Practice Management

Dr. Brad has one of the more successful dermatology practices in his area. Although he has a computerized office, his staff in the past only used the computer for billing and scheduling purposes.

Non-genital warts continue to be almost as common as acne in the dermatology practice, according to Dr. Beutner.

Most physicians and staff feel relatively comfortable with the global surgical package - what it includes and what it doesn't. I have written numerous articles over the past several years reiterating the details of the concept so that everyone is clear about the rules that govern the global billing package.

Q & A

Dermatologists and other physicians should be aware of several key recent developments at the Centers for Medicare & Medicaid Services (CMS) that could affect their practices.

Outsourcing can offer a practicethe necessary support so physicians and staff can remain focused on patients while experts help manage the bottom line.

Providence, R.I. - Mohs surgery appears to be a more cost-effective strategy for the treatment of facial nonmelanoma skin cancers (NMSCs) compared with traditional surgical excision, although the advantage of Mohs surgery is sensitive to the type of repair performed, according to the results of a study presented by Tracy L. Bialy, M.D., M.P.H., at the annual meeting of the Society for Investigative Dermatology

Botox injections may help ease stubborn pain in the neck and upper back when other treatments fail, preliminary research shows. A study of 25 patients whose chronic pain had resisted other therapies found that a single round of Botox injections coupled with physical therapy brought pain relief within a month.

Don't complain, just do something

Trying to get out from under coverage denials, late payments, and mountains of paperwork

Treatment of hyperhidrosis with botulinum toxin injections or iontophoresis might be covered by insurance, but receiving reimbursement depends on obtaining pre-certification and using the correct billing codes, said Dr. Ramsey F. Markus, M.D.

Prescription drug makers will be required within two years to put bar codes on packaging in an effort to reduce potentially dangerous dispensing errors in hospitals, U.S. health officials said. The bar codes are meant to enable nurses and other healthcare workers to electronically verify that they are giving the right drug at the right dose at the right time. The Bush administration published a final regulation on the bar-coding requirement in February. Under the requirement, each bar code must contain a drug's unique identification number. Companies also may include information on the product's lot number and expiration date. A nurse using the system would scan a patient's identification bracelet and then the drug label, and then a computer would compare the information. An error message would appear if the drug, dose, or time of dose were incorrect.

Before adding an allied health professional to your practice, keep in mind these practical suggestions from four practice management experts on how to identify and attract prime candidates:

We get many questions about issues that do not warrant an entire column in response. Many of these are asked over and over again. I have collected these and will dedicate the next few months to answering them. I refer to these as "Dermatology Potpourri". Enjoy!

Washington - Researchers have discovered an algorithm that could provide a consistent tool for analyzing cases of mottled hyperpigmentation (MHP) based on photographic images.

Switching to electronic medical records is the smart thing to do. An EMR puts information-legible information, databases of it-right at your fingertips.

Anew option is available to all physicians, whether they seek healthcare insurance coverage for themselves and their families or affordable options for the employees of their practice.

In the new millennium, we are confronted with rising overhead and decreasing reimbursements, which translates into loss of income.

Dallas - Pre-clinical research suggests a new compound can boost the efficacy of diagnostic and laser therapeutic applications. The chemical mixture appears to increase the transparency of normal human skin, thereby allowing a better, deeper and much greater penetration of light for diagnostic and therapeutic purposes.

Dermatologists and other physicians are being caught in the middle of a growing political battle over health care policy, along with 41 million Medicare beneficiaries, as Republicans and Democrats position themselves for political advantage in this critical election year.

Q. In order to have more money available for my own personal investments, I first need to improve on our collections in the practice. Any suggestions?

As physicians, we're all faced with making decisions about the purchase of new electronic technology that promises to streamline the efficiency of the practice and significantly reduce our overhead expenses. Vendors ply their products and promise us the sun and the moon, yet few office managers and even fewer physicians know how to evaluate these products.

Amgen has gotten Medicare to pay for limited amounts of Enbrel, the $1,000-a-month rheumatoid-arthritis drug. The coverage, tucked in the new Medicare law that covers drugs for seniors, includes some expensive biotech drugs that patients can inject themselves, such as Enbrel and a rival, Abbott Laboratories' Humira.

Dr. B, with an active dermatology practice, sought to increase revenues in his office. After considering a variety of practice enhancement options, he hired a Web master who designed his new highly interactive Web site.

We get many faxes regarding issues that don't warrant that I dedicate an entire column to their responses. Many of these questions can answered with simple "yes' and "no" answers. I have collected the questions and will dedicate the next few months to answering them. I refer to them as "Dermatology Potpourri." Enjoy!

National Report - For most professionals, accepting another job or retiring involves little more than giving notice and enduring a farewell party or two. Not so for physicians. You have to notify patients, colleagues, employees, insurers, hospitals, and medical boards. You must make appropriate referrals, see that patient records remain accessible, collect accounts receivable, and arrange for continued liability coverage. If you're a solo office-based practitioner, you'll need to find a buyer, hire an associate who will eventually take over, affiliate with another practice, or shut down the business.

In the beginning of Internet marketing, the most important aspect of the strategy was the practice website. Today, in order to capture Internet traffic and manage it, there are five necessary components, including: 1) an effective website; 2) a directory listing; 3) search engine optimization; 4) a commercial e-mail program; and 5) integration and implementation. Without these five components, a practice is missing out on the complete equation.

You have an employee who makes a salary of $480 per week. Your practice has been busy and the employee stays 60 minutes late for a few days to catch up on paper work. You tell the employee to take off a few hours next week to compensate for staying late a few hours. You believe you are being a good employer or office manager by balancing the situation with fewer hours worked the following week.

We've seen sweeping changes in treatments, how medical care is delivered, and how it is paid in 25 years of publishing Dermatology Times.

Q: I have known for quite a while that there are site-specific codes for biopsies. I don't know why I never used them but perhaps I was a little afraid to try something new (new to me, that is).