THE VOICE
December 1999
Wow, it's hard to believe that 1999 is coming to an end along with the century and millennium too. The leaves have fallen from the trees and the holiday season is fast approaching Autumn is my favorite time of the year because it means the start of football season, raking leaves, preparing for the holidays and for a new year for WMCA. It's the time when I ask myself; "What still needs to be accomplished by the end of the year?"
Deb Gustafson and the Quarterly committee d id an excellent job on the October meeting held on a beautiful autumn day. For those who missed it, the presentation on APC's was very informative. WHA recently sent a memo stating "It's looking more and more like HCFA will implement, by as early as July of 2000, its new payment system for outpatient services, using Ambulatory Payment Classifications (APCs). "Brian Potter and George Quinn from WHA have agreed to be at our December meeting to listen to our concerns.
I hope to see you at the next WMCA meeting at the Crowne Plaza in Madison December 10. Besides WHA, the program includes representatives from Medicare, Medicaid, and The American Collectors Association. It looks like an excellent workshop that you won't want to miss.
I'd like to take this opportunity to welcome new WMCA members: cbix inc.; Von Briesen, Purtell and Roper; and WHIN. If you know of an organization that is interested in becoming a member of WMCA, give them our e-mail address or the application included in this issue of the Voice. Also a reminder to renew your WMCA membership. Statements went out October 15, 1999. If you did not receive yours, please call Steve Baseley at 920-926-4464.
On behalf of the WMCA Board of Directors and staff I would like to wish each of you a joyful holiday season and a New Year filled with love and good fortune. Enjoy it with family and friends.
Jackie Lippe
President, WMCA
Writing Compliant Collection Notices
The following is an excerpt from the Legal & Legislation Service Booklet, a publication of the American Collectors Association's Health Care Services Program.
Question:
A hospital is currently using a three part series of collection notices, which state as follows:
Answer:
The FDCPA does not apply to the hospital in his case. The FDCPA does not apply to a creditor collection debts in its own name.If the hospital is a non-profit, charitable corporation, then Section 5 of the Federal Trade Commission Act will not apply to the hospital's conduct either. The FTC lacks jurisdiction over non profit corporations which do not have shares of capital, which are organized for and actually engaged in business for only charitable purposes, and which do not derive any "profit' for their members within the meaning of the word "profit" as attributed to corporations having shares of capital. Therefore, there would be no violation of the FTC Act if the hospital is not subject to the jurisdiction of the FTC.
Assuming the FTC does have jurisdiction over the hospital (if it is for-profit), stating that the failure to pay could jeopardize the patient's credit rating could violate Section 5 of the FTC Act. The hospital cannot threaten to report the account to a credit reporting agency unless the hospital intends to take such action. Threat of such action without intent of carrying out such a threat or a past history of following through on a threat is a deceptive act and is unlawful under Section 5 of the FTC Act.
Similarly, the threat of legal action by " legal collection representative" without any intent of carrying out such a threat or a past history of following through on such a threat is also a deceptive act, which is unlawful under Section 5 of the FTC Act. Merely referring the account to a collection agency would not be sufficient action. Moreover, for the notice not to be deceptive, this action would have to be taken once payment was not received within ten days, as indicated in the notice.
The updated 5th edition of the Legal and legislative Booklet is now available! The booklet contains over 60 questions in the areas of provider billing and collection practices, collection agency practices, provider treatment obligations, payments and debt responsibility. Each question has been answered by Basil J. Mezines, the American Collectors Association's general counsel in Washington and former executive director of the FTC.
Addressing issues such as statute of limitations on billing, the Truth in Lending Act, the Fair Credit Billing Act, collection notices, charging interest and fees, token payments and guarantor responsibility, this booklet is an excellent reference for every billing and collection professional.
To obtain copies of the HSP Legal and Legislative Booklet for your staff, healthcare providers should contact the HSP member who sponsors this newsletter for you.
Note: The legal guidance given by ACA's legal counsel is not in tended to replace the advice of the healthcare provider's or collector's own attorney, but to supplement that advice in the areas of credit and collection where specialized legal knowledge is useful . Information in the booklet is accurate as of the publication date. Please note that the relevant laws may change over time.
