What Does a Medical Practice Manager Do?
Whether the title is manager, medical practice manager, physician practice manager, administrator, practice administrator, executive director, office manager, CEO, COO, director, division manager, department manager, or any combination thereof, with some exceptions, people who manage physician practices do some combination of the responsibilities listed here or manage people who do.
Human Resources: Hire, fire, counsel, discipline, evaluate, train, orient, coach, mentor and schedule staff. Shop, negotiate and administer benefits. Develop, maintain and administer personnel policies, wellness programs, pay scales, and job descriptions. Resolve conflicts. Maintain personnel files. Document Worker’s Compensation injuries. Address unemployment inquiries. Acknowledge joyful events and sorrowful events in the practice and the lives of employees. Stay late to listen to someone who needs to talk.
Facilities and Machines: Shop for, negotiate, recommend, and maintain buildings or suites, telephones, hand-held dictation devices, copiers, computers, pagers, furniture, scanners, postage machines, specimen refrigerators, injection refrigerators, patient refreshment refrigerators, staff lunch refrigerators, medical equipment, printers, coffee machines, alarm systems, signage and cell phones.
Ordering and Expense Management: Shop for, negotiate and recommend suppliers for medical consumables, office supplies, kitchen supplies, magazines, printed forms, business insurance, and malpractice insurance as well as services such as transcription, x-ray reads/over-reads, consultants, CPAs, lawyers, lawn and snow service, benefit administrators, answering service, water service, courier service, plant service, housekeeping, aquarium service, linen service, bio-hazardous waste removal, shredding service, off-site storage and caterers.
Legal: Comply with all local, state and federal laws and guidelines including OSHA, ADA, EOE, FMLA, CLIA, COLA, JCAHO, FACTA, HIPAA, Stark I, II & III, fire safety, crash carts and defibrillators, disaster communication, sexual harrassment, universal precautions, MSDS hazards, confidentiality, security and privacy, and provide staff with documentation and training in same. Make sure all clinical staff are current on licenses and CPR. Have downtime procedures for loss of computer accessibility. Make sure risk management policies are being followed. Alert malpractice carrier to any potential liability issues immediately. Make sure medical records are being stored and released appropriately.
Accounting: Pay bills, produce payroll, prepare compensation schedules for physicians, prepare and pay taxes, prepare budget and monthly variance reports, make deposits, reconcile bank statements, reconcile merchant accounts, prepare Profit & Loss statements, prepare refunds to payers and patients, and file lots and lots of paperwork.
Billing, Claims and Accounts Receivable: Perform eligibility searches on all scheduled patients. Ensure that all dictation is complete and all encounters (office, hospital, nursing home, ASC, satellite office, home visits and legal work (depositions, etc.) are charged and all payments, denials and adjustments are posted within pre-determined amount of time. Transmit electronic claims daily. Send patient statements daily or weekly. Negotiate payer contracts and ensure payers are complying with contract terms. Appeal denials. Have staff collect deductibles, co-pays and co-insurance and have financial counselors meet with patients scheduling surgery, those with an outstanding balance, or those patients with high deductibles or healthcare savings plans. Make sure scheduling staff know which payers the practice does not contract with. Liaison with billing service if billing is outsourced. Credential care providers with all payers. Perform internal compliance audits. Load new RBRVS values, new CPTs and new ICD-9s annually. Run monthly reports for physician production, aged accounts receivable, net collection percentage and cost and collections per RVU. Attach appropriate codes to claims for e-prescribing and PQRI. Have plan in place for receipt of Recovery Audit Contractor (RAC) letters. Make friends and meet regularly with the provider reps for your largest payers.
Marketing: Introduce new physicians, new locations and new services to the community. Recommend sponsorship of appropriate charities, sports and events in the community. Recommend sponsorship of patient support groups and keep physicians giving talks and appearing at events. Thank patients for referring other patients. Track referral sources. Recommend use of Yellow Pages, billboards, radio, television, newspaper, magazine, direct mail, newsletters, email, website, blog, and other social media. Prepare press releases on practice events and physicians awards and activities. Recommend practice physicians for television health spots.
