2013 planning Archives - Capko & Morgan

13 for 2013 Tip #5: Review your maintenance contracts

Starting a new year is a great time to review your equipment maintenance contracts and evaluate alternatives. Independent service organizations compete for your business -- if your contract costs keep rising, consider putting your contracts out for bid. In some cases, rising maintenance costs may also mean that replacing outdated medical equipment is more cost-effective than continuing to service older assets. The same thinking applies to office technology assets. If the Geek Squad tech who helps you fix your PCs or your network is on a first-name basis with everyone in the office, you may be better off upgrading. And practice management software that requires costly upgrades may be better replaced with a cloud-based solution that updates automatically.

By Judy Capko|2013-01-15T14:32:54-08:00January 15th, 2013|

13 for 2013 Tip #3: Cash management quick-check

Do you accept cash payments at your practice? The start of a new year is a great time to review how your practice handles cash -- to determine if your internal controls could use some tightening up. With cash, the biggest temptation is to handle these "small" amounts more casually than other payments. When cash payments are rare -- a $30 co-pay here, a $25 co-pay there -- it can seem that they're less important to the bottom line. But, over the course of a year, even a single $30 cash payment per day amounts to close to $8,000! Keeping tabs on those "unimportant" cash payments is actually very important, indeed. The biggest pitfall: mixing cash receipts with petty cash. This all but ensures these amounts won't be deposited and may not be properly tracked. Petty cash should never be more than about $50 or so -- just enough to handle small payment amounts for the office that cannot be handled by credit card or check. Allowing petty cash to grow creates a temptation for misuse -- or worse, theft. Cash should be deposited regularly -- ideally, every day -- for security and for effective tracking for practice evaluation and tax reporting. Receipt stock should be monitored, and the cash received should be reconciled against the day's postings by some at the practice who doesn't collect it and post it to the billing system (in smaller practices, this might need to be the physician/owner).

By Joe Capko|2022-01-01T22:52:36-08:00January 10th, 2013|

13 for 2013 Tip #2: Analyze your E&M code utilization

For most practices, E&M codes represent a significant portion of billings -- and, for some practice types like pediatrics and other primary care, E&M codes can approach 100% of billings. Physicians and non-physician providers are often so sensitive to the risk of down-coding, denial or audit that they develop a bad habit of 'defensive' E&M coding -- i.e., sticking to the lower range of the codes for virtually every patient. Far from being an effective defense, though, this type of habitual coding may actually create more audit risk, since it leads to a distribution of codes that is skewed rather than the expected bell-shaped curve. And, it does so while also leaving thousands of the practice's dollars on the table! The end of one year and the beginning of another is the perfect time to analyze your practices E&M coding patterns -- and set new habits for the new year. Run a report for each physician by code for the full year, and you can create a table like this that totals how many times each provider used each code: code 99201 code 99202 code 99203 code 99204 code 99205 Total Anderson 12 252 900 12 24 1200 Buford 0 132 996 348 0 1476 Cochrane 12 996 96 0 0 1104 Delaney 0 36 732 432 120 1320 Elliott 12 48 1092 156 24 1332 From this data, you can easily calculate percentage utilizations to get a clearer idea of distribution -- and from there create a chart to spotlight any skewed coding: E&M Distribution Chart E&M Distribution Chart Notice the skewed utilizations of Cochrane, Anderson and Elliott? It's unlikely these codes are accurate -- especially Cochrane, who appears to be habitually and defensively under-coding. (Note, also, the addition of the CMS averages to the chart -- available from the CMS website. This is a great double-check to see the typical coding mix based on all practices billing Medicare -- and to get a sense if your coding patterns will look odd (or audit-worthy) to the CMS.) Next step: identify the number of instances of

By Laurie Morgan|2022-01-01T22:52:37-08:00January 8th, 2013|

13 for 2013 Tip #1: Master the deductible re-set

Too often, patients and practices alike are caught off guard by the resetting of deductibles on January 1. When patients forget they'll be responsible for a larger portion (or all) of the cost of their services, it can be difficult for front desk staff to handle the situation if they're not prepared -- and even physicians and managers find it hard to refuse a request to "please just bill me." The best solution to the problem is to prevent it. Make sure everyone in the practice knows that more patients will be responsible for payment until their new deductibles are met -- and that patients need to be informed and reminded before their visit. That means mentioning that deductibles have re-set when they set appointments, and checking patient responsibility amounts and outstanding balances before reminder calls -- and alerting patients to what they'll be expected to pay at visit time. Knowing that patients have been informed about their responsibility should make it easier for the front desk to collect in a matter-of-fact way. ("How will you be paying today, Ms. Jones?")

By Laurie Morgan|2022-01-01T22:52:37-08:00January 5th, 2013|

New series: 13 tips for 2013

All of us at Capko & Company want you to start 2013 off right! We're rolling out a series of quick tips -- short bites that will take just a minute to read -- to help you make the most of all the opportunities of a brand new year. First up: don't let the deductible re-set short-change your first quarter revenue.

By Laurie Morgan|2022-01-01T22:52:37-08:00January 5th, 2013|