• Withheld by employer
• Employer responsible for submitting

• FICA

• Funds Social Security and Medicare
• Employer responsibility is 7.65%

• FUTA

• Federal unemployment tax
• Paid by employer to fund state unemployment programs

• State Unemployment tax

• Based on employer payroll
• And number of unemployment claims

As an employer, you're no stranger to the deductions made from your employees' paychecks. Being on the opposite side of the table, though, offers a whole different viewpoint on employee taxes. 

Given the difficulty and significance of correctly filing employee taxes, it is understandable that doing so might take a lot of time and effort. There are several choices that can help make life easier and guarantee compliance. The process can be streamlined by using payroll software, outsourcing human resources and payroll to HR companies or CPAs, or hiring a qualified practice manager. Always remember that it is strongly advised to visit a tax specialist or have someone educated about tax issues.

Remember, mastering employee taxes is a crucial aspect of running a successful business, ensuring compliance, and fostering a healthy employer-employee relationship. Join us on this insightful episode as we equip you with the knowledge and understanding necessary to navigate the intricate realm of employee taxes. 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Where should I choose a space to lease for my practice?
• How does using a commercial realtor work?
• Can I negotiate with multiple landlords at the same time?
• Should I choose a gray shell or a turn-key space?
• Do I have to pay for tenant improvements or does the landlord?
• How much does a buildout cost?
• Do I need an architect and/or contractor before I choose a space?
• and so much more

If you ever need to look for space for your medical practice you are not going to want to miss this episode!

Colin's firm only represents physicians who are looking to rent or buy medical office space. Here's the link to Carr Healthcare Realty-- https://carr.us. (I have no affiliate relationship with Carr Healthcare Realty)

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

What is Chronic Care Management?
CMS defines CCM as care coordination services done outside of the regular office visit for patients with two or more chronic conditions that are expected to last at least 12 months or until the death of the patient. In addition, these conditions need to place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

You can bill for CCM when a physician or qualified health care professional directs your staff to spend at least 20 minutes of non-face-to-face clinical time treating the patient per calendar month.

CMS distinguishes between complex and non-complex care. The key differences between them are the:

• Amount of clinical staff service time provided
• The Involvement and work of the billing practitioner
• And The extent of care planning performed

Wondering how much you can increase your revenue by?

Currently CMS reimburses $42.00 for providing a minimum of 20 minutes of CCM per patient per month. Provide 60 minutes of CCM per patient per month and your practice will get $117.60. Let’s say you have a practice with100 CCM patients you could earn an additional $4,200-$11,760 per month for work you are likely doing anyway.

What is Principal Care Management (PCM)?

PCM is similar to CCM because both services are intended for patients requiring ongoing clinical monitoring and care coordination. One of the key differences, however, is that PCM only requires patients to have one complex chronic condition. 

There are 6 criteria for PCM:

• The condition is expected to last at least three months.
• The condition places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death.
• The condition requires the development, monitoring, or revision of a diseas

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Die with your boots on 
• Just close your doors and turn off the lights
• Bring on partner physicians and selling them shares of the practice
• Sell the practice to private equity or other corporate entity
• Sell the practice to a hospital system

It's exceedingly unlikely that you want to die while still owning/running your practice. If you simply turn off the lights then you don't get any sale price for having built this successful business. And, for most of us, it's unlikely that one or more of your children will join you. 

Realistically, that leaves the last 3 options. Given that, how do you maximize your practice's EBITDA so that you get the biggest return on your investment? Because your practice is an investment. 

There is no "right" answer for what your exit strategy should be. You need to educate yourself and understand the pros and cons of each option.  Set yourself up from the start to have multiple options by having a well-defined operating agreement that spells out buy-in/buy-out, drag along rights, decision making, partnership and more. Understand what's need to sell your practice to others including partner physicians, physicians (not already in your practice) or corporate entity.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

FMLA allows employees to take an unpaid leave of absence for up to 12 weeks for medical reasons or family reasons. The first thing I want to point out is that FMLA is only applicable to employers who have 50 or more employees working at least 20 hours per week to comply with FMLA. Employees who have worked at a company for at least 1,250 hours during a 12-month period are eligible for FMLA. 

Realistically, many smaller medical practices aren’t legally required to provide their employees with FMLA. It'a very likely that  your employees will think they’re entitled to FMLA regardless of the size of your practice. This is why you need to have clear cut policies about leave and what your practice offers if you are not obligated by law to offer FMLA.

1. Develop comprehensive policies

• Have a written policy that defines what type and amount of unpaid leave you will be offering 
• The policy needs to apply to all employees
• Include the policy in your employee handbook

2. Define the 12-month period in which the employee can access it

3. Determine the parameters of your policy

•  Will you require your employee to exhaust all of their paid-time-off benefits before accessing unpaid leave?
•  Or can the employee choose whether to use PTO or unpaid leave? Now you may be thinking why would any employee want to take unpaid leave if they can get paid? 

The whole reason is all of this is important is that you are trying to run a business. In order for your practice to run efficiently, you need to understand your staffing requirements. You need to think about how long you realistically can hold a job for someone who is out. And, of course, how you are going to staff their position during their absence. Having a well-defined policy will help prevent misunderstandings.

One of the most difficult situations though, is when, near the end of their leave, the employee requests that they need a different schedule.  Under FMLA, the law states that you only have to guarantee that the employee has the same position to return to, or a similar position

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Many physicians are under the impression that hiring someone as an independent contractor is going to be less expensive than as an employee. But not so fast. The IRS has rules.  The employer is responsible for determining if the new hire meets the criteria. Choose the wrong status and you may be liable for past taxes and the associated penalties.

What does it mean to be an Independent Contractor?

The IRS and many states have adopted common law principles to define an independent contractor. These rules focus primarily on the level of control an employer has over a service or product. 

The nature of the work that you expect this new hire to perform also helps to define the employment status. When work is considered integral to the business, it is more likely that the person is an employee.

Another factor that helps define employment status is the method of compensation. If a person is on your payroll and receives a steady paycheck they are an employee.

The Economic Realities Test

The “economic realities test” looks at the dependence of the worker on the business they work for. If a person gains a large portion of their salary from that business, chances are that person qualifies as an employee. 

The Right to Control Test

Courts also use the "right to control" test. When an employer controls the way work is carried out and a product is delivered, the relationship between the parties is employer/employee. 

Employer Responsibilities
As an employer, your tax liability is determined by your worker's employment status. When a worker is an employee, you are required to pay state and federal unemployment tax, social security tax, as well as workers compensation and disability premiums to your state’s insurance fund. When a worker is an independent contractor, the hiring party is not required to make any of these payments. 

The Law Is Clear

Most of the staff that you would hire for your medical practice are most likely going to be employees.  I would strongly encourage you to review the IRS guidelines and have a conversation with your CPA prior to hiring any new staff.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

How you will use email with protected health information

The first questions to ask are, “Is my email network is behind a firewall?” Are you only emailing protected health information between you and your staff within the confines of the firewall? If you answer yes to both questions, then you don’t need to encrypt your emails. But, you do need access controls for email accounts so that only those individuals who are authorized have access to protected health information.

On the other hand, if you intend to use email to send protected health information externally, you are responsible for protecting the protected health information—in other words, making it HIPAA compliant.  Encryption is the key to making your email HIPAA-compliant but it’s not that simple. Many email service providers that offer an encrypted email service are not HIPAA compliant because they do not incorporate all the necessary safeguards to meet the requirements of the HIPAA Privacy and Security Rules. 

 Here are some of the things you will want to consider to make your email is HIPAA compliant 

• Ensure you have end-to-end encryption for email
• Enter into a HIPAA-compliant business associate agreement with your email provider
• The most important step—Develop policies on the use of email and train your staff
• Emails containing PHI need to be retained for 6 years
• Secure, encrypted email archiving saves storage space and is indexed making its easier to search
• Obtain consent from patients before communicating with them by email

HIPAA email compliance should be included in your compliance plan. You don’t want something we all do every day—send and receive emails to get you into HIPAA trouble. If you are unsure of the requirements of HIPAA compliant speak with a healthcare attorney that specializes in HIPAA to advise you of your responsibilities and the requirements of HIPAA with respect to email.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• How to choose which social media channel(s) should you choose
• What content should you post
• How to get your posts seen
• Should you spend money on ads (and how much)
• Your personal FB profile vs. your practice's business page
• How to use your practice's FB page to engage with your community
• How to monitor whether your SM posts are working for you.

One of the key points we discussed was using your personal FB profile to share your business info. Unfortunately, your FB business page is much more likely to get folks that are already interested in hearing from you. So how do you connect with others? You can use your personal FB profile. But--how do you separate your posts about the info you want to share about your practice and your truly personal info?  You can divide your FB contacts into FB audiences. Here’s a link to how to divide Facebook audiences. 

My take-home message to you about social media: It's a top in your tool chest. Even if a new patient doesn't find you on social media, they probably checked out your website and FB page. 

Click here if you'd like to know more about Wendy Margolin's  The Clinician’s Social Media Club for monthly fill-in-the-blank social media captions and customizable Canva templates. 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• A cardiologist refers patients to a diagnostic testing facility in which he has a financial interest. 
• A physician is found to be billing Medicare for services provided by an unlicensed midlevel. 