Reprinted with permission of State Collection Service Inc., Madison, WI "Pulse".
www.medicaretraining.com
By: Rich Donkle
Rural Wisconsin Health Cooperative 608-643-2343One of the challenges of compliance faced by smaller providers is related to staff education. Finding appropriate, economical and relevant training for staff can be very difficult.
Now, HCFA training is available through the Internet. The Website, www.medicaretraining.com, offers basic Medicare information and computer-based training in seven topics. It is available free of charge.
The basic information is entitled "Introduction to the World of Medicare," providing the basics about the Medicare program.
The Seven topics now offered are:
•HCFA - 1500. This lesson provides essential information required to properly complete the HCFA - 1500 claim form for Medicare Part B.
•Home Health Agency. This lesson emphasizes the guidelines that providers must follow when dealing with home health agencies.
•HCFA - 1450 (UB92). This lesson provides essential information required to properly complete the HCFA - 1450 claim form for Medicare Part A.
•Fraud and Abuse. I his topic emphasizes the prevention and early detection of Medicare fraud and abuse in a practice setting.
•ICD-9-CM Diagnosis Coding. click on this lesson to learn how to use the ICD-9-CM manual for correct diagnosis coding for Medicare.
•Medicare Secondary Payer (MSP). The MSP course provides information about the Medicare Secondary Payer program.
•Front Office Management. The Front Office course provides the essential knowledge and skills needed for checking in Medicare patients.The lessons are intended for beginners, as well as advanced students.
Each topic can be downloaded on a local computer and can he used by several individuals. Based on an individual initial assessment, the training is tailored to meet the needs of the person using the training. Topic areas can be completed in one session or over a period of time. Each individual's course is password protected so the topics can be accessed by several individuals who each can have a course tailored to their own needs.
Providers should take advantage of this computer-based training to provide some of the education required in compliance plans. Compliance officers should determine how to integrate this training into their compliance education requirements.
Another valuable source of compliance information is available through HFMA's Compliance Officers Forum. This forum exists to meet the specialized educational, technical, leadership and networking needs of traditional and emerging health care compliance professionals. Joining the forum is one way to make sure you are at the fore front in dealing with compliance issues.
state of Wisconsin
Share your experiences!
A wedding?
A significant Anniversary
A job change?
An unusual vacation?
A new baby?
An unusual experience?
A promotion?
Commentary!Are any of these events going on in your life or of anyone we know?
Call Bud Brauer at (414) 964-6000 or fax Bud at (414) 964-6040Whatever Happened to Common Courtesy?
I'm sure that my comments and thoughts expressed here will he considered "old fashioned" by at least some of you. But I don't happen to think that technology and the " promises" of the new millennium should overshadow common courtesy. Nevertheless, they seem to be. Allow me to illustrate.
On the Road...
Trying but not quite making it through the left turn arrow before it goes out, thus delaying the oncoming traffic and nearly causing an accident.
When planning a turn, slow down first, then put on the turn signal.In the checkout lane...
Taking 12, 15, or even 20 items into the 10 or less lane. So what if the next person has three items and a crying baby?
Waiting until the cashier has told you the total, then start fumbling for the money. Wasn't paying for it something you had in mind?On the phone...
Having call waiting relegating the first caller to second place as if it is expected.
Employing caller ID privacy manager, and using voice mail and answering machines to "screen" calls. And my very favorite is simply not returning calls.
Why not just disconnect the phone and be done with it?And while I'm on the soapbox, how about this piece found in the Metropolitan Milwaukee Association of Commerce "hotline."
"Slobbing of America" - Men wear caps, women jeans in good restaurants. Casual Friday is all week. Plane passengers look like flood victims who've lost their good clothes. Retirees brag they haven't worn a tie in years, even in church where we see shorts but don't know if God notices. In USA Today, a consultant on such matters said firms are tightening dress codes to discourage sloppy, provocative, and even ghastly, attire.Summing it up...
