A Medical Office Manager’s Job Is Never Done

Sylvia Aldama and Maria Marin

SDP: How long have you been working in healthcare?
Maria: Thirty years.
Sylvia: 23 years. We’ve worked together six years at this office.

SDP: What do you love most about your job?
Maria: It’s a challenge. It’s interesting. It’s new each day. Especially in our specialty, it’s not your typical office visit.
Sylvia: There’s so many changes, and it’s always evolving, keeping up with changes in medications and Medicare. It’s not boring!

SDP: What has been your biggest challenge this past year?
Maria: Having to deal with each insurance company’s and HMO group’s unique requirements. Every time we figure it out, it changes!
Sylvia: More and more medications that need prior authorizations. Also, getting assistance for patients for medications so they can get treatment.

SDP: What has been your biggest success this past year?
Maria: Having the billing portion of the practice completely automated. We are less hands-on with paper and much more online, so we can give the patients more time and attention.

SDP: How has SDCMS helped you do your job better?
Maria/Sylvia: Marisol Gonzalez, SDCMS’ physician advocate, was able to get to the appropriate people at Palmetto when we were having such difficulty with our claims. We were getting tossed around at Palmetto, but when Marisol got involved, the issues were resolved quickly and smoothly.

SDP: What is your goal for the next year?
Maria/Sylvia: To be fully EHR.

Christina Binkowski

SDP: How long have you worked in healthcare?
Christina: Thirty-five years.

SDP: What do you love most about your job?
Christina: We’ve seen so many advances, both administratively and medically. I came back to the healthcare field after six years in law enforcement and everything was new! It’s exciting and challenging.

SDP: What’s been the biggest challenge for you this past year?
Christina:  Finding new physicians to come into our practice … basically to come into California because of the economy here, coupled with the doctors who don’t want to be on-call at the hospital, it’s a challenge.

SDP: What has been your biggest success in your job this past year?
Christina: Finally establishing a cohesive, consistent staff. All the current staff members have been here for more than three years. Until four years ago we were going through people every six months. I had to find people with a strong work ethic and accountability.

SDP: How would the staff describe you?
Christina: I have high expectations because I’m older and I have an old-fashioned work ethic. They would say I am fair and flexible and that I’m loyal.

SDP: Describe your technique for hiring.
Christina: I am at an advantage because I have been in law enforcement, so I can interview people very well. I am able to sit back and be an active listener. Be personable so the candidate relaxes and you can see a little more of their personality and their real skills.

SDP: What are your goals for the next year as an office manager?
Christina: We just hired two new physicians, so the goal is to get the office running with the new additions and to get Dr. Silver back on the lecture circuit.

SDP: How has SDCMS helped you be a better office manager?
Christina: I’ve attended seminars and webinars. It’s nice because I can pull up webinars online and have access to information on the website. I recently called SDCMS regarding guidelines for the use of a sign language interpreter and was given assistance with the requirements and CMA guidelines.

Tammy Haupert

SDP: How long have you worked for Medical Group of North County?
Tammy: Twenty years. It started out as a single-employee practice, and, as it grew, I grew with it.

SDP: What do you love most about your job?
Tammy: The doctors and the staff. It takes more than one person to manage an office like ours, and it’s nice to have the doctors’ support.

SDP: What has been the biggest challenge for you this past year?
Tammy: Keeping it a win-win for the staff and the patients with all the healthcare changes.

SDP: What has been your biggest success?
Tammy: The growth of the company. It has gone through all the challenges and has come out of all of it with quality healthcare still being the goal.

SDP: What resources are you most interested in from SDCMS?
Tammy: I am very excited about the seminars and the website.

SDP: What is your goal for the upcoming months and years?
Tammy: EMR! Our second conversion — hopefully we learned a lot from the first one. Definitely EMR, and then the growth of the practice.

Debbie Morgan

There are many challenges today in the role of practice manager, far more than there were 10 years ago. I have been a practice manager for more than 25 years, and the changes that have occurred in the past 10 years have been innumerable. We as practice managers find ourselves working longer days and taking less time off to accomplish the day-to-day responsibilities associated with the job.

One of the many challenges I face as a practice manager is dealing with the employees’ behaviors and personalities and keeping cohesiveness within the practice. I have learned over the years to listen to employees’ concerns and issues, to be open, and to encourage communication. Problems are not always “black and white.” I ask my employees what they’re willing to do to resolve an issue and what they aren’t willing to do. I strive to approach a problem this way because I feel it will lead to relationships based on trust, accountability, and mutual respect.

