Practice Management
Spring 2024
by Corinne Wohl, MHSA, COE, and John B. Pinto
Being organized and understanding every component of your practice is not merely helpful, it is essential. Whether you are a practice owner or administrator, being organized and ensuring that other key leaders become and stay organized is an important priority company-wide.
Being well-organized helps ensure that resources are used efficiently and effectively. Productivity improvements, cost reduction, and streamlined processes are the outcome and lead to a well-managed practice.
It can be easy to assume that “being organized” is a given, an in-built talent that everyone possesses. But how do you really know?
As practice leaders and managers, here are some examples of being organized:
Knowing where important documents are located (like employment contracts, key vendor contracts, insurance binders, pension reports, your facility lease, etc.). Are they in the administrator’s office, or on a shared drive with limited access? Does your attorney have copies?
Keeping these documents up to date. A majority of our new clients have key contracts they have not reviewed for years and/or are not abiding by the agreed terms.
Having an annual calendar of key dates (like tax and other reporting dates, inspection and service intervals for equipment, contracts that are coming up for review this year, compliance reviews, staff performance evaluations, etc.).
Maintaining an employee handbook that is reviewed periodically by your labor counsel and management team.
Following an operations and training manual that shows—by department—the protocols that staff are obliged to follow.
Ensuring that meetings are of proper content and frequency, including board sessions, all-hands staff meeting, department meetings, and the rest.
No matter how large or small your practice is, here are six category examples of what needs to be tracked and well organized regularly…compare your practice with these rudimentary checklists:
1. Important documents are usually managed and maintained by the administrator. Schedule a review of each of these documents (monthly, quarterly, or annually) by placing the review dates on an annual calendar. Organizing review dates by calendar is a great way to avoid gaps or delays, as well as the opportunity to discuss pertinent components with the management team or practice owners. These documents include:
- Partnership and operating agreements
- Facility leases
- Vendor contracts
- Equipment maintenance contracts
- Banking documents (loan covenants, credit lines)
- Employee files and other HR documents
- Position descriptions that provide structure for each employee to know their role and responsibility
- Organization chart that improves communications and clarifies roles
- Compliance plan and associated documents
- Financial reporting
- Business benchmarking standards (cost and profit ratios, labor productivity, etc.)
- Regulatory documentation (e.g., OSHA, CMS, etc.)
2. New employee onboarding is often an unmonitored task, with the assumption that a manager knows how to onboard and train new staff, because said manager knows how to do the tasks. This big leap of faith can lead to poor orientation, frustrated staff, and excessive staff turnover. Here are components of onboarding that benefit from detailed attention:
- Contracting, where relevant
- Orientation plan, specific to each department
- HR required paperwork (personnel files, I-9 forms, regulatory and compliance education, etc.)
- Benefits administration
- Training and ongoing education plans and operations manual references
3. A well-organized billing department recovers allowable fees most efficiently. Are the following components reviewed and reported regularly at scheduled meetings:
- Insurance contracts with associated fee schedules. (Where are they kept? Have efforts been made to renegotiate fees? Are we getting paid according to our contracts?)
- Charting and utilization audits
- A/R aging summary report (with special attention to older/larger open accounts)
- Monthly financial reporting
- Key performance indicators (e.g., denial rates, collections reporting, staff productivity)
- Anti-diversion policies and auditing control mechanisms in place (reviewed regularly by your CPA)
- An effective protocol to catch coding and demographic errors, and take them back to the provider or staffer who erred, so they can learn from their mistakes
4. The clinical services department can get so busy and focused on patient care, customer service, and meeting doctor needs that administrative functions can be lost in the shuffle. Are the following organized and tracked in your practice?
- Department operations manual
- Expired drug calendar and reviews
- Supply ordering lists
- Retinal injection drug control (from ordering and inventory, on through to the billing and claims management process)
- Equipment and maintenance contracts
5. Because optical services are more of a retail business than a clinical function, the business components tend to be more organized and prioritized than in other departments. These are typical examples that need regular review and managing.
- Department operations manual
- Inventory and loss control processes
- Financial reporting and tracking
- Benchmarking performance indicators (e.g., second pair sales, remake rates, goods costs, etc.)
- Vendor agreements and periodic price comparisons
- Employee sales tracking and incentivizing
6. Communication throughout the practice is proportional to the frequency and quality of the meetings you hold. The formality and calendar of your meetings should be driven by the size and aspirations of your organization.
- All-staff meetings: ranges from monthly in small practices to semi-annually in larger ones
- Departmental meetings: typically monthly
- Management team meetings: weekly or bi-weekly
- Administrator and managing partner meetings: weekly
- All-provider meetings: monthly or quarterly
- Board meetings: monthly
If you find gaps in practice organization and preparedness, there are some next steps to take.
- Develop a written “let’s get organized” plan with goals, including a time schedule. Focus on priority items that have the most potential impact on patient care and financial performance.
- Set small achievable goals. Make daily, weekly, or monthly lists to check off, and celebrate your progress.
- Adopt tools that work best for you and the team. Some administrators work best with formal by-department checklists and detailed instructions on a shared computer drive. Some prefer a less formal approach.
- Ask yourself, “Am I an organized person in other areas of my life?” (A sometimes painful test for this is to look at how tidy you keep your desk or car or garage at home.) If you are not very organized by nature, a consultant may help you jumpstart new habits.
About the authors
John Pinto
President
J. Pinto & Associates
San Diego, California
Corinne Wohl, MHSA, COE
President
C. Wohl & Associates
San Diego, California
Contact
Pinto: pintoinc@aol.com
Wohl: czwohl@gmail.com
