks, Brandon. Putting it altogether like this made me both proud to be in this profession, and amazed at what we do!
Mary Pat
This is a fantastic primer for building an understanding of a “day in the life of.” Thank you!
Hopefully a manager wouldn’t have to do everything on that list in one day, but some days it does feel like it!
Best wishes,
Mary Pat
Love it…unfortunatly it is true
Thank you for posting. I’m thinking about becoming a healthcare manager, and you post is very helpful!
Hi Mary,
I’m glad to hear it was helpful. Let me know if I can help you in your journey.
Best wishes,
Mary Pat
[...] and more! (see my post on what managers do here.) [...]
Hello Mary,
Great article. I have a question though. In your vast experience with practice managers, what is the downside to hiring someone with military experience only as a practice manager?
From what I have read here and my knowledge and backgraound as a Navy Hospital Corpsman, the only significant difference is the volume of Third Party Reimbursement activities between military and civilian practices/ medical organizations.
What are your thoughts?
Hi Gary,
What a great question! Hiring a manager who does not have any direct experience with third-party payers could be considered a risk if the practice is relying completely on the manager to negotiate contracts, monitor payer performance and go toe-to-toe with the payer when the contract terms are being abused. No manager is strong in every aspect of practice management so often a practice will augment a manager’s experience with some additional training or education, or will bring a specialist on board (an experienced billing manager) or use a consultant.
Tell me about asking this question – what has your experience been?
Best wishes,
Mary Pat
Hi Mary Pat,
Love your blog! Question for you. I am a nurse consultant and have developed a training program for medical office staff to become more efficient at prior authorization for advanced imaging. I do cold calling to medical offices to sell my training program and am in the process of hiring a salesperson to help me. Who in the office do you think I would have a better chance selling my services to? The person actually doing the prior auths, office manager or the medical provider? Any advice would be so appreciated! Thanks!
Hi Terri,
Thanks for your questions. Your training program sounds great. Unless a physician is very deeply involved in the billing and day-to-day operations, I would not propose marketing to him/her. The two most likely candidates for understanding the value a program like yours could bring to the table are the manager/administrator or the billing manager, if the practice is big enough to have one. Selling to the person who actually does the pre-authorizations might be hit or miss, depending on their knowledge base and their relationship with decision makers. I hope this is helpful.
Best wishes,
Mary Pat
Thanks so much for the advice! Yes, very helpful. Do you mind if I list a link to your blog on my blog and website? Your info is very relevant and spot on. I also quoted you in a recent article I wrote. You can check it out on my blog under the link: “The Future of Health Care”.
Take care,
Terri
Thanks, Terri, for the quote and link. I’m glad I could be of help.
Best wishes,
Mary Pat
[...] Manager (see the Library tab for job descriptions) see my posts on what an administrator does here, and a day in the life of an administrator [...]
Great post Mary, I found it very helpful.
I’m new to the medical sales industry, and I’m glad to have found this on my search to better understand what an office manager dces.
I have a question for you though, similar to one asked previously. We have a new solution in the medical industry, one that has an over 90% hit rate among eligible practices. The hardest part that I have, being new to the industry, is setting appointments with office managers. (Now I see why with their busy schedule)
Do you have any tips for me as to how to successfully get through to set an appointment with an office manager as busy as yourself?
Greg
Hi Greg,
This is a great question! Managers get bombarded by salespeople all day long, so it’s no wonder that they are often resistant to setting appointments to meet with them.
Medical office managers are usually generalists and need to have knowledge about a lot of different things. Because their time is limited, they often rely on references from other medical managers who have spent the time to delve deeply into a product or service. Therefore, a salesperson needs to sell one manager on their product and once it is proven to perform well, ask that manager to refer you to others. Find the manager in the community who the other managers look up to and you will find the person you want to work with first.
Also, most managers belong to a managers’ group that meets monthly – sponsor the meeting, get in front of the managers and make a special offer to the managers in attendance to get them to open their doors to you. Find their pain points, make sure your product addresses one of them and find out how managers want to communicate with you. Don’t harrass them!
Best wishes, Greg.
Mary Pat
Thank you for all of the helpful information, I am currently going to school for my Associates degree in Health Care Administration services. An have to write a paper about what I will be doing on a day to day bases. Again thank you for the brake down of what I someday will be doing.
Mary Pat, I have written a GREAT deal, I mean a G-R-E-A-T deal about and for medical assistants, and medical billers. As a former certified medical assistant and medical assistant instructor I know this role very well, however, your article was a real eye-opener as to the masses of function and plethora of responsibilities the medical office manager has to master. I really enjoyed reading the article from top to finish, and I was looking for any linking, or quoting instructions, or permissions to reprint, at least in part as a primer on related websites. I would LOVE to share this insight with the thousands of medical assistants that visit my medical assisting – and also the medical billing and coding – websites.
Thank you!!!!
Danni R.
Hi Danni,
Thanks for the feedback and taking the time to write. I’ll contact you offline to discuss reprint guidelines.
Best wishes and Happy New Year!
Mary Pat
Hello everyone I am about to graduate in 2 weeks from Medical office Adminidtrative program I’m excited I would love to hear from some of the experienced people opinion of the field. Because I am a newbie I don’t know what to expect but I am ready for it
… Thank you
Hello Mary Pat
I am currently working on getting my Bachelors in Medical Office Management and eventually hoping to get my MBA in Healthcare threw George Washington University in Washington DC. You said you are a Medical Practice Manager, is that the same as a Medical Office Manager? If not then how are they different? What state offers the most potential in the field?
