Disclaimer: Since this information may be of a generalized nature, no final decisions should be based on this information without first seeking professional advice for your specific circumstances.

General Questions:
01 - How do I change my address?
02 - My practice seems to have a lot of no-shows. What should I do about it?
03 - I'm trying to decide if I should join a large group practice. Are there advantages in being a small office?
04 - Which is better, one fee schedule or multiple fee schedules? Is it even legal to have more than one fee schedule?
05 - Is there any way to get claims paid more quickly?
 
Our Company :
06 - How can I recognize a good manager? Are there certain recognizable qualifications?
07 - I submit claims electronically and try to always submit clean claims but nothing seems to help. What do I do?
08 - We seem to have a difficult time getting the most out of new employees. Are we doing something wrong?
09 - My practice is thinking about hiring a PA or NP. Can we bill under the supervising physician's Medicare number?
10 - As a manager is there anything I can do to monitor employee effectiveness?
Practice Management :
11 - As a physician, what data should I review from my manager?
12 - I trust my employees completely. Is that a bad thing?
13 - Do I really have to comply with the HIPAA privacy section?
14 - I have heard Centers for Medicare/Medicaid Services (CMS) might be changing the E&M documentation rules. Do I still need to worry about the 1997 E&M documentation guidelines?
15 - I have been told to hire someone with an MBA to manage my practice. Is that a good idea?
16 - When I ask my manager questions, she sometimes seems to make up an answer. Is this a sign she may be in trouble?
If you have a question that isn't answered here, or would like further information about ZII;
please contact us at info@zenithintegrated.com.
01 - How do I change my address? Top
  • You may change your address on-line.
02 - My practice seems to have a lot of no-shows. What should I do about it? Top
  • Do not tolerate staff members being unprofessional with patients.
  • Do not charge a no-show fee.
  • Investigate and try to determine the reason behind no-shows.
  • Stay positive when dealing with missed appointments.
  • Call forty-eight hours in advance with appointment reminders.
03 - I'm trying to decide if I should join a large group practice. Are there advantages in being a small office? Top
  • A "personal touch" is easier to establish and retain in a small practice.
  • Overhead is easier to control and therefore remains lower.
  • A small practice normally can function effectively with fewer employees. This in turn makes managing easier.
  • Actual office space can be more inviting rather than appearing as an institution. A more welcome feel draws new patients.
04 - Which is better, one fee schedule or multiple fee schedules? Is it even legal to have more than one fee schedule? Top
  • Yes it is legal to have multiple fee schedules, as long as no fee is lower than the amount you bill Medicare.
  • The majority of practices are best advised to maintain only one standard fee schedule; however there are exceptions depending on payer mix.
05 - Is there any way to get claims paid more quickly? Top
  • Submit all claims electronically.
  • Submit clean claims by understanding the rules of coding.
06 - How can I recognize a good manager? Are there certain recognizable qualifications? Top
  • Raw talent. The best managers have high intellect.
  • They are self-developers. Added skills can't be forced on someone unwilling to learn.
  • They lead with tact, grace and authority.
  • They are not only efficient but also effective.
  • They have technical skills and know how each job is done within the organization.
  • They understand who the employer is and identify with the physician.
07 - I submit claims electronically and try to always submit clean claims but nothing seems to help. What do I do? Top
  • It is recommended that follow up is performed on unpaid claims within 45 days of the original date of submission.
  • Handle denials immediately. All denials should be worked within 5 business days of receiving them.
  • Get the patient involved in the process. Whenever possible, let the patient know when payment has not been received.
08 - We seem to have a difficult time getting the most out of new employees. Are we doing something wrong? Top
Many times offices simply hire people and put them to work with either improper or no instruction.

Follow the "Hersey Way", referring to the well known management technique leader.
  1. Telling-Train in the tasks necessary to do the job.
  2. Selling-Explain the importance of the job and say it is important to do it a certain way.
  3. Participating-Ask employee for input on better ways to do the job once they fully understand it.
  4. Delegating-After the first three have been accomplished, leave the employee alone to do their job with limited supervision.
09 - My practice is thinking about hiring a Physician Assistant or Nurse Practitioner. Can we bill under the supervising physician's Medicare number? Top
Yes, if the physician performs any face-to-face service with the patient and documents the "face-to-face", then you may bill under the physician's number following the "shared evaluation and management services".
10 - As a manager is there anything I can do to monitor employee effectiveness? Top
  • Perform daily and weekly audits. Keep a pulse on the practice.
  • Perform a daily reconciliation of the schedule against the encounter forms. This checks for failure to capture all charges.
  • Perform a weekly reconciliation of patient encounter forms against the computer to identify charge entry errors. Continue the process by performing a review of payments received and the final posting to the computer.
  • Review the aged accounts receivable to determine neglect for follow up collection efforts.
11 - As a physician, what data should I review from my manager? Top
  • It is vital to understand where the practice is and where it should be. The practice should be benchmarked against the Medical Group Management Association data by specialty.
  • After you have the data, monitor your 90+ past due A/R gross and net collection rate, and A/R multiple. By monitoring these indicators, you will be able to identify "red flags".
12 - I trust my employees completely. Is that a bad thing? Top
  • It is not a bad thing to trust employees but it may be shortsighted for complete trust.
  • All employees need to be aware there are checks and balances built into the system. This protects them as well as the practice.
  • Make certain the money collected both from the patient and insurance companies are handled in a complete and thorough manner.
13 - Do I really have to comply with the HIPAA privacy section? Top
If your office submits claims electronically or has more than ten employees and participates in Medicare, you must comply by April 14, 2003 for the HIPAA privacy section.
14 - I have heard Centers for Medicare/Medicaid Services (CMS) might be changing the E&M documentation rules. Do I still need to worry about the 1997 E&M documentation guidelines? Top
The 1997 E&M guidelines are going no where. It appears that CMS and the AMA have stopped revamping the E&M documentation guidelines. We may never get rid of the 1997 E&M guideline requirements.
15 - I have been told to hire someone with an MBA to manage my practice. Is that a good idea? Top
Very little of what is taught in MBA school help prepare a potential employee to effectively run a physician office. An MBA graduate will still need to learn, on the job. For example: Medicare rules and regulations, physician scheduling, and clinical staff productivity. Without these basic skills, it is hard for any manager to gain the trust of the very employees they manage.
16 - When I ask my manager questions, she sometimes seems to make up an answer. Is this a sign she may be in trouble? Top
Yes-When a manager bluffs a physician or an employee, it is the beginning of the end. Both a physician and employee will lose respect and trust in the manager.