Executive Update

January 2006   

The Exit Interview

Turnover is a reality for most practices. So your soon to be “previous employee” will be departing the practice. What can he or she possibly have to say that you really want to hear? This was how I had perceived the Exit Interviews in past years. Recently, I have come to recognize the value of this process. No longer do I view it as an optional management tool but I now see the Exit Interview as a due diligence process necessary to improve my management skills and to protect the practice.

The process of conducting an Exit Interview is not a lunch date where you casually ask the departing employee what they think about the organization. It is an information gathering process that does not have to take a lot of time but does need to be completed in its entirety. Some time ago, I was motivated by a form that Walt Underwood of Thomas Eye Group posted to E-talk. We utilized Walt’s experience and developed our internal form (133K)  for documenting Exit Interviews. The first page is completed by the employee and the second page is completed in tandem by the interviewer and the employee’s supervisor. The form facilitates a process that has multiple purposes.

Achieving a mutual understanding 
Both the departing employee and the practice will benefit from this process. You will understand the reason(s) the employee is leaving. This information is also helpful in the event you have to respond to a claim for unemployment benefits, an EEOC complaint or other legal inquiry. While the existence of the documentation may not in and of itself prevent paying these demands, it will ease the investigation process by documenting perceptions of both parties. 

Further, the employee may benefit from another opportunity to help you understand what they think about the practice. Channeling accumulated ill will may not be a pleasant experience but it is important to give the employee an opportunity to voice any resentments during the exit interview and better to hear these now than later on (as in only after receiving notification of a wrongful termination claim).

By forcing the supervisor or yourself to complete the Exit Checklist, you know the employee has been properly informed as to how compensation and benefit matters will be handled. This can serve to reduce or eliminate those phone calls that come in later.   

Documenting compliance
In question four of the Exit form, employees are asked, “Did you know or have knowledge of any activities or procedures within the practice that would be in violation of any laws, regulations, or that you considered unethical or illegal?” By directly asking the employee to report any perceived inappropriate activities or procedures, you have documentation that they either were not aware of any such activities or chose to not follow the procedure for reporting them.

This may be of little consolation should the employee attempt to become a whistle blower or bring some sort of legal action but, in these circumstances, all documentation helps. Plus, maybe they really do know something you don’t!

Administering compensation and benefits properly 
Prompt notification to all benefit carriers reduces the possibility that the practice will be billed for another month of coverage inappropriately. Utilizing the Checklist prompts you not only to notify the health insurance carrier but also to think about how the employee Cafeteria/Flex Plan balances will be handled and when and how their retirement plan balances can be accessed. Only recently did I become familiar with the requirements for COBRA notification on the Cafeteria Plan.  I also was not aware of the actual state law requirements regarding the issuance of final employee paychecks.  If you have to teach someone else how to explain these things, you become much more consistent with how you handle the details.

Properly securing the patient record and the practice 
In an electronic environment, all passwords need to be disabled immediately. Most computer systems allow the system administrator to access the passwords but it is still a good idea to obtain this information from employees. Review the employee e-mails still in the system, disable all passwords and remove the employee as a user of the system. Ask the employee what keys they have, even if you think you know. Be sure to collect all keys before the employee departs the practice. It is also recommended that you change the locks or the codes to the security system.

Undergoing a momentary reality check 
Regardless of efforts to stay abreast of the morale of our staff and the employment marketplace, it is possible that our impressions are not totally in touch with reality. Soliciting simple input from a departing employee about their experience tests your impressions and perhaps may lead you to tweak practice policy and procedures to prevent future employee loss. For example, did the employee perceive the pay to be fair given the skills required and work load?

The benefits of following this one-hour personnel procedure can be many. The documentation and responses will have more credibility if done by someone who was not involved in the supervision of the employee. Don’t do it yourself and don’t have the supervisor do it. You will probably find the departing employee will be much more open with an emotionally removed individual. Whomever you select, the interviewer should be someone you trust to be professional and keep the information shared confidential.

