As some of you know, I put in my "six week" notice to my current employer on June 19th, at the end of the day. I said I would be leaving within the six weeks... so if I was offered a job position during that waiting time, I would be able to leave when needed instead of waiting until the end of July to leave my current position. As it stands, I will be out of here on July 31st. I am looking forward to the end of July. As it stands, I have no current job offers, even though I've put my resume out there on numerous occasions. I'm optimistic, though. And if I still don't have a new job by the end of July, I can work with a staffing/temp. agency until September, when I can go back to substitute teaching. It's all part of my master plan... hehehehe....
Today, I decided to look back at the last 6 months in the appointment book and see why my boss was complaining about there being "lots of openings" in the schedule and "no full patient days," resulting in why I was scored so low on my annual review in April. As a reminder, I was given a 2 in scheduling out of a possible 5, meaning "needs improvement." (And somehow, my co-worker got a 5 out of 5 on scheduling on her recent review)
As I was looking through the schedule, I only counted openings of 3 spaces or more, since no appointment should be schedule for less than 30 minutes (30 minutes for acupuncture and 40 minutes for a visit). There were a few 10 and 20 minute openings here and there, but not too many. If there was a chunk of time, I split it into 30 and 40 minute appointments; I didn't count that as one opening. I was fair.
Here's what I got for the last six months:
January: 13 working days, 2 days full, 25 openings (some due to snow), and a total of 108 patients seen/appointments scheduled.
February: 12 working days, 6 days full, 10 openings (some due to snow), and a total of 113 patients seen/appointments scheduled.
March: 13 working days, 3 days full, 20 openings, and a total of 107 patients seen/appointments scheduled.
April: 13 working days, 6 days full, 11 openings, and a total of 117 patients seen/appointments scheduled.
May: 13 working days, 5 days full, 15 openings, and a total of 116 patients seen/appointments scheduled.
June: 13 working days, 6 days full, 8 openings, and a total of 128 patients seen/appointments scheduled.
My review was in the middle of April. I wonder if I would have gotten more of a raise if the review would have been done at the end of this month...? haha I'd just like to know where all the "openings" and "empty days" are.
Granted, there were a few days, looking back, that were absolutely horrible and empty, but, as another doctor put it, "That reflects poorly on the doctor, not on the staff."
When I went to my chiropractor a few weeks ago, he asked me, "Don't you hate it when people no show for their appointments?" (He knows I'm a receptionist) I agreed and said, "I feel bad for your receptionist." He asked why... I told him, "Doesn't it look poorly for her, seeing as how the schedule isn't full now?" And he replied, "No, it looks poorly on the patient- they are the one that didn't show up."
I wish *my* boss realized that.
I'm so glad I'm out at the end of July.
SO GLAD.
I will be a much happier, improved Dot.
It's a good thing.
Tuesday, June 30, 2009
Monday, June 22, 2009
At home...
So, here I am, sitting at home at 10am on a Monday morning.
I'm sure you're thinking, "Why aren't you at work, Sarah (Dot)?"
I'll tell you... My car is in the shop.
Yeah, gross.
On Friday, I drove home from work- no problems. On Saturday, I drove into Clackamas twice and then around town for a bit with a friend, running "errands." No problems with the car. On Sunday, I went to start the car and it had a hard time wanting to start. It was weird. I called my dad- he thought it might be the battery, since it's been a while since it was changed. I ran my errand and when I got in the car to start it up again, it had a VERY hard time starting up. I drove to Felicia's house and left it there and we ran a few more errands. When I tried to start it at her house to go home, it almost didn't want to start... it took a few times, but it finally did.
I got it home and Sam took a look at it. We thought it was the battery, but took it to AutoZone and they said it was the alternator. Apparently, the alternator is hard to get to on my car... so Sam and I took it to a shop this morning. The guy called me no more than 30 minutes after we dropped it off- "It's not the alternator."
Yeah, it's the battery.
Way to go AutoZone.
Long story short... I'm on my way to pick up my car to park it in front of the house, waiting for Sam to get home so we can buy a battery and he can install it for way less than a shop. Exciting.
Anyone want to come over and craft wedding invitations with me?? :) haha
I'm sure you're thinking, "Why aren't you at work, Sarah (Dot)?"
