Readers Write 7/4/12

Dear Doctor, From Your Lawyer – Four Questions Doctors Should Ask Themselves
By Jessica Shenfeld, Esq.

I have worked with doctors throughout my entire career and have noticed a few areas that are commonly overlooked by many private physicians. As such, I believe every physician with a private practice should ask themselves the following four questions.

Have you established electronic health records (EHR)?

• Common answer: I don’t want to change the way I have practiced for years. The EHR systems will slow me down. The government will be more likely to audit me if I have EHR. The Meaningful Use regulations are too complicated.
• Best practice: act quickly. The sooner you adopt EHR, the sooner you can take advantage of the incentives. Plus, it will streamline your practice. As if you needed more incentives, there are already reductions in reimbursement for those that don’t comply with e-prescribing. For those physicians accepting Medicare, October 1, 2012 is the last date that a physician can adopt a new EHR system while still being eligible for the full $44,000 incentive. After October 1, the maximum incentive available drops to $39,000. For those physicians accepting Medicaid it is even simpler – all you need to do to be eligible for the first incentive payment of over $18,000 to each physician is install a certified EHR system.

Are you collecting on accounts receivable from patients?

• Common answer: it’s the cost of doing business. My billing department is taking care of it. My collections company is taking care of it, slowly but surely. I don’t want to sue my patients.
• Best practice: hire a collections attorney or a very good collections agency, especially if you are an out-of-network provider and insurance companies send reimbursement to the patients directly. Although your billing department and office manager can try to collect from patients and appeal denials, if you farm out this work to professionals, you will likely see a greater return. Additionally, a third party is doing the collecting, which will allow you to maintain your relationship with patients.

When is the last time you looked at your office lease?

• Common answer: when I signed it.
• Best practice: have an attorney that specializes in health law review your lease, particularly if you sublease any space to another provider. Leases for medical offices are much more complex than standard commercial leases. Health law attorneys are familiar with the Stark Law and Anti-Kickback Statute, as well as requirements for fair market value in all sublease transactions. Their review will ensure that physicians are fully protected while complying with the requirements of the law.

Have you negotiated employee contracts? Do you have a written office policy?

• Common answer: a handshake is enough — I don’t need more paperwork.
• Best practice: have your employees sign a contract laying out the terms of their employment. Employee contracts are a useful tool when running a medical practice because they define the scope of the employee’s job and your expectations upfront. More importantly, physicians must protect themselves from possible lawsuits in the future. Negotiating solid contracts now will protect doctors’ interests down the line.

 

This list is certainly not exhaustive, but it highlights some of the areas where physicians can enhance the administration of their practice. As business management becomes more complicated (as if it wasn’t already) addressing the above four items will help protect a physician’s interests now and in the future.

Jessica Shenfeld, Esq. is the founding partner at The Law Office of Jessica Shenfeld, a boutique law firm that caters to physicians’ legal needs. She is also CEO of EHR Incentive Help, Inc., which helps physicians satisfy the Meaningful Use criteria and apply for the Medicare/Medicaid EHR Incentive benefits.