What if Year End Bonuses are Disappointing?

Many practices are confronted with doctors who are not getting the year end bonus they anticipated; bonuses that are less than last year. No one likes to get less—especially busy general surgeons who are working as hard as they can.

Why isn't the money there?

In each practice with a disappointed doctor, there are a combination of factors that led to the shortfall. Consider the following possible reasons:

The Accounts Receivable have not been worked thoroughly or have not been worked correctly.

If you are the doctor or the administrator in charge, run your AR report by payor and you’ll have a good diagnostic tool in hand. Here’s a quick indication that your billing team needs the equivalent of Code Blue treatment. If you see that there are significant (each doctor we know defines that term differently) dollars in AR for Medicare past 45 days—this is a sure sign that you have big trouble. It is a leading indicator, because unlike the managed care insurance bullies, Medicare has rules, they publish them, and they pay by them. By statute they have to pay on a clean claim, submitted electronically, in 14 days. If they don’t, they pay you interest!!! When they deny a claim, they tell you why they aren’t paying and you have an opportunity to fix it; you can resubmit with the correct information. When we see big balances, explanations are needed.

Other symptoms that indicate larger troubles:

*Staff organize work incorrectly and run reports in alphabetic order instead of focusing on large balances first.

*When you run a small balance report—you note a lot of balances under $50. This means you have a point of service collection problem. Check the total amount; small balances add up.

*Staff still waste valuable account follow-up time copying and filing EOBs in charts.

*The practice fee schedule is under market—we’ve seen this in our last 4 reviews of client fee schedules!!

The AR is a gold mine—if only somebody would get after those dollars. The doctor has already done the hard work of caring for patients, so it’s important to capture all recoverable dollars.

Most of all, someone in the practice with “MD” or “DO” after their name MUST pay attention. Never abdicate collection responsibilities to the administrator, manager, or your billing staff. It is your money—make sure you know what’s going, never guess that everything is in order.

KZA helps physicians achieve their economic goals by instituting better business systems, training staff in all aspects of their jobs, showing physicians how to monitor the business health of their practice with useful reports. We can turn around seemingly “hopeless” situations.

If you want to improve physician bonuses in your practice, call Colleen Gallagher, KZA Client Service Director, at (312) 642-5616, or email her at cgallagher@karenzupko.com. A Prospective Client Information document can be downloaded at our website by clicking here.