FAQs

Answer: Patients should never be told to call back. A message with the patient's name, phone number, date and time of the call and the reason for the call should always be taken by the answering service and relayed to the office. This policy ensures patients, established and new, are accommodated and not lost to another practice.

Answer: Yes. This policy is very difficult to monitor. However, written policy should state "No blatant displays of affection in the workplace and no favoritism".

Question: One of our best employees constantly "forgets" to punch out when leaving for lunch, errands and breaks. She has been warned several times and it has been noted in her personnel file, but she still forgets. We are reluctant to terminate her because she generates considerable amount of income. What should we do?

Answer: No employee is above adhering to office policies since those actions can influence other employees to do the same. The offender should first be given a verbal warning followed by one or two written warnings (The written warnings must be signed by the offender acknowledging the consequences. Refusal to sign means immediate termination). Third, a suspension without pay for a specific period of time. Fourth, termination. Your office policy manual should clearly outline the steps for this procedure so everyone understands in advance.

Question: My partners and I are looking for a fourth physician to join our practice. We have narrowed it down to eight possible candidates. Should we first conduct phone interviews or just continue to screen the resumes?

Answer: Phone interviews are an excellent means to qualify job candidates. However, before using this method be sure to outline specific questions for the candidates that will enable you to identify the most qualified and compatible ones.

Question: Other practices have used employment agencies to find clinical and administrative staff. What are the advantages?

Answer: If your office manager or administrator is not responsible for hiring, then a "headhunter" might be in order. Before such an agency is used you should check their reputation and employment fees. Have your attorney scrutinize the employment agency's contract since hiring a poor candidate can be very expensive in both time and money.

Question: Unlike our retired office manger, the new one refuses to fill in for absent employees. She will not answer the phone, stamp the mail, greet a patient, etc. What should we do?

Answer: Your manager should designate subordinates to fill in for absent subordinates. Actually, a clause to this effect should be part of the employee's job description.

Question: A patient we billed for co-insurance claims he paid cash for the visit. He does not have a receipt and we do not have a record of the payment. What should we do?

Answer: Co-payments must be collected from patients according to guidelines set forth in most payer contracts. You should query the staff to find out who collected the cash and why the patient was not given a paid receipt. However, a firm policy of issuing a receipt for every payment received should be implemented immediately and enforced. If this happens again, you may want to review employees activities to check for theft.

Question: Should my office issue receipts for co-payments? If a patient cannot pay at the time of service, should we send him home with a bill or mail the bill when we close the day's bookkeeping?

Answer: A receipt of payment should be issued for every payment, including co-pays by cash, check or credit card. Receipts are a paper trail for payments and for basic accounting to balance charges and payments. Every office should have a written financial policy requiring co-pays be paid before service are rendered. This eliminates any patient payment problems after the fact. It is not cost effective to bill patients for co-pays. However, it is less costly to give the patient a bill at the time of service rather than mail one.

Question: From a legal standpoint, how long are you obligated to keep medical records?

Answer: The answer depends upon where you do business. It is generally required to keep the records for 7 years for patients over 18 years of age. For patients under 18 years of age, records must be kept until they turn 18.

Question: Do you have any information on average turnover rates for physicians at academic medical centers?

Answer: Your best bet is to check with the Specialty Medical Societies or the AMA.

Question: I am having a dispute with one of my partners concerning what is the proper salary for an office manager. We are fortunate to have a very diligent, professional, hard working manager whom we pay $40,000 per year. I remember reading in one of those management magazines that the average wage is higher than this. Could you give us some direction on this matter?

Answer: You did not mention where your practice is located so the answer is difficult. Regardless, $40,000 is on the low side for a "bona fide" office manager. You also did not mention how many people the office manager supervises and the extent of responsibility. The higher that number, the higher the salary. To give you an idea: A 4 doctor orthopedic practice in central New Jersey (50 miles from New York City) with approximately 13 employees demands $75,000 to $85,000 per year plus a bonus. Keep in mind that this is for a real practice administrator who has been delegated complete hiring, firing and managing authority. In this case the doctors do what they have been trained for and leave the management to a professional. It would interest you to know what this practice grosses per year!

Question: What are the most important financial ratios and benchmarks?

Answer: A/R turnover rate; gross collections ratio; net collections ratio; days revenues outstanding; profit margin. Benchmarks for these ratios vary depending upon how heavily contracted you are.

Question: Our practice has a gross A/R of $8 million with 64% of the A/R greater than 90 days. How many collectors are needed to achieve industry standards?