I'll tell you... My car is in the shop.
Yeah, gross.
On Friday, I drove home from work- no problems. On Saturday, I drove into Clackamas twice and then around town for a bit with a friend, running "errands." No problems with the car. On Sunday, I went to start the car and it had a hard time wanting to start. It was weird. I called my dad- he thought it might be the battery, since it's been a while since it was changed. I ran my errand and when I got in the car to start it up again, it had a VERY hard time starting up. I drove to Felicia's house and left it there and we ran a few more errands. When I tried to start it at her house to go home, it almost didn't want to start... it took a few times, but it finally did.
I got it home and Sam took a look at it. We thought it was the battery, but took it to AutoZone and they said it was the alternator. Apparently, the alternator is hard to get to on my car... so Sam and I took it to a shop this morning. The guy called me no more than 30 minutes after we dropped it off- "It's not the alternator."
Yeah, it's the battery.
Way to go AutoZone.
Long story short... I'm on my way to pick up my car to park it in front of the house, waiting for Sam to get home so we can buy a battery and he can install it for way less than a shop. Exciting.
Anyone want to come over and craft wedding invitations with me?? :) haha
Wednesday, June 17, 2009
My Work Ethic
I know, I always complain about where I work... and I know you're probably thinking I should just cut my losses and quit, and believe me when I say I'm seriously thinking about typing up my notice today, but I need to get this off my chest/conscious first.
First, a break down of my doctor's cash rates:
New Patient = $235
10 min = $64
20 min = $80
30 min = $96
40 min = $135
50 min = $185
"extended service code" = $144 (basically anything that runs over the first 50 minutes)
Now, the story:
About a month or two ago, we had a new patient come into the office who lives in another state. She is the mother of a good friend of my doctor. This woman came into our office and unfortunately did not have insurance coverage for her visits, so she agreed to pay cash. The lady came in twice before she had to go back home; both visits were a little longer than our usual visit time and the lady was charged accordingly.
Her first visit was $235, the usual charge, but then $50 worth of in-house lab fees on top of it. Total: $285
Her second visit was $285, which includes a $44 discount off of the extended service code, but had an additional $71 in pharmacy, $30 of in-house lab fees, and a (refundable) $10 thermometer. Total: $396
Her third visit is the one I'm having a personal issue with. And so did the patient when she saw her bill.
For her third visit, my doctor called her (which is "cash" anyway, since insurance won't cover phone consults, regardless) and talked to her for 40 minutes. At the end of that time, my doctor asked if it was ok for her to call the patient back after she was done with the next patient (who was waiting). The patient agreed; my doctor called her back for another 25 minutes. The total time of 65 minutes is documented in both the chart as well as on the patient's personal notes about the visit. The patient got charged $329 for the visit, $25 for a nutritional evaluation, $30 for another in-house lab, and $293 in pharmacy purchases. Total: $692, after her $10 thermometer refund and $25 in shipping charges to mail the pharmacy items to her home.
Wow, this patient must be rich by the way she's spending all this cash at our clinic, right?! WRONG.
The patient called on Monday, asking if I would re-check the bill I sent her for her most recent visit. She was concerned about the $354 charge for her office visit alone (about half of her total charges). I looked it over and checked her chart and realized something wasn't right. In the patient chart, there is a documentation for the initial call of 40 min, then the call back of 25 minutes, then a random 30 minutes, 10 minutes and then it says: "Write up = 10 min." at the end of the chart notes with a total below of 95 minutes... which, if you actually add up would equal 115 minutes in total.
I asked my doctor if there was any way we could reduce her fees and my doctor informed me that the phone consult from start to finish was 95 minutes- so what ISN'T documented is the additional "30 minutes" worth of time that my doctor is claiming to have spent writing chart notes, patient instructions, etc. after the phone call ended. Either way, I'm expected to relay this information to the patient and have everything be OK enough for the patient to actually want to schedule another phone consult with my doctor.
