Part one of a two-part series

You face unique challenges when trying to build teamwork and resolve problems in a practice-especially when working with physicians. By understanding the jumble of personalities and agendas and discussing the problems openly, you can find realistic solutions for uncomfortable situations.

Every wound requires a unique debridement procedure based on its severity. Each unique debridement procedure requires a different code. The wound type and severity determine who handles the debridement, says Susan Welch, CPC, coder for HCA Healthcare in Nashville, TN. "The procedure is usually performed by ancillary personnel at the practice or office, but sometimes the physician likes to perform the initial debridement."

Preferred provider organizations (PPOs)-a basic form of managed care-dominate many market areas. A legitimate PPO consists of a network of hospitals and providers who agree to accept a discounted fee schedule in return for being a "preferred" provider. When a provider joins a PPO, the organization enters into an agreement with payers.

The pros and cons of using an internal or external auditor to look at your practiceWhen auditing your practice, you have two options: Choose someone from your office to do the job, or hire an outside consultant. Each choice carries pros and cons, Emily Hill, PA-C, president of Hill and Associates in Wilmington, NC, said during a recent Medical Group Management Association conference. Consider the following before you decide: Outside consultants1. Their opinions may weigh more with office staff. Your office workers will likely have greater confidence in private consultants, said Hill, b

Much like eating ice cream for dinner, changing a diagnosis after an insurance company rejects your claim is not a smart habit to fall into. There are some situations, however, in which fixing an original diagnosis can work to your benefit and keep you free from fraud. Quinten Buechner, MS, MDIV, CPC, CHCO, president of ProActive Consultants LLC in Cumberland, WI, says there are three reasons you could legally change a diagnosis code:1. Choosing the wrong code on the claim form. An insurance company may find fault with a generic code and deny your claim. A generic ICD-9 code, for examp

As an office manager, you wear many hats. Don’t forget to don your cap as financial advisor from time-to-time. “It’s important because the financial services industry changes so quickly,” says Brian Beall, CLTC, CSA, vice president of Executive Financial Planning Services of Bloomington, IN. “In the medical community, things are being done like they were a few years ago. You may not be taking advantage of current laws, [financial] providers, or products that would enhance some of the things the office. What type of plan do you have?When it comes to future

How to get ahead, and stay there (Part two of two)By Barbara Eberly6. Inflexible schedulingNot every routine problem has a 10-minute fix. The theory is that if some problems require five minutes of face-to-face provider time, most need 10, and some need 20. Then, on average, you can allow 10 minutes per routine appointment. But there’s a kink in that theory when you book three or more 20-minute problems in back-to-back 10-minute slots. Tip: Use an electronic scheduling package that allows you to associate types of problems or procedures with provider time needs. By selecting th

Celebrating transition: Ogden Clinic

Could an "at-home coder" work for you?