Key to Quality Care is Managing Practice Operations Efficiently: MSHP Spotlight on CIN Primary Care Provider, Dr. Danuta A. Jankowska
Fee schedules. Coding. Rejected claims. Managing overhead. Staff communications. The financial and business elements of running a practice aren’t often covered in medical school and can be a cause of burnout for many physicians. We sat down with primary care physician, Dr. Danuta A. Jankowska and her brother, Legal Analyst and Chief Clinical Officer, Dr. Slawomir Jankowski, to discuss their approach with managing the financial and business operations to ensure they get reimbursed appropriately so that they can truly focus on quality care for their patients.
Like many of our physicians in the CIN, Dr. Danuta A. Jankowska was inspired at an early age to become a physician. When she was 11 years old, she was terrified of not knowing how her father would be after an open heart surgery. But to this day, she remembers the cardiologist who gave her and her family the comfort and peace of mind that her father would be okay. From that moment forward, she knew that she wanted to be a primary care physician — someone who would play an important role in patients’ lives. However, Dr. Jankowska learned very quickly that setting up a private practice would not be easy.
Dedicating Time to Understand Billing Operations
For Dr. Jankowska, the biggest challenge was ensuring patient quality while financially sustaining the practice. She recognized the importance of taking time to review practice operations, particularly around billing. She wanted to give her patients quality time and care and to be reimbursed appropriately for that time, and not rely on providing minimalistic care for a greater patient volume.
After working with several billing companies and starting from scratch each time to find one that worked for her, she decided to address the challenge herself. Together with Dr. Slawomir Jankowski, the two brainstormed a solution that would allow them to take control of their billing challenges. They considered hiring a private tutor, looked into media and academic resources, and studied payer feedback when the plans denied claims. They spoke with different billing experts and researched specific codes.
Being Consistent and Persistent with Payers
One of the most important aspects of their billing transformation, though, was fearlessness and persistence in challenging payers. According to the Jankowskas, the key is to be consistent, follow through, and unafraid to keep asking until you get an answer. They soon proved to payers that they could substantiate whatever their claims were and that they would follow up with phone calls and faxed letters until they got an answer.
“Physicians should write appeals. Don’t be afraid to ask for what you’ve earned and can substantiate. Show the insurance companies that you know what you’re doing and you do it right and to stop making each other’s lives difficult,” Dr. Slawomir Jankowski said. Getting to this point wasn’t easy or quick, but they have worked hard to get their reimbursement rates to as much as 98%.
Relying on Team Communications
In addition to managing her billing operations, Dr. Danuta A. Jankowska implemented team meetings. She believes in the power of empowering her team and developing strong team communications. While she has a small team of three now expanding to four, being part of the Clinically Integrated Network helps relieve some administrative burdens, such as credentialing. Dr. Danuta A. Jankowska handles all the clinical work with the help of a nurse practitioner and partial aspects of the billing, Dr. Slawomir Jankowski manages the legal and clinical-administrative leadership of the practice, including billing operations, and an administrator manages the front desk and any additional administrative tasks. As a team, they meet weekly on Thursdays for just 15 minutes after patient visits are complete to review outstanding issues, obstacles, and what’s coming up. Through these brief meetings, everyone knows what they’re doing and issues never stack up.
Minimizing Inefficiencies for Quality
Knowing that she’s not losing revenue due to inefficiencies with billing and administrative operations, Dr. Jankowska doesn’t feel pressured to try to squeeze in another patient or two. She notes that her patients are happy because she spends more time with them than they may be used to. She greets them at the front desk, takes their vitals, and walks them out after their appointment. This additional facetime also means more opportunity for patients to discuss their concerns. The quality time she can spend with her patients and the comfort she can provide is ultimately what she had hoped for at the age of 11. It’s at the heart of why she practices.
If you are interested in being featured in the MSHP Provider Spotlight Series, please contact Tiffany Cheng at Tiffany.Cheng@mountsinai.org.
Click here to read our previous provider spotlight, Cultural Medicine, Coast to Coast: MSHP Spotlight on CIN Family Medicine Provider, Dr. Margaret Kearns-Stanley.
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