So, I call the patient back and explain our fees to her and let her know that the charge for up to 50 min = $185, but since she went over by 15 minutes, that's why there was an extended service fee of $144. The patient understood, since she had noted a call time of 65 minutes, but asked if my doctor could reduce the fee, since it was only 15 minutes over. When my doctor got that note, she was puzzled; my doctor had told me to explain to the patient that she was being charged for an additional 30 minutes worth of paperwork, chart notes, and other documentation at the end of the phone call. I told my doctor that I had a hard time explaining that to the patient and my doctor told me to say exactly what was on the note, word for word, so the patient would understand better. I said ok and just went on with my business.
So, here's my concern:
1. Wouldn't you expect chart notes/documentation to be "included" in your doctor's fees?
2. In the chart, it says 10 minutes for write-up... not 30 minutes. Even then, you shouldn't charge the patient because you write slow!
3. I should NOT have to be stuck in the middle of my doctor's greed.
I need to go to lunch before my head explodes. I'll write more later.
First, a break down of my doctor's cash rates:
New Patient = $235
10 min = $64
20 min = $80
30 min = $96
40 min = $135
50 min = $185
"extended service code" = $144 (basically anything that runs over the first 50 minutes)
Now, the story:
About a month or two ago, we had a new patient come into the office who lives in another state. She is the mother of a good friend of my doctor. This woman came into our office and unfortunately did not have insurance coverage for her visits, so she agreed to pay cash. The lady came in twice before she had to go back home; both visits were a little longer than our usual visit time and the lady was charged accordingly.
Her first visit was $235, the usual charge, but then $50 worth of in-house lab fees on top of it. Total: $285
Her second visit was $285, which includes a $44 discount off of the extended service code, but had an additional $71 in pharmacy, $30 of in-house lab fees, and a (refundable) $10 thermometer. Total: $396
Her third visit is the one I'm having a personal issue with. And so did the patient when she saw her bill.
For her third visit, my doctor called her (which is "cash" anyway, since insurance won't cover phone consults, regardless) and talked to her for 40 minutes. At the end of that time, my doctor asked if it was ok for her to call the patient back after she was done with the next patient (who was waiting). The patient agreed; my doctor called her back for another 25 minutes. The total time of 65 minutes is documented in both the chart as well as on the patient's personal notes about the visit. The patient got charged $329 for the visit, $25 for a nutritional evaluation, $30 for another in-house lab, and $293 in pharmacy purchases. Total: $692, after her $10 thermometer refund and $25 in shipping charges to mail the pharmacy items to her home.
Wow, this patient must be rich by the way she's spending all this cash at our clinic, right?! WRONG.
The patient called on Monday, asking if I would re-check the bill I sent her for her most recent visit. She was concerned about the $354 charge for her office visit alone (about half of her total charges). I looked it over and checked her chart and realized something wasn't right. In the patient chart, there is a documentation for the initial call of 40 min, then the call back of 25 minutes, then a random 30 minutes, 10 minutes and then it says: "Write up = 10 min." at the end of the chart notes with a total below of 95 minutes... which, if you actually add up would equal 115 minutes in total.
I asked my doctor if there was any way we could reduce her fees and my doctor informed me that the phone consult from start to finish was 95 minutes- so what ISN'T documented is the additional "30 minutes" worth of time that my doctor is claiming to have spent writing chart notes, patient instructions, etc. after the phone call ended. Either way, I'm expected to relay this information to the patient and have everything be OK enough for the patient to actually want to schedule another phone consult with my doctor.
So, I call the patient back and explain our fees to her and let her know that the charge for up to 50 min = $185, but since she went over by 15 minutes, that's why there was an extended service fee of $144. The patient understood, since she had noted a call time of 65 minutes, but asked if my doctor could reduce the fee, since it was only 15 minutes over. When my doctor got that note, she was puzzled; my doctor had told me to explain to the patient that she was being charged for an additional 30 minutes worth of paperwork, chart notes, and other documentation at the end of the phone call. I told my doctor that I had a hard time explaining that to the patient and my doctor told me to say exactly what was on the note, word for word, so the patient would understand better. I said ok and just went on with my business.
So, here's my concern:
1. Wouldn't you expect chart notes/documentation to be "included" in your doctor's fees?
2. In the chart, it says 10 minutes for write-up... not 30 minutes. Even then, you shouldn't charge the patient because you write slow!
3. I should NOT have to be stuck in the middle of my doctor's greed.
I need to go to lunch before my head explodes. I'll write more later.
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