Court Upholds Healthcare Reform Law

Madeleine Lovette

Madeleine Lovette On June 28, 2012, the Supreme Court of the United States upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The 5–4 decision came as a shock to many, particularly since it was Chief Justice John Roberts who cast the deciding vote.

Commonly Asked Foot and Ankle Coding Questions

Mary LeGrand, RN, MA, CCS-P, CPC

This month’s coding column addresses questions related to coding of foot and ankle procedures. Metatarsal fracture Q: A patient is diagnosed with a metatarsal fracture; the shaft is fractured both proximally and distally. The surgeon treats the fracture of the shaft with an open reduction and internal fixation (ORIF) and internally fixates both fractures as a single unit.

20 Steps to Getting Paid Faster

Jackie Ryan; Jerry Winkelmann

Many orthopaedic practices spend far too much time fixing and resubmitting claims that were denied due to errors. Following are 20 steps you can take on a daily, weekly, and monthly basis to submit cleaner claims and get paid faster. These tips will help you reduce accounts receivable days, as well as the time and costs associated with resubmitting claims. General principles Identify one staff member to review all insurance payments for accuracy.

Improving the Primary Care/Specialist Referral Process

Meagan A. Thompson; Craig R. Mahoney, MD

Both the ease and the speed of the specialist referral process are major concerns for patients and their primary care providers. Factors that slow the process decrease the efficiency of care delivery and make future referrals less likely. Any medical specialty office should strive to coordinate referrals seamlessly, providing optimal and timely care to the patient.

Improving Patient Flow Yields Big Dividends

Amy Fletcher

Improving patient flow can have an impact on many aspects of a practice’s success, including shortening wait times and increasing patient satisfaction. Depending on how the process is revised, it can also boost employee morale by using critical knowledge from within the organization. Just ask Julie Meurer, health services manager at Panorama Orthopedics & Spine Center in Denver. Ms.

Physician Stress and Burnout: Prevalence, Cause, and Effect

Alan H. Rosenstein, MD

A nationwide, multispecialty survey of more than 2,000 physicians conducted by Physician Wellness Services and Cejka Search in late 2011 found that almost 87 percent of respondents felt moderately to severely stressed and burned out on an average day, and almost 63 percent admitted feeling more stressed and burned out now than they did 3 years ago.

Healthcare Texting in a HIPAA-Compliant Environment

Andrew A. Brooks, MD

Texting speeds communication but could put you at risk Andrew A. Brooks, MD I’m often amazed at how little healthcare communication has changed in the nearly 25 years since I was a medical student. The last great innovation was the introduction of the pager. In most hospitals, the communication process among physicians is arcane, inefficient, and potentially dangerous as it relates to patient care.

Favoring the Injured Limb: Perspectives on Workers’ Compensation

J. Mark Melhorn MD

According to the AAOS 2010 report on Orthopaedic Practice in the United States, most orthopaedic surgeons in private practice have four major sources of income—private payers, Medicare, self pay, and workers’ compensation. For the practitioners who responded to the survey, workers’ compensation accounted for between 11 percent and 15 percent of their total compensation.

Joint and Several Liability Reform

James Ogilvie, MD; David H. Sohn, JD, MD

Tort reform has been widely advocated as a means to help control healthcare expenditures by reducing the practice of defensive medicine. Much attention has been focused on capping noneconomic damages, mostly due to the real-world savings seen when caps were implemented in California and Texas. However, the influence of trial lawyers at the federal level makes implementation of these caps on a national level unlikely, which has raised interest in noncap reforms.

Responding Effectively to Adverse Events

Darren Bouwmeester, JD

Sharing bad news is never easy. And although most physicians understand that it’s the right thing to do, disclosing an adverse medical event to a patient can be especially difficult. However, when an adverse event occurs, patients want to understand what happened and why, and they expect open communication, honesty, and empathy from their providers. For patients, professional competence in health care isn’t just about clinical skill, it’s also about integrity and caring.

Potential Liability Risks of Electronic Health Records

Thomas Fleeter, MD; David H. Sohn, JD, MD

Due to federal incentive payments, electronic health records (EHR) are rapidly becoming a part of the U.S. healthcare landscape. Although EHRs may offer opportunities to improve health care, electronic record keeping may also result in unforeseen liability exposure for physicians. For example, consider the following scenario: In the preoperative holding area, a nurse enters the patient’s relevant health history into the hospital’s EHR.