The following is reported to be written by ~ Columbine High School student and found on the Internet. "The Paradox of our time in history is that we have taller buildings, but shorter tempers; wider freeways but narrower viewpoints; we spend more but have less; we buy more but enjoy less. We have bigger houses and smaller families; more conveniences but less time; we have more degrees but less sense; more knowledge but less judgement; more experts but more problems; more medicine but less wellness. We have multiplied our possessions but reduced our values. We talk too much, love too seldom, and hate too often. We've learned how to make a living, but not a life; we've added years to life, not life to years. We've been all the way to the moon and back, but have trouble crossing the street to meet the new neigh bor. We have conquered outer space but no inner space; we've cleaned up the air but polluted the soul; we've split the atom but not our prejudice. We have higher incomes but lower morals; we've become long on quantity but short on quality. These are the times of tall men and short character; steep profits and shallow relationships. These are the times of world peace but domestic warfare; more leisure but less fun; more kinds of food but less nutrition. These are the days of two incomes but more divorce; of fancier houses but broken homes. It is a time when there is much in the show window and nothing in the stock room; a time when technology can bring this letter to you, and a time when you can choose either to make a difference...or just hit delete."Congratulations!
After an ever so brief stint as Collections Unlimited, Kenlyn Gretz has returned to Americollect in Manitowoc - not to the collection manger position he left, but the new owner. Kenlyn had replaced Brenda Wagner as CU I ' s production manager. Best wishes for success!And speaking of Brenda, she has moved on as well, leaving PRM and the collection business to pursue other business interests.
Karin Harras, another former CUI employee has replaced Brenda at PRM.
Personally Speaking
For those of you who have heard for the past six years about the planned Brauer family millennium trip to Disneyworld, the time has come. You will hear no more. All 29 1/2 of us leave December 26th (yes, we are expecting grandchild #17 in March) and return on January 3, 2000.
Best Wishes
To all for a Happy Holiday Season.Benchmarking: Measuring Yourself Against The Best
Want to get better fast? Learn from the hospitals who do it best.By David Zimmerman, Chief Executive Officer Zimmerman & Associates
Desperate times breed desperate actions. Some hospitals have decided to take dramatically different approaches to managil1g receivables, and thereby put themselves in a much more favorable financial situation, particularly with Y2K payment problems looming on the horizon.
Turning around financially-troubled hospitals will take on a new meaning in year 2000. It will become the central theme for hospitals. There are some who have gotten a head start. Consider the following we have come across just for starters.
A 560 - bed hospital in Fort Worth, Texas, reduces its days revenue outstanding by 46, going from 104 to 58, and increases reserves by over $5 million; in highly-regulated Massachusetts, a 350 - bed hospital drops from 110 to 63 days, and offsets a serious cash flow problem in the process; a 545 - bed hospital in Florida, losing $3.5 million a year, reduces days outstanding from 1 l 4 to 46 and begins to make a profit for the first time in years; a 456 - bed institution in Michigan reduces receivables by $20 million, days by 62 and creates a $39 million swing; a southern California hospital with 363 beds produces a 55 - day reduction in days outstanding, going from 102 to 47 and adds over $5 million to reserves in the process!
Sounder Financial Footings
All of these actual turnarounds took less than two years. All are on much sounder financial footing since they started their turnaround program. And it was accomplished primarily by better management of their receivables.So, some hospitals have already begun their receivables turn around. There are more than a few hospitals in the nation that have taken themselves from serious cash flow problems to financial success in a relatively short time.
These hospital financial managers may not have known the proper term when I interviewed them, but when they started their turn around, it was a benchmarking project. They each told me - they wanted to be among the best.
Benchmarking is a process of finding the world-class examples of a product, service or operational system, and then adjusting your products, services or systems to meet or beat that standard. The term, originally used by land surveyors to compare elevations, was pioneered in the U.S. business world by Xerox Corporation in the late 1970s.
Benchmarking can be a foundation of any receivables improvement program. If a hospital wants to be the best, it must know how the current stars manage to be so good. And it must then measure itself against those standards.
Our advice - first, decide you'll need to improve, then hunt for the hospitals that do their best.
Here are some composite statistics of some of the best performing hospitals in the nation.
How Xerox Does Benchmarking
With its years of experience in benchmarking, Xerox has developed a 10-step model that is used by all departments that want to do benchmarking studies. The steps:
Author - David Zimmerman is chairman and CEO of his own health care receivables consulting group, Zimmerman & Associates, for the past twelve years in Milwaukee, Wisconsin. He is also the author often diverse books including his most recent effort, Unleash the Potential, Unlocking the Mystery of Motivation.
A popular lecturer know nationwide, Mr. Zimmerman is quoted regularly in a wide variety of 7 newsletters and national trade magazines and has been interviewed numerous times on television and radio.
