Professional interpretation of X-rays

Our physicians understand the need to dictate a report for the professional interpretation of an X-ray, but they question whether the report must be separate from the evaluation and management (E/M) note. Can you clarify this for us? This question is asked regularly. In February 2007, AAOS Now addressed the issue in the article “Do professional interpretations of X-rays require a written report?

Information equals power

Carolyn Rogers

Is your practice keeping pace with the competition? Does the education, training, and experience of your staff measure up to their peers across town? As an employer, are you offering your workers a competitive compensation and benefits package? If you don’t know the answers to these questions and others, isn’t it time you found out? The American Association of Orthopaedic Executives’ (AAOE) is an ideal place to start.

Small groups have big advantages

Jennie McKee

Setting offers autonomy, flexibility, but has downsides as well Recently, AAOS Now explored why some orthopaedists are leaving private practice to become full-time employees of a multi-specialty group, hospital, or health maintenance organization (See “Is the private practice orthopaedist disappearing?”).

No such thing as minor adjustments

Jennifer A. O’Brien, MSOD

By Jennifer A. O’Brien, MSOD Tips to improve your net collections ratio “We have a net collections ratio of 99 percent!” the physician partner declared confidently during a recent revenue cycle consultation. “No, you don’t,” I responded sadly. “Your staff has been writing off everything the payors don’t allow to ‘contractual adjustments.’ Your real net collections ratio is much lower; the calculation is flawed by these inaccurate adjustments.”

Contracting: Beyond the basics—II

Charles E. Rhoades, MD

More contract terms you should know In today’s economic climate, an awareness of the options available to physicians—as well as a willingness to negotiate—is key in executing acceptable physician contracts with insurance carriers. Last month, I reviewed several contract terms and provisions that practice managers and physicians should know as they review insurance carrier physician contracts.

Planning a practice retreat

Robert H. Blotter, MD

Retreats can be helpful—if planned properly A period of tremendous change is frequently the impetus to plan a practice retreat. It certainly was in the case of my practice, Orthopaedic Surgery Associates of Marquette (Mich.), PC. During the past few years, we had built a new office, replaced our chief operational officer of more than 30 years, hired two new partners, and attempted several joint ventures with hospitals.

The more you use EMR, the more you benefit

Charles E. Rhoades, MD

After implementation, it just gets better! Many essays, conferences, and instructional course lectures have been given on selecting and implementing an electronic medical record (EMR) system for your orthopaedic office. By now, many practices are using fully integrated EMRs; the next wave of learning is the continued refinement of EMR use in years 2 through 5 after implementation. E-prescribing When EMRs were first introduced, e-prescribing was considered an advanced use.

Ad damnum: The plaintiff’s hope

Melissa Young

If it seems that plaintiffs are seeking more and more in damages in medical liability lawsuits, they probably are. The big dollar damage figures contained in the plaintiff’s initial court paperwork are called the “ad damnum” clause, from the Latin meaning literally “to the damage.” These sometimes shocking figures on the last pages of a complaint are the plaintiff’s notification to the defendant of the damages being claimed.

Setting yourself free with a “captive”—II

Thomas B. Fleeter, MD

The story of a successful captive company When the medical liability situation in Virginia reached crisis proportions 5 years ago—steadily rising premiums with no legislative relief in site—our seven-physician group sought new avenues for insurance. Joining forces with other “high-risk” and high premium physicians, we formed our own captive insurance company. In doing so, we used captive insurance companies located in Arizona and California that had good track records as models.

Establishing standards of care: Locality rules or national standards

C. Jerry Willis, JD

A trial lawyer provides his perspective on the issue A commentary in the Journal of the American Medical Association (June 20, 2007) discussed the merits of a national standard of care versus a locality standard of care. The authors advocated eliminating locality standards in favor of a national standard of care.