Bài dạy Medical Assisting - Chapter 56: Practice Management

56Practice Management56.1 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 Outcomes56.4 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 Outcomes56.6 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 OutcomesIntroductionPhysicians less likely to manage officeMedical practice managerDay-to-day operationsWorks with physicians and staffOrganizational DesignOrganizational chartSupervisory structureReporting relationships Effective functioningPhysician-Owned Medical PracticeUltimate responsibilityDaily operations and administrative functionsDirect responsibility for direct patient careCompany-Owned Medical PracticeUltimate responsibilityDaily operations and administrative functionsPatient care responsibilityEqual in rank & collaborateCollaborateMidlevel providersThe Chain of Command“Rank” and accountabilityAuthority is passed down the chainUnderstand the chain of commandKnow who your supervisor isStay within the chain of commandApply Your KnowledgeWhat 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 PracticeResponsibilities CommunicationCompliance Physical plantFinancial viabilityRisk management Customer care and satisfactionCommunication Skill of the Practice ManagerExceptional skillsVerbal and writtenInterpersonal skillsKnowledge of businessProblem-solving Communication AppropriateRespectfulTimely HIPAA compliantThe Policies and Procedures ManualKey communication toolPolicies Guidelines Chain of commandStatement of intent or goal  proceduresProcedures - manner for carrying out policiesLicenses, Certifications, and ContractsStaff credentialing DEA formsStaff training and certificationLicenses for operation of facilityInsurance requirementsBusiness contractsCompliant with reporting authoritiesBudget and Overall FinancesBudget – predicts expenses and revenuesPractice manager shouldKnow total expensesReview and renegotiate contractsMake budget cuts if necessaryBudget and Overall Finances (cont.)Managing petty cashStart and maintain fundCheck for cashVouchers and petty cash record Document each withdrawalReplenish fund At minimum levelTotal vouchers and receipts disbursement recordManaging the Medical Practice (cont.)Scheduling and travelOther Business functionsTechnology systemsMailing and shipping resourcesInventory and supplyMarketing and public relationsApply Your KnowledgeList the responsibilities of the practice manager.ANSWER: Responsibilities include:Communication within and outside the practiceMaintaining the P & P manualEnsuring licenses, certifications, and contracts are currentMaintaining the budget and office finances including petty cashStaff scheduling and travelKeeping technology current Human Relations and Practice ManagementEmployee related issuesHiring and terminatingTraining BenefitsLabor relationsThe Hiring ProcessFederal, state, and local regulationsInterview – legal vs. illegal questionsInterview process and orientationCompetenciesPolicies and proceduresCross-trainingThe Hiring Process (cont.)The basics of successful hiring Find the most qualified person Check references carefullyHave a salary range for negotiationDiscuss policies, procedures, and expectations Train properly and retrain as necessaryOrientation and Staff DevelopmentOrientationThe organizationHealth and safetyThe employee’s jobEmployee handbookSexual harassmentAttendance policiesDress codeOrientation and Staff Development (cont.)Probationary periodStaff development and trainingDetermination of “fit”Termination without causePerformance reviewsTraining and staff development recordsStaff CommunicationStaff meetings AgendaMinutes or notesE-mailNewsletters Bulletin boardsOpen-door policySuggestion boxesLabor RelationsEmployee – management issuesFunctions Overseeing grievance processMediation Facilitates communicationFocus on issues of disagreementConflict resolutionApply Your KnowledgeWhat are HR responsibilities?ANSWER: HR is responsible for hiring and terminations, orientation and staff development, and labor relations.Being a Leader Be able to followDesire to achieve goalsWork with a team to accomplish goalsCommunicateAccommodate changeIntegrity Accept responsibilityGive recognitionBeing a Leader (cont.)Building your teamCapitalize on strengthsEncourage teamworkSetting goals Know expectations Method to measure progress and areas for improvementDiversity and LeadershipUnderstand and respect differencesCommunicate openlyBe