Properly manage the administrative (non-clinical) staff of your practice to optimize the efficient operations of your practice. Staffing needs will vary significantly based on practice size and office space; remember, there is no “one size fits all” template. However the essential functions that must be performed (or outsourced) are similar for all practices. The key is ensuring that there is accountability for all key functions.
Key Non-Clinical Functions in a Medical Practice
- Scheduling and Scheduling Reminders
- Chart Preparation and Update
- Patient Check-in and Insurance Verification
- Obtaining Prior Authorization, When Required
- Fax Lab Orders, Prescriptions, etc.
- Claims Submission
- Claims Remittance Reconciliation (Was Claim Paid at Contracted Rate?)
- Claims Denial Management
- Accounts Receivable Monitoring
- HIPAA Compliance
- Telephone Call Management (Minimize Physician Disruption)
In a Solo Practice Can One Staff Person Do All of This?
No. The only way a busy solo foot and ankle surgeon could operate an office efficiently with one staff person is if the practice outsourced the entire billing function to a billing service. The model of the jack-of-all trades practice administrator/receptionist who handled all front office and back office functions is obsolete in the current environment. The back office functions (coding, billing, denial management, etc.) have become increasingly demanding and require specific technical expertise. The receptionist’s role in scheduling, chart prep, patient check-in and as the public face of the practice remains as critical as ever.
Key Signs Your Practice Staff is Not Optimized:
- Patient Schedule Backs Up on a Regular Basis (Long Waits, Left in Examining Rooms)
- Claims are Being Routinely Denied Because of Coding and Other Administrative Errors
- You Don’t Have a Good Sense of Your Accounts Receivable
- You Are Spending too Much Time on Administrative Matters, Which Also Hurts Revenue
What Do I Do if I See Warning Signs that the Practice is not Running Efficiently?
- Address the issue as soon as possible with your staff. Sit down with them individually, and sort out their job responsibilities.
- If there are no job descriptions, this is the time to create them to make sure that someone is accountable for each of the critical functions.
- Identify gaps in accountability and address any misunderstandings among staff about responsibilities.
- Create draft new or revised job descriptions and meet as a group to discuss and to brainstorm solutions for administrative problems, such as time management and appointment scheduling challenges.
What if One of My Current Staff is Not “Right for the Job” Anymore?
- Are there steps you could take help the person? For example, if you have shifted responsibilities for something technical (i.e. claims processing) to someone without the technical background, should you offer continuing education or other help to help them get up to speed?
- Could you shift responsibilities in a manner that plays to that person’s strengths?
- Or has the practice evolved in a manner that the person is no longer the “right fit” for the practice because of changing needs?
A medical practice must be run like a business, and if you need new and different skill sets to function effectively in a changing environment, you must make tough decisions.,If you do decide to make staffing changes, you need to contact your attorney to make sure any personnel actions comply with federal and state laws.
How Do I Limit Staff Turn-Over?
A certain amount of staff turn-over is expected. However, frequent staff turn-over reflects a problem in the working environment and is costly for a practice in terms of lower service levels, lost revenue, and poor morale among remaining staff. If your practice is suffering from frequent staff turnover, take a hard look at the following:
- Does the practice provide for recognition and feedback (including annual performance review?
- Are relations among staff collegial? Are conflicts resolved or allowed to fester?
- Are staff respected, listened to and asked for input? (Both by supervisors and providers?)
- Does the practice provide adequate training and supervision?
- Are job responsibilities clear?
- Is your compensation and benefits package competitive? Note that while this is important, leaving a job is typically not related to compensation but to negative aspects of the work environment.
Remember, your administrative staff is the engine that drives the business side of your practice. You need to hire and retain the right people to optimize your practice.