Strategic Planning: Prepare ROIs (Return on Investment) and pro formas for new physicians, new services, and new locations. Forecast potential effect of Medicare cuts, contracts in negotiation or over-dependence on one payer. Discuss 5-year plans for capital expenditures such as EMR, ancillary services, physician recruitment, and replacement equipment. Explore outsourcing office functions or having staff telecommute. Always look for technology that can make the practice more efficient or productive.
Day-to-day Operations: Make the rounds of the practice at least twice a day to observe and be available for questions. Arrange for temporary staff or rearrange staff schedules for shortages, meet or speak with patients with complaints, and meet with vendors, physicians and staff. Open mail and recycle most of it. Unplug toilet(s).
Stay Current in Healthcare: Attend continuing education sessions via face-to-face conferences, webinars, podcasts and online classes. Maintain membership in professional organizations. Pursue certification in medical practice management. Network with community and same specialty colleagues. Participate in listservs, LinkedIn and Twitter.
What did I leave out? Take a lunch?
Read my post on “How Much Do Medical Practice Managers Make?” here.
gee – that sounds so easy 🙂
That nearly covers everything. I would add “Red Flag Rules” to the Legal category. But, this is the most comprehensive list I have seen thus far!
Wow Mary, pretty comprehensive list. When people ask me what I do as a practice manager, I tell them that my job is to make sure the office runs smooth. Now, I can just point them to your blog.
Thanks, Brandon. Putting it altogether like this made me both proud to be in this profession, and amazed at what we do!
This is a fantastic primer for building an understanding of a “day in the life of.” Thank you!
Hopefully a manager wouldn’t have to do everything on that list in one day, but some days it does feel like it!
Love it…unfortunatly it is true
Thank you for posting. I’m thinking about becoming a healthcare manager, and you post is very helpful!
I’m glad to hear it was helpful. Let me know if I can help you in your journey.
Great article. I have a question though. In your vast experience with practice managers, what is the downside to hiring someone with military experience only as a practice manager?
From what I have read here and my knowledge and backgraound as a Navy Hospital Corpsman, the only significant difference is the volume of Third Party Reimbursement activities between military and civilian practices/ medical organizations.
What are your thoughts?
What a great question! Hiring a manager who does not have any direct experience with third-party payers could be considered a risk if the practice is relying completely on the manager to negotiate contracts, monitor payer performance and go toe-to-toe with the payer when the contract terms are being abused. No manager is strong in every aspect of practice management so often a practice will augment a manager’s experience with some additional training or education, or will bring a specialist on board (an experienced billing manager) or use a consultant.
Tell me about asking this question – what has your experience been?
Hi Mary Pat,
Love your blog! Question for you. I am a nurse consultant and have developed a training program for medical office staff to become more efficient at prior authorization for advanced imaging. I do cold calling to medical offices to sell my training program and am in the process of hiring a salesperson to help me. Who in the office do you think I would have a better chance selling my services to? The person actually doing the prior auths, office manager or the medical provider? Any advice would be so appreciated! Thanks!
Thanks for your questions. Your training program sounds great. Unless a physician is very deeply involved in the billing and day-to-day operations, I would not propose marketing to him/her. The two most likely candidates for understanding the value a program like yours could bring to the table are the manager/administrator or the billing manager, if the practice is big enough to have one. Selling to the person who actually does the pre-authorizations might be hit or miss, depending on their knowledge base and their relationship with decision makers. I hope this is helpful.
Thanks so much for the advice! Yes, very helpful. Do you mind if I list a link to your blog on my blog and website? Your info is very relevant and spot on. I also quoted you in a recent article I wrote. You can check it out on my blog under the link: “The Future of Health Care”.
Thanks, Terri, for the quote and link. I’m glad I could be of help.
Great post Mary, I found it very helpful.
I’m new to the medical sales industry, and I’m glad to have found this on my search to better understand what an office manager dces.
I have a question for you though, similar to one asked previously. We have a new solution in the medical industry, one that has an over 90% hit rate among eligible practices. The hardest part that I have, being new to the industry, is setting appointments with office managers. (Now I see why with their busy schedule)
Do you have any tips for me as to how to successfully get through to set an appointment with an office manager as busy as yourself?
This is a great question! Managers get bombarded by salespeople all day long, so it’s no wonder that they are often resistant to setting appointments to meet with them.