Other Exceptions to the Stark Law

•  "In-office ancillary services" allows physicians to refer patients for certain designated health services provided in the same building where the physician's medical practice is located if the service is furnished under the direct supervision of the referring physician or another provider in the same group practice and that the arrangement complies with fair market value (FMV). 
• Healthcare providers to give non-monetary compensation to physicians and their families up to the annual limit. 
• FMV compensation allows providers to enter into financial relationships with other providers if does not take into account the volume or value of referrals.
• Academic medical centers that meet certain criteria may provide compensation to physicians who are engaged in teaching or research activities.
• Rural providers  may be able to enter into certain financial relationships that would otherwise be prohibited under the Stark Law provided certain criteria are met. 

Safe harbor provisions that provide exceptions to the Anti-Kickback Statute :

• Investments in entities that provide healthcare services if held for one year, and is not be tied to the volume or value of referrals.
•  Office space or equipment rented between providers if the rental amount is consistent with FMV and is for a period of at least one year.
• Personal services and management contracts between healthcare providers if the compensation paid is at FMV and  not be tied to the volume or value of referrals.

The key takeaways—you can’t do things that are tied to volume or referrals and any financial arrangement has to be at FMV. 

I strongly urge you to discuss Stark and AntiKickback with your healthcare attorney so that you know

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Medical malpractice insurance protects healthcare providers from claims of negligence and medical errors. You want to have a separate policy protecting your practice--not just the individual provider.

• General liability insurance covers your business from claims of property damage or bodily injury that may arise from accidents on your premises.

• Cyber liability insurance provides coverage for data breaches and other cyber threats that could compromise your patients' confidential information.

• Workers' compensation insurance is required by law in most states and provides coverage for your employees in case they are injured on the job.

• Business interruption insurance  can provide financial protection if your business is forced to temporarily close due to an unexpected event such as a natural disaster or a pandemic.

• Employment practices liability insurance can protect your business from claims of discrimination, harassment, and wrongful termination brought by employees.

• Business overhead expense disability insurance can cover operating expenses such as rent, utilities, and employee salaries, even if the owner or key employee becomes disabled and unable to work. 

Find an insurance professional who can bundle all of the business-related insurances. They can help you assess your needs (the amount of coverage, deductible, etc.) and bundling will give you the lowest cost.  

While hopefully you will never need to make a claim against any of  your insurance policies, the cost of having the insurance is trivial compared to what it will cost to deal with any of these events without insurance.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

•  the difference between a benign audit and the one you should be worried about
• what to do if you get audited
• what your liability is with regard to coding
• the importance of self-audit
• how denials may give you insight into your audit risk
• the difference between federal payers and private payers
• in-network vs. out-of-network audit risks

If you are in private practice you will not want to miss this episode!

More about David Vaughn: David is one of a limited number of healthcare attorneys in the United States who is also a Certified Professional Coder®, certified by the American Academy of Professional Coders® (“AAPC®”).

David has served on the Legal Advisory Board of the AAPC and has written several coding and compliance books and manuals. He is also a national speaker on the legal implications of billing and coding. He also has a national healthcare law practice, and has represented over 2,000 physicians in approximately 40 states in over 10 physician disciplines. His practice consists of representing providers in federal and state prosecutions, qui tam cases, and Medicare and third-party payer audits. He also conducts audits and provides education to providers.

You can reach David at david@lalawfirm.net.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• What is the demographics of your practice?
  • Can you "afford" to lose that patient population?
• What percentage of your payor mix does the insurance company make up?
• How much time (% of an FTE) does it take you and your staff to get prior authorizations and payment for this insurance company?

One of the key points of our discussion is that being In-Network  or Out-of-Network is not an all or none decision. Both Dr. Lin and I started our practices In-Network with most payors in order to get our practices full. And then, with time and experience, evaluated and re-evaluated each payor and their contracts to decide whether it was beneficial to our practices.

You'll want to listen to our discussion of the decision-making process as you consider these choices for yourself.

Dr. Lin is a private practice urologist in Gilbert, Arizona. He is also an immigrant, operates multiple businesses, is an angel investor, and is a very grateful winner. He is an avid student of efficient practice management and frequently speaks on coding, billing, practice management, and online reputation management. 

Urologists from across the U.S. and the U.K. have visited his practice to learn about practice efficiencies. 

Dr. Lin consults for numerous physicians who are starting and running successful practices.

He believes in sharing knowledge and paying it forward.

Dr. Lin helps urology practices throughout the U.S. as the host of The Thriving Urology Practice Facebook Group. He runs multiple YouTube channels. You can also find him on all the popular social media channels as @jclinmd.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

What is a MAC? 
A MAC is a private health care insurer that’s been awarded a geographic jurisdiction to process claims for Medicare Fee-For-Service beneficiaries.  

CMS relies on the network of MACs to serve as the primary operational contact between the Medicare Fee-For-Services program and providers enrolled in the program.   Some of the activities the MACs include:

• Processing claims, enrolling providers, handling 1st stage appeals redetermination requests, responding to provider inquiries, educating providers about Medicare billing requirements, reviewing medical records for selected claims and establishing local coverage determinations 

One of the functions of each MAC is to establish local coverage determinations (LCD.)  An LCD is a determination of whether a particular item or service is going to be covered on a contractor–wide basis. 

Before an LCD can be put in place, there's a whole process:

• The Proposed LCD describes the MAC’s proposed determination regarding coverage, non-coverage or limited coverage for a particular item or service. The public announcement  begins with the date the proposed LCD is published on the Medicare Coverage Database.
• After the proposed LCD is published, the MAC has to provide a minimum of 45 calendar days for public comment. 
• The MAC has to establish a Contractor Advisory Committee to discuss the quality of evidence used to make a determination. You can volunteer to be part of the CAC. 
• The MAC holds open meetings to discuss the review of the evidence and the rationale for the proposed LCD.  
• Once these steps are completed, the final LCD and the response to comment  is published. This marks the beginning of the required notice period of a minimum 45 calendar days before the LCD can take effect. 

There is an LCD reconsideration process. As a physician you can request a revision to an LCD—either in its entirety or any provision. 

An LCD can definitely throw a wrench into your revenue cycle management if it takes you by surprise. It’s imperative that your bil

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Before I talk about where to buy supplies—buying  for your practice is no different than buying anything else. You need to comparison shop. There is tremendous variability in pricing. 

You can buy from individual vendors. Create an excel spreadsheet –put the item name in each row and the vendor in the column so that you can compare prices of vendors. You will also want to consider buying from a General Purchasing Organization (GPO).

How do GPOs source and negotiate prices for products and services?

 GPOs help source and negotiate prices for drugs, medical devices, and other products and services for healthcare providers.  GPOs don’t take own or take possession of the product. They are the middlemen. 

If GPOs are middlemen, how do they save healthcare providers money?

It is simply an economy of scale issue. It takes time and effort fr a supplier to negotiate a price for every item it sells with every healthcare provider that wants to purchase that item. GPOs can decrease costs by lowering transaction costs and prices through joint negotiation. 

How much can I save with a GPO?
GPOs can save providers 10% to 18%.

How else can a GPO benefit me?
As a small private practice, you may discover that it is difficult to obtain certain products at the scale you need them. Joining a GPO can help you procure the product because they have a steady inventory and a lower per unit cost on each order. 

GPOs pre-screen vendors to reduce the risk of working with a problematic supplier. GPOs also has access to more member reviews. You can save time and manpower because your staff doesn’t have to screen each vendor for every purchase. 

How to choose a GPO?
You will need to vet any GPO that you want to join. Start by asking other medical practices that you know. There are many large national, regional and local GPOs. Combine that with the ability to join multiple GPOs, easily

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Get to clinic before your first scheduled patient. Preferably you get to clinic early. If you show up at 8 am, your first patient is at 8am and then you first need put out whatever this morning’s fire is, you start the day off behind and you will be all day long.  The other advantage to getting in early is to huddle with  your MA so that you have a game plan for potential bottlenecks. 
• Create a block schedule. Train your scheduler the rules of the block schedule. 
•  Communicate scheduling issues with your scheduler. If you have a patient that always takes more time, schedule them in a longer slot. 
• Don't routinely double book. If it takes you 15 min to see a follow-up and you put 2 patients in every 15 min slot you will invariably run behind. 
• There will be times that you have to double-book. Have a code so you don't double book one of those patients that always takes longer. 
• When you enter the room, set an agenda by greeting the patient, and asking them what they are here for today. The better you define and manage the expectations of the visit, the greater the patient satisfaction.  
• Set the timer on your phone. The vibrating phone is a gentle reminder that  time is up. 
• Have a plan with your MA-instant message, a knock on the door, a "call."
• Do your absolute best to not answer calls in the middle of clinic. Use HIPAA compliant email and text messaging for quick questions. If you must talk on the phone, set up a time—before patients, after patients or as a scheduled appointment. 
• Have information about diseases and procedures ready to print during the visit. Discussing the patient handout(s) and then handing it to the patient at discharge with improve patient comprehension, decrease phone calls to your office and improve patient satisfaction and outcomes. 
• Most EMRs have instant messaging. If yours doesn’t, install a HIPAA compliant instant messaging application. We all know how questions, unplanned tests and procedures can disrupt your otherwise perfectly flowing day. With instant messaging you can be in an EMR chart and have a separate window open for instant messages to communicate with your staff without leaving the room. 
• Create a list of supplies that every exam room should be stocked with.

