Fam Pract Manag. 2005 Sep;12(8):59.

Streamline patient registration

In many practices, patient registration is delegated to front-office staff who are overloaded with greeting patients, booking appointments, coordinating referrals and answering phones. This may result in inadequate information being collected to meet the needs of the back-office billing staff, which can result in delayed or denied claims.

To optimize the registration process, consider separating it from the front desk and train one or more staff members to manage this function. The registration staff can even contact patients before their scheduled appointments to ensure your office has accurate demographic and insurance information.

Source: Landers M. First spin in the revenue cycle: good front-end practices make the difference. MGMA Connexion. April 2005:32–33.


Ensure optimal care for obese patients

Approximately 30 percent of U.S. adults are obese, an increase from 15 percent nearly 20 years ago. These patients often delay seeking medical care because of self-consciousness about their weight and challenges accessing services.

To ensure optimal care for these patients, educate your staff about treating them with respect. Make sure your office has adequate equipment, supplies and furniture, such as extra-large gowns, large blood pressure cuffs, sturdy examination tables, and armless chairs or couches in the waiting room. In addition, make sure to weigh patients in a private area.

Source: Weight-Control Information Network. Medical Care for Obese Patients. Bethesda, Md: National Institutes of Health; 2003.


Can Medicare be charged more than other payers?


Do we have to give Medicare the “lowest price” we charge anyone? For example, if Medicare pays me $40 for a service, can I accept $25 for the same service from a private payer?


You can accept payments from other payers that are less than what Medicare pays. A widely misunderstood provision in Title XVIII of the Social Security Act says a provider can be excluded from Medicare if he or she charges the program “substantially in excess of his [or her] usual charge” for the same service. However, this statute says nothing about what providers may accept as payment from Medicare relative to what they accept from other payers, and it has never been interpreted in final regulations to apply to physicians.

That said, it would be wise to limit the amount of “below-Medicare” payments you accept from other payers to less than half of your business for that code. You do not want to call into question your “usual charge” as a result of your discounting.

Enhance team performance

While there’s no guaranteed formula for creating a high-functioning staff, successful teams share the following approaches:

  1. They establish an urgent, worthwhile purpose to drive performance.

  2. They select members based on skills and potential, rather than personality.

  3. They understand that first impressions matter, especially ones made by those in authority, because they set the tone for the entire group.

  4. They establish clear rules of conduct, such as “no finger pointing” or “everyone gets assignments and does them,” to help them achieve their goals.

  5. They gain momentum by setting a few performance-oriented goals that can be reached early on.

  6. They regularly seek new information, which may redefine and enrich their understanding of their purpose, goals and approaches.

  7. They spend time together, both scheduled and unscheduled, especially in the beginning.

  8. They use positive feedback, recognition and rewards to shape behaviors critical to team performance.

Source: Katzenbach JR, Smith DK. The discipline of teams. Harvard Business Review. July/August 2005:162–171.



Practice Pearls presents the best advice on effective, efficient practice operations and patient care drawn from the medical and business literature, along with tips developed from your experience. Send us your best pearl (250 words or less), and if we publish it, you’ll earn $25. We also welcome questions for our Q&A section. Send your pearls and your questions to us at


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


Copyright © 2005 by the American Academy of Family Physicians.
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