Barbara C Phillips, NP

In today's economic climate, your business is most likely feeing a pinch. Here are a few things you can do to reduce your overhead and improve your revenue.

STAFF: Take a good look at staffing. You want to look beyond the cost of the individual. Staff members who are efficient, can multi-task and are a pleasure to work with is almost always well worth his or her weight in gold. Look for ways to utilize staff more efficiently and make sure you listen to their suggestions - often they know exactly what is needed.

BUILDING: Assess your need for the amount of space you have and how well you are utilizing it. Perhaps you can get by with less space. If allowed by your lease, consider subletting space to other providers such as nutritionists, acupuncturists, mental health professionals as well as other medical providers.

If you are purchasing your space, is it possible to get a more favorable mortgage?

COMMUNICATIONS: You may have some wiggle room here. Evaluate your phone service: the number of lines, the level of service, and what it includes (ie, internet service). With all the competition out there, you may be able to find a better package elsewhere. Do you really need all those lines, or do you really need more of them? (Too many or too little can certainly affect your office efficiency.)

OFFICE SUPPLIES: Consider buying your supplies in bulk. Often you will save money by purchasing in larger supplies at a big box store rather than you smaller local office supply. What about purchasing as a group with other NPs and providers in solo practice? You'll all save. Don't forget to evaluate for waste. And please recycle when possible.

MEDICAL SUPPLIES: Look for waste here as well as utilization. This is another ideal place to buy in bulk. Do shop around; the difference in prices from vendor to vendor is amazing. And don't forget to check out medical surplus stores as well as eBay.

THE SCHEDULE: Are you seeing enough people? How many no shows are taking up space? It may be time to re-evaluate your office policies regarding this. People who take up space and don't show cost the practice revenue.

If you are not seeing enough people, you may need to take a look at your marketing activities. What can you do to bring in more clients?

TIME MANAGEMENT: Are you using your time, and the time of your staff efficiently. We recently looked at how much time we were spending on referrals for a particular managed care plan and found that we were actually losing revenue by seeing those patients. It was taking us much more time to locate specialists accepting this plan and processed those referrals. In other words, because of the inefficiencies with this plan, we were actually in a deficit by seeing patients belonging to this plan.

ANCILLARIES: consider value added services that will generate cash. For example many providers now offer aesthetic procedures, or they carry a line of high-quality pharmaceutical grade supplements. You will need to check the legalities for your locale.

DO MORE PROCEDURES: instead of referring out that I&D, learn how to do them. In addition, you may want to learn how to do biopsies, nail removals, and joint injections. Procedures, almost always pay better than office visits.

REIMBURSEMENT: You will want to evaluate your billing procedure and follow-up. Make sure you are collecting co-pays up front, you are capturing all charges, and denied claims are followed up in a timely manner. Also consider renegotiating your reimbursement rate with insurance companies.

While we are all in the business of providing excellent healthcare services to our clients, we are also in business. In order to stay in business and serve our clients we must remain fiscally sound.