September 2002

Playing the Championship Game
Why Detailed Job Descriptions Make a Difference
By Timothy J. Gay, DC

In every game that requires teamwork, one of the keys to the great success of the team is the necessity for all the players to have a detailed job description. Their responsibilities and job requirements are what make them accountable for their positions.

Anyone who watches sports can relate to the broken plays or miscommunications that were major components that cost a particular team a championship that they had worked hard for all season. Likewise, in a chiropractic office, some of the reasons offices don’t succeed may include something that was overlooked, a missed telephone call that was a new patient, schedules not being kept by patients, or important reports that have not been sent.

The players in your office should be a finely tuned team and have an in-depth understanding of the importance of their roles in your office. Everything that happens in the office revolves around how well your staff members are trained in their specific positions.

Have you ever watched a football game where the coach had three quarterbacks that are playing at the same time? Of course not! That is why it’s always imperative to look at what each player does best and use them in their most useful position.

Many times, we waste the potential of our best players by not putting them to their best use. Some players should be cross-trained and taught to play other positions in the office; notice the key word is taught. We must make sure everyone on the team understands the role they have been given. A common mistake is to put someone into a position with inadequate training and still have the same high expectations of doing the job well.

The vital step in creating your winning team is to have job descriptions for your players. You should have complete job responsibility lists for every position in your clinic. These lists are a key factor in creating an efficient and successful team. Outlines of specific responsibilities that the players are to perform create the clear understanding as to what is expected of them.

Here are some examples:

• The Coach aka The Doctor

Financial Management:
- Budget
- Fees
- Salaries
- Overhead

Vision and Planning:
- New staff
- Practice growth
- Purchase new equipment
- Remodeling

Marketing:
- Attorney letter program
- Direct mail
- Networking
- Newspaper
- Yellow Pages
- Presentations to groups
- Referral programs
- Safety presentations
- Spinal care classes
- Spinal screenings
- Testimonials
- Speaking engagements in the community

Office Procedures:
- Developing and implementing procedures
- Effectiveness of procedural changes

Patient Care:
- Bond with each patient every visit
- Case history
- Conduct consultations
- Provide education to patients
- Conduct examinations for new patients and re-examinations for continuing patients
- Give recommendations for multiple appointment scheduling
- Conduct patients’ report of findings
- Treat/adjust patients
- Take, develop and analyze X-rays

Administering the Practice:
- Associate doctor program
- Be a loving, caring, supportive manager, but an authoritative figure
- Ensure coverage of patients during vacations, etc.
- Hire good people
- Terminate when necessary
- Interview potential candidates
- Job descriptions
- Motivate staff and maintain morale
- Enforce office policy
- Pay the bills
- Give performance evaluations to staff
- Policies/contracts
- Staff meetings
- Staff training

• The Quarterback aka The CA
- Answer incoming phone calls.
- Retrieve calls from answeringmachine.
- Write up charges and pull treatment cards.
- Escort new patients to consultation room or examination room; for regular patients, use the clip system to channel them to the right adjusting room.
- Make scheduled appointments.
- Tally daily sheets and monies at the end of the day.
- Learn how to develop X-rays.
- Use the Recall System to take care of missed appointments - call patients and establish new appointments.
- Pull old treatment cards.
- Get new patients’ folders ready before the patient arrives. Prepare the file, treatment card, invoice, and X-ray card for each new patient.
- Have new patient fill out proper insurance information or necessary personal injury or workers’ compensation forms.
- Get patients ready for reports - set up the report room and put the file in the file outside holder. Notify the doctor.
- Release X-rays to patients and copy treatment cards when requested, after checking with the doctor.
- Let doctor know when a patient is ready for an exam by having the chart outside the door in the file holder.
- Take messages for doctor.
- Process credit card payments.
- Pull X-rays for doctors when requested.
- Send birthday cards to patients with complimentary adjusting cards.
- Send referral thank-you letters.
- Update referral board.
- Maintain letter program.
- Maintain appearance of office by keeping front office tidy. Pick up necessary papers, books, etc., in the reception area. Keep the work area neat and orderly. Check all rooms periodically. Vacuum if necessary.
- CA report or financial reports.
- Once a month, check out the entire office from the patient’s point of view. Sit down in the various chairs in the reception room. Lie down on the adjusting tables, etc. Sometimes perspective is the only way to detect peeling wallpaper, crooked pictures, the need for paint touch-ups, etc., that deter from the professional atmosphere of the office.

• Offensive Line aka Insurance CA
- Prepare insurance packet and claim forms for each insurance patient.
- Verify insurance coverage as soon as possible with the patient.
- Financially counsel all new patients.
- Enter patient information in the computer or complete file manually in non-computer office.
- Bill insurance claims, according to daily, weekly, or monthly billing schedule.
- Call insurance companies regarding lag in return of payment after claim is mailed. Run aging report on a monthly basis to help keep track.
- Bill secondary insurance carrier once primary carrier pays.
- Make necessary calls and
correspondence with insurance companies as problems arise. Be prepared to make copies of ledgers, reports, etc. for insurance companies and patients, upon their request; check with the doctor before sending any records out of the office.
- Compile reports and narratives for insurance companies and attorneys when doctors makes request.
- Post all communication logs with the various activity that has taken place on an account, such as insurance feedback, complaints, etc.
- File copies of EOBs and claims forms in patient files once claims have been paid.
- Prepare and make deposit daily.
- Assist the front desk CA with balancing daily ledger sheets if necessary.
- Once a month, go through all the patient records to identify accounts to bring to the doctor’s attention for possible collection action. If the doctor advises collection action, prepare materials and start the collection process.
- Call patients about their past due accounts. Mail additional statements to patient if necessary.
- Discuss accounts with patients in a private room in the office as necessary.
- On a regular basis, check patient accounts for secondary billings.
- Prepare monthly billings.
- Once a claim has been completely paid, file copies of EOBs and claim forms in patient file.
- After insurance billing is finished, file patient folders.
- Open and distribute mail daily. Process and mail outgoing mail daily.
- Process insurance correspondence.
- Provide front desk back-up when front desk CA is unavailable by making appointments for patients, answering the telephone, and
filling in wherever necessary.
- Assist with keeping office appearance tidy and comfortable.

You can use these job descriptions as a solid starting point, and then you and your team can fill in the gaps by including information specific to your practice. When it comes to staff management, remember that teamwork counts.

Dr. Gay has had a long-standing and successful 23-year career as a chiropractor. He is now a national speaker and president of Ultimate Practice Systems, based in San Marcos, Calif., managing and consulting with chiropractors across the nation on practice success. He can be reached at 866-797-8366; ultimatepractice@aol.com; or via his company’s website at www.ultimatepracticesystems.com