Board Of Directors Meeting Highlights
The Board of Directors meeting for the Wisconsin Medical Credit Association was held October 7, 1999 at the Country Inn in Pewaukee, Wisconsin.
The meeting was called to order at 5:10 P.M. by Jackie Lippe.
A motion was made by Steve Marg to approve the August 1999 minutes. The motion was seconded by Deborah Gustatson, motion carried.
MEMBERSHIP REPORT
Wisconsin Health Information Network (WHIN) and Von Briesen, Purtel and Roper have applied for membership. Cindy Lichter made a motion to approve these new members, Steve Marg seconded, motion carried.ANNUAL MEMBERSHIP DUES
The WMCA has a total membership of 142.
Cindy Lichter made a motion to increase the annual dues to $160.00. The motion was seconded by Julie Smith, motion carried.COMMITTEE REPORTS
Annual Institute 2000: I)Deborah Gustafson stated that our members have made a request to have Bobbette Gustafson speak again. Deborah will try to schedule her for the Annual Institute.QUARTERLY MEETINGS/WORKSHOPS
Dave Miess will speak on BadgerCare and the " FORWARD " card. A representative from Medicare will be scheduled for a half day at an upcoming quarterly meeting.BY LAWS
The By Law committee will meet prior to our next board meeting December 9, 1999 at 3:00 p.m.NOMINATING COMMITTEE
We will have five board vacancies. We need to encourage members to run for board positions.Motion was made by Cindy Lichter to adjourn at 7:0() p.m. Motion was seconded by Jennifer Tarantino, motion carried.
Respectfully submitted by R. James Kluge, WMCA Secretary
Teaching Others is the Best Education
Find out what works with training and progress monitoring.
By Robert Borchert, President, Best Practices Management
When we think of what's needed to achieve and maintain a professional career, we think of the long hours of training and education involved. Lawyers and physicians attend years of advanced classes and receive experience through working in the field. Even with all their years of study, lawyers are basically legal clerks working with experienced lawyers until their employers believe they're ready to handle a case. A physician also goes through extensive training and monitoring by experienced physicians.
It 's safe to say this type of training and monitoring has proven successful in the fields mentioned above. Given that most of us have not had the same amount of training as people in those fields, are we less professional? Further more, staff typically has less training than managers. Does that mean they are not professionals? Before you begin a training program for staff, it makes sense to evaluate your view of professionalism.
Ask yourself some basic questions:
- Have you received formal education in areas of your profession?
- Have you read articles, books and other materials about areas of your profession?
- Have you attended seminars regarding your profession or topics relevant to it?
- Have you attended meetings inside or outside of your facility where you have contributed to a discussion based on your personal knowledge and experience?
- Have you worked with others outside of your professional area to help them understand patient business management?
- Have you assisted in the training of others in your office?
- Have you counseled others in how to improve their work?
If you've answered the above questions with a "yes, " then you are a professional. If you answered any of them with a "no", ask yourself why. You may need further training to become the best professional you can be.
Confidence and self-image
Do you remember the first time you felt like a professional? There is so much to learn it seems endless and can be frustrating, particularly with frequent changes. It can also be frustrating to feel like you don't understand, despite all the effort you put into learning.At the beginning, I didn't have the confidence to fully implement what I knew. My confidence came later when I was asked to be part of a presentation on certain aspects of my job. I suddenly realized I knew what I was talking about! What a great feeling! I was able to tell others what I knew, and they understood what I was saying. Today I'm a great believer that teaching others is the best trainer, and I try to implement this philosophy as often as possible.
Learning by doing So, what does all this mean relative to a good training and monitoring method? It means we should first address the issue of whether we consider ourselves professionals. If we do, then we need to decide whether we consider our staff to be professionals as well. If we do not then we must address training and monitoring from the elementary approach of rote. That is, teaching the job by continually repeating procedures until room for thought or variance are removed. I his is often very difficult and frustrating for both managers and staff. There are no personal rewards associated with this type of training. In fact, the best thing you can say about it is, when you do the job right, there's no need to be corrected. There's nothing innately wrong about this, except you can't learn and perform everything by rote. It makes us little more than robots, and isn't very good for morale. Plus, it leaves no room for thought or introspection, ruling out future improvement.
