COPM Operations, Operational Reports, an Policies & Procedures

Mon, 18 Aug 2014 15:39:51 GMT

Hello!

This week's review will cover Chapter 6 in the Resource Manual: Operations, Operational Reports and Policies & Procedures.

Operations comprises 35% of the COPM exam.

Operations encompasses every day to day activity that we encounter in our practices. Operations must be measured for quality and must start from a strong set of Policies and Procedures.
This week we will explore the operational indicators, reports and their uses and the ever important Policies and Procedures.

Let's talk about Operational Indicators.

Statistical, operational and financial indicators are very helpful in understanding the business

of your practice. Some examples of Operational Indicators include:

Monthly Operational Reports:

Collection ratio

Days billing (revenue) outstanding (also called accounts receivable ratio)

Accounts receivable turnover

Aging accounts receivable

To help you to understand the profitability and operating costs of your practice, there are

several statistical indicators to consider:

 Operating costs per procedure

 Total operating costs as percentage of total net medical revenue

 Total operating cost per FTE physician

 Total physician costs as percentage of total net medical revenue

 Total physician costs per FTE physician

 Revenue after operating costs per FTE physician

 Revenue after operating costs

 Total net medical revenue per FTE physician

 Nonsurgical operating cost per procedure

In order for you to determine how your practice is performing in the accounts receivable and

collections department, you need to know the following:

 Percentage of total account receivable 0 to 60 days old

 Adjusted fee for service collection percentage

 Number of months gross fee for service charges in accounts receivable

 Total accounts receivable per FTE physician

Let's try a sample question:

What does a Collection Ratio report describe?

A. the percentage of total gross charges that won’t be collected for services

rendered.
B. the collection margin for the group or the amount of work that needs to be

done relative to the actual revenue collected.

C. the amount of total cash flow available for physician compensation.

D. an overall picture of the financial productivity for a particular physician.

The Answer is B

The Collection Ratio provides a ration by which you can measure the effectiveness of the practice's ability to collect on charges. High ratios indicate high effectiveness and high efficiency and low value indicate low effectiveness and low efficiency. These ratios can be used to measure the productivity of the billing staff and their collections efforts and identify potential billing process problems.

We'll cover more operational reports and indicators tomorrow!

Tue, 19 Aug 2014 14:50:14 GMT

Hello!

Today we will talk about a few more Operational Indicators and Benchmarking!

As we discussed yesterday, Operational Indicators and Reports help to give you a snapshot of how your practice is performing. Financial, Statistical, Staff, and Productivity indicators can help you identify where your practice needs improvement. Here are some more indicators you should be familiar with:

Staffing Indicators
Productivity, capacity and staffing are important benchmarks in a practice. Four indicators to
help you understand the staffing in your practice are:
Total support staff per FTE physician
Total gross charges per FTE physician
Procedures per FTE physicians
4Total RVUs per FTE physicians

Accounts Receivable Indicators/Collections Indicators
In order for you to determine how your practice is performing in the accounts receivable and
collections department, you need to know the following:
 Percentage of total account receivable 0 to 60 days old
 Adjusted fee for service collection percentage
 Number of months gross fee for service charges in accounts receivable
 Total accounts receivable per FTE physician

The Operational Indicators can help you Benchmark your practice. Benchmarking is the process of comparing one's business processes and performance metrics to industry bests or best practices from other industries.Essentially, benchmarking provides a snapshot of the performance of your business and
helps you understand where you are in relation to a particular standard. Benchmarking can tell you how your office compares others, how processes compare to each other, Streamline processes, evaluate staff performance, help with compliance, and help you identify problems and set goals within your practice.

Benchmarking your operations embraces everything from staffing and productivity to office flow and analysis of procedures performed. It will help you to uncover such details as:
 How many patients per month each provider is seeing,
 How many more procedures your practice is performing this quarter than last,
 Where the bottlenecks in office flow are and
 What your patient retention rates are

Similarly, Benchmarking your revenue-related trends and statistics - whether concerning reimbursement, claim rejections and denials, the collections process or payer trends - can reveal the financial
health of your practice and what steps you need to take to control it.

Be familiar with types of benchmarking and the information you can derive from benchmarking. How do you, or how would you, use benchmarking in your practice.

Go over Chapter 6 in the AOA Resource Manual for more detailed information.

Any questions so far?

Wed, 20 Aug 2014 14:22:53 GMT

Hello!

How is everyone doing so far? Please feel free to ask questions if you have anything you are unsure of. We are here to help!

Let's continue with Operations. Today we will talk about RVU's and RBRVs and Policies and Procedures.

Be familiar with the RVU's and RBRV's

Policies and Procedures:

A company policy refers to a business' approach to a given issue. It is a written, predetermined course of action that defines the accepted objectives and strategies of the practice.

The Policy spells out WHAT and WHY. In other words, what management wants employees to do regarding certain situations. Procedures outline HOW and WHEN a policy must be carried out.

A Policy & Procedures manual differs from an Employee Handbook in that a Company P & P houses ALL company policies and procedures, not just those that regard employee issues.