Another challenge I face is keeping up with and understanding the many state and federal regulatory issues, e.g., PQRI initiative, HIPAA, HR, Red Flags Rule, OIG compliance program, etc., and the list gets larger each year. We now have a bigger responsibility of obtaining the knowledge, and doing this takes a significant amount of time, educating yourself to understand and implement the changes into the practice. This of course cannot all be accomplished during regular working hours, so you find yourself educating yourself on your “own” time.

I guess my biggest fear is letting my physicians and staff down because there are just not enough hours in a day, days in a week, and weeks in a year to accomplish all that needs to be accomplished to assure that we have a successful and profitable practice, as well as happy and motivated employees and satisfied patients.

I do want to take this moment to thank SDCMS for all of their help and valuable resources. I frequently use their website for answers to many of my questions and feel that their resources are invaluable. I would hope that every member would use the available resources to answer any questions or address any issues you may have in the day-to-day operations of a medical practice.

Thank you, SDCMS!

Vicky Morgan

SDP: How long have you been doing your job?
Vicky: I have been in the medical field for 19 years and with Dr. Wilson for more than 17 years now.

SDP: What do you love about your job?
Vicky: I love working with the patients. We have a lot of long-term, chronic-pain patients who have been coming in for years. They are like family to me, and it is always great to catch up with them and their families.

SDP: Biggest challenges?
Vicky: As our office got busier, we transitioned job duties among the staff. This was challenging at first, but we worked out a system, and things are running really smoothly now. I also have had to share and transition some of my job duties with Nathan Hughes. He is running the day-to-day operations at the office now, and this has allowed me to concentrate exclusively on the billing management and collection side of the practice. Having a strong dual management team for Dr. Wilson has definitely helped our practice through all of our growth.
Secondly, I think another big challenge is dealing with the insurance carriers. There is a lot more follow-up and numerous phone calls on the physician’s end than ever before to get any claim issues, prior authorizations, or appeals through their systems.

SDP: Biggest successes?
Vicky: One of our biggest successes, I would say, is that we stay on the cutting edge of all of the new resources available for our staff to get their jobs done more efficiently. We use Navinet for insurance benefits checks, they use all of the insurance websites available, we e-prescribe, and they upload authorization requests online. They all use the scanner, and we also have an automated appointment call reminder system tied to our schedule.
We have also been billing our workers’ comp claims electronically with the carriers that are currently accepting these claims. This has allowed us to get prompt payments in from these carriers.

SDP: How has SDCMS helped you do your job better?
Vicky: I have been coming to the mangers meetings for years and years. We actually used to bring our own sack lunches way back when!

All of the topics and speakers have definitely helped us run our office more efficiently. It’s always good to be on top of all of the current changes and having the resources with just a phone call or email to SDCMS. The staff is always fast and efficient in getting me the information I need or directing me to the right resources.

I also like the fact that coming to the meetings, I get to meet other practice managers. I think it’s great that we have a forum that we can share ideas and problem-solve together.

SDP: What are some of your goals for the next few years?
Vicky: We are currently looking into EMR software for our office and all of the changes that will have to be made. Since we are a solo practice, we also have to look at the expense and all of the EMR incentives available.

Personally? I am hiking Mt. Whitney on the 31st of August! We have our permit, and I am hiking with a group of 15. We have been training for this hike for the past six months!

Alex Rader

SDP: How long have you been an office manager?
Alex: Almost 20 years off and on.

SDP: What do you love most about your job?
Alex: There is no getting bored! There’s always something going on.

SDP: What was your biggest challenge this year?
Alex: The Medicare rollercoaster … it’s a hard one. It’s so volatile and emotional. One of our doctors had to retire. All costs to do business are going up, and reimbursement is all over the place.

SDP: What did you accomplish this past year that you are most proud of?
Alex: Converting doctors to e-prescribing through iPads!

SDP: How has SDCMS helped you do your job better?
Alex: SDCMS has provided wonderful resources. For example, we have had an ongoing issue with Medicare for more than two years, and SDCMS has helped us whenever we needed it. The training provided is valuable, and SDCMS truly recognizes the required ongoing training for compliance purposes. If my doctors had to pay for these training seminars, they’d be paying hundreds of dollars, but the seminars are free because of their membership.

SDP: What is your goal for the next year as an office manager?
Alex: To go “live” with an EHR system, provided that we can still afford to stay in business with that cost.

Kimberly Riley

Some of you might remember the Leave It to Beaver episode where the Beav climbs up onto a billboard and ends up falling into the giant coffee cup. Well, change that to a bowl full of alphabet soup and that’s how I was feeling shortly after joining my first office. Dip your spoon in and you will lift out many, if not all, of the abbreviations listed above, and more are appearing every time you turn around.

