The Primary Care Provider's Guide to Compensation and Quality:
How to Get Paid and Not Get Sued
by Carolyn Buppert, CRNP, JD
Reviewed by Marty Couret, RN, MSN
ISBN #: 0-8342-1744-9
List Price: $105.00
Publication Date: April 2000
Publisher: Aspen Publishers, Inc.
"The Primary Care Provider's Guide to Compensation and Quality" by Carolyn Buppert is an excellent guide for any primary care practice. She not only makes suggestions on how to improve your practice, she also gives the PCP the tools to follow through with her advice. Each chapter is packed with pearls of practice- and time-saving strategies.
In the chapter entitled Systems for Meeting Benchmarks for Screening and Health Maintenance, Buppert gives performance standards for PCPs. She also provides a personal health guide for patients to keep track of their own blood pressure, immunizations, mammograms, cholesterol, and weight. A prevention guide for parents to monitor their child's wellness is also included. In addition, the book also includes flow charts for chronic illnesses such as asthma and diabetes.
Possibly the most interesting and helpful information the book furnishes is the malpractice avoidance section. Within this section are malpractice case studies. Each case study has an example of common mistakes and the lessons that can be learned from them. Buppert then delves into how to avoid elements of malpractice. She includes an extensive list of documentation "Dos" and "Don'ts" for the Primary Care Provider. Once again Buppert gives the PCP the forms to help keep patients from slipping through the cracks with referral tracking forms, medication refill tracking forms, telephone documentation forms, and diagnostic follow-up forms.
Ms. Buppert then brings everything to the bottom line, reimbursement. The book takes the PCP through the step-by-step process of how to get the most out of billing. Examination charts are included to assist in thoroughly assessing each body system required by payers. The PCP is even given guidelines for history taking to avoid leaving anything out. She also goes into contract negotiations with HMOs and methods of maximizing reimbursement.
"The Primary Care Providers Guide to Compensation and Quality" gives PCPs the tools they need in an easy to read and interesting format. Buppert successfully takes a normally dull subject and turns it into an intriguing educational experience. This book should be read by all PCPs trying to stay ahead in an ever changing health care market.
- Chapter 1: Measuring Performance in Primary Care
- Chapter 2: Systems for Meeting Benchmarks for Screening and Health Maintenance
- Chapter 3: Measuring Outcomes in Primary Care
- Chapter 4: Systems for Measuring Outcomes at the Practice Level
- Chapter 5: Systems for Tracking Functional Status
- Chapter 6: Systems for Measuring and Tracking Patient Satisfaction
- Chapter 7: Malpractice: The Ultimate Failure in Quality
- Chapter 8: Systems for Avoiding Malpractice
- Chapter 9: Reimbursement for Primary Care
- Chapter 10: What is Fraud and Abuse in Billing
- Chapter 11: Systems for Complying with Requirements of Medicare and Other Payers
- Chapter 12: How to Contract with Managed Care Organizations
- Chapter 13: How to Maximize Reimbursement
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Last updated: October 2, 2001