Are you following Concorde on Twitter? It’s your convenient connection to all the latest trends, tips and developments in healthcare staffing. We’re determined to save you time while keeping you in the know.

Don’t overload your already busy day trying to spot the important stories in all those newspapers, magazines and journals. Our team is surveying the whole scene – so you don’t have to.

You can access it all in one feed, whenever you want, from your smartphone, tablet or PC. It’s the easiest, quickest way to stay on top of what matters in the field.

Here’s a sampling of recent nuggets from our feed:

• Bringing PAs and NPs on board: what to do when you’re hiring http://bit.ly/eio875
• 20 statistics on salary offered to top recruited physician specialties http://bit.ly/QMdBU1
• Medscape Physician Compensation Report: 2012 Results http://bit.ly/QFCKkl

And coming soon, get a front-row seat for a first-year physician’s experiences. Don’t miss out on these and other valuable insights. Connect with us now athttp://twitter.com/concordestaff.

A recent industry survey indicates that Locum Tenens medical professionals are here to stay.

Here are some Locum Tenens facts revealed in a recent survey by Staff Care:

• The percentage of medical facilities using locum tenens physicians hasn’t been lower than 75% since 2006.
• On an average day in 2011, more than 40% of all medical facilities were searching for locum tenens doctors.
• In 2011, most medical facilities used one or more locum tenens doctors every 31 days.
• Nearly 80% of administrators feel the value of locum tenens physicians outweighs the cost.
• Locum tenens doctors are most frequently used as back-ups while administrators search for more permanent staff.

Meanwhile, to help meet the demand, we’re happy to report that we’re seeing an increase in high-quality physicians looking for LT positions. So be sure to give us a call to learn about our latest candidates who can help you fill the gaps.

RVU Maximizing Your Reimbursement?

By Kathryne Plato, CPC
Director of Coding at ebix

Proper dictation and coding is a key to maximizing revenues both for your organization and your physicians – especially if you’re using a Relative Value Units (RVU) formula. That’s why the following tips on RVUs are a win-win; share them with your physicians.

First, a quick look at how RVUs are calculated. They’re dependent on the patient encounter being coded accurately and in a timely manner.

• Physician Work RVUs account for the time, technical skill, mental effort and judgment, and stress to provide a service.
• Practice Expense RVUs account for the non-physician clinical and non-clinical labor of the practice, as well as expenses for building space, equipment, and office supplies.
• Professional Liability Insurance RVUs account for the cost of malpractice insurance premiums.

Each of these components is adjusted geographically using separate Geographic Practice Cost Indices (GPCI). The final formula to calculate your area’s specific relative value:

(Practice Expense RV x Practice Expense GPCI) + (Work RV x Work GPCI) + (Malpractice RV x Malpractice GPCI)

5 RVU Tips for Physicians

1. Note that if level 3 and level 4 visits are done in the office, your RVUs may be similar to those of a physician who performs many level 1 and level 2 visits in the hospital.
2. Know your payer mix and review your contracts to determine your reimbursement. For example, if services you provide target a specific demographic (e.g. the elderly) then the largest payer will be Medicare/MCO (Managed Care Organization).
3. Keep up with industry changes to help improve productivity without interrupting the quality of care. For example, 5010 Electronic Billing and EDI Transactions compliance is required by Jan. 1, and the ICD-10 requirement begins Oct. 1, 2013.
4. Stay informed on specific payer guidelines to ensure prompt payment. A good start would be to review local and national coverage determinations (LCD/NCD).
5. Be certain your practice management system is in accordance with AMA guidelines to create customized reporting.

[panel style=”box”]ABOUT ebix
ebix inc., Greendale, WI, is a revenue cycle management firm offering independent Emergency Room physician groups coding expertise, denials minimization and data analytical services. For an average client, ebix inc. generates an additional 10% of revenue. ebix provides complete, consistent and timely medical coding and billing services, letting physicians focus on the excellence of their patient care, not back room operations. To learn more, please visit www.ebixinc.com[/panel]

In Concorde’s stringent qualification process, it’s often as much about the candidates we don’t send you, as those we do. So we thought you might like to know why some candidates might not make the cut. Here are the six most common reasons:

