Fam Pract Manag. 2001 May;8(5):52.
Charging for forms
We're considering charging for completing monthly disability forms and FMLA forms. Do other offices charge for this? How much?
I consult with many family practices and find that they do charge $10 to $15 for completing forms such as these. I think this is appropriate given the staff and physician time required and the costs of records processing and copying.
Patient appointment software
What should I look for when selecting scheduling software for my practice?
The most important feature to look for is ease of use. If the patient appointment software is not user-friendly, it may be difficult to convince your staff that it's better than the appointment book. User-friendly scheduling software should have the following characteristics:
It should allow your staff to categorize appointments by type and schedule them in a way that mirrors how your providers prefer to see patients (e.g., new patients at 10 a.m., “recheck” patients every 15 minutes).
It should highlight the first available appointment, making it easy for your staff members to locate.
It should display schedules for more than one provider at the same time, so your staff can quickly see which provider has the first available appointment for the type requested.
It should display more than one day's schedule at a time for each provider, which allows your staff to offer appointments on different days without having to bring up each daily schedule on a separate screen.
It should allow your staff members to make changes to the schedule easily. For audit purposes, the software should also track any changes made.
Ideally, your scheduling package should also be compatible with your medical management software. This allows you to track patient appointments and cancellations, verify that charges have been posted for each appointment and avoid entering patient information more than once.
Of course, before you buy, be sure to ask many questions of any vendor, and talk with other practices about their scheduling software.
Practice start-up resources
I'm planning on opening my own practice. Are there any flow sheets, itemized expense sheets or schedules I can use to plan my move?
Start-up publications that offer the kinds of items you mention are available from a number of organizations, including the AAFP (“On Your Own: Starting a Medical Practice From the Ground Up,” item #749, 800–944–0000), the AMA (“The Physician's Practice Start-Up Pack,” order #OP048097, 800–621–8335) and the Medical Group Management Association (“Private Medical Practice: Getting It Started & Making It Work,” item #OLC-5419, 877–275–6462, ext. 888).
Generally, publications such as these include information about starting a business (such as insurance requirements, personnel issues and tax requirements) and information tailored specifically to starting a practice (such as regulatory issues, medical records and office design). Some are more practice-oriented than others. For example, the AAFP publication includes a sample budget, an itemized expense table and a timetable for starting a practice – all of which are specific to medical practices.
RVUs and compensation
Our 25-physician group is adopting a new physician compensation method based on relative-value-unit (RVU) productivity. Can you offer any specific recommendations about this compensation method? Are there any available measures of RVUs that can help us determine whether this is a fair and reproducible way of distributing revenue?
I'm not aware of any specific recommendations regarding the use of RVUs as a productivity measure in physician compensation. However, there are some general questions you should consider when adopting this type of compensation method:
Which relative value scale will be used? The most prevalent is the resource-based relative value scale (RBRVS), which is the basis for the Medicare Fee Schedule. You can access the RBRVS online at www.hcfa.gov/medicare/pfsmain.htm.
Which RVUs in a given scale will be used to measure physician productivity? For example, under RBRVS, it's more common to use the physician-work RVUs than it is to use the total RVUs. The physician-work RVUs are the most widely accepted because they represent what most productivity-based compensation systems are trying to measure – the amount of physician work involved in a service.
Which services will the physicians get credit for? For instance, will they get credit for services they order as well as for those they perform?
The Medical Group Management Association (MGMA) is one of several organizations that collects information about physician productivity expressed in RVUs. You can purchase a copy of the MGMA's Physician Compensation and Production Survey online at www.mgma.com/surveys/compensation/physcomp00.cfm.
* Denotes member of FP Assist, the AAFP's online clearinghouse for consultants and attorneys.
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