Another instance of an employee stealing patient copays in a medical practice. The following was excerted from an email I received:
A simple post today: Remember that growing a medical practice today is ALL ABOUT GROWING THE TOP LINE.
The following was from a recent post to one of the MGMA listservs: I fully agree that once you have your fixed overhead covered it is good business to try to fill up the rest of your capacity with "lesser reimbursement" patients. Once those fixed expenses are met you just have variable incremental expenses on the remaining volume…giving credence to the theory that "you can make profit from volumes of
Physician just called and employees have been caught stealing patient copayments. I think this kind of behavior is rampant in medical practices because of a lack of continuous oversight and the lack of proper internal controls.
I am working with a doctor who recently purchased a medical practice from another physician. The selling physician insisted that the purchasing physician buy the stock of the medical practice corporation, which he did (the seller physician obviously wanted to maximize capital gain rates on the sale). This obviously hurts a buyer because the buyer’s tax benefits are foregone (depreciation on acquired assets, amortization of a covenant not to compete,
Don’t forget to sign up for my monthly electronic newsletter that is written only for physicians and physician medical practices. Go to http://www.envoyglobal.net/elawmarketing/tinsley/tinsleyform.htm to sign up.
In the June 3rd issue of Medical Economics, the Practice Management Q&A Forum had the following question: My three doctor cardiology practice is considering a merger with one of the three other cardiology groups in our community. Would this violate antitrust rules? The answer in the article was "probably not" as long as it is a merger in the true sense of the word but as always, a healthcare attorney
In the June issue of Private Practice Success newsletter, the director of the Office of Civil Rights was quoted as saying in the two years since covered entities were required to comply with the HIPAA privacy rule, 11,920 complaints have been lodged with the OCR, most of them against private healthcare practices. "The complaints are coming from where the patient has the most contact with the provider – the day
I am working on an independent embezzlement review that resulted from a medical practice employee going to the bank and trying to cash SEVEN insurance checks. Luckily the bank called the practice first before cashing them. To date, we have found her to have taken numerous patient copays and pocketing the money.
A commentary to this blog asked "What is a good resource to use for training staff on HIPPA privacy rules?" The American Medical Association has very good resources but also check out www.hcpro.com or www.ingenixonline.com.
When I negotiate managed care contracts on behalf of clients, one part of the process is to take a practice’s top 20 CPT codes and then pull the most recent EOBs from that payer showing these codes. An excel spreadsheet is then created showing the payer’s allowable for each of the 20 codes and a comparison to current Medicare rates (More on this subject later).
The Austin American Statesman recently ran an article about Jack Welch, the former CEO of GE. In the article, he was asked about GE’s approach to managing people, which focuses on rewarding stars – the top 20% or so – and easing out the bottom 10%, the low performers: "It’s differentiation, and I believe in it to my toes. It’s somewhat controversial at times." said Mr. Welch. Mr. Welch advises