Retention of our experienced workforce is a large part of our administrative challenge. When your employees consider the practice to be a good place to work, Exit Interviews should only be an occasional occurrence and should provide you with valuable feedback to make reasonable improvements to recruitment and management practices. The process can be quickly put into place moving “best practice” procedure into the “we do that” category.

About the author: Ann Hulett is the administrator of Rocky Mountain Eye Center and the 2006 chair of the AAOE Board of Directors. She has more than 20 years of management experience, inclulding 12 years in medical management. She has worked six years in her current position for a comprehensive eye care organization in Pueblo, Colo. which includes seven general ophthalmologists, an oculoplastics specialist, a retina specialist, three optometrists, an ASC, six satellite offices, seven optical shops and just over 100 employees. She has served on the AAOE Board of Directors since 2003.

Bulletin Board

CODEquest in the New Year
Optimize your practice’s revenue through accurate coding. AAOE’s CODEquest Ophthalmic Coding College 2006 is a convenient one-day seminar sponsored with your state society to get you up–to-speed and up-to-date on state and specialty-specific coding information. Find out what’s new in 2006 with the latest coding updates.

CODEquest seminars will be held in Arkansas, Kentucky, Minnesota and South Carolina in January. February sessions will be held in North Carolina, Oklahoma, Tennessee and Utah, followed by March sessions in Texas and Washington. Additional seminars will be added throughout the year. Complete schedule and registration instructions

Do you have vacancies to fill in your practice?
Professional Choices, the online ophthalmology career center, is the most efficient way to find qualified ophthalmologists, administrators, registered nurses and technicians looking for work in your area. Listings are continuously updated, and you can sign up for regular e-mail alerts of candidates meeting your criteria. At $335 for a 90-day job listing, Professional Choices ad space costs less and is more targeted than classified newspaper ads. Professional Choices is always free for job seekers.

2006 Ophthalmic Coding Coach now available
A complete coding guide for minor, major and special testing services in ophthalmology, the 2006 Ophthalmic Coding Coach is the most comprehensive coding reference available. New this year: the option of purchasing the Ophthalmic Coding Coach in book version (012201), on CD-ROM (012301) or together as a kit (012303). For more information, or to place your order, visit the Academy Store.

Did you pre-order your copy of the 2006 Ophthalmic Coding Coach? Advance orders will ship in early February.

Test your coding knowledge
The Ophthalmic Coding Specialist™ (OCS) exam is offered year-round to coders who want to demonstrate coding proficiency. Those who pass the take-home exam will be awarded the OCS designation. AAOE’s Ophthalmic Coding Series is the perfect study guide. The 2006 edition is on sale now.

To learn more about the Ophthalmic Coding Specialist Exam visit www.aao.org/aaoesite/coding/ or contact JCAHPO at 800.284.3937.

AAOE to host its first Web conference
Maximizing Your Optical Dispensary: Pitfalls, Pearls and Profit Potential is scheduled for March 14. The Web conference will be delivered live over the telephone. Participants will be able to view the speaker Art De Gennaro’s slides as he presents. Registration details

Did you miss the 2006 Coding Update Audioconference?
Audiotapes, CDs and handouts of the Jan. 10 AAOE audioconference are now on sale. Sue Vicchrilli, COT, OCS, Academy coding executive, discussed how the 2006 changes affect ophthalmology practices and income, and answered questions from participants. The cost of the recorded audioconference and handouts is only $115. Order online or call 800.651.7916.

AAOE welcomes two new board members
Pamela Andrews is the administrator of ARENA Eye Surgeons, Columbus, Ohio and Sandra Farr is the lead coding and reimbursement specialist for the Texas Tech University Health Sciences Center, Department of Ophthalmology. AAOE Board of Directors

January Issue of EyeNet Magazine is now live
Savvy Coder tells you what you need to know about the activities that the Office of Inspector General will scrutinize in the next fiscal year. Practice Perfect discusses how you can create a low vision-friendly office without breaking your budget.

Share your insight with your peers
AAOE is currently seeking:

• Article submissions for the Executive Update. 
• Moderators to discuss a practice management topic on the E-Expert listserv and during the Annual Meeting
• Course panelist during the Annual Meeting

Contact Donna Lock for more information.