Practice Management

Relationships with payers range from quite content to quite contentious, but physicians are beginning to reap huge rewards from lobbying efforts aimed to stop the bundling of procedures and to boost reimbursement up to Medicare levels.

Many dermatologists perform pathology services in their offices. Some read their own slides and purchase the slide (e.g., the technical component from an outside reference laboratory), some have a totally equipped office laboratory and make and read their own slides, while others still don't do any of these services but just bill the insurance company for them.

Their plight is one told a countless number of times by the press: a physician in a high-risk specialty endures medical liability premiums of $200,000 a year or more - a price that is so debilitating that the doctor is forced to limit services, retire early, or move to a state with medical liability reforms that keep premiums more stable.

Despite the combined fiscal pressures of a defense buildup, promised tax cuts, and a growing federal deficit, intense pressure by physicians - including dermatologists - has resulted in a 1.6 percent Medicare physician-reimbursement increase rather than the 4.4 percent cut that had been slated for 2003.

With the new Republican-controlled 108th Congress now in business, there is an improved chance that lawmakers will get the message about sky-rocketing cost of malpractice insurance and provide some relief.

Dr. Derm runs a small, efficient, single-physician dermatology practice. He is a participant in many managed care plans, accepts Medicare payments and has no interest in changing either the thrust or the way he operates his practice.

Q: My doctors commonly use the following example in their dictation: "IDN back, no other suspicious lesions noted on complete general cutaneous skin exam." Would this documentation support a 99213, 99202, or 99242 level of care since six body areas are required to meet the documentation guidelines for the examination?

Not only did dermatologists not get relief from the Medicare payment cuts imposed in 2002 because of a fee schedule glitch, now more cuts are on the way unless the

Enhanced solidarity. These two words sum up what Boni E. Elewski, M.D., wants to accomplish during her tenure as president of the American Academy of Dermatology, beginning in February 2004. Dr. Elewski, a Birmingham, Ala., dermatologist, becomes president-elect of the academy in March.

Medicare spending for hospital outpatient services will increase by nearly 6 percent in 2003 under a final regulation published by the Centers for Medicare & Medicaid Services late in October. However, the new rate schedule will reduce reimbursement of some drugs significantly, including blood products, medical devices, and high-technology procedures that do not require an overnight stay.

Now that many of us have been online for a number of years, we are getting as many as 200 e-mails a day from friends, family, business associates, and spanners.

New Orleans -- Running an efficient office is a matter of combining myriad criteria, among them productivity, capacity utilization, and managing and turning over accounts receivables. While traditional benchmarks are a natural fit for these areas of practice management, a fourth is the sole responsibility of the physician - managing the productivity and satisfaction in the daily work environment.

I live in a small town in North Carolina known as High Point. High Point was so named because it was the highest point on the railroad line that connected New York with Florida. Due to the excellent transportation and the abundance of hardwood trees in the area, High Point became the center for furniture manufacturing in the United States. The surrounding area is scattered with about 250 furniture companies producing everything from one-of-a-kind hand-carved treasures to buy-it-in-a-box-and-build-it furniture. It is the location of the International Home Furnishings Market, which occurs twice a year and brings people from all over

It is not uncommon for dermatologists to repair defects left by excision of benign or malignant lesions with sophisticated surgical techniques. Repairs can be basic, such as the intermediate repair (CPT codes 12031-12057) commonly performed on the trunk and extremities.

Flint, Mich. - The debate surrounding malpractice insurance is heating up in the wake of some specialists closing their doors rather than pony up exponential increases in their premiums. Though neurologists and obstetricians appear to be taking the most shrapnel, it's a dermatologist leading the crusade for a no-fault insurance policy in Michigan.

Performing surgical services is an integral aspect of the practice of dermatology. Excising skin cancers and nevi, doing sophisticated repairs, destroying benign, premalignant and malignant lesions, performing incision and drainage on cysts and abscesses, and taking biopsies are part of the daily routine of a normal dermatologic practice.

Most practices are familiar with the concept of compliance. Compliancein the medical office setting is geared mainly at the billing activities,the office's interaction with third party payers, and the medical recorddocumentation that supports the services billed.

Every day physicians are audited by both Medicare as well as other third-partypayers.

Effective negotiation the secret to winning favorable terms in managedcare contracts

There are endless articles, reference materials, and seminars that teachthe fine art of CPT coding. Everyone knows that understanding the CPT descriptors,selecting the correct code to reflect the service(s) provided, having substantivedocumentation, mastering the rules governing bundling and unbundling, andconquering the use of modifiers are all essential to getting insurance claimspaid properly and timely.

After years of relatively stable levels on the cost of malpractice premiums,many physicians across the country experienced sticker shock when they openedtheir bills in January.

With a 5.5 percent decrease in Medicare reimbursement rates now in placefor 2002, dermatologists and other specialty groups are hoping to convinceCongress to quickly reduce those cuts and act on other issues importantto them, as well.

Dr. Franks routinely speaks to his referring doctors about patients,sends insurance documents electronically and by way of the mail, and hasalways stressed that his staff be confidential about all patient issues.Recently, he received a threatening letter alleging that his

The treatment of warts can be a frustrating experience for both the dermatologistas well as the patient and/or patient's family. The provider needs to bewell versed in the many rules and regulations that govern the billing ofwarts (e.g., medical necessity issues, CPT and ICD-9 coding) while the patientneeds to be educated on the nature of the condition and the complexitiesassociated with the treatment arsenal.

Whether your interests are wild life or a wild night, the Big Easy hassomething for everyone. Visitors can check out the safari that awaits atthe zoo, step back in time strolling through a centuries-old mansion, orhit it big at the blackjack table.