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

1. Set up your phone system's phone tree
When a patient calls after hours, your phone system should answer and give the patient a set of instructions. The message should start with, “If this is a medical emergency, please hang up and dial 911 or go to the nearest emergency room.” 

2. Automate commonly requested information

Your after-hours message should include the information that patients are routinely looking for like your address, office hours, directions to the office, your fax number and your website URL. Mention your website multiple times during the message to direct patients to that site. The person recording this message must articulate clearly and speak slowly so. this automated message can be easily understood. 

3. Divert non-clinical calls

Non-clinical calls, including requests to change, cancel and schedule appointments, requests for medical records, and billing questions can account for a significant percentage of your after-hours calls. Set up a phone tree prompt that sends people to a voicemail box that the staff will answer during regular office hours. 

4. Automate medication refills

Ideally, refills are timed to patient follow-ups. Have all refill requests come from the pharmacy. Adopt a policy of no refills on nights, weekends and holidays. Employ a phone tree prompt that sends patients to a voicemail box for non-urgent refill requests.

5.  Indicate that you may bill for non-urgent calls

Another strategy is to inform the caller that if they chose to contact the on-call provider, there will be a charge for the service. You can decide whether you want this to apply to all calls or only ones that are not urgent. You can also decide whether or not you actually want to drop a charge. 

5. Instruct callers to hang up and dial the answering service directly

If you are going to use an answering service, I would suggest having a pre-recorded message on your phone system that directs patients who still want to speak with the on-call provider to hang up and call the answering service directly.

6. Target high uti

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Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

You need to have a Business Associate Agreement in place before you share protected health information.  

The goal behind the Business Associate Agreement is to acknowledge that both parties are obligated to follow federal HIPAA regulations and to protect both parties in the event of a breach.

According to HHS, the Business Associate Agreement must: 

• Describe the permitted and required protected health information uses by the Business Associate and /or their subcontractors
• State that the Business Associate and their Subcontractors will not use or further disclose protected health information beyond what is  permitted or required by the contract or as required by law;
• And require the Business Associate and their Subcontractors to use appropriate safeguards to prevent inappropriate protected health information use or disclosure

A Business Associate Subcontractor is a person or entity to that the BA delegates to perform a function, activity or service.  

Contractors and Confidentiality Agreements

Your employees, independent contractors who work exclusively for your company or a sole proprietor with other clients are not BAs. In this case your practice is solely responsible if someone breaches protected health information. One way to address this from a compliance perspective is to have your employees and independent contractors sign a confidentiality agreement.  The confidentiality agreements should:

• Clarify the type of information the agreement covers.
• Describe what type of information cannot be copied, downloaded or modified. As an aside, this is a very common source of a HIPAA breach—when some piece of protected health information is downloaded onto a desktop because its “easier” to access but it’s not secured.
• Address issues like not removing a laptop containing protected health information from your office
• State information must be returned upon employer’s request
• Disci

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The good news? The new changes have actually streamlined the process (to some extent.) But, as with all changes--you have to learn the new rules.

While there are multiple changes, the 3 big ones are: 

• 99201 (Level 1 new patient visit) has been deleted. I doubt this affects most physicians—I can’t really think of an instance where anyone was billing this code—which is probably why they got rid of it. 
• You can now bill an additional 15-minute prolonged services code with 99205 and 99215. 
• The biggest however are the changes in how you code for E &M office-based services.

In this episode I'll tell you about what these changes mean to you. 

• The new guidelines have eliminated the history and physical as elements for code selection. 
• Yes, you will still have to include these sections because it's part of good patient care.
• Yes, you'll  still get coding credit because both the pertinent history and relevant physical exam contribute to both time and medical decision making which are the new criteria for coding.  

Coding E & M office visits will be either by total time or medical decision making (MDM):

• You can bill by time--but the definition of time has changed
  • Face-to-face: Time a provider spends directly interacting with the patient and/or family or caregiver. 
  • Non-face-to-face: Time the provider spends managing the patient outside of an encounter, such as before and after direct patient care. 
  • Total time: is defined as the overall time on the day of the encounter during which a provider provides services related to patient care, even if the times are not consecutive. The time spent over the course of the day is totaled, with the day starting at 12:01 am and ending at midnight. The time calculation includes a provider’s face-to-face and non-face-to-face time.
  • Total visit time is the only thing that counts now.  
• You can bill by the level of medical decision-making--but there are changes
  • Fewer ambiguous terms and concepts
  • Better definition of several important terms
  • Redefined data elements move

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Print the contract and all communication
• Put the contract in order
• Use a color-coded binder to differentiate between insurance companies
• Label everything, use dividers
• Don't throw anything away--keep all documentation for future reference
• Memorialize every conversation with the insurance company including names, dates and  summary of the verbal statements

Step 2: Assess your and the payer's positions

• Avoid the temptation to think "I HAVE to be in network"
• Evaluate the health insurance company's network. 

The goal here is to make sure that you are signing up to be in network with an insurance company that is actually to your benefit rather than just signing up to sign up. This is ultimately one of the keys to working smarter, not harder.

Step 3: Understand the Key Terms in a contract before you start to read it

• Type of Agreement:
• Amendment
• Term, Termination, and Renewal
• Claim Filing and Payment
• Compensation

Step 4: Skim the Contract

Skim the agreement the first time through, locating the key data that you outlined in your checklist. Focus on what matters most, and don’t get lost in the verbiage. You’ll notice that the reimbursement is always an attachment at the very back of the agreement. Don't allow yourself to get bogged down by the recitals and definitions at the very beginning.

Step 5: Read the contract

• Get an electronic copy of the contract and make red-lined changes as you go. Make sure that you turn on your track changes so that it's easier to identify changes. 
• It's better to give your own proposed language rather than allow the other side to paraphrase your thoughts. 

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

1. What is the service or business you are offering?
2. Who is your ideal client?
   • Demographics
     • Do they have insurance?
     • What is their Income level?
3. What is your competition doing? 
   • Do they take insurance?
   • How do you figure that out?
4. How many patients do you need in order to make the service or business profitable?
   • How large is the catch area?
   • How much competition is there?

Deciding whether you should take insurance needs to be based on real data rather than emotion. Understanding and evaluating these factors will help you to mitigate the risks of starting any new venture. 

Look out for my FB Live where I will be answering questions about this podcast episode.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Your decision on whether to take only cash or accept insurance
  • If you are planning a cash only business--no worries
  • If you are planning to take insurance--regardless of whether you will be in-network or out-of-network--this step takes at least 3 months. Start now!
• Figure out your new space
  • How much space do you need?
  • Are you renting or buying a space?
  • How much renovation is needed?
  • Obviously, some renovations  take longer.
  • If you are buying a space this will also take longer especially if you need financing.
• Money (that dirty word)
  • If you don't need financing for your start-up and initial operating costs and you don't need a mortgage (if you are buying)--great--this won't affect your time to open.
  • If you are need financing from a bank to cover your start-up, initial operating costs or mortgage--this step can take a significant amount of time. You will need to have:
    • Your financial projections for your revenue ramp-up
    • Projected start-up expenses and operating expenses
  • In order to have your projected start-up expenses and operating expenses you will have to estimate your personnel needs, furniture and equipment and other expenses.
• Furniture and equipment
  • Determine whether you need some special piece of furniture (like a built-in) or a specific piece of equipment in order to open your doors as early as possible.  This is the last thing that you want to stand in the way of getting your doors open.

You can mitigate the issues that are most likely to cause a slow down by being proactive.

For a complete list of the steps to starting your own practice, download

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Communication is key between all team members 
• Make sure that your messaging (as the physician) is consistent 
• Patients need explicit instructions (even doctor patients) and are looking to you for clear, definitive answers.
• Patients don't like the run around or having to make multiple calls to your office. I know that we all get annoyed by those patients that are difficult or who are repeatedly calling our offices. But having been on the other side I will tell  you  that you need to make sure that your staff is not contributing to the repeated calling and patient frustration.
• Your office staff is a reflection on you. Make sure that they are delivering the best customer service.
• Act like a secret shopper and assess your office's customer service
• Do patient satisfaction surveys so you understand (and correct) any weaknesses--before the poor online review.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

When you are considering which benefits to provide, recognize that there are certain benefits that are required either by state or federal law:

• Social Security
• Medicare 
• Unemployment insurance
• Workers’ compensation
• Others:
  • Uniforms
  • Employment Training Tax
  •  Several  states require compensating employees for time spent voting or serving on a jury
  • Several states have health insurance required by law 

Voluntary benefits:

• Health insurance
• Paid holidays
• Paid time off
• Retirement plan

When you are deciding on which benefits to offer, you will need to understand their costs.  Each benefit, regardless of whether it is mandated by law or voluntary, can affect the profitability of your business. Make sure to assign a dollar value to each benefit when you are doing your financial projections.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• If you want to be credentialed by an insurance company, you have to send them a whole bunch of documentation--licenses, proof of malpractice, your DEA/state CDS and more. And when each document expires, you have to provided updated documents. 
• Using CAQH allows you to upload the documents in one central location and have them disseminated to insurance companies rather than having to send the documents to each individual insurance company. It will save you a huge amount of time.
• CAQH does not submit application to the insurance companies or complete the credentialing process for you.

