Practice Management

The typical difficult patient can ruin a perfectly good day at your practice if you let them. By not taking it personally and keeping your cool you can successfully deal with this type of patient without adding stress and frustration for you or the patient.

Practices can increase their efficiency by performing surgery in only one location, having multiple operating rooms (ORs) and an efficient preoperative area available, using anesthesia blocks preoperatively instead of topical anesthesia in the OR, choosing a safe and reliable phaco technique that minimizes surgical time, and hiring well-trained staff members.

It is just as important to create a supportive and friendly atmosphere in a negotiation so that continuous relationships can form, as well as a good reputation. Here are ten Commandments for carrying out a negotiation in the ophthalmology practice.

An ophthalmic practice must create an environment in which employees are engaged with their work and are motivated to perform it well. Such an environment can be achieved by obtaining information about employee strengths, weaknesses, and goals and tying these to the practice goals.

The particulars of partnership agreements often vary depending on the circumstances and culture of a practice, in almost all cases they cover four subjects: practice buy-ins, division of net income, governance issues, and buy-outs. The three elements, which a person is essentially buying, are a practice's tangible assets, accounts receivable, and goodwill.

The leaders of two professional ophthalmology organizations discuss ways to hire top talent and retain them. Included in their tips are over-looked sources for potential employees such as national chains, the importance of job descriptions and what to include in them, and training.

With the flattening of the LASIK market comes the need to diversify and one procedure in particular to accomplish this is cataract surgery with an IOL implant.

Change in the practice setting can affect acquired skill sets, physician expectations and, perhaps most significantly, delivery of patient care. Major sources of change in ophthalmic practices include: technology, personnel, compensation, workload, patient mix, and payers.

People, whether they are the patients, co-workers, or just a stranger re-affirm why some people are still in the field of patient care. They give the opportunity to "care."

There is an inherent tension between the appeal of maintaining a successful, secure business and the desire to expand the business. According to Dr. McDonnell it is much more common for practices and departments to wait too long before beginning the process of adding excellent people to build upon a successful and vibrant operation.

Monovision offers a safe and an effective option while multifocals are a high risk strategy, Dr Graham D. Barrett controversially told delegates during a session that discussed whether surgeons should introduce multifocal IOLs (MFIOLs) into their practice.

David Bailey, president of international operations at Staar Surgical, makers of the Visian ICL & TICL, says ICL technology allows surgeons to differentiate themselves in the slowing LASIK marketplace.

Marketing at the practice level offers a less expensive and easier way to increase patient volume. Creating a memorable patient experience by showing the practice's superiority over others, starting at the consultation, as well as addressing concerns and fears at the beginning, will help retain patients and increase references.

The efficiency of an ambulatory surgery center can be accomplished by aligning leadership, having congruent goals of leadership, the placement of a consistent pattern for analysis of processes, problems, and situations in the surgery center, and a courageous leader on the frontline. Finally, and probably the most significant-recognition that quality produces quality.

Both Medicare and private payers are known to deny coverage for glaucoma screening tests. Knowing which patients qualify for tests based on medical necessity is important. Also, knowing the rules will prevent abuse, while allowing you to confidently report the services you provide.

Asking a financial advisor to assist with business matters for many physicians and other professionals may seem unacceptable. However, financial professionals focus exclusively on a relatively narrow segment of business operations. Their specialized training and experience may open doors to opportunities that haven't been considered.

To help reduce projected expenditures, Medicare is turning to physician profiling. Economic profiling gives a certain level of cache to a commercial healthcare plan. It works by profiling every provider in the system for at least 3 years. The goal is to find providers that cost the system less. However it is differentiating on cost of efficiency not on quality.

The key to hiring good people is setting high standards for whom you hire and sticking to them. Place to find potential hires, job descriptions, and some key warning sign to a bad hire are included.

One's own practice has a lot in common with the standards of a 5 star service. A patient should leave feeling better than when they came in and that it was an overall good experience from the front desk, to the tech, to the doctor. It is a lot to ask to be just like the Four Seasons but little things like displaying flowers or greeting guests warmly can do the trick.

Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.

When you plan to appeal an audit, it's important to know that there's a new process in place. Here are the details.

The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.

The aging baby-boom population will make eye care a growth industry, resulting in ophthalmology practices adding new physicians. Examine whether the practice really needs to add another physician, avoid overcompensating new hires, and negotiate an associate's buy-in as a partner carefully.

The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.

Never operate a practice as a general partnership, say two consultants on business planning and wealth protection. They say that a general partnership is a creditor or plaintiff's dream and a partner's liability nightmare.

Change in an office environment can more effectively promoted by management by understanding diverse motivations and personalities, acknowledging a perceived loss, and sympathizing with feelings.

Some ophthalmologists have suggested applying the non-covered services concept, as stated in CMS rulings 05-01 and CMS-1536-R, to other procedures that alleviate the symptoms of presbyopia, specifically pseudophakic monovision-cataract surgery with IOLs to create monovision.

CPT coding for after hours and office emergency services changed in 2006. It is important for practices to be aware of the changes and to implement them promptly if they have not yet done so.

Time may be considered a key factor in selecting the level of service when at least half of the encounter consists of counseling or coordination of care.

San Bernardino, CA-Medicare claims for eyeglasses after cataract surgery are the single most complicated claims to file, according to Kevin Corcoran, COE, CPC, FNAO, president of Corcoran Consulting Group.