Medical office managers are usually generalists and need to have knowledge about a lot of different things. Because their time is limited, they often rely on references from other medical managers who have spent the time to delve deeply into a product or service. Therefore, a salesperson needs to sell one manager on their product and once it is proven to perform well, ask that manager to refer you to others. Find the manager in the community who the other managers look up to and you will find the person you want to work with first.
Also, most managers belong to a managers’ group that meets monthly – sponsor the meeting, get in front of the managers and make a special offer to the managers in attendance to get them to open their doors to you. Find their pain points, make sure your product addresses one of them and find out how managers want to communicate with you. Don’t harrass them!
Best wishes, Greg.
Thank you for all of the helpful information, I am currently going to school for my Associates degree in Health Care Administration services. An have to write a paper about what I will be doing on a day to day bases. Again thank you for the brake down of what I someday will be doing.
Mary Pat, I have written a GREAT deal, I mean a G-R-E-A-T deal about and for medical assistants, and medical billers. As a former certified medical assistant and medical assistant instructor I know this role very well, however, your article was a real eye-opener as to the masses of function and plethora of responsibilities the medical office manager has to master. I really enjoyed reading the article from top to finish, and I was looking for any linking, or quoting instructions, or permissions to reprint, at least in part as a primer on related websites. I would LOVE to share this insight with the thousands of medical assistants that visit my medical assisting – and also the medical billing and coding – websites.
Thank you!!!! 🙂
Thanks for the feedback and taking the time to write. I’ll contact you offline to discuss reprint guidelines.
Best wishes and Happy New Year!
Hello everyone I am about to graduate in 2 weeks from Medical office Adminidtrative program I’m excited I would love to hear from some of the experienced people opinion of the field. Because I am a newbie I don’t know what to expect but I am ready for it :)… Thank you
Hello Mary Pat
I am currently working on getting my Bachelors in Medical Office Management and eventually hoping to get my MBA in Healthcare threw George Washington University in Washington DC. You said you are a Medical Practice Manager, is that the same as a Medical Office Manager? If not then how are they different? What state offers the most potential in the field?
There are many different titles for what we do, and in my mind, it comes down to a difference of how much responsibility one has and who is the position reporting to. Many think that “office manager” is a step down from “practice manager,” but because people can use the titles interchangeably, you have to dig under the job to find out what it really entails. I have been called many things, from Office Manager to CEO, but in some ways those two titles weren’t radically different. What counts is the expectation that your boss has of you.
This may not be the black and white answer you hoped for, but in healthcare management there is not a lot of standardization.
This sounds like a challenging profession that requires specialized skills and knowledge. My wife (the physician) and I (the MBA) are seriously looking into starting our own practice in a small town. Since I would likely handle a great deal of the business side of things, how would I go about beginning to educate myself on some of the specific areas relating to the management of a medical practice? Any guidance would be greatly appreciated. My prior experience is in the financial side. Sounds like there will be a steep learning curve.
The two areas that I think are most critical are revenue cycle management and technology.
I wrote about RCM here: https://managemypractice.com/what-is-revenue-cycle-management/
My favorite book about RCM is here: http://www.mgma.com/Store/ProductDetails.aspx?id=38731 and is called “The Physician Billing Process 12 Potholes to Avoid in the Road to Getting Paid”
Technology is a little trickier, but there is a fair amount of info on the web about PMs, EMRs, patient portals and payment portals. There are lots of products out there and depending on your wife’s specialty and her anticipated demographic, you could go fairly simple with technology but you could also spend lots of bucks. I think the key here is visiting lots of other practices to see what they use and exactly how they use it.
I hope this is helpful.
Hi Mary Pat,
Can you recommend a good course that will provide good training for managing a doctor’s office. I am looking at Kaplan, Allied, Virginia College, etc. Are these types of courses any good? Most of the reviews are terrible. I have a technical background and have a opportunity to manage an office that a relative is starting up. Any recommendations would be very appreciated.
I wish I had an answer to give you, but I am not aware of any program that truly prepares you to manage a practice. Managers need to know business, PM and EMR software, Human Resource laws and protocols, coding and billing and marketing. I have not reviewed any of the programs you mentioned in depth, but healthcare is changing so much in such a short time, that most programs cannot keep up with it. I have always wanted to start a school for practice managers, maybe now is the time!