How to register with CAQH?

1. Have all of your documents ready for uploading. Make sure your CV is updated. You'll need your license, DEA/CDS, proof of malpractice, CV, W9, proof of board certification, diplomas, and proof of hospital privileges (if applicable.)
2. Have three professional references
3. If you are starting a practice you'll also need information about the new entity: the legal entity info, tax id #, address (including payment and correspondence if they're different), billing company info if you are outsourcing, credentialing contact, billing contact, hours of operation, phone/fax, group NPI (if you have multiple providers) and your NPI. 
4. Once you have everything ready, go to https://proview.caqh.org/pr/registration/selfregistration
5. At the end of your application you need to grant access to the payers. In order to do this you MUST submit a signed ATTESTATION form provided by CAQH.
6. Once you have signed and dated the attestation, make sure to upload the document (or nothing will happen).
7. Save your CAQH ID#, user id and password in a safe place. Check CAQH at least every 60 days to make sure there's nothing that needs attention.

Can you do this yourself? Yes, absolutely. The majority of the time and effort comes from gathering all of the information. You will need to do this part regardles

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Executive Summary
  • Even though this is first, write it last
  • Essentially this is your elevator pitch
• Company Description
  • What problem do you solve?
  • Who is your ideal client?
  • What's your niche?
• Market Analysis
  • Who's your competition?
  • What can you do better?
• Organization
  • How is your business organized?
  • Who's responsible for running the business?
• Service
  • What service do you provide?
• Marketing
  • What is your marketing plan?
• Financial Projections
  • First year--monthly--outlining your ramp up of revenue, your start up and operating expenses
  • Subsequent years can be projected either quarterly or annually

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• You will need this information in order to come up with your financial projections including your ramp up.
• Everything from space to number of employees and more depends on understanding this number.

I totally get that you may not have all of the answers. You will have to make assumptions. But let me reassure you that these assumptions can be based on information that you have readily available. Where? Right in front of you. Look at your current situation--how many new patients and follow-ups? How long do you spend with each of them? If you are looking to add a service or another business--what does that utilization look like. For example, if you want to start a Physical Therapy center and are currently referring to PT--what does your script look like. Hint--I would write for 3x per week. And most commercial insurances and Medicare will cover up to 12 weeks.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

1. What type of patient do I want to bring into my practice?
   • Better insurance/payer
   • Need a specific procedure
   • Have a certain diagnosis
2. Where do I find the patients that I want?
3. Why do they want to see me? And how do I communicate that?
   • Hint-it's not about you. It's about them
4. Are there obstacles in your practice that limit your growth?
   • Scheduling
   • Space
   • Staffing

Zed also shared how to determine the cost of acquisition of a new patient. You can reach out to Zed for his calculator at zed@trackablemed.com

Last,  we discussed the invaluable task of writing out the step-by-step process that a new patient would go through so that you can identify any roadblocks that limit  your practice's growth. 

Zed Williamson founded TrackableMed in 2011, a patient demand acceleration platform rooted in neuroscience. Zed grew frustrated by the lack of accountability in the advertising industry and started TrackableMed to focus on results. TrackableMed  helps private practices create patient demand for their therapies.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• 2022 Profit and Loss statement
• 2021 Profit and Loss statement (so you can look at the year-over-year changes)
• Year end billing reports

To develop this year's strategic plan we need to do a post-mortem on the prior year. We need to figure out what went right and what we can improve. Examples of what we're looking for:

• Did you meet your 2022 goals?
• Did your revenue grow? 
• How's your volume?
• What's happening with your expenses? What expenses  can be pruned?

One of the first goals should be your profit projection. How much money do you want to make this year?

This year's strategic plan involves setting both yearly and quarterly goals. These goals depend on the stage you are at. 

The quarterly goals should  build to achieve the yearly goals.

Examples of possible yearly goals:

• Getting credentialed and contracted by Fill in the Date
• Add a new physician and/or midlevel to my practice
• Add a new revenue stream
• Have X% year over year growth in Revenue &/or Volume

Examples of possible quarterly goals:

• Increase volume by X%
• Develop standard operating procedures for front desk (or whatever needs work)
• Decrease average days in AR
• Decrease number of days until claims are submitted
• Decrease days to complete charts
• Increase front desk collections

Mine last year's data to look for the good, bad and ugly of how things are going to help you determine the items to focus on this year.

If you have any questions about your practice's strategic plan for 2023 contact me at drweitz@drsandraweitz.com.

Earn 1 AMA CME when you learn and reflect: CMEfy link for it: https://earnc.me/tkXPli

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• help you assess your draw area
• give you insight into your competition and  community in general
• help market you
• do research for you--about reimbursement, new procedures, demographics
• help you recruit new physicians
• help you determine where to open a satellite clinic
• help you with social media posts
• help you with social media content including testimonials, videos of procedures

Key point: Make the rep part of your team rather than view them as a nuisance. 

Here's some suggestions for how to make the rep part of your team:

• Set parameters for when you are available to meet with them
• Be explicit in what your needs and wants are
• Understand they may not have dollars to spend but they have time
• Empower them to help you
• Be nice. Get to know them.
• Give them something back. Sure they want you to use their product more. But aside from that--a Linkedin pat on the back, a written or verbal compliment to their manager, inviting them for a cup of coffee. All of these things are either free or low cost to you and high value to them.

I know that all of this may seem counter-intuitive and burdensome. That's exactly why you need to listen to this episode. I don't want you to miss out on this opportunity to grow your practice!

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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• Are you wondering what the right structure is for your medical practice? 
• Do you know the difference between cash and accrual based accounting? 
• Are you trying to figure out whether you should buy or lease equipment? 
• Do the depreciation rules confuse you? 

Jeremy Klibert is a Tax Partner with Faulk & Winkler, LLC.  He is responsible for providing tax return review, tax research, tax planning, and consulting services for the firm. Jeremy works with a wide range of clients and focuses his efforts on serving high net-worth individuals, nonprofit organizations and closely held small businesses including medical practices. In his client relationships, Jeremy provides invaluable insight on tax, accounting and consulting issues.  You can reach him at jklibert@fw-cpa.com

Click here to reflect and unlock credits & more: https://earnc.me/bGHo7s

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

You use an ABN when you are offering a service that is usually reimbursed by Medicare but may not be reimbursed by Medicare in this particular case. 

Voluntary use of an ABN
When you know, in advance, that the service is not covered by Medicare you voluntarily use an ABN to notify the patient.  The ABN puts the patient on notice that they are financially responsible.  

Mandatory use of an ABN
An ABN is required when Medicare covers the service but may not be in this case. For example, Medicare may determine that the service or treatment was not reasonable and medically necessary for this patient. If you know, from the outset that something may potentially not be considered medically necessary by Medicare you must get that ABN signed. 

Importance of local carrier determinations (LCD)

I previously explained Medicare LCDs . LCDs may account for why something is not covered by Medicare.  Understand LCDs can help you navigate when an ABN is required.

For any service or item that Medicare covers but you are concerned that they won’t cover in this case, you will want the patient to sign an ABN.  If you did not get the patient to sign the ABN before the service or item was provided, then you cannot demand payment from the patient.  

Key point-- You must have informed the patient before the service  was provided that this is typically paid for by Medicare but that there is a chance in this case that it will not be covered and they and must sign the ABN form. 

The ABN isn’t a blanket form. Avoid the temptation of thinking, “I'm not sure what’s covered so I'm just going to get everybody to sign this form.”  The ABN needs to specific. Identify what service or item is being offered and communicate that to the patient. The patient needs to understand that you will transfer the liability to them for that specific thing if it isn’t covered by Medicare. 

It’s your responsibility to know what is and isn’t covered. changes in what Medicare pays f

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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The HIPAA guidelines state that you must “do your best” to get your patients to sign an acknowledgment that indicates that they have

• received a copy of your Notice of Privacy Practices
• been made aware of a notice copy posted in your waiting area, or
• been informed that a copy is available on your practice’s website

What should you include in your privacy notice:

• Rights:  Your privacy notice must clearly spell out your patients’ rights 
• Choice: Patient privacy choices must also be clearly listed
• Use: You are required to tell your patients how you will use their information
• Date and Sign: Although your patients are not required to sign and date your privacy notice, there must be a place for them to do so on the document 
• Change: Your patients have the right to change the instructions on how you are authorized to utilize their information 

Here's a HIPAA-compliant sample Notice of Privacy Practices form.  

How to use the form correctly:

• Timing: Every new patient packet must contain a complete copy of your privacy notice. Have patients review your privacy notice again at least every three years.
• Availability:   Post a copy of your Notice of Privacy Practices where your patients can easily see it. 
• Signature: Make a “good faith” effort to document acknowledgment of your privacy notice by getting your patient to sign and date it. 
•  Refusal to Sign: If they refuse to sign,  document the reasons.
• Language:  Your Notice of Privacy Practices form needs to be available in other language options as your practice represents.

Who can Sign a Privacy Notice? 

