Whether the title is Director, Practice Manager, Physician Director, System Administrator, Executive Director, Executive Director, Office Manager, CEO, COO, Manager, Department Manager, Department Manager, or any combination thereof, with few exceptions, individuals who lead physician practices perform some combination of the responsibilities listed here or control people who do.
Human Resources: Hire, fire, advise, discipline, evaluate, train, direct, coach, direct and schedule staff. Buy, negotiate and manage benefits. Develop, maintain and administer personnel policies, welfare programs, salary scales and job descriptions. Resolve conflicts. Maintain personnel files. Document worker’s compensation injuries. Answer unemployment surveys. Recognize happy and sad events in practice and in the lives of employees. Stay up late to listen to someone who needs to talk.
Premises and machines: Purchase, negotiate, recommend and maintain buildings or suites, telephones, handheld dictation devices, copiers, computers, pagers, furniture, scanners, post machines, specimen refrigerators, injection refrigerators, patient refreshment refrigerators, staff lunch refrigerators, medical equipment, printers, coffee makers, alarm systems, signs and mobile phones.
Orders and expense management: Purchase, negotiate and recommend vendors for medical supplies, office supplies, kitchen supplies, magazines, printed forms, business and malpractice insurance, and services such as transcription, x-ray/overreading, consultants, CPAs, attorneys, lawn and snow service, trustees, answering machine, water service, courier service, factory service, housekeeping, aquarium service, linen, hazardous biowaste removal, crushing service, outdoor storage and catering service.
Legal matters: Comply with all local, state and federal laws and guidelines, including OSHA, ADA, EOE, FMLA, CLIA, COLA, JCAHO, FACTA, HIPAA, Stark I, II and III, fire safety, crash carts and defibrillators, disaster communications, sexual harassment, general precautions, safety data sheet hazards, confidentiality, security and privacy and provide staff with documentation and training on the same. Ensure all clinical staff licenses and resuscitation are current. Implement downtime procedures to prevent computer downtime. Ensure risk management practices are followed. Notify the practitioner of abuse immediately about potential liability issues. Ensure patient records are maintained and published appropriately.
Accounting: Pay bills, do payroll, Prepare physician reimbursement schedules, Prepare and pay taxes, prepare budget and monthly variance reports, make deposits, reconcile bank statements, reconcile merchant accounts, Prepare income statements, Prepare reimbursements for payers and patients, and file lots of paperwork.
Invoicing, claims and trade receivables: Perform eligibility searches for all scheduled patients. Ensure all dictations are completed and all encounters (office, hospital, nursing home, ASC, satellite office, home visits, and legal work (for example, depositions)) are billed and all payments, denials, and adjustments are recorded within a predetermined amount. time. Submit electronic reimbursements daily. Submit patient statements daily or weekly Advise on payer contracts and ensure payers are in compliance Complaint denials Ask staff to collect deductibles, copayments and coinsurance and have financial counselors meet with patients planning surgery, those with past due balances, or patients with high deductibles or health savings plans Ensure scheduling staff knows which payer the practice does not contract with Billing service contact if billing is outsourced Authorization providers with all payers Perform internal compliance oral audits. Download new RBRVS values, new CPTs, and new ICD-9s annually. Complete monthly reports on physician production, expired accounts ivable, net collection percentage, and costs and collections per RVU. Attach appropriate codes to e-prescribing and PQRI requirements. Make a plan to receive Recovery Audit Contractor (RAC) letters. Make friends and meet regularly with your major payer’s provider representatives.
Marketing: Introduce new doctors, new places and new services to the community. Recommend sponsorship for appropriate charities, sports and events in the community. Recommend sponsoring patient support groups and have doctors speak and appear at events. Thank patients for referring other patients. Follow referral sources. Recommend the use of yellow pages, billboards, radio, television, newspapers, magazines, direct mail, newsletters, email, website, blog and other social media. Prepare press releases about practice events and physician awards and activities. Recommend doctors to TV health points.
Strategic planning: Prepare ROI (Return on Investment) and proforma for new doctors, new services and new locations. Forecast the potential impact of Medicare cuts, negotiated contracts, or overreliance on a single payer. Discuss five-year plans for capital expenditures such as EMR, ancillary services, physician recruitment, and replacement equipment. Find out about the outsourcing of office functions or the remote working of staff. Always look for techniques that can make your workout more efficient or productive.
Daily activities: Do practice rounds at least twice a day to observe and be available for questions. Arrange for temporary workers or reschedule staff for shortages, meet with or discuss patients with complaints, and meet with vendors, physicians, and staff. Open the mail and recycle most of it. Unplug the toilets from the mains.
Stay up-to-date on healthcare: Attend continuing education sessions at face-to-face conferences, webinars, podcasts and online courses. Maintain membership in professional associations. Complete medical practice management certification. Network with colleagues in the community and in the same specialty. Participate in listservs, LinkedIn and Twitter.
What did I leave out? Have lunch?