Five Reasons for Medical Practice Staff Development

"We've never had a budget for staff training."

After years of working with physician practices, I've heard this more times than I can count.

If it holds true for your practice, here are five reasons why 2017 should be the year you shift away from this mindset and get serious about investing in employee development.

1. Reduce the risk of lawsuits, paybacks, and audits

Managers and staff who don't refresh their knowledge regularly (at least annually) are working under outdated, often false, and sometimes even illegal assumptions. Just as physicians are required to take CME courses, administrators and managers must attend professional association meetings in their specialty. Billing staff need coding and billing regulation updates. And annual HIPAA training is a must for everyone.

Failing to budget for these updates will leave your team frozen in time, following old rules. Simply put, they won't know what they don't know, putting your practice at risk of violating current regulations or laws or maintaining costly or inefficient operations.

The manager of a large orthopedic group insisted that refunds were not to be made unless patients or plans requested them. Had her knowledge been current, she would have known that the $75,000 in credit balances our consulting firm identified should have been refunded long ago - regardless whether patients or payers asked. CMS requires providers to report and return overpayments within 60 days of identification. And according to healthcare attorney Michael Sacopulos, founder of the Medical Risk Institute, most managed-care contracts have clauses that state overpayments must be refunded upon discovery. Sacopulos also notes that even out-of-network claim refunds must be refunded to patients, based on certain language in the Affordable Care Act.

And, we regularly observe under-trained billing staff following procedures that put their physician employers at risk for False Claim Act and HIPAA violations, as well as payer audits. Unbundling procedures because they don't understand current coding rules, naively submitting level 4 and level 5 E&M codes when the physician's documentation and/or medical necessity does not support them, and emailing protected health information (PHI) to patients or third-party billing services instead of using secure messaging, are a few examples.

2. If you budget for it, you will spend it

Funny thing about earmarking dollars for something specific. They typically get spent. And, you will be more apt to seek out training opportunities knowing there is a budget to cover them.

3. Boost morale

Our firm has worked with thousands of managers and staff for more than 30 years. A constant and consistent request we hear from them is that they'd like more training so they can do a better job.

I can almost guarantee that establishing an annual budget for professional development will be a positive and welcome announcement for your team. I frequently see it perk up the attitude and performance of employees who are in a rut or looking for opportunities to advance.

4. Increase revenue or reduce expenses

An educated and informed team does things right. Typically, that bodes well for the bottom line. When front desk staff are trained to ask patients for money, daily revenue goes up. When billing staff understand how to code correctly - and are kept abreast of rule changes - it's more likely that all your billable services will actually be billed and paid.

5. Monitor and benchmark learning investments

A training budget gives the practice a benchmark against which to measure expectations against reality. With "staff training" as both a budget and expense item, managers can monitor the percentage being spent each month and quarter. If you've set aside, say, $5,000 for the year, and have spent $6,500 by August, you can adjust next year's budget accordingly, as well as benchmark how much you've invested in employee development, year over year.

Fall is the perfect time to initiate a training budget for next year. Whether it's a specific dollar amount or a percentage of total expenses, set aside an amount, inform the staff, and spend the money. Your team and your bottom line will benefit from the results.

Cheryl Toth, MBA,is a consultant and trainer with KarenZupko & Associates, Inc. She brings more than 20 years of practice consulting, training, and technology product management experience to her projects.