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Once you have made the difficult decision to end the doctor-patient relationship, there are a number of steps you need to take:

1. Understand the legal standards for duty of care and for patient termination.
   • Duty of care—this refers to the doctors responsibility to provide patients with treatment.  In order for a physician to be obligated to a patient, you must either:
     • have a pre-existing relationship with the patient
     • have a commitment to the patient by proxy
     • take affirmative action to treat the patient
2. You need to send out a termination letter to the patient. 
3. Notify all office staff about the termination. 
4. If you have more than one physician, you absolutely want to notify all practice physicians about the termination.  
5. Your next step is to remove the patient from your roster of active patients. 
6. After you have fired the patient, i.e. sent the termination letter, it’s imperative that you document All Post-Firing Encounters. 
7. You need to use  a disclaimer for Emergency Care. 
8. You need to know how much notice you need to give the patient. 
   • There’s no federal standard that defines “reasonable notice"
   • Know your state's requirements 
   • Look to your payor contracts for guidance 
   • Contact a healthcare attorney in your state

Here's a list of dos and don’ts for you, as the treating physician to keep in mind as you interact with your soon-to-be ex-patient:

• Never discuss the patient’s health or wellbeing if you encounter him or outside of the office. 
• If you participate in health fairs, online medical discussions or any other situation in which there is the potential for your opinions to be interpreted as medical advice, you will want to include a disclaimer. 

In the end, there will be occasions where you want to and are justified in firing a patient. You just want to make sure that you do it the right way.

For a full searchabl

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Join my FB group, The Private Medical Practice Academy.

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• All things Human Resources
• Oversee billing and  understand revenue cycle management. 
• Medical records management

 One of the questions that I’m frequently asked is, “How much should I pay my practice manager?” In my experience, there are 3 general categories of practice managers. 

• The starter—when you are first getting started and have only a few employees and the complexity of the tasks is limited. 
• The growing manager—more staff, billing,  expenses, and providers to manage. 
• The scaling manager- adding new providers, satellite offices and multiple additional revenue streams requires a whole new list of competencies. At this stage, you need someone who has the ability to help you grow rather than simply manage the practice. 

Now that I’ve told you the list of potential tasks you’re going to want your new practice manager to take on, I’m sure you’re wondering where you are going to find a person who possesses all the required characteristics you should be looking for. The answer is that it’s incredibly unlikely that you will find someone who checks off every single box. 

What's the  one quality that’s essential in a good practice manager? Regardless of what stage you’re at, your practice manager needs to have excellent communication skills in order effortlessly communicate with everyone in your practice including patients, physicians, and other administrative staff. 

Here are some of the things you’ll want to consider when hiring a practice manager: 

• Check the candidate’s previous work experience.  Even in the beginning stages, you are going to want a practice manager with at least two to five years of prior work experience And, you want to specifically know what tasks they were previously responsible for.
• Look for the necessary personality characteristics: Hiring the right person is all about fit. In order for your practice manager to be successful, they must be empathetic, compassionate, and pay attention to detail.  
• Your practice manager is really your

Support the show

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The first impression that people have of you is their experience when they walk in your front door.  The person at the front desk is the first person from your office that someone is going to meet. 

By far, the MOST important skill set is communication. Aside from the fact that great communication skills are the backbone to professionalism and excellent customer service, it’s probably the hardest one to actually teach. Regardless of the exhaustive list of tasks and responsibilities that you want to assign to your front office staff, absolutely none of their skills is going to be more important than their ability to communicate. 

Patients, just like any other customer, do not want to feel like they are a transaction. When you are interviewing potential staff—especially for your front desk, I want you to think about whether they are easy to connect with. 

Connection is all about communication. But communication is so much more than simply what comes out of someone’s mouth.  What’s more important than words?  Body language and tone.  

Whether your patients trust you, the physician, starts with your (front desk) staff. Every message has to have both content and feeling. 

Patient satisfaction and retention is directly related to their interaction with your staff. Patient trust stems from confidence in your staff’s competence and communication skills.

What are key components needed for great communication?  Active listening, empathy, confidence, friendliness, respect, responsiveness, and ability to adapt communication style to the audience.

Let’s dissect this into things you can do to train people and skills they inherently need to have. You can empower your staff and give them confidence by developing processes. 

 But friendliness, empathy and respect are not qualities that you can easily teach. 

I know that when you need to hire an employee, you’re preoccupied with what should the job description include.  And, of course, you’ll need that list of responsibilities to write the job description and the ad. 

But it’s really the  intangible qualities that you are going to want to evaluate w

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The problem for physicians who are in-network is that they get paid according to their contracted rates. They can't pass the credit card fees they pay for accepting this form of payment to the patient.

But patients expect that you will take credit and debit cards for their co-pays, co-insurance or deductible. It's part of doing business, right?

I know that when you are busy starting or running a practice you're not thinking about how much you pay for accepting credit cards. That said, there's no reason to pay more than you have to.

Yes, but not all credit card processing fees are the same. In this episode of The Private Medical Practice Academy, I sat down with Dr. Jennifer Mogan of Park Place Payments to talk about how credit card processing fees are structured and how to figure out whether you are getting the lowest possible rate.

Dr. Mogan is an anesthesiologist in a private practice group in Rochester, NY where she has been practicing for the last 15 years.  She attended college at Colgate University, and medical school and residency at the University of Rochester.  On the side, she is also working with Park Place Payments, a women-founded and women-run credit card processing company built with the core mission to bring honesty and transparency to this industry.  Dr. Mogan has been using what she has learned about the payments industry over the past year and a half to help her colleagues in medicine become more informed and make wise choices for their payment processing.  She is happy to do a complimentary consultation for your practice with a full analysis and side by side comparison to make sure your practice is receiving the rates and service you deserve. https://www.parkplacepayments.com/contactjennifermogan/

For a full searchable copy of the transcript, https://www.thepracticeb

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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But all of that's about to change. When the No Surprises Act, a federal law, goes into effect on Jan 1, 2022, you'll no longer be allowed to balance bill. But that's not all. This law, as the name states, is meant to protect consumers from the cost of unanticipated out-of-network medical bills.

The No Surprises Act extends to most out-of-network providers. 

Under the new law, if you're an out-of-network provider, you can't bill patients more than in-network cost-sharing amounts. While the No Surprises Act only holds the patient responsible for their in-network cost-sharing amount, you'll have the opportunity to negotiate reimbursement with insurers through an arbitration process. 

With arbitration, both the provider and the insurance company submit an amount to be paid to an independent arbitrator. The independent arbitrator chooses one payment or the other with no ability to split the difference. The party whose offer is not chosen is responsible for the costs of arbitration. 

What this does is put the burden on you, the out-of-network provider to determine a patient’s insurance status and the applicable in-network cost-sharing for the surprise medical bill.  This means that your staff and billing folks are going to have to do more work to potentially get no more than if you are in-network. You will want to carefully monitor changes in reimbursement and changes in expense required to collect that reimbursement.

You can be out-of-network and get around this by providing the patient with written notice that you are out-of-network, disclose the charges and obtain consent  at least 72 hours in advance of the appointment. 

How to deal with the No Surprises Act:

• Review your process for eligibility and insurance verification. 
• Provide a timely Advanced EOB notification to the patient and include: 
  • Good-faith estimates of:
    •  costs based on the codes you expect to use 
    •  what the insurance company is responsible for paying
    • cost-sharing –basically what you expect that the patient’s responsibility is
    • the amount the patient has met towards out-of-pocket maximum and deductible

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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What is a clean claim?

The claim for payment has to be submitted via an acceptable claim form or electronic format with all required fields completed with accurate and complete information in accordance with the insurer's requirements.

What is the significance of a clean claim?

Most practices have a clean-claim submission rate of 75-85% which means that 15-25% of submitted claims are not clean.

Claim rejections actually cost you money. When a claim is rejected, it means that those claims have to be reworked and resubmitted. Your clean claim rate should be 95%. Anything lower than this means that you are losing money. 

Your clean claims rate directly affects your practice’s overall revenue. Problematic billing and coding practices on result in delayed or denied claims that can have devastating results for your practice. 

Let’s put things in perspective. Every claim that is not paid on the first submittal wastes your practice’s valuable time and money.  Many rejected claims are resubmitted multiple times, often without their errors even being addressed or corrected.  I also want to point out that when a rejected claim needs to be reworked beyond its timely filing deadline you end up not getting paid.  

What Clean Claim Rate should do I need (want)?

In the ideal world you would have a 100% clean claim rate. But let's be real--errors happen. That said, you should not be satisfied with a clean claims rate under 95%, and especially anything under 90%. Anything above a 5% claims rate is costing your business money and time. Your overall profitability depends on having your clean claims rate under control. 

So how do you achieve that 95% clean claims rate?

