Part B Insider (Multispecialty) Coding Alert

The more eye contact, the better the information flow

Are your physicians and billing staff locked away in separate boxes?

Having a more open layout to your office can improve communication and create more of a sense of teamwork, say experts. Of course, examination rooms need to be closed off from the rest of the office, but there's no reason to have walls separating billers, coders, administrative people and doctors from each other.

Some practices are experimenting with increasing the amount of eye contact that doctors, nurses and administrative staff can have from their work areas. Having fewer  barriers "opens the lines of communication," says consultant Gail Lorenzen with the Sage Group in Newbury Park, CA. When doctors are "tucked away, they have a tendency to stay in a routine and not talk to the staff, and the staff sense that."

In some newer practices, you'll experience the feeling of openness as soon as you walk into the reception area. Instead of a big wall with one glass window, there's more glass and you can see into the rest of the office. "It's not like you're going into some jail," says Lorenzen.

And in these offices, the billing staff is in the same open area behind the reception desk. They may be in cubicles or have their back to the receptionist, but "they can still hear what's going on," says Lorenzen. "They're not completely isolated in an office. If they have a question, they can feel comfortable and confident going and asking someone," without having to knock on a door.  Also, these offices will have a nurse's station out in the open, with exam rooms both to the left and the right.

When the staff and the physicians can interact more during the day, it makes them feel like a team," Lorenzen says. In turn, the physicians know what the staff is doing, and don't get blindsided by new developments.

Non-verbal elements of communication such as eye contact are more important than people realize, says David Hester, a risk management consultant with American Physicians Assurance Corp. But the more open the floor plan, the more you must be concerned for Health Insurance Portability and Accountability Act (HIPAA) privacy compliance.

Another downside to a more open layout is that the physician may become distracted or confused when she's trying to focus on something, says consultant Owen Dahl with SALCO in New Orleans. But Dahl has definitely seen a more open plan work in an oncology office with open infusion suites where the physician and nurse can communicate from one suite to another.