Four Overlooked Tactics That Bring in Big Money

Betsy Nicoletti, MS


August 25, 2011


"A physician needs 3 things: availability, affability, and ability -- and ability is the least important," said a consultant 20 years ago to a physician setting up a practice.

With today's lawsuit climate, many would argue that ability is not the least important. However, some might claim that availability is the key to a practice's success, particularly when the competition includes Minute Clinics and retail clinics in pharmacies and malls.

Physicians of all specialties need to be available to new and established patients, and be able to accommodate referrals from other physicians in a timely manner. Practices need to use all of their appointment times because patient visits drive revenue. Having a full schedule creates obstacles that practices must work hard to overcome.

Still, by making 4 small -- but important -- practice changes, you can greatly increase the revenue that you bring in. Here are the areas to change.

Practicing Medicine Over the Phone

How much time each week do physicians, physician assistants, and nurse practitioners spend on the phone? How much time does the nursing staff spend on the phone with patients? Take a moment to calculate the number of hours spent by each clinical staff member, and add it up.

What is the practice paid for all of that time? Probably nothing. Although there are Current Procedural Terminology (CPT) codes for phone calls, these codes are not covered by insurance. Medical groups are reluctant to bill patients for the service.

Patients like phone medicine because there's no copay or other charge. When asked why a phone call instead of a visit, many physicians respond that there is no time in their schedule for these visits. However, the time is being spent on the phone! Instead of solving the problem on the phone, have some of these callers come in for low-level office visits and receive reimbursement for the time, expertise, and risk involved in the care. Convert 5 hours per week of phone call time to 25 visits billed as 99212's and collect $1011 in revenue (1.22 nonfacility relative value units, conversion factor of $33.9764). The clinicians are doing the work: Over the phone the reimbursement is zero. In the office, the reimbursement is over $1000.


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