Billing, coding, and practice management: a primer for today's reproductive medicine professional.

Despite years of recognition that many physicians are woefully unprepared to face challenges regarding the business of medicine, marginal progress has been made. In this piece, we aim to provide the contemporary reproductive medicine physician with an understanding of billing, coding, and, most importantly, cost containment for a typical fertility practice. It is critical for modern practices to not forego hard-earned revenue to insurance companies or not be aware of critical rules and regulations. While running a successful fertility practice requires good medical care, a profitable practice is necessary for overall long-term success. This article provides a brief history of medical insurance and billing, explains the process of updating billing codes, and reviews the revenue cycle, cost containment, and contract negotiations with insurance companies.

Practice management/role of the medical director.

Although the nature of ambulatory surgery has changed over the years, the ideal role of the medical director mirrors its earliest iterations, focusing on excellent customer service and high quality of care. These efforts are supported by 3 modern methods of quality management borrowed from industry: intentional process improvement, standard care pathways, and monitoring outcomes to determine the efficacy of each. These methods are critical to master in order to lead the facility and providers to the highest quality of care and service.

Sigmund Freud's practice: visits and consultation, psychoanalyses, remuneration.

This paper provides an overview of the quantitative side of the systematic records kept by Freud on his practice. He left precise records of the duration, frequency, and fees of psychoanalytic treatments. These statistics are compared with the treatment duration and frequency customary in present-day psychoanalytic practice in German-speaking countries. The results suggest that, regarding frequency and duration and their relationship, there is little difference between Freud's psychoanalytic practice and that of the present day.

Hospital governance and the medical practitioner in Belgium.

PURPOSE: This paper aims to attempt to explore current transformations in hospital governance by tracing the evolution of medical autonomy in the Belgian hospital sector in the second half of the twentieth century. DESIGN/METHODOLOGY/APPROACH: Using published secondary sources and archive data the paper developed a historical approach to the relationship between profession and organisation, asking qualitative questions of the characteristics of professional power and knowledge. FINDINGS: Since World War II, two important evolutions have occurred: first, the hospital evolved into an organisational entity that is described as a "professional bureaucracy"; second, at the sectoral level the hospital adopted a position that is characterised as a "divisional structure". Both evolutions are linked by the processes of rationalisation and bureaucratisation. The findings do not support the thesis of an overall loss of autonomy but bring into focus the transformation of medical autonomy. New forms of professional power and knowledge are emerging with the processing (bureaucracy) and pre-processing (rationalisation) of information on medical work as key elements. ORIGINALITY/VALUE: The paper explores the evolution of the medical profession's autonomy in the second half of the twentieth century. It highlights reflexivity in the changing relationship between professions and organisations and how physicians are becoming "managers of expertise" who are important for both the hospital organisation and the state.

Practice development credentialing in the United Kingdom - a unique framework for providing excellence, accountability and quality in nursing and healthcare.

This paper will describe the purpose, process and value of an international Practice Development Program by which clinical units can choose to be credentialed. It will describe how the fourteen criteria that a Unit is credentialed against takes them along a journey of practice, personal and professional development that equips them to not only positively respond to, but to proactively influence, the challenges and changes that healthcare is facing globally. It explains how The Program focuses on credentialing sustainable practice development that then contributes to the development of both the capability and capacity of healthcare services. As a result, it crosses professional and organisational boundaries and constraints and concentrates on their shared purpose, delivering excellent patient care.