Responses to AOPA O&P Profitability Guide

Responses to AOPA O&P Profitability Guide

Jessica Imhof

2/10/2011

Here is my original post and the responses.  Most asked for me to post responses
because they are in a similar situation. I am not sure that we are going to
utilize this product.  I think we are just going to go about what we have been
doing and evaluate one aspect of the company at a time.  Thanks to those who
took the time to respond.
 
 
Jessica Imhof
 


I am working with my employer to increase profitability and efficiency;
something I know most companies are doing. We are looking at all aspects of our
business, which is honestly a daunting task.  I ran across this program
called AOPA O&P Profitability Guide.  For those who have used it I would
appreciate your input.  Has it helped your company and it what ways?  For those
of you that have used a different product to help your company grow, your
opinion is equally valuable.
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The only way our administrative side really became efficient was to go to a
uniformed software practice management system so that all could communicate and
stay on top of things...Im not by any means trying to sell you on this but I
would recommend you all look into something like OPIE practice management
software.First Post:
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One word - useless

I can give more words but they aren't any nicer

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I would say you are on the right track. The guide is very useful (thinking its
the one I completed) . The fact is just completing all the work will normally
provide you with the answers you need. I completed a few times and being a
private business, it really helped my better understand what I knew.



My two cents.  There are many ways to be profitable and efficient, but also,
there needs to be a balance between patient care and profitability.  Thus, there
is a conflict between non-patient care management and the patient care
provider.  As a resident, learning the trade, you need to find this line for
yourself.  However, many times, one is taught the profitabilty without being
taught the legal aspects.  In some instances, one often is taught the incorrect
viewpoint, and only many years later does one realize what has occurred.


I am speaking generally, as I do not know where you work, and thus, have no
knowledge to base my opinion on other that which I have seen or followed up on. 
However, there appears to be a change underway in the recovery of the health
care funds being spent.  Always when money is tight, people look to get back
overpayments, as well as the political changes that occurred with the transition
from Bush to Obama.  What was overlooked in the past, is under a microscope now.


For example, there is the integrated HEAT teams, which are recovering lots of
mis-spent American tax dollars.  In conjunction with this, they are asking for
repayment by those involved, either jointly and severably, and also
individually.  Just recently, a group of nurses were convicted of billing
issues, and besides being sent to prison, these nurses are required to repay the
entire amount that they caused to be billed to Medicare, even though the money
was paid to the company they worked for.  Another example is with a doctor and
DME companies that improperly billed, and when convicted, each was jointly and
severably liable for the other's billing too.  People are now being held
accountable for their entire improper billings, as well as the improper billings
that they are associated with.  People are going to jail.

With the OIG work plan for 2011, one aspect is the investigation with regard to
the qualified practitioner providing custom items to Medicare patients and BIPA
427.  With you being a resident, part of the NCOPE requirements for the provider
comply with the ABC Cannon of Ethics (sic)  (Standard GP 4, professional
responsibility, objective 6).  The cannon of ethics were downgraded years ago to
the Code of Professional Responsibility.  C1.2 deals with ethics, custom, and
the law.  Note the word may in the description. 

I am interested to see the findings of what the OIG reports on when the
investigation is completed with regard to the qualified practitioner, as well as
the impacts created by the report and findings.

As a practitioner, one always wants to provide in the best way for the patient,
while being ethical to him or herself to their own internal ethics level, while
balancing the needs and requirements of the employer.  However, this does not
mean that since a K-3 is more profitable than a K-1 person, that the K-3 bar is
lowered so that profitablity is increased.  A varied cadence does not mean
determining if the patient can walk slower.  Do most people omit the full
description, and look at only the first sentence.
Functional level 3: The patient has the ability or potential for ambulation with
variable cadence. Typical of the community ambulator who has the ability to
traverse most environmental barriers and may have vocational, therapeutic, or
exercise activity that demands prosthetic utilization beyond simple locomotion.


For you, you are going to find your own balance.  It is great to be aware of
ways to become more profitable, but remember to balance this with your own
ethics, and not the ethics of the dollar.  There is no value to the company if
the moneys collected have to be entirely returned at a future date, especially
when the microscopes are out and looking at our field.

There are great ways to become more profitable, such as choice of brands of
products purchased and used.  Having salaried people work more hours.

These are my two cents.  While I did not answer your question, I hope that it
provided you some consideration, and I hope that it did not cause more issues
than it helped.

Good luck on your research
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