Launching a Mohs Surgery Program.

BACKGROUND: There is a paucity of data or publications in the literature on best practices for opening a new Mohs surgery unit. OBJECTIVE: The goal of this article is to be a "how to" guide for starting a Mohs and dermatologic surgery practice. MATERIALS AND METHODS: Two academic Mohs surgeons share their personal experiences and data from the literature. RESULTS: Topics discussed include picking a location and identifying space, equipment, staffing, regulatory practices, policies and procedures, marketing and outreach, patient experience, building culture, clinic efficiency, and vision. CONCLUSION: Although opening a new Mohs surgery unit is challenging, it can be rewarding to have the opportunity to develop best practices and systems that create a wonderful working environment and allow for exceptional care of patients.

Keys to securing data as a practitioner.

With patient identity theft on the rise, it's important that practitioners and patients alike know how to prevent a security breach. Because of HIPAA, physicians that are covered entities are required to take action to protect their patients' medical records or protected health information. Physicians and medical centers should be proactive while securing sensitive data. Some of these safeguards are physical security, electronic security, monitoring, and employee training.

Decoding incident-to and provider-based billing: ensuring payment and avoiding liability.

In this increasingly complex world of Medicare reimbursement, physicians must constantly review their billing practices to ensure compliance with all Medicare requirements. "Incident-to" billing and provider-based billing are two areas that present unique challenges for providers, especially those practicing in hospital-owned practices such as hospital outpatient departments. Both incident-to and provider-based billing limit providers' abilities to bill for and receive reimbursement in those practice settings. The Office of Inspector General's 2012 Work Plan Report identified both incident-to billing and place-of-service errors as two of the many areas for investigation and compliance efforts in 2012. This article focuses on identifying the unique point-of-service challenges presented by physicians practicing in hospital outpatient departments or hospital-owned clinics.

Consent by proxy for nonurgent pediatric care.

Minor-aged patients are often brought to the pediatrician for nonurgent acute medical care, physical examinations, or health supervision visits by someone other than their legally authorized representative, which, in most situations, is a parent. These surrogates or proxies can be members of the child's extended family, such as a grandparent, adult sibling, or aunt/uncle; a noncustodial parent or stepparent in cases of divorce and remarriage; an adult who lives in the home but is not biologically or legally related to the child; or even a child care professional (eg, au pair, nanny). This report identifies common situations in which pediatricians may encounter "consent by proxy" for nonurgent medical care for minors, including physical examinations, and explains the potential for liability exposure associated with these circumstances. The report suggests practical steps that balance the need to minimize the physician's liability exposure with the patient's access to health care. Key issues to be considered when creating or updating office policies for obtaining and documenting consent by proxy are offered.