Archive for the Practice Management Category

Red flag implementation delayed (again)

Posted in Medicolegal, Practice Management with tags , , , on July 31, 2009 by drbobbs

redflagThe Federal Trade Commission (FTC) has delayed the enforcement date of the so-called Red Flag Rules regarding identity theft protocols for medical practice.  November 1, 2009 is the latest revised target date by which medical offices must comply with the rules.

Just a reminder: the American Academy of Family Physicians (AAFP) has a link to help offices navigate this process, as well as a Microsoft Word format, one-page, ready-made Red Flag protocol.


Identity Theft Red Flags Rule Delayed

Posted in Health Care Policy, Medicolegal, Practice Management with tags , , , on May 5, 2009 by drbobbs

agentsmithThe Federal Trade Commission has decided to allow medical practices until August 1st, rather than the original target date of May 1st, to implement identity theft prevention programs, according to AAFP News Now.  At least the creep of government overregulation of medicine has been slowed a bit.  Better than nothing, but not by much.

Identity theft and medical practices

Posted in Medicolegal, Practice Management with tags , , , on April 16, 2009 by drbobbs

Identity theftEffective May 1st, medical offices will be required to have in place an identity theft prevention program.  Is there really any reason for having this?  No.  There was also never a plague of patient confidentiality violations, but that didn’t stop HIPAA.  When the government has a solution, little details like the non-existence of the problem are simply ignored.

Fortunately, the American Academy of Family Physicians has resources in place to help medical offices deal with this latest (but by no stretch of the imagination last) unnecessary bureacratic intrusion into the art and science of medicine.  This link to the AAFP’s Identity Theft Red Flags Rule page is a good place to start.  The “meat and potatoes” of this nonsense can be found here.  To really get to the bottom line, the AAFP has developed this one page Red Flag Rule table in Microsoft Word format that can be downloaded and printed and will probably answer as a serviceable plan for most practices.

HITing back

Posted in Practice Management with tags , , , on January 29, 2009 by drbobbs

An article in Medical Economics about self-service patient check-in kiosks reveals something about modern American health care:

Similar to check-in kiosks found in airports, Clearwave kiosks ask patients to swipe their insurance card or type in the information from it.

The kiosk then recognizes the patient and populates the system with his or her personal and medical information. The kiosk also sends a Health Insurance Portability and Accountability Act 270 inquiry, regarding benefits eligibility and coverage, to the patient’s insurance company.

The insurance company, in turn, sends a HIPAA 271, which tells the practice everything it needs to know about the patient, including co-pay, co-insurance, deductible, and how much of the deductible has been met.

For a quarterly fee, Clearwave provides real-time updates of insurance company information.

Verifying eligibility status, for example, can be a time-consuming chore for an office administrator. The kiosks, on the other hand, connect directly to more than 1,000 insurance companies and provide an automated response in 10 seconds, according to Clearwave.

“We get the right information, so we can bill correctly, and we get our money from the insurers in a timely manner,” says Galantino, whose wife, Karen LoCicero, MD, is the group’s lead physician.

To me it sounds like having to use a lot of technology just to get someone from the waiting room to the hallway leading to the exam rooms.  And the necessity (real or imagined) for this sort of thing stems from relying on third party payors instead of the patient simply paying directly for the physician’s services.  Speaking of payors, exactly how much does this set up cost?

The kiosks and ongoing fee for the real-time updating of insurance information may represent only a modest investment for many practices. Clearwave has four charges based on the number of patients per day and the number of kiosks needed: $5,000 per kiosk; $3,000 to $5,000 for installation, training, and setup; a $250 to $400 monthly network fee; and $2,000 to $10,000 for integration services.

Dear God, I hope this article is an early April Fools joke!

Unfortunately, these are the kinds of insane “solutions” that get proposed when health care becomes a perpetual street fight with third party payors, government regulation, and medicolegal defense with a bit of patient care done as time permits.  Instead of trying to offset the inefficiencies of the current health care system with exorbitantly expensive gadgets, we should be trying to eliminate, not accommodate, those inefficiencies.

Quite a bit of HIT sounds suspiciously like the Broken Window Fallacy.

Practice Management Idea Contest

Posted in Practice Management with tags on January 10, 2009 by drbobbs

PookieMD is offering a $15 gift card for the best practice management plan for 2009.

Tough times for solo docs across the pond

Posted in Health Care Policy, Practice Management with tags , , , on December 21, 2008 by drbobbs

Britannia AsclepiusIn 2008, one out of ten solo general practices in Great Britain closed for business according to a report in Pulse.  It probably didn’t help that British Health Secretary Alan Johnson has attacked solo practices, saying that some  “don’t even reach 1948 standards” as laid out by the National Health Service.  Given the problems with the NHS, maybe Johnson meant that as a compliment.  I doubt it.

I hope the remaining solo general practitioners in Albion remember the words of a fellow countryman of far greater stature than Mr. Johnson:

Never, never, in nothing great or small, large or petty, never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.


Cybermedicine at the point-of-care

Posted in Electronic Medical Records, Practice Management with tags , , on December 13, 2008 by drbobbs

Half of doctors consult web tools during visits reports Morgan Lewis, Jr. at Medical Economics.

I do that myself.  In fact, having a number of useful websites bookmarked, or even having multiple-tabbed homepages that open up when the browser is launched, is essential for any EMR-based practice.  It’s also a good idea to have a patient handouts website bookmarked and to print out handouts as needed rather than storing handouts in paper form.