• Keep patient information updated
• Verify eligibility prior to the date of service
• Provide detailed documentation of medical information
• Be mindful of insurance claim filing timelines
• Double-check modifiers

You want and deserve to be paid for the work you do. Having a 95% clean claim rate will increase your profitability by increasing your collections and decreasing the expenses incurred collecting your money. And, of course, it will shorten your revenue cycle—sai

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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• If you are all Cash Pay--you don't need to worry about being either credentialed or contracted.
• Credentialing is the equivalent of the good housekeeping seal of approval. It means that the insurance company "recognizes" you. It has absolutely nothing to do with money--meaning how much the insurance company is going to pay you. 
• You need to be credentialed regardless of whether you plan to be in network or out of network.
• You can use CAQH Pro to apply for credentialing with multiple insurers--and it's a free service. Here the link: https://proview.caqh.org/Login/Index?ReturnUrl=%2f
• Get all of your documents together before you even start--this is the part that takes the longest time. 
• Here's a list of the documents/info you need to get started:
  • License to practice
  • DEA and CDS certificates
  • Education and training 
  • Board certification
  • Work history
  • Malpractice history (NPDB)
  • License sanctions (NPDB)
  • Medicare/Medicaid Sanctions (NPDB)
  • Hospital privileges
  • Current malpractice coverage
• If you are going to be out of network, you do not need a contract. You only need to be credentialed.
• If you want to be in network, you need to have a contract.
• Many insurers will allow you to go through the credentialing and contracting process simultaneously
• Credentialing and Contracting take a long time--way longer than you think (like 3-6 months)--Plan ahead

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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• What does payor mix mean? The breakdown of all of the sources paying for your service. There are basically 3 categories: cash, insurance (out-of-network), and insurance (in network). Out of network insurance is essentially the same as cash since you can balance bill.
• What is an example of a payor mix?
  • Medicare-25%
  • Commercial-55%
    • Blue Cross-28%
    • United-18%
    • Aetna-9%
  • Self-pay (Cash)-20%
• Why is the payor mix important? If you accept insurance then you are likely to have different contracted amounts for the same code. Therefore, your overall reimbursement is going to be a blend of rates based on your payor mix. As you build out your financial projections for your business plan you will need to have this information.
• How do I figure out the demographics? Here is a link that will give you a breakdown in your catch area.
• Where can I find the Medicare fee schedule? Click here to access the Medicare fee schedule. Make sure to look for the rates for your specific geographic area. This fee schedule will give you a starting place for understanding rates.
• What is an example of blended reimbursement? The blend of reimbursement as a function of your payor mix percentage. Use my calculator to determine this.
• I have created a plug-and-play calculator for you to determine your payor mix and to determine your blended reimbursement rate. Click here to get your calculator.

The purpose of this episode is to show you how understanding your projected payor mix will help you assess opportunities. I will discuss strategies for changing your payor mix to maximize revenue in a future episode.

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Demographics--who exactly is your ideal client for this new opportunity? You can check out https://datausa.io for demographic info. Using this site you can get information regarding age, gender, employment, healthcare and more.
• Catch Area--how large is the geographical area needed to provide enough clients to make your new opportunity successful
• Payor Mix--the same website, https://datausa.io, will give you information regarding what is the % uninsured, Medicare and commercial insurance for a particular demographic or catch area. 
• Competition--don't let competition scare you. But you do need to understand it.
• Cost of Doing Business--obviously, places with a higher cost of doing business require better demographics, more patients, larger catch area and/or better payor mix

The purpose of this episode is to help you understand the information you need to collect in order to make the most educated decisions in evaluating how great an opportunity is.

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Difference between claims-made and occurrence malpractice insurance
• When do you need a tail?
• How often you should shop your malpractice insurance
• The key elements of a malpractice policy
• Attorneys and who decides when to settle a case
• Why your practice needs a malpractice policy (and not just the individual physicians)
• How to choose a malpractice carrier
• Do you need a broker and if so, how do you which one

We all know that malpractice insurance is a major expense. You want to make sure that your money is buying you the best policy for your practice.

Reflect and earn CME here https://earnc.me/H64Hxk

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• The more you can identify the holes in what your competition has to offer and then use them to define your niche--the easier to compete
• The client customer service experience will help differentiate you from everyone else
• You can compete with the big organizations by offering better customer service--even if you just get their overflow. You can have a very successful business just from overflow.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Call your own office as a secret shopper
• Have calls answered by a live person
• If someone is put on hold, tell them how long it will be
• Fill the dead space so they know they're still connected

As you'll hear, "First impressions" do matter. Listen to this episode to learn what steps you need to have your staff take to get that patient's needs addressed and loving your practice.

After spending years in advertising, Zed Williamson founded TrackableMed in 2011, a patient demand acceleration platform rooted in neuroscience. Zed grew frustrated by the lack of accountability in the advertising industry and started TrackableMed to focus on results. Today, you can find him reading, spending time with his wife and teenage sons, and running a highly innovative business that helps private practices create patient demand for their therapies.
https://www.trackablemed.com/patient-engagement-solutions

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Using FDA-approved devices, remote monitoring remote patient monitoring (RPM) and remote therapeutic monitoring (RTM)  patients  can alert physicians to any concerning  data between visits. That way, physicians can intervene before things spiral out of control.  The goal behind remote monitoring programs is to improve patient care, decrease healthcare spending by being proactive and improving patient compliance.

And while I'm sure that we are all for improved patient care and outcomes, I know that nobody wants to do more work. Or do it for free.

Here's the good news: 

• Implementing RPM/RTM does not require more physician time. When set up correctly, you only have to write the order. You can use your staff to do the rest. 
• RPM/RTM can significantly increase your revenue.

In this episode I'll tell you the key differences between RPM and RTM and how to utilize them in your practice.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Social Media is Media. It's a form of advertising. Don't think about it as "Social"
• Whatever content you put into the digital space represents you and your brand
• Your priority is the prime real estate you own--your website
  • Make your website unique
  • Provide content geared to the audience you want to read it
• You can re-purpose content from your website 
  • Post it on one of the social media channels--Facebook, Instagram, Linkedin, etc.
  • Be consistent
• Establish yourself as an expert
  • Publish articles on doctorsonsocialmedia.com and other sites so that you are identified as an expert in your field
• You never know who will see your content--patients, referral sources, others.
• Use social media to drive people back to your website.
• People may not find you on social media but your patients and referral sources will definitely check out your website before coming to see you or referring patients.

Dana Corriel, MD, is a board certified internist, entrepreneur & digital stratgeist. She is the founder of DoctorsonSocialMedia.com, an online platform that functions as a mix of media outlet, marketplace, & talent agency for “medical brains”, serving both a physicians and public audience. Over the years, Dr. Corriel has learned how to create truly stand-out content online & has expanded her own career in just a few short years, using simple online tools. Her company has helped numerous physician influencers and innovative new healthcare businesses grow, thanks to its communities and networking power. Many of these experts now successfully occupy top healthcare positions, appear in influential outlets, and accomplish feats doctors never thought possible.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Define your message
  • Differentiate yourself from the competition
• Create your brand
  • The name of your business
  • Your tagline
  • Your domain name
  • Your logo
• You need printed materials. This isn't old-fashioned. 
  • Business cards
  • Appointment cards
  • Stationary
  • Brochures
• Your website is your digital business card
• Promote early and often
  • Tell people where you are
  • Schedule appointments before your opening day
• Your open house
  • Not just a celebration
  • It's a powerful form of advertisement

You will want to implement these 6 steps before you open your business in order to maximize the likelihood that you will be busy straight from the start.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The revenue cycle begins when the patient makes the appointment and ends with successful payment collection.

The first step in the revenue cycle happens when the patient schedules an appointment.  Your best chance of beating the revenue cycle management game is to collect your money upfront. Pre-registering patients allows you to  determine the patient’s financial responsibility.

Key points: 

• You need to have explicitly spelled out policies and procedures for your staff to follow.
• You need someone in your office figuring out eligibility and then coordinating that information. 
• Know and collect what is due upfront

The patient visit

Complete your notes and drop the charge in a timely fashion. The clock doesn’t start ticking with regard to when the insurance company has to pay you until they get your claim. 

Coding mistakes, billing errors because of duplicate data, missing information and misspellings all result in lost revenue. In order for a claim to  go to the insurance company and be processed, it has to be a clean claim.

Once the claim get to the insurance company, the provider has less control over how long it takes for payment. However, knowing the rules of what’s a covered benefit, what’s defined as medically necessary and what documentation you need can go along way to saving you and your staff from the denial-appeal cycle.

Communicating with health insurance companies is a key component. Neglecting to manage the claims process after submission can result in pending, rejected or denied claims, or ones that were never received.  In addition, you need to determine where problems originate if there are issues with specific procedures or codes, can help increase awareness and reduce recurrences.  

Once the insurance company pays the claim, they'll send you an electronic payment directly into your practice checking account and an explanation of benefits. From there you either submit the claim to the secondary or move the accounts receivable to the patient's responsibility.

If you collected the money that the patient is responsible for upfront, there should be nothing left after the insurance pays. B

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• When you should  start the whole contracting process
• How to figure out who are the insurers in your area
• How many insurance companies you should initially contract with
• And, the steps you need to take to get a contract

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• The importance of understanding every aspect of how a private practice functions before starting your own
• How to get patients BEFORE you open your doors
• How to create the right culture for your employees
• How to leverage yourself with physician extenders (and get paid)

Dr. Ruan is hosting the  Physician Practice Automation Summit Oct. 17-24, 2021. He's put together 40 experts including doctors, lawyers, marketing executives and more to help teach how to grow and scale private practices and I'm thrilled to be one of the speakers.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Claims-Made Coverage
  • With a claims-made policy, your insurer will only cover malpractice claims if the claim is made against you while you are covered.  With claims-made coverage you will need tail coverage if you leave the practice or insurance company.
• Occurrence Coverage
  • This is the broadest and most protective type of medical malpractice policy. With this policy, it does not matter when a medical malpractice lawsuit files, so long as the incident occurred during the policy period.
• Claims-Paid Coverage
  • With this coverage, the claim is not recognized until the indemnity pays out or the claim closes. The downside of this type of coverage is that if you do have a claim made against you, as long as your claim remains open, you will need to maintain coverage with the claims paid insurance carrier. This could mean years of paying premiums that you don’t want to pay until the claim is closed (often 3-4 years) or an even larger tail payment to get out of the policy if needed.