I have been a practice manager for more than 25 years now. 25 years ago, I had to really search for stuff to keep me busy. After I reconciled the bank statement, ran the monthy reports for the accountant,paid the bills ( hand written from a regular check book, reconciled the peg board system, wrote a few letters to insurance companies, filed very few claims. pehaps made sure the office staff was kept enthusiastic about their jobs. We would meet our goals, take 2.5% of the gross and devide it among the employees, for a job very well done. 99% of our patients paid cash at the time of service. We did general dermatology and cosmetic dermatology. We were naking money hand over fist.Our doctor decided that the employees were getting paid too much and cut out the bonuses. (extremely stupid move)and did not allow any bonuses in it’s place.
I always hired the most vivaceous ladies I could find. People that were excellent on the phone, as well as in person, and very personable to the patients. That was the number one priority. I did not allow any gossip what-so-ever. THEN THE AMA DECIDED THEY COULD CASH IN ON THE CODING
MAKING MILLIONS OF DOLLARS PER YEAR BY MAKING INDIVIDUAL PHYSICIANS BUY THE NEW CPT CODE BOOK EACH YEAR. AS FAR AS I AM CONCERNED THIS IS A TRUE CONFLICT OF INTEREST. THE AMA DID NOTHING TO PROTECT DOCTORS FROM OBAMA CARE. TO THIS DAY I STILL DO NOT UNDERSTAND WHY DOCTORS LET THE AMA SCREW them OVER SO BADLY. WHEN I STARTED IN MEDICINE 35 YEARS AGO, THE AVERAGE OFFICE VISIT WAS 27.00 IN MY FIELD. TODAY, WE GET REIMBURSED BY MEDICARE SOMETHING LIKE 29.00. THE SECONDARY OR THE PATIENT MAY HAVE TO PAY AN ADDITIONAL 7.20.
AFFAIRSRS FOR BOTH THE PATIENT AND THE DOCTOR. NOTHING WILL HAPPEN UNTIL DOCTORS UNITE AND STAND UP TO THESE INSURANCE COMPANIES.
I HAVE A FRIEND WHO IS AN ENT. HE WAS PAID SOMETHING LIKE 113.00 FOR REMOVING A BRAIN TUMOR IN THE HOSPITAL SETTING. THE HOSPITAL WAS PAID 43,0000.00 FOR HAVING THE PATIENT IN THE HOSPITAL FOR 2 DAYS. THERE IS SOMETHING SO WRONG WITH THIS PICTURE!!
I COULD GO ON FOR HOURS BUT MUST GET BACK TO WORK. Maybe when I retire in December, I will write a book, this is NOT going to get better.
Let me know when your book is published!
Hello. I am grateful that I just googled “how to run a medical office” and found this article. After many interviews and putting my resume out in a harsh market I landed an interview for a supervisor position for various medical offices connected to a local hospital. I would manage (day to day operations floating a few days here and few days there traveling between offices) all staff and the physicians on contract. Also budget and medical supplies so forth. Your list covers everything I will be responsible for, which I learned in my interview. I am writing to ask for advice as I have a second interview and also I had a few questions that were asked of me during my first interview. One was how would you deal with a complaint or issues in the office when it came to managing the physician. My answer to this and to the management for medical staff as well would be to first come in asses, gain respect, loyalty and to let all levels of personal in the office know that I was there as a resources and a tool to help everyone succeed and for the office to run smoothly. I do not like to micro manage and believe in education and empowerment of personal (one minute manager/who moved my cheese) Other factors such as meeting budget, HR issues and supplies I answered with also that upon starting that I would pull the last 3 – 6 months of budgets reports (HICKPICKS to meet or be below 20% on coding and review of random medical charts to make sure the staff is properly coding and following up on) or so forth meet with each department (HR, Finance) to find out what the policies and procedures were for the company and to put in place a plan to meet or except the individual office budgets. I also said that if I had a personal issue, I would follow all HR protocol, possible do a verbal then a written warning then escalate any issues depending on who I was dealing with Physician vs general staff and what the issue of course is any hand to HR. I also stated I wanted to develop relationships with all departments and meet with all staff and physicians one on one from time to time to assess how the medical offices and personal are doing. My background is in business administration and project management. However I was a Fire fighter and EMT for 2 years and have several FEMA and other certifications. I do not have a degree but I feel with my project management background that I would like to set up a standard program with projectives and goals for the offices and outside departments. This position is new so I do not have anyone to train with, shadow or starting point. I know I can do this job and I am very excited about it. It was brought to my attention that it would be a challenge (from the interviewer), but with my vast experience in Project management (budgets, goals, timelines dealing with large teams from all departments and businesses) and administration I feel/know I would greatly excel and contribute to great service, work place environment and bottom line for this company. I am looking for your option on what other questions that maybe asked in future interviews and also how to answer how to deal with physicians who sometime (do not like to micro manage) are difficult as I am not as educated and feel that they would not like to take orders or directive from a manager even though they are on contract. Overall I look at my position as someone that a physician can use as a resource to help solve issues but when the issues is them how do I communicate and resolve those issues in the most effective way? Am I going about this multi management of several offices in the right direction? Is there a better way? Any tips? I am great under pressure, excel in challenging environments, have great management and interpersonal skills and can multi task and follow through well. With any experience I believe that we can always make improvements to our self and continually learn from others. Any comments from anyone is appreciate. Thank you for your time.
