Practice Management

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There are two key elements to successful billing and collection-bothnow and in the future. The first is the accuracy of your documentation andcoding, basically the responsibility of the urologist. The second elementis the billing process, which can be computerized, automated, and performedby others.

Chicago-The Coalition for the Advancement of Prosthetic Urology (CAPU),fresh from its first battle in Washington earlier this year over reimbursementfor prosthetic urology devices and procedures, took another big step forwardwith a standing-room-only presentation at the AUA meeting here on Tuesday.

Chicago-Urologists interested in Medicare reimbursement rates for prostheticurology should consider attending an informational lunch hosted by the Coalitionfor the Advancement of Prosthetic Urology (CAPU). John Mulcahy, MD, chairmanof CAPU, which is comprised of leading clinical experts and researchersin prosthetic urology and the nation's leading manufacturers and developersof prosthetic urological devices, will discuss the group's advocacy andoutreach initiatives.

Pharmaceutical manufacturers have long been under scrutiny for the methodsthey employ in marketing their products to physicians. Now, increasing concernthat drug makers are winning physician favor by deeply discounting chemotherapymedicines is placing those physicians under the microscopes of federal andstate authorities.

As most urologists know, new federal standards have been established to ensure the privacy of patients' health information as part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. In my September 2002 article, I presented limited information on HIPAA and its impact on physicians' practices, including the standards for the electronic transmission of health care transactions and the rules associated with implementation.

Denison, TX-A non-existent cap on non-economic medical liabilitydamages and the disproportionate number of high jury awards in the country'slargest state have physicians wondering if relief will ever come, even withlegislation in the works.

Philadelphia-The City of Brotherly Love has what many say is theleast friendly climate for physicians when it comes to medical liabilityinsurance. Insurance and reimbursement problems, however, are statewidephenomena in Pennsylvania. In Scranton, located in the northeastern cornerof the state, a seven-urologist group has said it will decide in Januarywhether to close.

With HIPAA compliance for the electronic transmission of health care data still looming, most urologists will have to modernize their practices by changing or significantly modifying their practice management information system (PMIS).

New Products

Hicksville, NY-Nuclear Associates offers the Urological Radiation Shield, which has been shown to reduce the exposure of radiation dose from scatter by 70%. After the patient has been positioned on the table, the support rail is attached and the shield is slid onto the rail so it hangs in front of the patient, between the radiation source and the surgeon. This shielding system allows maximum radiation protection to be maintained, according to the company.

An astounding article in this issue of Urology Times details how oneurologist quit all commercial insurance participation, then "optedout" of Medicare-and is not only surviving, but thriving. Mike Harris, MD, a well-trained, board-certified, respected urologistin Traverse City, MI, said "Enough is enough!" and did somethingabout it. He no longer exists in any private insurance carrier databaseand likewise does not appear anywhere on the Medicare radar screen.

Ex-urologists say they wanted to escape reimbursement woes, pursue morefulfilling careersMedicine is a commitment. Pre-med, medical school, internship, residency,and building a reputation in academia or in community practice adds up toa self-imposed promissory note that can take a decade, perhaps two, to payoff. This is why it is unusual when an established physician opts to changecareers.

Technologies are currently available or in development to make use of real-time wireless technology, which can be applied to the office practice of medicine and is affordable to large and small practices. Using wireless technology, physicians can have access to data on their patients anytime and anywhere.