For More Information

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1 For More Information Articles: 10 Ways Family Practices Lose Money, Keith Borglum, Family Practice Management, June 2003 EMR Search, While Tough, Can Be Done, Karen S. Schechter, American Medical News, Dec. 20, Tips for Evaluating Electronic Medical Record Software, By Jerome H. Carter, ACP Observer, April 2004 How Does Your Practice Sound on the Phone? Lyndia Flanagan, Family Practice Management (January 1999). Managed Care Rebound? Recent Changes in Health Plans Cost Containment Strategies, Glen P. Mays, Gary Claxton and Justin White, Health Affairs, Web Exclusive, Aug. 11, 2004 ( U.S. Health Spending Projections for , Stephen Heffler, Sheila Smith, Sean Keehan, Christine Borger, M. Kent Clemens and Christopher Truffer, Health Affairs, Web Exclusive, Feb. 23, 2005 ( Changes in Medicaid Physician Fees, : Implications for Physician Participation, Stephen Zuckerman, Joshua McFeeters, Peter Cunningham and Len Nichols, Health Affairs, Web Exclusive, June 23, 2004 ( cgi/reprint/hlthaff.w4.374v1). A Look at Medicare s Kinder, Gentler Auditing Process, Brett Baker, ACP Observer, July-August 2004 Leasing Rather Than Buying Equipment Raises Own Issues, Stephen M. Harris, American Medical News, Oct. 7, 2002 Books and Surveys: The American Medical Association offers a number of coding 122

2 references and packages based on its Current Procedural Terminology (CPT) code set. In addition, the AMA publishes many other books on other practice management topics and benchmarking tools. Go to click on Bookstore for an on-line catalog or call If you are an AMA member, you can obtain a free copy of Benchmark Capitation Rates: The Physician s How-to Guide for Calculating Fee-for-Service Equivalents ($100 for nonmembers). This spiral-bound guide, published jointly by the AMA and the California Medical Association (CMA) was developed to provide physicians with the necessary tools and data to negotiate with third-party payers. The American College of Physicians offers ACP titles and books from other publishers at a discount for ACP members. Go to the ACP Website and click on Shop ACP. The American Academy of Family Physicians offers a number of practice management resources, some free of charge. Go to and click on Shop Catalog. This will bring you to a menu that lists books as well as on-line resources. The Medical Group Management Association publishes an extensive array of practice management references and benchmarking surveys. For information, go to and click on Store. Some examples of MGMA s publications and tools include the following: Physician Practice Management: Essential Operational and Financial Knowledge by Lawrence Wolper. Price: $132 for MGMA members; $ for nonmembers. Building Practice Revenue: A Guide to Developing New Services, by Bruce A. Johnson, Price: $45 for MGMA members; $70 for nonmembers. Performance and Practices of Successful Medical Groups: 2004 Report Based on 2003 Data. Price: $280 for members; $490 for nonmembers. Rightsizing the Medical Group s Staff: How Many Is Too Much, How Few Is Not Enough, By David Gans and Deborah Walker. This audio conference offers practical information on finding the right staff mix for a medical practice. Available in CD format (price for MGMA members is $191.50; nonmembers: $251.50) and in cassette tape (members: $181.50; Nonmembers: $241.50)

3 The Health Care Group, a consulting firm in Plymouth Meeting, Pa., publishes a number of books and surveys that can help you improve the management of your practice. One example is the annual Staff Salary Survey, which provides salary and fringe benefit information for 32 different job categories. Staff pay levels are broken down by years of service, geographic region and specialty. The survey is available for $195. To order or see a list of other publications offered, go to and click on Products. Practice Support Resources ( is a publisher and bookstore for managers, administrators, physicians, hospital executives, consultants and other healthcare professionals. The company sells reference manuals, training books, newsletters, information packets, special reports, benchmarks and other educational tools in healthcare management. Examples of the company s titles include the following: Guidelines for Monitoring a Profitable Practice. This is a step by step guide to evaluating your practice s billing, collections, expenses, staffing, scheduling, financial, productivity, record keeping, patient relations/marketing and compliance. Price: $69. Practice Management STATS Quick Reference This publication offers benchmark data on key indicators, such as charges, collections, expenses, patient visits, fees, salaries, physician compensation, collection percentages, staffing ratios, financial ratios and accounts receivable. Price: $49. Billing & Collecting Tools for the Physician Office. This volume provides tools and information on collection techniques. Price: $54. Web Resources The Internet is a good source for all kinds of practice management information. Many consulting firms have Websites, on which they post valuable information that you may access free of charge. In addition, medical organization Websites are an excellent resource on many practice management topics. Some are available only to the associations members, while others are open to anyone who browses by. The following Internet resources are categorized by subject, to help you narrow your focus

