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Fam Pract Manag. 2006;13(2):78-79

Allocate overhead fairly

Streamline the Rx refill process

To help your patients get the prescription drug refills they need without disrupting your practice and tying up your phone lines, follow this approach:

  1. Instruct patients to call the pharmacy directly when they need a prescription refill.

  2. Encourage pharmacies to contact you by fax with refill requests.

  3. Consider whether your nurse or medical assistant is capable of approving refills for certain types of drugs.

  4. Let the pharmacy inform the patient when the refill is ready.

  5. Document the patient's refill as soon as the decision is made. The longer you wait, the more likely you are to forget to update the patient's record.

Make better decisions by improving your meetings

Good decisions are often the result of rich and honest dialogue among members of a group. To improve the dialogue that takes place at your meetings, take the following steps:

  • State up front, and repeat as needed, the purpose of the meeting. This will keep everyone focused on the issue at hand and not on their own views and self-interests.

  • Draw out the opinions of each person attending the meeting so you can be sure you have viewed the issue from all sides.

  • Make sure the important players are present for the discussion.

  • If information is missing, postpone the meeting until everything has been gathered. You don't want relevant information to show up after the decision has been made.

  • Follow through by making sure everyone knows what they need to do as a result of the meeting, how they will do it and by when. Write it down if needed.

Do your homework before offering online consults

More and more health plans are beginning to pay physicians for online consultations with their patients. Before you dive into the world of e-visits, you may want to square away a few things.

  • Make sure you know what online services are reimbursable. For example, some payers will not pay for an e-visit that does not include clinical advice, such as a prescription refill or scheduling an appointment.

  • Make sure you aren't losing revenue by swapping e-visits (which pay around $25) with office visits (which run around $75). You should number crunch how many office visits you'll lose to e-visits, if any.

  • Check with your malpractice insurance carrier before you begin offering online consults to see whether it will affect your coverage. The carrier may even be able to offer risk-management advice.

  • Don't forget about the Health Insurance Portability and Accountability Act. Use a secure Web-based system that encrypts all correspondence.

  • Keep records of all your online correspondence with patients.

Go to the right source for help with Medicare reimbursement questions

To find out if Medicare reimburses for a particular service, contact your local Medicare contractor's call center and request to speak to a Provider Relations Research Specialist. They are required to answer your question, in writing, within 10 to 45 business days.

This customer service program, which began Jan. 1, 2005, was mandated by the Medicare Modernization Act of 2003 to ensure that physicians receive accurate and timely responses to their Medicare questions.

Provider Relations Research Specialists are experienced in Medicare policies and work with certified coders to answer your questions.

To find the phone number of the call center in your area, view the online directory at


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


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Copyright © 2006 by the American Academy of Family Physicians.

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