Interviewing Tips

PREPARE

It sounds silly but it really helps if you prepare for an interview.  Ask yourself sample questions.  Some of these questions can be found on my website under the Practice Search Tips button.  Better yet, find someone who will ask you the interview questions.

DON’T BE NEGATIVE

Never say anything that is negative during the interview.  This is particularly true of any negative comments about your current employer or practice.  These comments can be construed by the interviewer as comments that you would make over time about your new jobs.

BACKGROUND INFORMATION

Do research on the practice/facility so that you can speak to it during your interview.  If you’re working with a recruiter, ask him/her to give you as much information about the practice/facility as possible; most places have a website that you can visit.  Try to find out about the organizational culture and structure, the job responsibilities, and the reason why the practice/facility is looking to add someone.

ASK QUESTIONS

The interview dialogue should be like a good conversation with both parties actively involved.  A good question is “What can I tell you that would convince you that I am the best one for the position?”  Questions such as this that focus on what you bring to the table are better than asking what the practice/facility can do for you.

Take Notes

It is worthwhile, if not necessary, to document the job contacts you’ve made.  It’s best to start documenting this information when you start your practice search.  This is important too because the practice search process is often an extended one which takes months from start to finish.  Document who you talked with, when you talked with them, their contact information and what you talked about.

You will get alot of information about alot of different practice opportunities so it is important to have a process of retrieving it at a later date.  It can be a paper or an electronic storage system.   You should file it by each practice opportunity.

You may need to contact someone that you haven’t heard from in months.  Or, they may contact you and if you have taken notes and filed information, you will be able to talk from an informed point.  It’s always impressive when you can recall and provide information to the caller about the points of their opportunity.

Most Common Interview Mistakes

A physiatrist recently went on a job interview and was checking his blackberry several times during the interview.    The employer later informed me that he was not interested in the physician because he did not seem to have an interest in the job because he was  checking his blackberry often.  When I checked with the doctor, he said that he was on call so that was why he was checking his blackberry and that he indeed had an interest in the opportunity.   This was an unfortunate turn of events.

Don’t use telephones during an interview.  If this is not possible, explain the reason to all the interviewers and limit your use.

The most common interview  no-no’s are appearing disinterested, appearing arrogant, and talking negatively about current or previous employers, according to Career Builder’s poll.  It’s important to inform the practice/hospital of your abilities but not to the point of bragging.

Always leave plenty of time to get to an interview.  It’s easy to get caught up with patients, get caught in a traffic jam, or get lost.  First impressions are key and late arrivals do not make a good impression.

To show your interest, look at the person who is talking with you.  If you truly are disinterested, maintain an aura of interest because who knows, you might run into the same practice/hospital another time so you want to leave a positive impression.

Leaving a bad job or you’ve been fired!

What should you say about why you’re looking for a new position when you’re leaving a bad job or you’ve been fired?   As I’ve said before,  you should never be negative about your current employer.   You can be negative about a situation but not about a person.  When negative about a person, the interviewer thinks that you will end up being negative about him/her in a year or two.  You can be negative about an aspect of your work but be sure that it isn’t about something that is vital to the new position.  A common answer is that you’re looking for professional growth and advancement and that your current place of employment doesn’t offer this ability.    You could say that the doctors in positions above you, don’t seem to have any plans to leave so there is no room for growth.

If you’ve been fired/laid off, then honesty is the best policy.  You can explain that there were differences of opinion.  Again, be sure that this explanation will not describe a situation that will happen in the new job.

5010 File Format Deadline Extended

As your billing personnel are well aware, CMS initially mandated a strict deadline of December 31, 2011, for sending Medicare claims and receiving remittances in 5010 format, after which claims would not be paid. The pressure by the Medicare carriers was intense, literally threatening the livelihood of all providers who did not comply.  But wait!

On November 17, 2011, CMS effectively extended the deadline for 5010 compliance until March 31, 2012.

So, how do you get ready for 5010? Among the options are:

1. Changing your billing software to allow creation of claims in 5010 file format, test with Medicare, and move to production. This option allows you to gain greater control of the process, but requires upgrading your billing software – which may be expensive.
2. Using a Clearinghouse which will convert your current 4010 file format to a 5010 file format. This option is cost effective since it does not require the purchase of new billing software, but will usually engender monthly Clearinghouse fees.
3. Using a Software Vendor which will convert your 4010 file format to a 5010 file format. This option is cost effective since it does not require the purchase of new billing software, does not require monthly fees, but only an annual service fee to the Software Vendor. In addition, some Software Vendors will allow free commercial claims to be sent.

Because the deadline has been extended, providers are in a better position to review all options, and make a sound business decision.