4 GOVERNMENT REGULATIONS The Centers for Medicare and Medicaid home page ( gov) is the launching point for reams of information about these government programs. The main menu for pages relevant to physicians is From this page you can find links leading to information on enrollment and participation, fee schedules, coding and documentation requirement, regulations, carrier contact information and much more. For beneficiaries seeking information, the correct Website is For information on how Medicare rates are set, you can access the Medicare Payment Advisory Commission s Website at This site provides transcripts of MedPAC s testimony before Congress on Medicare reimbursement issues as well as extensive research and data into the program s workings. Another interesting site is that of the Government Accountability Office ( The GAO is the investigative arm of Congress. Independent and nonpartisan, the GAO studies how the federal government spends taxpayer dollars. The agency has issued many reports on physician Medicare reimbursement issues. Physicians with in-office lab facilities can access information on regulatory compliance at This is the home page for the Clinical Laboratory Improvement Amendments law, which regulates virtually all laboratory testing. Another site that offers information on Federal statutes regulating medical offices is hosted by the AMA at Another government Website that may be useful to you is that of the Health and Human Services Department of Inspector General ( This site offers guidance on staying on the right side of the federal anti-fraud initiatives. Click on Fraud Prevention & Detection for advisory opinions, fraud alerts and bulletins, safe harbor regulations and guidance on compliance with anti-fraud statutes. MEDICAL ORGANIZATIONS The American Medical Association s Website ( provides AMA members with access to the organization s services as well as general information on all AMA services, publications, advocacy efforts and more to anyone who 125

5 logs on. The AMA offers a number of practice management tools on its site; from the home page, click on Professional Resources for a list of links to information on coding, regulatory issues, medical ethics and much more. The American College of Physicians Website ( provides free practice management assistance to ACP members through its Practice Management Center, which covers a spectrum of business issues associated with running and working in a medical practice. You don t have to be a member to access articles on practice management from the ACP Observer. From the home page, click on Your Practice and scroll down to the link Observer Articles. This will bring you to an extensive list of articles on practice management. The practice management section of the American Academy of Family Physicians Website ( offers an array of information on coding, regulatory compliance, computerization and health information technology, Family Practice Management articles and much more. You don t need to be an AAFP member to access these services, but the information is tailored to family practitioners. The Medical Group Management Association s Website ( offers a portal to MGMA services for members. The home page also offers free access to the ACMPE Guide to the Body of Knowledge for Medical Practice Management, prepared by the American College of Medical Practice Executives, an MGMA affiliate. This free interactive document explains in detail the profession s job skills, tasks and knowledge areas. PRACTICE MANAGEMENT CONSULTANTS Many practice consultants and the organizations that represent them host Websites, on which they publish useful information that physicians can access to learn about practice management. If you re looking for a practice consultant, you can check out the following membership organization Websites: National Association of Health Care Consultants: Society of Medical-Dental Management Consultants: www. smdmc.org. Institute of Certified Healthcare Business Consultants: www. ichbc.org

6 You can also get referrals through the American Academy of Family Physicians FP Assist service ( x19729.xml), which links physicians with practice consultants and healthcare attorneys. The American Medical Association offers a similar service called AMA Consulting Link ( Practice consultants Websites are generally set up to provide information on the firms and the services they provide. Some, however, also offer articles, newsletters and links that may be useful to physicians. Here are some that are worth exploring: The Coker Group ( is a Roswell, Ga.- based healthcare consulting firm with a national client base. The Website offers an extensive list of links, a bookstore and a free subscription to the firm s newsletter, Coker Connection. The Health Care Group ( a consulting firm in Plymouth Meeting, Pa., offers an extensive archive of useful practice management articles, forms and checklists. Professional Management and Marketing ( offers a list of useful articles and links. Karen Zupko & Associates ( a Chicago-based consulting firm, posts on its Website many articles, links and free resources, such as downloadable forms and checklists that you can customize to your own needs