Much Thanks
Kilynn Kramer
Hi Kilynn,
There are many different titles for what we do, and in my mind, it comes down to a difference of how much responsibility one has and who is the position reporting to. Many think that “office manager” is a step down from “practice manager,” but because people can use the titles interchangeably, you have to dig under the job to find out what it really entails. I have been called many things, from Office Manager to CEO, but in some ways those two titles weren’t radically different. What counts is the expectation that your boss has of you.
This may not be the black and white answer you hoped for, but in healthcare management there is not a lot of standardization.
Best wishes,
Mary Pat
Mary Pat,
This sounds like a challenging profession that requires specialized skills and knowledge. My wife (the physician) and I (the MBA) are seriously looking into starting our own practice in a small town. Since I would likely handle a great deal of the business side of things, how would I go about beginning to educate myself on some of the specific areas relating to the management of a medical practice? Any guidance would be greatly appreciated. My prior experience is in the financial side. Sounds like there will be a steep learning curve.
Thanks,
Carlin
Hi Carlin,
The two areas that I think are most critical are revenue cycle management and technology.
I wrote about RCM here: http://www.managemypractice.com/what-is-revenue-cycle-management/
My favorite book about RCM is here: http://www.mgma.com/Store/ProductDetails.aspx?id=38731 and is called “The Physician Billing Process 12 Potholes to Avoid in the Road to Getting Paid”
Technology is a little trickier, but there is a fair amount of info on the web about PMs, EMRs, patient portals and payment portals. There are lots of products out there and depending on your wife’s specialty and her anticipated demographic, you could go fairly simple with technology but you could also spend lots of bucks. I think the key here is visiting lots of other practices to see what they use and exactly how they use it.
I hope this is helpful.
Best wishes,
Mary Pat
Hi Mary Pat,
Can you recommend a good course that will provide good training for managing a doctor’s office. I am looking at Kaplan, Allied, Virginia College, etc. Are these types of courses any good? Most of the reviews are terrible. I have a technical background and have a opportunity to manage an office that a relative is starting up. Any recommendations would be very appreciated.
Thanks,
Nick
Hi Nick,
I wish I had an answer to give you, but I am not aware of any program that truly prepares you to manage a practice. Managers need to know business, PM and EMR software, Human Resource laws and protocols, coding and billing and marketing. I have not reviewed any of the programs you mentioned in depth, but healthcare is changing so much in such a short time, that most programs cannot keep up with it. I have always wanted to start a school for practice managers, maybe now is the time!
Best wishes,
Mary Pat
I have been a practice manager for more than 25 years now. 25 years ago, I had to really search for stuff to keep me busy. After I reconciled the bank statement, ran the monthy reports for the accountant,paid the bills ( hand written from a regular check book, reconciled the peg board system, wrote a few letters to insurance companies, filed very few claims. pehaps made sure the office staff was kept enthusiastic about their jobs. We would meet our goals, take 2.5% of the gross and devide it among the employees, for a job very well done. 99% of our patients paid cash at the time of service. We did general dermatology and cosmetic dermatology. We were naking money hand over fist.Our doctor decided that the employees were getting paid too much and cut out the bonuses. (extremely stupid move)and did not allow any bonuses in it’s place.
I always hired the most vivaceous ladies I could find. People that were excellent on the phone, as well as in person, and very personable to the patients. That was the number one priority. I did not allow any gossip what-so-ever. THEN THE AMA DECIDED THEY COULD CASH IN ON THE CODING
MAKING MILLIONS OF DOLLARS PER YEAR BY MAKING INDIVIDUAL PHYSICIANS BUY THE NEW CPT CODE BOOK EACH YEAR. AS FAR AS I AM CONCERNED THIS IS A TRUE CONFLICT OF INTEREST. THE AMA DID NOTHING TO PROTECT DOCTORS FROM OBAMA CARE. TO THIS DAY I STILL DO NOT UNDERSTAND WHY DOCTORS LET THE AMA SCREW them OVER SO BADLY. WHEN I STARTED IN MEDICINE 35 YEARS AGO, THE AVERAGE OFFICE VISIT WAS 27.00 IN MY FIELD. TODAY, WE GET REIMBURSED BY MEDICARE SOMETHING LIKE 29.00. THE SECONDARY OR THE PATIENT MAY HAVE TO PAY AN ADDITIONAL 7.20.
AFFAIRSRS FOR BOTH THE PATIENT AND THE DOCTOR. NOTHING WILL HAPPEN UNTIL DOCTORS UNITE AND STAND UP TO THESE INSURANCE COMPANIES.
I HAVE A FRIEND WHO IS AN ENT. HE WAS PAID SOMETHING LIKE 113.00 FOR REMOVING A BRAIN TUMOR IN THE HOSPITAL SETTING. THE HOSPITAL WAS PAID 43,0000.00 FOR HAVING THE PATIENT IN THE HOSPITAL FOR 2 DAYS. THERE IS SOMETHING SO WRONG WITH THIS PICTURE!!
I COULD GO ON FOR HOURS BUT MUST GET BACK TO WORK. Maybe when I retire in December, I will write a book, this is NOT going to get better.
Karen,
Let me know when your book is published!
Best wishes,
Mary Pat