Twenty years ago I chose a profession that I thought was challenging and rewarding: healthcare. I started my career in the pre-hospital world as an emergency medical technician, and, over the years, I made the transition into the medical office. Like many others at the time, my medical insurance knowledge and office management knowledge came from hands-on experience.

My first office position came with all of 30 minutes of actual in-office training from the person I was replacing; fortunately, the physician was very understanding and helped me through those first few weeks of adjustment, as did the medical biller, whom we outsourced to. While I was grateful for their patience, I knew that I needed to find someone with greater resources to whom I could ask questions and who was willing to answer them no matter how many times I had to ask the same thing. I looked into local training programs and schools; however, those were either too expensive or the courses were during work hours.

I was about to give up until one day, I was going through the faxes and ran across a flyer from SDCMS; it was offering a seminar for physicians and office staff on HIPAA. At this seminar I was relieved to find that I was not the only one drowning in the soup bowl. That day I left knowing I had found the answer to my prayers.

Since that fateful day, I have regularly attended seminars and webinars that SDCMS has offered, including the certified office manager course and the certified medical coder courses offered in conjunction with Practice Management Institute. I encourage all medical office managers and office staff to use the resources that are offered by the San Diego County Medical Society.

Lisa Sullivan

SDP: How long have you been an office manager?
Lisa: Twenty-two years.

SDP: What do you love most about your job?
Lisa: The variety of tasks. It’s always interesting!

SDP: What has been the biggest challenge in your job this past year?
Lisa: Keeping costs down. We gave no salary increases to the staff for the first time.

SDP: What has been your biggest success in your job this past year?
Lisa: Being able to keep up with reimbursement issues and staying up-to-date.

SDP: How has SDCMS helped you do your job better?
Lisa: By keeping me informed of the updates. One of the best and most helpful seminars was Catherine Sherman’s [with TSC Accounts Receivable Solutions] billing/collections seminar.

SDP: What do you hope to accomplish next year?
Lisa: Same thing as last year: Search for solutions to navigate the changes in healthcare.

Renee Thompson

SDP: How long have you worked for Dr. Ansari?
Renee: Nine years.

SDP: What do you love most about your job?
Renee: Being able to help patients get care. I do authorizations that are very hard, and being able to get authorizations or resources for treatment that the patients may not have been able to afford otherwise is very rewarding.

SDP: What did you accomplish this past year that you are most proud of?
Renee: Being able to manage my job and cover for a staff member who was out on maternity leave.

SDP: How has SDCMS helped you be a better office manager?
Renee: By offering all the classes and the invaluable “News You Can Use.”

SDP: What is your goal for the next year as an office manager?
Renee: To be more versed in human resources.

Stephen Villa

SDP: How long have you worked in healthcare?
Stephen: Eighteen years. I started in healthcare when I was 17; I joined the Air Force and was a med tech.

SDP: What do you love about your job?
Stephen: It’s so diversified — there’s a little bit of everything, from patient care, to business development, to strategic planning, to human resources, to counseling staff, to government interactions, to legal, to accounting, to networking, to financing, to remodeling … and the list never ends.

SDP: What was your biggest challenge this past year?
Stephen: Strategic planning because of the Medicare cuts and the economy.

SDP: What are you most proud of having accomplished this past year?
Stephen: Communication has improved throughout the office due to honest and sincere listening and honest feedback.

SDP: How has SDCMS helped you?
Stephen: Seminars are great! From the workers’ compensation seminar to the EMR trunk shows, to contract negotiations and the certified medical coder course. One of our physicians attended the coder course, and it was excellent. “News You Can Use” is great! We also use the website for the calendar of events.

SDP: What is your goal as office manager for the next year?
Stephen: To maximize function in the leanest possible way. To keep the staff we have, but to continue growing. To get our doctors out there more to have a bigger presence in the community.

Carmen Williams

SDP: How long have you been working for Dr. Thota?
Carmen: Eleven years.

SDP: What do you love about your job?
Carmen: I love my boss! He is passionate about his work and caring for his patients. It is so inspiring that ever since I started I have not called in sick once. I am compelled to come here each day!

SDP: What was your biggest challenge this past year?
Carmen: How to financially manage this practice with the Medicare cuts.

SDP: What are you most proud that you accomplished this past year?
Carmen: Achieving 10 years working with Dr. Thota and obtaining six successful contract negotiations for our surgical center. Also, creating a very strong employee team.

SDP: How has SDCMS helped you?
Carmen: I love the seminars! The information available through SDCMS is so handy. I attended the certified medical office manager course offered at a significantly discounted rate through SDCMS, such excellent training. Also, the terrific resources on the website help me out a lot. I love to be part of something in our community that allows us to provide a better level of care.

SDP: What is your goal for the next year as an office manager?
Carmen: To continue to give the best care we can while keeping up with the financial changes.