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.

With all the competition for high-quality physicians right now, retention programs are increasingly important. It pays to be creative and committed in encouraging the hard work of your best physicians. Here are four areas where you can be more effective in your physician retention program.

Networking opportunities

• Social events targeted at connecting physicians with their colleagues, patients or community.

Physician-friendly scheduling

• Aim for consistency and stability.
• Ensure appropriate amount of time off.
• Offer flexibility to participate in conferences, teach or work on special projects.

Professional development support

• Cover memberships, conference attendance, certification programs, etc.

Pay for performance

• Closely connect salary and bonuses to quality and commitment.

Concorde is committed to supporting your retention efforts by finding the candidates who fit best with your organization.

So if you’re looking to add a compatible, high-quality physician, contact us to discuss your unique needs today.

Two major healthcare facilities in Northern Wisconsin were having difficulty locating high-quality radiologists. As a stopgap while they searched for permanent staff, they contracted with several locum tenens firms. In the process, Concorde created a whole new approach to the problem. We call it Supplemental Staffing.

While the other firms were simply filling positions with whoever was available, we began to develop Supplemental Staffing, a more custom staffing method involving a consistent pool of talented physicians proven to be a good fit with the client’s culture.

The new approach delivers a staff that’s more fully integrated into an organization. The client came to realize that Supplemental Staffing was working far better than the traditional LT piecemeal approach, and they selected our team as their sole supplier.

Supplemental Staffing Results
Providing a pool of 10-15 radiologists, Supplemental Staffing from Concorde fostered a mutually beneficial relationship:

• Staff and patients received consistent care.
• Referring physicians were comfortable and viewed the Radiologists as part of the hospital staff.
• The Concorde radiologists liked being familiar with the facilities, appreciated the regular scheduled work and enjoyed using time away from their practices to learn about smaller facilities.

On occasion, our radiologists even drove several hours on their off day to do a procedure that they had expertise in so a patient didn’t have to leave the area.

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[panel_title]Expanding into New Regions, Specialties[/panel_title]

Thanks to the initial success of the new approach, we’ve expanded Supplemental Staffing to meet the needs of groups and facilities in other states, including Kentucky, Tennessee, Texas, Illinois and North Dakota.

We’ve also expanded the service to cover other specialties, including Emergency Medicine, Anesthesiology, Pathology, Urology, Otolaryngology and Hospitalist Medicine.

Interested in learning more about what Supplemental Staffing can do for your facility? Contact Concorde today at (414) 291-6180.

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Authored by: Jean Kaiser, Regional Sales Executive, ebix Inc.

Thinking of taking some time off? If you’re a physician who wants to continue billing Medicare Part B for services rendered by a locum tenens substitute, there are certain rules you need to know.

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A patient’s regular physician may receive Medicare Part B payment, for covered visit services of a locum tenens physician who is not an employee of the regular physician. However, one of the Medicare conditions for locum tenens service is that the substitute physician does not provide services to Medicare patients over a continuous period of longer than 60 days.

Physicians billing under locum tenens must make sure there is a definite break in coverage after 60 days of continuous coverage. Current Medicare policy allows physicians to cover absences of longer than 60 days by hiring multiple substitute physicians. For example, if a physician needs to be absent from his or her medical practice for 120 days, the absent physician may need to hire one locum tenens physician to work the first 60-day period and a different locum tenens physician to work the second 60-day period.

As an alternative to hiring more than one locum tenens physician, a physician could return to work in his or her practice for a short period of time to reset the 60-day clock.

Congress passed an exception to the 60-day limit for physicians being called to active duty in the armed forces. There is no time limit for locum tenens physicians substituting for physicians called to active duty.

Finally, physicians leaving a medical group on a permanent basis must enroll in the Medicare program and must either reassign payment for his/her services or bill themselves (in their own name and billing number). When a physician permanently leaves a practice, a substitute or temporary physician is filling a staff void, rather than substituting for a regular physician of a medical practice.

About ebix Inc.
For over 35 years, ebix Inc. has been providing medical billing services for independent physician practices and clinics. ebix serves hospital based practices, such as emergency departments, to maximize their revenue.  For an average client, ebix generates an additional 10% of revenue per year. It is done through their proprietary process of:coding expertise, denials minimization and data analytics.

With so many hospitals running on tight margins, the need to capture revenue wherever possible has never been greater. Few practices have the potential to drive greater revenue than timely, rigorous and consistent physician charting and dictation. These skills should never be overlooked in your recruiting and training efforts.

Many organizations rank their physicians by their attention to detail in recommending and tracking healthcare services for patients. They look for careful notation of every conversation, prescription and piece of advice given, because such vigilant recordkeeping helps ensure they’re seizing every opportunity to both drive revenue and provide better care.

Interested in learning more about our locum tenens staffing services, or anything else? Please don’t hesitate to contact us today.

Charting and dictation, however, are not learn-on-the-fly skills. There are a set of best practices for success, and the physicians who follow them help support the profitability and decrease the malpractice risk of the organizations they serve.

That’s why Concorde includes screening for charting and dictation skills as part of our stringent physician qualification practices. It’s just one more way we’re holding ourselves, and our candidates, to higher standards—and helping our clients achieve higher performance along the way.