The Policy and Procedures Manual is used for many reasons, such as:
Communicate company values and expectations
Legal Protection
Ensure decisions are aligned with practice mission and objectives
Compliance
Staff Training
General Protocols
Disciplinary Action

Let's stop here and try a sample exam question!

Relative Value Units ( RVU's) include which three components?

A. Work, Fee Schedule, and Facility
B. Work, Practice Location, and Payor
C. Work, Malpractice, and Payor
D. Work, Malpractice, and Practice Expense

The answer is D

Relative value units (RVUs) are a measure of value used in the Medicare reimbursement
formula for physician services. RVU is the Relative Value Unit used by the RBRVS.
Resource-based relative value scale (RBRVS) is a process used to determine how much
money medical providers should be paid for CPT codes.
It actually consists of three components: the provider Work RVU (representing the work of the
provider), the Malpractice RVU (for insurance related expenses), and the Practice Expense
RVU component which is valued for either the Facility PE RVU (hospital based) or the Non-
Facility PE RVU (non-hospital based; i.e. private practice). Each of these component values
is added up to arrive at the RVU value.
RBRVS is the Resource-Based Relative Value Scale. It uses value units (based on the
resources required or consumed to provide a medical procedure) to relate medical procedure
codes to each other on one scale (i.e. the Relative Value Scale). It was created at Harvard
University in 1985 and adopted by Medicare in 1989.

Feel free to ask any questions! Tomorrow we will complete the Policy& Procedures portion of Operations.

Have a great day!

Thu, 21 Aug 2014 13:47:12 GMT

Good Morning!!!

Let’s continue with Policies and Procedures Manuals.

What cave covered what a P & P is and why they are important. Today let’s go over what they need to include.

A comprehensive P & P is essential for your practice. It covers all aspects of your daily operations and outlines every situation that may be encountered in your practice and directs staff on how to handle these situations.
It is recommended that you review your P & P every 2 years for updates. Make sure your management and physicians read, approve, and support the policy and any changes or reviews done to it. Management and Physicians should sign off on all approvals. This is very important. If you are writing a policy for the first time, or if it has been a long time, consider having a Lawyer review it.

A policy must:
Always be in writing
Be complete and detailed
Include an effective or revised date
Use clear and concise language
Be simple and factual
Be legally compliant
State who the policy applies to
Be signed off on by the management and Physicians

A Comprehensive Policy should include:

Federal & State Laws and Regulations
Practice Goals and Mission
At-Will Statement
Disclaimers
Personnel Policies
Disciplinary Policies
Detailed Operation protocols
Compliance Standards and timelines
General Policies
A complete list of recommended P & P content can be found in the AOA Resource Manual. Also visit the Resource Library on the AOA website for sample P & P’s.

In Addition to a General Policy & Procedure Manual, you may also have separate Employee Manual, Compliance Plan, Disaster Recovery Plan, HIPAA Policy, and OSHA Policy.

Sample Question:

How often is it recommend that you review your Policies and Procedures for changes in Federal and State Laws, HIPAA, OSHA, and timely information?
A. 2 years
B. 5 years
C. 7 years
D. 10 years
The answer is A. It is recommended that you review all policies every 2 years for changes in Federal Laws, State employment laws, HIPAA, OSHA and other regulations, and emerging trend that need policies, such as cell phone use and social media.

Fri, 22 Aug 2014 15:49:41 GMT

TGIF!!!!!
How is everyone doing so far on Operations? Any Questions?

Today we will finish out Chapter 6 in the AOA Resource Manual. Let’s talk about Inventory and Supplies.
Do you keep inventory in your office? How do you track it? How do you order supplies?
Stock control, otherwise known as inventory control, is used to show how much stock you have at any one time, and how you keep track of it.
It applies to every item you use to produce a product or service, from raw materials to
finished goods. It covers stock at every stage of the production process, from purchase and delivery to using and re-ordering the stock.
Efficient stock control allows you to have the right amount of stock in the right place at the right time. It ensures that capital is not tied up unnecessarily, and protects production if problems arise with the supply chain. Be familiar with the different types of Inventory control.

Let’s try a sample question:

What is a Disadvantage of “Just In Time” (JIT) Inventory control methods?
A. You can keep up to date and develop new products without wasting stock
B. You only have what you need when you need it
C. You are dependent on the efficiency of your suppliers.
D. You have low storage costs
The answer is C.
Just In Time Inventory Control aims to reduce costs by cutting stock to a minimum. Items are delivered when they are needed and used immediately. There is a risk of running out of stock, so you need to be confident that your suppliers can deliver on demand. These methods can be used alongside other processes to refine the stock control system.

Advantages
Efficient and flexible - you only have what you
need, when you need it

Lower storage costs

You can keep up to date and develop new
products without wasting stock

Disadvantages

Meeting stock needs can become
complicated and expensive

You might run out of stock if there's a hitch
in the system

You are dependent on the efficiency of
your suppliers

Have a great weekend!