Medical assisting Administrative and clinical procedures (5e) Chapter 56 Practice management

After studying this chapter you will be able to understand: Explain the basic organizational designs of the medical office and the relationship of the physician and the medical assistant with the practice manager and direct supervisors, describe the responsibilities of the practice manager, summarize the basic human relations functions in practice management,...

Practice Management

56.1 Explain the basic organizational designs of

the medical office and the relationship of the physician and the medical assistant with the practice manager and direct supervisors

56.2 Describe the responsibilities of the practice

manager.

56.3 Summarize the basic human relations

functions in practice management.

Learning Outcomes

56.4 Distinguish the four traits of someone with

leadership skills and the importance of these skills to the healthcare team.

56.5 Compare risk management and quality

assurance in a medical facility.

Learning Outcomes

56.6 Calculate an employee’s gross earnings,

deductions, and net earnings for a pay period.

56.7 Describe the tax forms commonly used in the

medical office and the purpose of the office tax liability account.

Learning Outcomes

• Physicians less likely to manage office

• Medical practice manager

– Day-to-day operations

– Works with physicians

and staff

Physician-Owned Medical Practice

Ultimate responsibility

Daily operations and administrative

functions Direct responsibility for

direct patient care

Company-Owned Medical Practice

Ultimate responsibility

Daily operations and administrative functions

The Chain of Command

• “Rank” and accountability

• Authority is passed down the chain

• Understand the chain of command

– Know who your supervisor is

– Stay within the chain of command

Apply Your Knowledge

What is the purpose of an organization

chart?

ANSWER: An organizational chart shows the

supervisory structure and reporting relationships

between different functions and positions.

Managing the Medical Practice

• Communication

– Appropriate – Respectful – Timely

– HIPAA compliant

The Policies and Procedures Manual

• Key communication tool

– Guidelines

– Chain of command

– Statement of intent or goal  procedures

policies

Licenses, Certifications, and Contracts

• Staff credentialing

• DEA forms

• Staff training and certification

• Licenses for operation of facility

• Insurance requirements

• Business contracts

• Compliant with reporting authorities

Budget and Overall Finances

and revenues

• Practice manager should

– Know total expenses

– Review and renegotiate contracts

– Make budget cuts if necessary

Budget and Overall Finances (cont.)

• Managing petty cash

– Start and maintain fund

• Check for cash

• Vouchers and petty cash record

• Document each withdrawal

– Replenish fund

• At minimum level

• Total vouchers and receipts disbursement record

Managing the Medical Practice (cont.)

• Scheduling and travel

• Other Business functions

– Technology systems

– Mailing and shipping resources

– Inventory and supply

– Marketing and public relations

Apply Your Knowledge

List the responsibilities of the practice

manager.

ANSWER: Responsibilities include:

Communication within and outside the practice

Maintaining the P & P manual

Ensuring licenses, certifications, and contracts

are current

Maintaining the budget and office finances

including petty cash

Staff scheduling and travel

Keeping technology current

• Employee related issues

– Hiring and terminating

– Training

– Benefits

– Labor relations

The Hiring Process

• Federal, state, and local regulations

• Interview – legal vs illegal questions

• Interview process and orientation

– Competencies

– Policies and procedures

– Cross-training

The Hiring Process (cont.)

• The basics of successful hiring

– Find the most qualified person

– Check references carefully

– Have a salary range for negotiation

– Discuss policies, procedures, and

expectations – Train properly and retrain as necessary

Orientation and Staff Development

• Orientation

– The organization

– Health and safety

– The employee’s job

Orientation and Staff Development (cont.)

Apply Your Knowledge

What are HR responsibilities?

ANSWER: HR is responsible for hiring and

terminations, orientation and staff development,

and labor relations.

• Integrity

• Accept responsibility

• Give recognition

Being a Leader (cont.)

• Building your team

Diversity and Leadership

• Understand and respect differences

• Communicate openly

• Be aware of your own biases

• Look at the individual – not the “group”

• Value a person’s uniqueness

Apply Your Knowledge

List 4 leadership skills that are important to

the healthcare team.

ANSWER: Any 4 of these:

Be able to follow

Confidence

Ability to be a team member

Ability to influence other members to accomplish goals

Communication skills

Accommodate change

Integrity

Willing to accept authority

Work with others to achieve goals

Give recognition when earned

Risk Management and Quality Assurance

• Risk management

– Plan and process

• Identify and minimize risk

• Opportunities for improvement

– Involves anyone

entering the office

• Quality assurance

– Service standards – Utilization review – Involves patient and patient care

Assurance (cont.)

• Problem-solving model follows issue to

resolution

Apply Your Knowledge

What is the difference between risk

management and quality assurance?

ANSWER: Risk management involves have plans and

processes in place to prevent negative outcomes and

minimize exposure to risk and liability It involves

anyone who comes into the office.