Probably one of the hardest skills to develop is the ability to create a win/win situation for the hospital and the practice. If the practice is owned by the hospital, the dynamics can be tricky. The hospital employs the physicians, yet the physicians make a lot of money for the hospital. Making that balance work and having the hospital administration feel in command and have an acceptable bottom line, and the physicians feel respected and clinically independent is a Big Deal.
It is important to understand the community dynamics, so if you get the job and you are not local, I would find someone (or several people) to clue you into the healthcare community. If there is a local MGMA chapter, I would join that and get to know your peers in the community.
From everything you wrote, it sounds like you are on the right track. The most important answer you can give to any question on something you haven’t done before is “Although I’ve not done that before, I know where to go to find the answers and I have the experience and skill to put together any initiative.”
Hello Mary, I am so grateful that i found your blog, I been in the biling and coding field for over 10 years, however my last job ended because my boss retired and now I found another job and based on my experience my new boss wants to offer me the position of billing and coding manager, but he would like for me to present him with a proposal on how i would run the office. I need help in how I should start writting the proposal, I have everything in mind but dont know how to put in in paper. Could you please help me? Thank you so much
Are you running the office or running the billing department?
A proposal can easily be written in bullet style, with an initial statement covering the intent of the proposal.
So your proposal might have a statement of intent, then a list of each of the major components you want to cover – Compliance, Human Resources, Productivity, Communication, etc. Don’t feel that you have to write everything out like a research paper, but give enough explanation to get your point across and for someone reading it to understand your points without complete explanations.
THIS IS A PODIATRIST OFFICE. WE HAVE 3 LOCATIONS…3 EMPLOYEES ONE WORKS FULL TIME…THE OTHER 34 HOURS AND THE OTHER ONLY 20 TO 25 HOURS. HE HAS OFFICE HOURS EVERYDAY. HE SEES ON THE AVERAGE ABOUT 110 TO 120 PATIENTS A WEEK. HE HIRED 2 DOCTORS TO DO HOUSE CALLS AND ON THE AVERAGE THEY SEE ABOUT 50 PATIENTS A WEEK PER DOCTOR. HIS BILLING IS OUTSOURCED. MY QUESTION IS: DOES HE HAVE ENOUGH EMPLOYEE FOR THIS SIZE OF PRACTICE?
I WOULD REALLY APPRECIATE YOUR OPINION BECAUSE AS I SEE IT NOW THIS OFFICE IS FALLING APART BECAUSE I FEEL THE OFFICE IN UNDER STAFF…WHAT DO YOU THINK?
The question I would ask you is what is causing you to feel that the office is falling apart?
Are the phones ringing off the hook and staff are not able to return calls in a timely manner?
Is the paperwork to send to the billing service not getting done so your charges and payments are not getting posted within 24 hours?
If you could tell me more about the situation I could give you a better opinion about your staffing.
What do you recommend for someone interested in being a manager for an ob/gyn office who has a business degree in marketing? I also have a well-rounded business education that would allow me to do accounting and all other duties required.