Managers have a unique opportunity to offer staff members the ability to view themselves as professionals and give them a career path. Education is a key element in this. There is always some staff turnover in business. Each time a new employee is hired there's an opportunity to let more experienced staff take on the role of mentor and guide. Tip: If teaching is the best trainer, why not have more experienced staff conduct training sessions to new employees and include selected staff members as participants? This type of training can be rotated among the experienced staff to allow for an atmosphere of cross-training. Suggested sessions would be:
- Medicare
- Medicaid
- Commercial insurance
- Managed care contracts
- Self-pay accounts
- Collecting at time of service
- Preregistration
- Submitting clean billing forms
Hold these educational sessions at least quarterly to reinforce the knowledge and give experienced staff members the opportunity to teach, learn and expand their professional horizons.
Advanced education
Make outside education for your staff a part of your budget. Organizations such as the American Association of Health Care Administrative Management (AAHAM, formerly AGPAM) and Healthcare Financial Management Association (HFMA) offer numerous programs that are valuable to the enhancement of your operations. Tip: Never attend or send an employee to a program without sharing that knowledge with the rest of the staff. After the program or conference, hold an in-house session involving the rest of the office. Important: This should be a recap of all the points of the program, with time spent answering questions and showing how the concepts apply to your office. You may even invite staff from other areas of the office to sit in, advancing the cross-training aspect. Tip: use this outline showing what the presentation should include:
- An overview/agenda of the subject matter
- A handout with bullet points for each of the major points in the agenda.
- Reference sources for each of the major points as needed.
- An outline of what is happening at your facility that works and doesn't work, relevant to what was learned
- An outline of what may be needed at your facility to comply with the new
- A method to monitor the new process
- A scheduled time for implementation (if possible)
- A scheduled time for reporting on the monitoring of the new process
This outline will help the presenter think through what he or she has learned and make professional recommendations as to the steps required to implement and monitor the new process.
In the future, this type of internal training combined with the normal business process will give your staff members the opportunity to think through their daily tasks and perhaps make recommendations on how to improve existing operations. Many times, there is so much detail involved with our daily tasks we lose track of it all. Yet, we expect staff to keep up. Rather than letting the details smother us, staff presentations on daily activities more human understanding of their workload an(l work habits. These presentations also embody and give credence to a continuous quality improvement (CQI) environment
Applications
I have a client who has recently formed a BARC(. (Billing, Admissions, Registration and Clinical coding) group. The members of this group are from the mentioned areas and also include thc clinic managers, home health managers, ancillary managers and finance managers. The initial meetings of the group consisted of each member making a presentation on exactly what that person and his or her department does in support of the hospital's operations. Then discussions continued on areas where improvement could be made, and members were assigned to develop a plan for improvement. When plans had been developed, the respective groups gave presentations based on the above format, with ideas subject to the whole group's approval.AlthoughtheBARCCgrouphasonlybeeninexistencefor4morlths, some significant improvements have already been identified and are in the process of implementation and progress monitoring.
Final comparison
Many different methods of training and monitoring are available. most tend to depend on the professional who is comfortable with training and who is in the position to monitor tasks. The problem with these kinds of training pro grams is the presenter/trainer then becomes the office police man in charge of correcting performance. On the other hand, the training and methodology de scribed above has the effect of self monitoring based on training others.When someone analyses his duties, he comes to realize this accountability. I le can then train someone else to recognize this accountability, become responsible for personal actions and share responsibility to the actions of others they have trained. That is professional behavior. Not everyone on your staff may be ready to become a professional, but they should be given the opportunity.
Rob Borchert is president of Skaneateles, NY-based Best Practices Associates and a member of the Receivables Report editorial advisory board.
Reprinted with permission of Aspen Publishers, Inc., Gaithersburg, MD with Midwest office in Brookfield. WI. "Health Care Collector."Back to the Drawing Board...
by Joan Carr
Joan Carr is president of Carr, LTD health coverage & reimbursements specialist. She holds an MBA and has 20 years in both the clinical and financial aspects of health care. She is a national member of the Medical Group Management Association and a member of the Wisconsin Medical Credit Association. You can phone Joan at 414-764-7743 or fax 414-764-6708.