Factors affecting malpractice insurance costs

• How much coverage you need will directly affect how much you will pay in insurance premiums. 
• Your prior claims history. 
• Where you work also factors into how much you’ll pay in insurance premiums.
• Regardless of your location, claims history, and coverage amounts, certain specialties are always going to pay more than others.

Bring down the cost of your malpractice premiums when you are first starting out by selecting a claims-made policy with a maturation date. With this policy,  the rates you pay increase over time from year one to year five.

What your malpractice insurance policy will cover and what it won’t

Will cover:

• Any claim made against the medical provider because of bodily injury based on: the services provided, a lack of services provided or medical negligence on the physician’s part. 
• Legal counsel and covers your defense costs, both preceding and during trial (should your claim go that far). 

Won't: 

• Sexual misconduct on the part of the physician 
• Illegal acts 
• Services performed while under the influence of alcohol or drugs

You need ma

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• You can take better care of your patients
• RPM can improve patient accountability 
• RPM can improve patient satisfaction
• RPM can help your practice meet value-based reimbursement criteria
• You can get paid for RPM

RPM refers to technology and practices that help practitioners track their patients’ health data remotely to design a treatment plan. It’s the process of combining remote patient monitoring technology with devices, and it enables the doctor to monitor vitals and other critical data remotely without the physician actually having to provide the service. 

How does RPM work? 

• A device transmits patient information, usually through a mobile app, which in turn sends the data to the provider’s office. 
• Core requirements include being  HIPAA compliant and EMR compatible. 
• The provider-side of the application must have these modules:
  • analytics 
  • notification 
  • decision support 
  • report 

How RPM actually works:

• Physician writes an order for RPM
• Patient receives the device. 
• Physician office can bill for set up/education as one time charge 99453
• Patient sends 16 readings/transmissions to physician office and physician office spends 20 minutes on RPM  per calendar month  in order to bill 99457
• If an additional  20 minutes are spent, you can bill 99458 (up to 2 x 99458 or 1 hour spent on RPM/month)

Things you’ll want to think about when choosing an RPM vendor:

• What services does the vendor provide?
  • Some vendors provide a software platform
  • Some provide software + device
  • Some vendors offer a completely turnkey solution
• What is the fee structure for the vendor's services?
• What additional staff do you need?

You will want to build out the revenue and overhead to understand your financial projections from the RPM component of your practice.

The key takeaways:

• Remote Patient Monitoring provides many benefits for you and your patients. 
• There are many conditions that can be monitored and a variety of devices to assess them. 
• For RPM to be successful it requires the patient to be compliant with t

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

RVU stands for relative value units and are basic component of the Resource-Based Relative Value Scale (RBRVS.) RVUs define the value of a service or procedure relative to all services and procedures. It’s based on the extent of physician work, the clinical and nonclinical resources needed and the expertise required to deliver the service to the patient.

When you are actually coding and billing for a service, you do not assign an RVU code. You assign a CPT code. And each and every CPT code has a dollar amount assigned to it by CMS. When your practice receives reimbursement from Medicare or a commercial payor, they pay you according to the CPT code. There is no direct payment for any service based on an RVU.

Key point: You need to be able to convert back and forth between CPT codes and RVUs—it’s nothing more than a formula. Here's a link that will allow you to  convert from CPT to RVU.

Under the RBRVS, payment for physician services is determined by: 

• Total RVUs
• Geographic Practice Cost Indices (GPCIs)
• A conversion factor

There are actually 3 types of RVUs that go into the calculation of the total RVU. 

• Work RVU 
• Practice expense RVU
• Malpractice RVU

Key Point: The place of service significantly factors into reimbursement. CMS makes a distinction and organizes all places of service into 2 categories: 

·   Non-facility- usually refers to the physician’s office 

·   Facility - inpatient hospital—even if its an outpatient clinic in an inpatient hospital, ambulatory surgery center or skilled nursing facility

If you go to the CMS physician fee schedule lookup you’ll notice that for each CPT code there’s one amount of payment if done in your office (the non-facility) and another for the facility. Essentially CMS compensates you more if you perform the service in your office because you are incurring the overhead. 

An RVU has to be multiplied by a dollar conv

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Join my FB group, The Private Medical Practice Academy.

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Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

First, Facebook is free. There’s no charge to create a Facebook business page. All you need is a Facebook account. And it’s quick to get started. There’s not a lot of time and effort required to set it up.
 
Reasons to have a Facebook Business Page:

1. You can build your patient community by posting content, engaging with your audience, and sharing. You can share knowledge and expertise that’s unique to your practice and skill set.  This will immediately establish your competence, know-how, and authority as an expert. 
2. Facebook provides a “voice of the customer”. One of the things that Facebook does is to facilitate communication in many directions…from you to them…from them to others…and from them to you. Listening to this interaction and feedback can really help you understand the needs and wants of your patients. 
3. Facebook extends your reputation and branding message. 
4. Facebook boosts search engine visibility and visitor traffic. 
5. Prospective new patients come from Facebook. 
6. And of course, Facebook is a great way to keep tabs on the competition. 

What to post on your Facebook Business Page

1. Communicate how patients can make an appointment to see you,  your hours, address, and any other information that you want patients to have. 
2. Announcements--closures, practice updates
3. Share Facts About Your Practice
4. Highlight You and any other providers you have. 
5. Provide information about your specialty and services you offer
6. Use your Facebook page to sharing patient testimonials
7. Share interesting articles that relate to your specialty

When you should post on Facebook, the best time to post on Facebook is between 12 p.m. and 3 p.m. Monday, Wednesday, Thursday, and Friday, and on Saturday and Sunday between 12 p.m. and 1 p.m. 

Your Facebook Business Page is a great way to communicate with your patients and provides you with free marketing.
For a full searchable copy of the transcript,

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

As a physician participating in one of these networks, you’ll be paid according to the provider network’s master contracts. I also want to be clear that you can also see patients outside of the insurers contracted through the provider network. You don’t have to limit your practice to only patients within the network.

Independent Practice Association (IPA)

• Loosely formed alliances among physicians
• Primarily focused on independent private practicing physicians
• Main purpose for forming an IPA is for payer contracting
• With the recent changes in reimbursement from fee-for-service to value-based, IPAs that aren’t not clinically integrated can’t effectively negotiate payer contracts

Clinically Integrated Network (CIN):

• Consists of a group of providers who come together to improve quality and cost efficiency in healthcare delivery
• Provide higher value to the consumer of healthcare services
• Employ best practice, process improvement methodologies and measure true cost and outcome metrics via direct methods such as patient surveys and activity-based cost accounting methods
• Facilitate referral optimization by matching patient needs with those providers best capable of meeting those needs
• Contract for services on behalf of their members
• Usually include a care management or care coordination infrastructure as well as an IT infrastructure that serves multiple purposes

In the end, you have to do the due diligence to make sure that you will be gaining enough—either in better contracted rates or reduced overhead—to make it worth joining a provider network.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Establish a salary range 
Salary.com will give you  salary ranges  by position and geography.  

Decide the top amount you'd be willing to pay. The next step is to figure out the least you'll pay.  You need to decide where that person falls on the spectrum with regard to your pre-determined salary range.

Decide How You'll Pay Your Employees

There are basically two types of employees: salaried and  hourly.

• Your office manager and other high level staff are typically salaried
• Front office staff, medical assistants and any billing staff are typically paid hourly

Bonuses 
Bonuses should be considered as part of your employees’ compensation packages. One major advantage of offering bonuses is that they give you, the employer, flexibility.

There are  three major categories: p

1.  Performance Bonuses
2.  Non-performance based bonuses
3. Non-monetary bonuses

The takeaway messages are that you want to define a clear salary range with a set upper and lower limit for each position. Match jobs whose value comes with hours to hourly pay and jobs whose value comes in insight or skill to salaried pay. Use bonuses to align everyone around your business’ goals.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Why? 
A formal compliance program is an indispensible part of an overall risk management plan for your medical practice. 

Compliance programs address billing practices, anti- kickback compliance, state and federal self-referral prohibitions, state fee-splitting laws, licensure and accreditation requirements, labor relations matters, antitrust and price fixing prohibitions, HIPAA and medical records issues and a whole host of other state and federal laws. 

The very first thing you need to do is select a compliance officer.

What goes into a compliance plan?

• Standards of conduct for your employees 
• Determining what is medically necessary 
• Compliance plan for billing--regardless of whether you take government and third party payor or only cash
• Compliance plan for how you market

Now that you know what needs to be included, how do you come up with the compliance plan?
You have to have written guidelines and manuals 
You need to train your employees 

What happens if there is non-compliance?
Your have to have a plan to address non-compliance is handled that defines how issues are reported and evaluated. And, of course, every aspect of the investigation requires a paper trail. 

And one of the most important parts of a complete compliance plan is the audit. You can demonstrate your compliance by being proactive and auditing yourself. This goes a long way if you are ever involved in an investigation. 