aware of your own biasesLook at the individual – not the “group”Value a person’s uniquenessBe respectfulApply Your KnowledgeList 4 leadership skills that are important to the healthcare team.ANSWER: Any 4 of these:Be able to followConfidence Ability to be a team memberAbility to influence other members to accomplish goalsCommunication skillsAccommodate changeIntegrityWilling to accept authorityWork with others to achieve goalsGive recognition when earnedRisk Management and Quality AssuranceRisk managementPlan and processIdentify and minimize riskOpportunities for improvementInvolves anyone entering the officeQuality assuranceService standardsUtilization reviewInvolves patient and patient careRisk Management and Quality Assurance (cont.)Problem-solving model follows issue to resolution Incident Reports Completed for an eventAdverse outcomeRisk of liability Factual information about the eventApply Your KnowledgeWhat 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!Handling PayrollObtaining tax ID numbersCreating payroll information sheetsCalculating earningsSubtracting taxes and deductionsWriting checksCreating earnings recordsPreparing a payroll registerSubmitting payroll taxesHandling Payroll (cont.)Tax ID numbersEmployer identification number (EIN)Form SS-4 Submit to IRSObtain state ID number if requiredCreating Payroll Information SheetsEmployee name, address, SSN, and marital statusEmployment Eligibility Verification (Form I-9)New hire Reporting form (NHR)Employee’s pay schedule, number of dependents, payroll type and deductionsCreating Payroll Information Sheets (cont.)Pay schedulePayroll type HourlySalaryCommissionDependentsRecord numberFound on Form W-4Voluntary deductionsGross Earnings Calculating gross earningsData from payroll sheetFirst step in payroll processFair Labor Standards Act Limits number of hours employee may workSets minimum wageRegulates overtime payMaking Deductions Tax liability accounts – used to pay taxesIncome taxes – federal, state, and local tax tablesFICA taxesHalf from employer and half from employeeReport Social Security and Medicare separatelyHandling Payroll (cont.)Unemployment taxesFederal Unemployment Tax Act (FUTA) State unemployment taxes Workers’ compensationHandling Payroll (cont.)Net earningsTake-home payGross earnings minus total deductionsPreparing paychecksManual Electronic bankingPayroll servicePaycheck stub should matchEarnings recordsPayroll registerHandling Payroll (cont.)Maintaining Employee Earnings RecordsGross earningsDeductionsNet earnings Handling Payroll (cont.)Maintaining a Payroll RegisterEarnings to dateHourly rateHours workedOvertime worked and earningsTotal gross earningsTaxable earningsDeductions Net earningsPaycheck number Handling Payroll ElectronicallyCreate and maintain employee payroll information filesPrepare employee paychecks, stubs, and W-2 formsUpdate and print employee earnings recordsUpdate bookkeeping recordsApply Your KnowledgeDistinguish 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 TaxesSetting up tax liability accountsChoose an authorized bankMaintain accurate recordsFederal Tax Deposit SchedulesDetermined by the IRS or prior year’s taxesExceptionsSubmitting Federal Income and FICA TaxesElectronic funds transfer (EFT)  TAXLINKIf EFT unavailableCheck to Federal Tax Deposit Processing CenterContract with an accountant or financial institutionCalculating and Filing Taxes (cont.)Submitting FUTA and SUTAQuarterly if over $1006.2% of first $7000 income/yearSUTA ~ submit with FUTAEmployer’s Quarterly Federal Tax Return Form 941Summarizes federal income and FICA taxesCalculating and Filing Taxes (cont.)State and local income taxesForms ProceduresSchedulesWage and tax statementsForm W-2Taxable incomeTaxes withheldForm W-3 All employees’ earnings Federal income and FICA taxes withheldApply Your KnowledgeWhat 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 Summary56.1 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 budgetcommunication and interpersonal skills evaluate and purchase equipment and systems that fit the practice’s needs and budget, facilitate the installation staff training oversee the ongoing operations. 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, deductions (including mandatory and voluntary deductions), and net paycheck.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 56Management is doing things right; leadership is doing the right things.~ Peter F. Drucker