1. Gaps in employment or residency changes. These issues must be looked at closely, but with proper and verified explanations, they may be fine.
2. Certification delays. It could mean the candidate didn’t pass an exam or didn’t believe it was important, but sometimes there’s a more satisfactory explanation.
3. Departures for “political reasons.” Peculiar or vague explanations for leaving a position are often a front for more serious issues.
4. Unacceptable malpractice history. The number, frequency, nature and judgment amounts of lawsuits must be carefully examined.
5. Appearing on Medicare or Medicaid exclusion lists. Any history of billing problems or fraud investigations can cause real problems for any employer.
6. Questionable job search priorities. If their major interest is money, then they may not be a good fit.

So, you’ve found that perfect fit in a physician for your open position. Now it’s time to close the deal. Find out which two aspects of the process will make or break your success.

Timeliness
Nothing demonstrates your interest in the candidate—and keeps your candidate interested—better than prompt responses at every step. Conversely, delays in responding to requests, setting up a visit and getting contracts out kill many deals. Timing cannot be stressed too much!

• Call a physician within 48 hours of receiving his or her CV.
• Set up a site visit within one week of the phone conversation.
• Get a draft contract into their hands within a week of that visit.
• Conclude negotiations within two weeks of sending the contract.

Site Visit Preparation
The visit is the pivotal moment in the recruiting process, so be ready for it.

• Professional and family needs – Do your homework about both the career and family interests of your candidate as well as his or her spouse or partner; the site visit is the ideal opportunity to address those issues.
• Well-planned itineraries – One professional meeting with existing physicians and administration; one social meeting with physicians and spouses/partners; one for spouse/partner to address their professional and family community needs. Know family needs in advance.
• A prepared contract – It’s a big plus to discuss general terms of the agreement while the physician is on site.

By Kathryne Plato, CPC | Director of Coding at ebix

In a previous newsletter, we looked at billing rules for locum tenens physicians. Now let’s look at the billing basics for Nurse Practitioners (NP), Clinical Nurse Specialists (CNS) and Physician’s Assistants (PA).

NPs, CNSs and PAs may apply for individual provider numbers for direct billing purposes.  All covered services rendered may be billed using the advanced practitioner’s direct provider number. The categories of third-party payers who may reimburse for NP/PA services are:

• Medicare
• Medicaid
• Commercial indemnity insurers
• Commercial managed care organizations

Each of these categories of payers and each of the commercial insurers has different rules on reimbursing NP/PA services.

Medicare’s Basics
To bill Medicare for services, an NP or PA must show that:

• He or she meets Medicare qualification requirements.
• The Practice accepts Medicare’s payment, which is 85% of the physician fee schedule rate for bills submitted under the NP/PA’s provider number.
• The services are for “physician services” or those for which a physician can bill Medicare.
• The services are performed in collaboration with a physician.
• The services are within the NP/PA’s scope of practice as defined in state law.
• No facility or other provider charges or is paid with respect to the furnishing of the services.

Medicare & Non-Physician Practitioner (NPP) & Shared/Split Services
A “Shared/Split Service” is for services provided when both the physician and a non-physician practitioner (NPP) provide, document and sign the work they each performed.  If the guidelines are met, the physician can bill the encounter to Medicare, not having reimbursement reduced 15%.

To bill for a shared service, there must be a documented face-to-face encounter with the physician. A note stating “seen and agree” or “agree with above” by the physician would not support a shared/split visit.

Critical Care services may not be billed as a shared service.  Non-physician practitioners may bill Medicare for Critical Care services.  However, it must be within the state scope-of-practice or the hospital policy does not require physician-supervised care in the life-or-death situations those codes cover.

Two or more doctors within the same group can provide critical care to the same patient in the same day and bill for their combined time, but this is not true with NPPs.  If the NPP provides the first hour and the physician provides the second half hour, it will have to be with two separate codes.

ABOUT ebix
ebix inc., Greendale, WI, is a revenue cycle management firm offering independent Emergency Room physician groups coding expertise, denials minimization and data analytical services. For an average client, ebix inc. generates an additional 10% of revenue. ebix provides complete, consistent and timely medical coding and billing services, letting physicians focus on the excellence of their patient care, not back room operations. To learn more, please visit www.ebixinc.com.