There has perhaps never been a time when anxiety among private practicing physicians was as high as it currently is.   The annual threat of substantial reductions in Federal reimbursements, an increasing likelihood of monies being taken back pursuant to an audit or claims review process, and payers shifting their compensation focus from treatment to efficiency, quality and patient satisfaction, all contribute to this heightened anxiety.  Because these and many other areas are beyond the control of a physician, it is essential that medical practitioners gain greater mastery of the matters within their control.  There are three areas relative to the income generation of a practice where effort can produce rapid improvement.

Increased Patient Volume

Improve your patient volume.  One or two incremental patients in the morning clinic session and another one or two in the afternoon, will have dramatic impact on practice profitability.  Since overhead is a static amount, and physician base salary and benefits are somewhat fixed, small incremental revenue has sizeable incremental impact on a doctor’s year‐ end bonus.  Arrive 30 minutes earlier for each clinic and challenge your staff to have the exam rooms full at an agreed arrival time.  Review your scheduling template for ways to include an additional visit or to better arrange new, follow‐up and consult visits.  Learn the ways to lessen the number of patient no‐shows and cancellations.  An empty exam room equates to a reduction in doctor compensation.

Charge correctly for what the doctor does and verify the sufficiency of chart documentation.  Many physicians habitually undercode their office visit charges.  Document all you do and charge for what you document.  When our certified procedural coder performs chart reviews, we find many instances where a higher level visit code would have been appropriate and the resulting cost to the practice can be significant.  In this era of increasing audit surveillance, there must be a regular chart review process to ensure that overcharges are not happening as well.

Collect effectively for all you do.  Insurance companies periodically modify their payment criteria and any practice not reviewing denials and claim rejections, is losing revenue of potentially sizeable amounts.  Our revenue cycle review has found stacks of rejected claim information in the drawer of the person responsible for submitting and collecting insurance claims.  The portion of medical costs which fall to the patient is increasing and will continue to do so.   Deductibles of $5,000 and even $10,000 are becoming more common.   Medical staff who struggled to ask for $20 co‐ pays, need training on how to artfully collect these much greater sums.  The collection cycle of a medical practice must begin at the point of scheduling the patient, not after sending three monthly statements to the patient following the delivery of care.

Many physicians acknowledge that they are working harder to earn the same income as in prior years.  There is a way to also work smarter and, thereby, earn income appropriate to your training, effort and commitment to excellence in taking care of their patients.  Doing so will better enable you to “fill the unforgiving minute with sixty seconds’ worth of distance run.”