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What You Should Do Now to Get a $100k Raise Next Year

Warning: What you are about to read and implement might make your colleagues envious.

An extended version of this article was featured in The White Coat Investor: 4 Tips to Increase Your Primary Care Physician Income

Do Primary Care

The annual physical is falling out of style, at least in adult medicine. But insurance companies pay for preventive care for a reason. An ounce of prevention is worth a pound of cure. Some doctors sprinkle health maintenance throughout their patient’s visits, but an annual physical ensures that your patients get all the evidence-based screening and disease prevention recommendations.

75 percent of all health care costs are due directly to preventable chronic conditions, yet as recently as 2004, only 1 percent of money spent on health care in the United States was devoted to prevention.

NHEA expenditures devoted to prevention1

You can follow the US Preventive Services Taskforce (USPST) recommendations by using StatNote dot phrases as evidence-based decision-making tools. They will also help you effectively chart all the onerous documentation requirements. This is especially true if you want to meet the ones required to bill for a Medicare Wellness visit.

According to this article from the AAFP, the average payment for the preventive visit is 25-percent higher than for the problem-oriented visit. 

Just by doing preventive medicine, and billing for it, you can see about a $70k annual increase in revenue in your practice while ensuring better patient care. (Take a look at the comparison of Physician A and B in this article from the FPM (Family Practice Management) Journal and calculated revenue (Family Practice Management)on this table.) You don’t need to see more patients. The patients are already coming to your clinic. You just need to spend more time with your patient.

Conduct a wellness visit and, when appropriate, conduct them with a problem-oriented visit on the same day. Most patients have chronic problems to discuss at their wellness visits. CMS allows physicians to report both the problem-oriented visit and the wellness visit on the same day, and the revenue implications of reporting both services are significant.2

This is where StatNote dot phrases come in handy. They enable you to expedite your medical documentation and spend less time in front of the computer. Therefore, you can spend more quality time with your patient. Your patients will love it. They will think you are an old-school doctor with good bedside manners.

Less than half a century ago doctors used index cards as a medical record tool and actually had conversations with patients.

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Spending the extra time to optimize your medical documentation is strongly encouraged. It is not only the main cause of physician burnout, but also of frustrated patients who only get five-minute visits with their doctors.

Practice Full-Spectrum Medicine

Have you thought about doing some inpatient shifts or working at urgent care? Maybe being on call coverage for OB? Having work outside of the clinic obviously helps with your income, but it is also a nice change of pace that might give you some sanity and time away from the never-ending inbox.

Practicing full-spectrum family Medicine is rare now, but there is no reason why you shouldn’t practice at the top of your license, spending less time doing clerical work and more time taking care of the patient. (BTW: You can also save a ton of time using StatNote dot phrases to reply to messages and send patient letters with lab and imaging results.) You should practice at the top of your license by using your training and expertise to take care of patients.

This is sometimes limited by time. We often don’t have the time to do that joint injection or remove that mole, so we end up referring the patient to a specialist, adding to the fragmentation of care and the burden of health care cost — not to mention wasting the patient’s time.

By carving out some time to make room for these and other minor surgical procedures, you will see an increase in your practice revenue. Using dot phrases and templates helps you by giving you the time to be able to do this. Check out this study that found that for every hour of direct clinical face time with patients, nearly two additional hours is spent on EHR and desk work within the clinic day. 

You have to learn the rules of the game. And then, you have to play better than anyone else. 

Albert Einstein

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Know Your Coding

If you want to get better at billing, you need to get better at coding. Know the rules of the game inside out. Read the AAFP’s FPM Journal and the FPM’s Blog Getting Paid. They are a great starting point.

Physicians routinely undervalue services they are already providing. Taking a coding training course might help you become more confident in the worth of the work that you are doing.

There are many courses out there. For example, the E&M CodeRight® course by MediSync can help you gain a clear understanding of the key components needed to calculate the level of coding. By incorporating this knowledge StatNote dot phrases could help physicians capture the essentials of the visit with minimal effort. 

By using StatNote dot phrases physicians can capture what actually goes on in the exam room. Instead of selectively picking from the laundry list of problems the patient presents at the visit.

As we transition from fee-for-service to value-based care, it is also important to know where other sources of revenue could come from. Insurance companies use HCC coding to assign patients a risk adjustment factor (RAF) score. Using algorithms, insurers can use a patient’s RAF score to forecast costs and therefore pay your practice. The AAFP has good educational materials, including this HCC Crash Course.

Other good resources are Optum360 EncoderPro and the AMA CPT Professional book. They are good reference tools when you want to get the right CPT code for your procedure. You can also have your most frequently used CPT codes built into your dot phrases so that you can easily retrieve common E&M and CPT codes used for billing.

Optimize Your Medical Documentation

Being more efficient at documenting your progress notes can have a huge impact on your time and therefore could potentially enable you to increase your income. Practicing at the top of your license, doing preventive care, minor procedures, or work outside the clinic are ways to maximize that revenue.

By reducing time in front of the computer, you can spend more time with your patient. For example, you can take the time to do Advance Care Planning with your senior patients, counseling on tobacco and alcohol use, or even do psychotherapy with your depressed and anxious patients. All of these counseling services should typically be reimbursed if they are properly documented.

Comprehensive care and doing what is best for your patient and for the healthcare system will also be the best for you. This will ultimately increase the joy of practicing medicine and enable you to be a Rockstar Doctor!

What do you think? What changes have you implemented in your practice to increase revenue? What tools do you use to optimize your medical documentation? Comment below!

REFERENCES

1. Center for Medicare & Medicaid Services National Health Expenditures and Selected Economic Indicators, Levels and Average Annual Percent Change: Selected Calendar Years 1990–2013 Washington, DC: Center for Medicare & Medicaid Services, Office of the Actuary; 2004.

2. Nicoletti, Betsy. “Four Coding and Payment Opportunities You Might Be Missing.” Family Practice Management, 1 June 2016, www.aafp.org/fpm/2016/0500/p30.html.

Posted on: December 15, 2019, by :

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