Basics Part 2
In the last article we discussed claim basics. This article will look at coding basics. This is not meant to be a "coding class" nor is it meant to take the place of coding reference books. The information is meant to keep you mindful of the different coding systems you use on each claim you submit: ICD-9 for diagnoses AND one, or more, of the procedure coding systems (ICD-9 for hospitals, HIPPS for skilled nursing facilities, CPT-4 for professional services) . As part of procedure coding, consideration must also be given to modifiers mandated by Medicare.To give you an example of what your challenge is, look at the following:
HIPPS MODIFIER 47 = SCPFA TO 14 DAY ASSESSMENT
CPT MODIFIER 47 = ANESTHESIA BY A SURGEONHIPPS MODIFIER 54 = 90 DAY COMPREHENSIVE ASSESSMENT
CPT MODIFIER 54 = SURGICAL CARL ONLYHCPCS MODIFIER QR = REPEAT PROCEDURE, SAME DAY (lab - HCPCS code)
CPT MODIFIER 91 = REPEAT PROCEDURE, SAME DAY (lab - CPT code)CPT4 PROCEDURE 01432 = ANESTHESIA FOR SURGERY ON
ARTERIOVENOUS FISTULA
ICD9 PROCEDURE 14.32 = REPAIR OF RETINAL TEAR BY CRYOTHERAPYCPT4 PROCEDURE 00142 = ANESTHESIA FOR LENS SURGERY
ICD9 PROCEDURE 01.42 = PALLIDOTOMY (BRAIN SURGERYCPT4 PROCEDURE 55200 = VASOTOMY
ICD9 DIAGNOSIS 552.00 - FEMORAL HERNIA WITH OBSTRUCTIONICD9 PROCEDURL 45.40 = LOCAL EXCISION OF LARGE INTESTINE
ICD9 DIAGNOSIS 454.0 = VARICOSE VEIN WITH ULCER(LOWER EXTREMITY)
Also consider the following for abbreviations: PT: physical therapy, proficiency testing, pr-time, patient??????????????????? BS: low blood sugar, decreased bowel sounds??????????????Now that you have this information in hand, understand that projections for ICD-10 diagnosis coding are lO/2002
and ICD 10 / Cl'T-5 procedure coding,2003. Following is a sampling of what is to come:ICD-9 ICD- 10
441 AORTICANEURYSM 171
564.2 POSTGASTRIC SURGERY SYNL). K91. I'E' codes (ACCIDENT/INJURY) become 'Y' codes:
E859 SELE-INFLICTED INJURY Y87Endocrine disorders become 'E' codes:
246.2 THYROID l)ISORDER F.07.$9'E' codes (EXTERNAL FACTORS) become 'V' codes:
E826 OTHER MOTOR VEHICLE ACCIDENT V98'V' codes become 'Z' codes or 'O' codes:
LIVEBORN INFANT
V30 V23.0 PREGNANCY, HXINFERTILITY O0.900For ICD - 10 (diagnoses), the coding system will be alphanumeric. The first character will be alpha (except for the letter "U") andthereforetherewillbe25categoriesinsteadofthe present 12 (E & V codes plus 0-9 categories). ICD-10 will also incorporate an additional (sixth) digit. This will result in more than doubling the codes we use as well as being a possible impact to your software. (Let your software vendors know and make this a consideration when purchasing new software).
The last factor to consider when creating UB-Y2 claims is the overlap in coding for occurrence, value, and condition codes. Make sure you put the right code in the right place or you will inadvertently give incorrect meaning to your claim.
One other thing as we look at the close of this millennium. Take a look at the good things once in a while in the midst of change & frustration: we have an organization which serves as a resource for information & idea exchange to make our jobs a little easier, more effective, and more efficient. In my travels throughout the country, there is no other state, which has this resource. Use the resource & support the organization with your presence at the meetings! Have a Great Y2K! Joan
The Best-Kept Secret in Motivational ManagementIt's not money, or recognition, or praise. One of the best-kept secrets in motivating employees is this: People really care about their careers. Managers sometimes forget that when it comes to motivating employees. Until retirement age nears, the average workers care more about their careers than about where a job is going to lead them than whether or not it's "fair" or "pays enough." That's why so many workers are willing to tolerate jobs that leave a lot to be desired if they really believe it will " lead to something better." Remember this when trying to motivate employees. Offer them training, opportunity for advancement, and career guidance, and employees will work harder and smarter.
-Adapted from Motivation in the Real World: The Art of Getting Extra Effort From Everyone - Including Yourself, by Saul W. Gellerman, Ph.D., Plume.
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