Non-Physician Practitioners

In today's economic climate, the hiring, retention and effective utilization of staff will differentiate practices that struggle from practices that thrive. A growing trend for orthopaedic offices is the hiring and utilization of Physician Assistants (PAs) and Nurse Practitioners (NPs) as providers. Collectively, PAs and NPs are referred to as non-physician practitioners or NPPs. With rising costs, declining reimbursements and increased paperwork, it's important that physicians and administrators are able to retain, utilize and optimize new NPPs to their highest capacity. This article offers tips on optimizing your NPP to thrive and advance in your practice.

Create an accurate job description. With years of experience in healthcare recruitment, we can attest to the importance of an accurate job description. Turnover is often attributed to inaccurately outlined job descriptions. You must be fully aware of your practice's needs before you develop a job description. Should your NPP serve full-time or part-time? Will he be utilized in the practice setting, the operating room or both? If you hire a NPP and inform her that she will be spending 80 percent of her time in the OR, this had better be true. If in reality the NPP will spend 80 percent of her time in a clinic setting and only 20 percent in the OR, you are setting up the NPP (and your practice) for failure. A surgical NPP won't be happy with an office based position. You can bet he will be on the hunt for a new position that can offer him the OR time he wanted (and that you had promised).

Research your payer mix and reimbursement rules. You must do your billing homework prior to bringing on an NPP. Contact your top private payers and find out how their specific policies, reimbursement rates and payment guidelines work for an NPP. You don't want to find out after you hire a new NPP that claims are being rejected or that reimbursement rates are lower than you thought. It is also pertinent to share this information with your billing team to assure that they are billing and collecting accurately. Do your research to determine your ROI when adding a new NPP to your practice.

Coordinate a pre-employment shadowing day. Before making a formal offer to an NPP, have her shadow your physician for a day or two. This will allow the NPP to get a clearer understanding of the pace of the practice and the overall responsibilities of the position. This experience will allow the NPP to make an informed decision as to whether the position is the right fit. It will also give both the NPP and the physician insight as to whether a good workplace relationship can be developed. Taking the time to do this before an offer is made and accepted can save time, money and the hassle of dealing with turnover.

Include professional memberships and CME allowance in your NPP's offer. Your practice should pay for professional affiliations and development to optimize your NPP's knowledge in your clinical specialty. Professional memberships will allow your NPP to stay current with industry trends and advancements. Providing an allowance for CME courses will also help to develop and optimize your NPP and his skills and knowledge.

Market your new NPP. Your practice is growing, and the community should know about it. Similar to bringing on a new physician, you should promote your new NPP. Some ideas may include an open house to introduce patients and referring physicians to your new provider. Make sure to promote your NPP on your website and social media pages, as well.

Provide one-on-one training with physicians. A new NPP should train with a physician during her orientation. The training time can vary from weeks to months based on your NPP's skills and level of experience. Even if your NPP has years of experience in your field of specialty, she will need time to adjust to your specific practices policies, procedures, EMR systems and patient flow.

Create patient scheduling policies and protocols for your staff. Make sure that your staff is aware of the scope of practice and types of patients that the NPP can and will see. Will the NPP be able to see patients for initial consults? Will he only see follow-up patients for maintenance visits? It is important for the practice manager to train staff on the type of appointments in which your NPP will be utilized. Also, in order to optimize your NPP's time, scheduling protocols should be clearly defined for your receptionists to ensure that patient appointments are coordinated correctly and blocked out for the right time increments. Remember, proper scheduling greatly contributes to your overall patient satisfaction. You should create scheduling templates in your EMR system or appointment calendar to ensure proper allotment for various types of patient visits. This will help your staff avoid double-booking your NPP.

Your Revenue Cycle Management provider can assist in formulating a training program. Train your NPP on billing and documentation. Take the time to have your billing manager train NPPs on proper documentation, including coding, to make sure that no services are missed that could have been billed for. Billing and coding rules and regulations are constantly changing. Therefore, your billing and documentation training should be an ongoing initiative between your NPP and administrative team. This will help you to optimize the NPP's services and your collections.