Quality assurance involves ensuring services to the

patient meet or exceed standards.

Correct!

• Preparing a payroll register

• Submitting payroll taxes

Handling Payroll (cont.)

Creating Payroll Information Sheets

• Employee name, address, SSN, and

marital status

• Employment Eligibility Verification

• New hire Reporting form (NHR)

• Employee’s pay schedule, number of

dependents, payroll type and deductions

Gross Earnings

• Calculating gross earnings

– Data from payroll sheet

– First step in payroll process

• Fair Labor Standards Act

– Limits number of hours employee may work

– Sets minimum wage

– Regulates overtime pay

– Half from employer and half from employee

– Report Social Security and Medicare

separately

Handling Payroll (cont.)

• Unemployment taxes

– Federal Unemployment Tax Act ( FUTA )

– State unemployment taxes

– Workers’ compensation

Handling Payroll (cont.)

– Take-home pay

– Gross earnings

minus total deductions

• Preparing paychecks

– Manual – Electronic banking – Payroll service

– Paycheck stub should match

• Earnings records

• Payroll register

Handling Payroll (cont.)

• Maintaining Employee Earnings Records

– Gross earnings

– Deductions

– Net earnings

Handling Payroll (cont.)

• Maintaining a Payroll Register

Handling Payroll Electronically

• Create and maintain employee payroll

Apply Your Knowledge

Distinguish between FICA and FUTA

ANSWER: FICA are taxes withheld for Social Security

and Medicare FUTA is the Federal Unemployment

Tax Act.

Right!

Calculating and Filing Taxes

• Setting up tax liability accounts

– Choose an authorized bank

– Maintain accurate records

• Federal Tax Deposit Schedules

– Determined by the IRS or prior year’s taxes

– Exceptions

FICA Taxes

• Electronic funds transfer (EFT)  TAXLINK

• If EFT unavailable

– Check to Federal Tax

Deposit Processing Center – Contract with an accountant

or financial institution

Calculating and Filing Taxes (cont.)

• Submitting FUTA and SUTA

– Quarterly if over $100

– 6.2% of first $7000 income/year

– SUTA ~ submit with FUTA

• Employer’s Quarterly Federal Tax Return

– Form 941

Calculating and Filing Taxes (cont.)

• State and local

Apply Your Knowledge

What are the W-2 and the Form 941?

ANSWER: The W-2 is the IRS form showing the

employee’s total taxable income for the year The

Form 941 is the Employer’s Quarterly Federal Tax

Return

Gold Star Answer!

In Summary

56.1 In a physician-owned medical practice, the medical

assistant will often report directly to the practice manager

In a company-owned practice, the medical assistant will often report to the medical director

Regardless of the practice’s organizational design, the MA should always know the office chain of

command and who her direct supervisor is, and

should consistently follow the chain of command as

outlined in the organizational chart and the office

policies and procedures manual.

In Summary (cont.)

56.2 The practice manager’s job description may

change from practice to practice, but there are common responsibilities

• practice’s finances and budget

• communication and interpersonal skills

• evaluate and purchase equipment and systems that fit the practice’s needs and budget, facilitate the installation

• staff training

In Summary (cont.)

56.3 The human relations role refers to how the

practice manages employees and deals with elements of hiring, orienting and training

employees, and terminating employees when necessary

Understanding the laws, acts, and regulations surrounding employment is also a large part

of the human relations aspect of the practice manager’s role.

In Summary (cont.)

56.4 There are traits attributable to a leader

These traits and the ability to be a leader are important in a medical assistant as a

healthcare team member because when the office members work together with the

common goal of caring for their patients, the

result is excellent patient care.

In Summary (cont.)

56.5 The term risk management (RM) is defined as a plan

and processes that continually identify, assess, correct, and monitor functions of the medical office

to prevent negative outcomes and minimize risk exposure and consequent liability

When an incident does occur, an incident report is completed to track the cause of the incident to

minimize future risk

Quality assurance (QA) are procedures that ensure the services provided in the medical practice meet or exceed the requirements and standards.

In Summary (cont.)

56.6 To calculate an employee’s gross earnings, multiply

the hours worked by the hourly rate

Using state, local, and federal tax guidelines, calculate the employee’s tax deductions

Add to these any voluntary deductions and subtract the total deductions to obtain the employee’s net earnings.

Using the employee payroll record containing the employee’s name, address, SSN, and number of exemptions, record the employee’s gross earnings,

In Summary (cont.)

56.7 A variety of tax forms are used in a medical practice

The practice liability account is set up to hold the money deducted from employees’ paychecks until the funds can be appropriately disbursed to

government agencies

There may be separate accounts for federal and state taxes as well as unemployment and retirement funds

Record the tax amounts deposited in the liability account as debits in the practice’s checking account.

End of Chapter 56

Management is doing things

right; leadership

is doing the right things.

~ Peter F Drucker