Your wage structure can vary widely depending on whether your practice is new, with freshly hired staff, or is older, with staff that have been with the practice for many years. For instance, you may find your office in the awkward position of having a long-term medical receptionist who makes more money than newly hired registered nurses. These apparent inequities can create resentment among staff. Your practice can generally handle this, though, via a smart wage structure and policy.
Many opportunities may arise in a physician practice for providing ancillary services, depending on the nature of that practice as well as the physicians’ interests. A short list includes anesthesia, diagnostic testing, endoscopy, pain management and physical therapy. (For more examples, see “12 ancillary services to consider.”)
Is it time to bring on an associate or partner? There are many reasons you might consider it. For example, your practice might have become so busy that you have little time with your patients. Perhaps your practice volume has grown so much that you need help managing it, or maybe retirement is around the corner and you’re thinking about eventually selling.
Coding after the end of the ICD-10 grace period
After the transition from ICD-9 to ICD-10 went into effect in October 2015, the Centers for Medicare and Medicaid Services ("CMS") allowed medical practices a one-year “grace period” in which to get up to speed with the new reimbursement codes. During the past year, physicians have had a safety net when they’ve made mistakes. But effective October 1, the grace period is over.
Practices often allow their payer contracts to renew automatically each year without re-examining the terms. But the practice may have changed and added new providers, new services, or a larger patient panel, and perhaps gained an enhanced bargaining position. If so, you may want to make changes to the contract.
How you can ensure its effectiveness?
Every medical practice is governed in some fashion or another, whether by an individual owner or a formal board of directors. Governance is a difficult job for physicians who are already working long hours providing care to patients. They must find ways to cope with regulatory pressures, stressful payer relationships, sophisticated technologies and rising patient expectations. Fortunately, a competent governance structure can help physicians meet those challenges.