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  |  Issue: July 2011  |  

Things to know about ZPIC audits:

  • They are never random;
  • The service is targeted through data analysis, post-payment audits, patient complaints, peers, and/or discontented employees;
  • There is a 30-day time limit to address appeals; and
  • Medical necessity of a service is determined by local coverage determinations and/or national coverage determinations.

It is important that physicians and their staff know and understand their rights when it comes to appealing an audit. For a detailed explanation of how to appeal an audit, see “Audited by a Recovery Audit Contractor—Now What?” in The Rheumatologist (December 2010, p. 19, or online at www.the-rheumatologist.org/details/article/973155/.html).

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A ZPIC audit is not a death sentence for a practice if the practice is in compliance with all coding and billing guidelines and all documentation for services provided will support medical necessity.

For additional questions or concerns about audits, contact Melesia Tillman, CPC, CRHC, CHA, at (404) 633 -3777, ext. 820, or [email protected].

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Dealing with a Short-Staffed Day

Dealing with a Short-Staffed Day

The phones are already ringing, the appointment schedule is jam packed—and you just learned that today you’ll be short staffed. Although stress and anxiety are about to kick in, here are some practical suggestions for dealing with a short-staffed day:

  1. Focus: Although there might be a million things to do, focus on what must be done today. Providing excellent care to the patients is goal number one.
  2. Rearrange the work: Once you know the day’s priorities, pull the team together and let them know what is happening. Be honest with staff and identify the biggest challenges, seeking input on how best to move forward.
  3. Communicate: Although there might be tension and stress, any and all communication should come with respect and gratitude.
  4. Have a positive attitude and smile: While it’s no fun to take on extra work, a positive attitude and being a team player help everyone to get through the day.
  5. Schedule breaks: Coordinate appropriately with staff to make sure that no one gets burned out. Breaks might have to be rescheduled, but everyone should be able to walk away from an area to stretch or eat. Proper coordination is the key.

In addition to these suggestions, employers can create policies and procedures to ensure that the practice is always fully staffed and ready to serve patients. Practices that invest in cross-training staff are better able to weather employee absences. For tips, see “Cross-Train Staff to Improve Practice Management,” in The Rheumatologist (April 2011, p. 30, or online at www.the-rheumatologist.org/details/article/1052257/.html).

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