Contributed by Bruno Stillo, Physiatry Billing Specialists, (800)835-4482, [email protected]

When to Start Your Practice Search

It’s best to start looking for a new position as soon as you know you want a new position.  For residents, you should begin at the start of your senior year.   The job search process takes awhile – the time it takes to get a new state license, to obtain a contract from the employer, to negotiate a contract, etc.  NJ and CA are some states that take 6+ months to get a license.  Starting early as with everything is advantageous however some employers aren’t actively looking until October/November when the Annual AAPMR meeting occurs.

On the other hand, it’s never too late to start looking when you’re a resident because even if you start looking then, there will be positions available that for one reason or another haven’t been filled.  It’s not that all positions that have been available for awhile aren’t good.  Sometimes, the parties can’t come to a compromise or the practice settles on one doctor who then decides to take another position.

Billing Team Conferences

Team Conference Reimbursement:  To bill Team Conference time, you upcode the initial CPT code (from previously rounding that day) 1 level.  You state in your documentation

“____ minutes spent face to face and in the coordination of care for this patient.”   This is one of the times where time is a factor in coding.  So if you have a level 1 (99231) based on medical necessity and you spend an additional 10 minutes in Staffing, then you technically have a total of 25 minutes face to face and coordination of care with that patient, which qualifies for a level II (99232).

Contributed by Liz Lee

President, PRS, Inc.

817-284-9850

1-800-324-4777

817-284-3425 FAX

817-907-0370 Mobile

Website:  PRSinc.com

Group Interviews

Don’t be afraid of a group interview.  As daunting as it might sound, think of it as a one-on-one to lessen any fears.  Just like for any interview, practice beforehand, find out as much about the hospital/group beforehand and remember exactly what is on your curriculum vitae as otherwise what you say will be taken into question.  In the case of a group interview, practice working a room.  Group dynamics is like team dynamics.

You may want to introduce yourself when you walk into the room.  This shows that you are able to lead and have initiative.  Just like in a one-on-one interview, listen to what is being said and not said.  Use these as clues to how and what you will respond.  Also, just like in a one-on-one interview, be assertive, not aggressive; be calm and discuss your skills and how they will benefit the group.  If one person in the group interview isn’t engaged, try to draw them into the conversation.   Don’t get intimidated by the group to the point that you’re afraid to ask questions.

Don’t try to be someone you’re not.  The group is trying to figure out how you will fit in.  You want them to know what you do best and enjoy the most.

Recruiting a doctor to a less attractive area

The best way to recruit for difficult geographic regions is to offer a great package deal, with partnership option after the 1st year.   The offer should include a sign-on bonus, relocation reimbursement,  health insurance/life insurance/long term disability, the ability to keep 70% of what they collect, plus a guarantee of a base salary until they are actually receiving reimbursement for their services (probably 2 months),  4 weeks vacation and 1 week CME, plus a CME allowance.  Keep in mind that a lot of doctors don’t want a partnership – they simply want to share overhead and build the practice.  That is where the LLC comes in handy.  You can all practice under an umbrella wherein you all share expenses, but you eat what you kill.  That is an incentive to really work hard to build your part of the practice, and it will keep physicians there long-term.

This blog was contributed by Elizabeth Lee, President, PRS, Inc, a physiatry practice management and billing company in TX, [email protected], 800-324-4777.

Percent of Overhead Responsibility

Q.:  What percent of the overhead should I as a new physician in a practice accept?

A.:  To answer the question, and it is a multi-faceted one, since there are many different types of overhead.

There is only one formula however, that works every time, and saves a lot of grief down the road.  The formula is that the physician pay only his direct expenses and not indirect expenses.  For instance, if you are sharing space with Orthopedic Surgeons – you only want to pay for your direct overhead – not their accounting, marketing, employees, etc. for which the physician has no benefit.  The physician sharing space should account for the exact sq footage he/she is utilizing, have his/her own dedicated staff for which he/she pays for, and pay the percentage of billing for only what he/she collects.

What is generally done, and is a huge mistake, is to share equally the expenses of the overall practice with all of the physicians in the practice.   An Ortho practice has huge expenses, most of which are not related to anything the PM&R physician generates.  This later ends up in huge disputes, and almost always ends with the PM&R doc leaving and not on so good terms.

The percentage of overhead cannot be calculated by percentage unless he is in his own practice, and then that is driven by the market values, i.e., cost of lease space, employees, marketing, etc.   Most of our practices have an overhead of around $6,000 per month before PRS fees and physician salaries.  Most physicians take a set salary, and then take bonuses with the surpluses.

Answer contributed by Liz Lee, President, PRS, Inc. a practice management and billing company that works mostly with physiatrists, 817-284-9850,1-800-324-4777, 817-284-3425 FAX,  Website:  PRSinc.com