For managers who want to move into the healthcare field, I suggest three things are important to understand and master:
– Revenue Cycle Management: an understanding of medical practice coding, billing and collections
– Electronic Medical Records: knowledge of how EMR technology works and how it impacts workflow and billing
– Physician Relations: an understanding of how physicians think and work and an ability to work comfortably with them without being intimidated
Mary-your posts have been intriging!
I’ve been an EMT and Medical Assistant for about 7 years. I decided to switch to admin and became a receptionist and then a coordinator at a very busy medical practice. My degree is in Health Studies with a minor in Healthcare Informatics. I left my job at the medical practice to work in health insurance. It has been very rewarding especially since I was a new graduate. With less than 2 years under my healthcare admin belt I was offered a position of Office Manager at a new practice a physician I use to work with was opening. In healthcare I’ve come to notice that your relationship with your physicians especially can be door openers. Since degrees in healthcare administration run rapid in my area, experience and connections is really what plays a key part in opening certain doors.
Completely agree with your view point on the importance of Physician Relations.
I love to hear from people how they got into healthcare administration – it sounds like you are well on your way!
Experience and connections are key, and making connections today with social media are much easier then they were “in the old days” when I was starting out.
Thanks for weighing in, Karen!
Pat, I was just wondering if you have found a way to keep all this organized, to be able to get it all done. I do have to do all these and that is my biggest complaint on myself. Finding a way to get it all done and not done at the last minute either. I just cant find a way to get everything done when I want it done. I mean everyone else is happey but I am not. It is hard keeping it all in you head sometimes.
I agree with you, it can be very overwhelming to do this job. What makes the job so difficult is also what seems to attract us to it – the variety and the challenge! It takes a lot of discipline to bring so many parts of the job together, and it can be very hard to prioritize.
It has taken me a long time to be able to say to my boss “Can you prioritize my projects? I have projects A, B and C and I only have time for one project before Monday. What do you want me to do?” If you never ask your boss to prioritize, they will keep piling on the projects and you will keep trying to handle it. Most of us want to be all things to all people, but that isn’t realistic and it isn’t healthy. Learn now to let your boss manage you with your help.
In addition, learn to delegate more, accept less than perfect outcomes, and plan a vacation before you even know you need one so that when you need one, it’s already there for you.
What DONT they do ? Is a better question.
Thank you to the Practice Managers of the world. 🙂
I am currently employed as EHR Dierctor by a large specialty practice (20+ providers). I have spent over 23 years in the healthcare industry in a multitude of positions including Surgical Tech, Medical Assistant, PQRS/MU Specialist, and Site Administrator (including HR, billing, and accounting).
I have recently been approached to manage a very busy 3-physician specialty practice with immediate plans of opening a satellite location as well as physician and staff recruitment. Considering the job requirements compared to your description, it is clearly a Practice Administrator position. (The current “Office Manager” is retiring and has been with the practice for 30 years, so I’m sure the title was appropriate during practice inception.) Once we agree on an appropriate title for the position expectations, what salary do you recommend I negotiate given Salary. Com suggests the median salary in my geographic location is 103K which, I might add, is much more than what is being offerred? Here’s the kicker….. I have a wealth of experience and excellent references, but absolutely no degree!
It’s very difficult to find exact information about what the salary should be for an administrator because there are so many variables: location of the practice, number of physicians, ancillary services, specialty, complexity, what services are outsourced/in-sourced and what the physicians believe about their own take-home pay (ever-shrinking?) and what they’ve paid previously for management positions.
Salary.com is one survey you can use, and others are available from mgma.com, pahcom.com, and the Department of Labor. You can also find information from the specialty society the practice belongs to as well as your local or state MGMA organization. Essentially, you can probably find a survey that will match any number you want, as these sources are not consistent in their ranges. The reason is that, especially for small practices, much of the decision for what salary is appropriate is based on cultural and personal ideologies of the physicians and/or owners.
Your excellent and well-rounded experience is worth more in my mind than a degree. The question is: what do you think you should be making? Regardless of what surveys say – what do you think the job is worth? If the job is a higher level than the practice has had before, are they knowledgeable about what they are getting in a Practice Administrator? Don’t overlook the possibility that you might need to accept a lower salary for the first year and make it up in bonus based on projects such as the new satellite office being completed.
I know I’ve not given you the specific answer you are looking for because it’s just not that black and white. I suggest that the appropriate salary lies somewhere between what the practice is offering and what the salary.com answer is.