In the end, being compliant really is nothing more than having a tangible, systematic plan for doing the right thing.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Do I really need to have a website when first starting out?  Yes! 

• Even if you are employed you can use your website to provide information.   When you leave your current job, your website still belongs to you and your patients will find you. 
• Use your website before you open to market--"Coming Soon"
• Provide information on scheduling and access to  things like your new patient packet with its relevant forms and policies. And
•  Your website will help you compete with other practices. 

What you need to launch a website:

• A domain name
• Verify the domain name you want is available
• Purchase the domain name and related variations (if possible)
• Sign up for auto-renew of the domain name
• Website host service
• Design the website--either do-it-yourself or outsource

Website tips:

• Make sure your website is mobile-device friendly
• Key information conveyed on your home page
• Easy to navigate content
• Search engine optimization (SEO)
  • Add a blog
  • Add custom content
• Regularly update your website

Make sure to claim and verify your local listings in the various search engines like Google, Bing and Yahoo.

After your listing is claimed and verified, you'll need to fill out as much information as possible   to make your listing stand out and improve your chances of showing up in search results. 

• Add photos of your practice 
• Add the hours you are open
• Add a short description about your practice

Once your website is up and running, be sure to tell everyone about it. Put signs up all over your office including in every exam room. Talk about it on your various social media platforms.
In the end, you want to drive any and all potential patients to your website.

For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• You want a bank that demonstrates a firm understanding of a medical practice’s unique cash flow needs. As we all know, medical businesses function differently than a typical business. What services are offered to you and how much they cost is largely impacted by how familiar the financial institution is with medical businesses.
• You want to understand the bank’s responsiveness. For example, how quickly are deposits credited to your account? Are capital requirements met in a timely and efficient manner? For example, if you have a line of credit with them—how easy is it to access? If you need a loan—how many hoops do you need to jump through.  Everything — from tracking an important wire transfer to helping finance an expansion project — should be addressed with speed and efficiency. The bank is there to make your life easier—not be a nosebleed.
• The bank should be easily accessible to answer questions; provide training on any account-related technologies; and offer insights into how it can meet your banking, financing and treasury management needs. Having a dedicated, single point of contact to address your businesses unique needs is crucial to understanding and anticipating challenges. Your financial partner should be easily accessible to answer questions. 

Before deciding on a bank ask for references from other medical businesses.

Now I want to talk about products and services that you want your bank to offer in order to address the unique financial needs of your medical business.

Business checking
There are several factors that you are going to want to consider: 

• Is a Minimum Balance Required?
• How quickly do You Have Access to the Funds?
• How Often Will You Make Withdrawals?
• How many deposits Will You Be Making?

Now that I’ve talked about banking (and essentially money coming into the bank), let’s talk about loans. 

• Revolving line of credit- borrow as much or as little as you need to meet your working capital needs
• Term loan- to finance longer term investments like an expansion of your office or opening a new satellite office

Full suite of treasury management products and other services:

• Lockbox services

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• To collect information from the patient
• To provide information to the patient

There are several ways in which your patient can access the new patient packet:

• Through your EMR's patient portal
• On your website
• On your Facebook business page
• A physical, printed folder

What goes in the new patient packet?

• Information you get from the patient
  •  Registration form
  • Insurance information
  • Patient questionnaire and history intake form
  •  Medical records release form on file
  • Release of information form
• Information you give to the patient
  • A comprehensive financial policy statement
  • Credit card on file policy  
  • HIPAA policy statement
  • Controlled substance agreement 
  • Patient responsibilities form
  • Brochure with a practice overview and provider bio(s)
  • Educational materials
  • Directions to your office

The two key takeaways from this episode are that a professional, comprehensive new patient packet will help

1. You and your practice make a great first impression
2. Improve your practice’s workflow

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Key Points:

• If you see more than 200 Medicare patients and/or bill more than $90,000 annually in Medicare Part B allowed charges, you’re automatically enrolled. 
• MIPS collects data and then you see the effect on your reimbursement 2 years later.

Why is participating in MIPS a big deal:

• MIPS results in Medicare Part B incentive payments and penalties.
• MIPS scores effectively market you—free advertising for exceptional performers, as well as potential liability for underperformers.
•  MACRA requires CMS to publish MIPS final scores and performance category scores on every MIPS participant within 12 months of the performance year through CMS’ online portal, Physician Compare and the database is available to third-party physician rating websites
• You can use your MIPS when negotiating commercial insurance contracts. 
• MIPS scores are irrevocable since they become a permanent part of public record. 
• CMS ties MIPS scores to the practitioner so that scores follow the practitioner from one practice to another. 
• Key point: MIPS scores will  impact patient attraction and retention, insurance contracting AND  physician recruiting, contracting, and compensation plans.

How MIPS Works?

MIPS is a performance-based payment system that includes four categories. You as the clinician have the flexibility to choose the activities and measures that are most meaningful to your practice. 

The four weighted performance categories are combined to create the MIPS Composite Performance Score (MIPS Final Score) and used in determining future Medicare Part B payment adjustments. 

How many points do you need to be eligible to get the incentive?

• Performance threshold: 60 points to avoid a penalty and start to earn an incentive. 
•  Additional performance threshold: 85 points to  earn additional incentives from the additional incentive pool of $500m. 

Key Points:  

• Your final total score is compared to everyone else participating in MIPS. If there are more people who

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

There are 3 basic ways for a new patient to come into your practice:

1.  Self-scheduled via your website or portal
2. Call your office and speak to a live person
3. Referral from another physician

Things you'll need to consider when setting up the process for scheduling new patient appointments: 

• Will the patient self-schedule or talk to a live person to schedule?
• Do you want relevant medical records to review in advance of their initial visit?
• How are you going to request those records?
• How do those records get into your system?
• How does the patient complete your new patient forms?
• How do the forms get put into the EMR? 
• You need to inform the patient whether you take insurance and who you are in and out of network with. 

Key points: 

• If your forms are not completed via a portal, they will need to be manually placed into the patient chart.
• If records or forms come as paper, they will need to be scanned into the system first. 
• You will need a HIPAA compliant secured email server to send emails.
• Collect the patient's insurance information at the time of scheduling and communicate your financial policy.
• Make sure it's easy for patients to schedule, reschedule and cancel appointments.

No matter how robust your EMR/practice management software, you have to define the process. Going through and setting up each and every step from the very beginning will improve your efficiency and productivity and greatly improve your patient's satisfaction. 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Today I'll talk to you about the key features that will impact your workflow and ultimately your profitability. 

But first, I want to address everyone's biggest concern—the cost. Don't sacrifice functionality, integration and flexibility for price. Your lost productivity will cost your more in the long run. 

• Software that knows the order of operations for your practice and helps guide users through them can save time for current users and decrease training time for new users. 
• You want an EMR that can be customized to your practice's workflow. 

Scheduling Features

• You  want your scheduling to be done through your EMR. 
• You want to make sure that the scheduling feature tool can be customized to meet your practice’s specific needs. 

The key takeaway here is that the scheduling features should improve your productivity by centralizing a lot of your workflow processes. 

Charting

• How many keystrokes are needed to complete a note?
• How many pull down menus are there? 
• How many pop-up windows there are when you complete a routine note? 
• If you click on something does it take you to a totally separate page for you only to have to navigate back to the main page? 

Each of these questions translate into a time calculation.  If your EMR is cumbersome, you won’t be able to actively engage with patients, your patient satisfaction will be poor and you’ll be charting long after the visit is over. 

Customizable templates that are capable of learning are the key to speeding up the charting process and improving your productivity.

E-Prescribing

The EMR should track medications that have been prescribed to your patients, notify you if any of their medications have potential interactions with other medications they’re taking, or with any allergies they may have and, offer an alternative if available.

E/M Coding

One of my favorite features is the ability for the EMR to suggest an E & M code based on your documentation.

Lab Integration

If you have a lab or imaging-dependent practice, you are going to want an EMR that is capable of automatically adding ordering tests and receiving results that ar

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

1. Determine whether you want an EHR that’s enterprise or cloud based. enterprise-based 

• Enterprise-based EHRs live on your server or servers in your office
  • Do you have a server? 
  • How much does a server cost? 
  • What happens when the server goes down? 
  • Do you have in-house IT person for when your server isn’t working?
• Cloud based EHR sits in the cloud and can be accessed from any device.
  • You don’t need a server.
  • You need a stable internet connection
  • Bandwidth and internet speed affect performance

There are obvious differences in the costs between enterprise- and cloud-based products but the cost differences may not be as great as you would initially think.

Tip: Create a spreadsheet so that you can compare all of the costs. 

• What type of infrastructure do you need and what does that cost?  (Servers vs. wiring for the fastest internet connection)
• Cost of the internet service with the bandwidth needed to run a cloud-based program.
• What is the purchase price? And what does that include?
• For the enterprise-based is there a yearly maintenance fee? 
• Costs associated with cloud based—how much do you pay per month? Is it by user? How often do they raise their prices? 

2. Determine whether you want a standalone EHR and standalone Practice Management Software or an integrated product. 

EHR and Practice Management Software are not the same thing.

• EHR--all of the clinical info
• Practice Management--the business side of medicine 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

First, you need to think through every step that occurs. Then, you’ll need to drill down and identify each task that goes into completing that step. From there, think about how long each task takes to complete for each step. With this information you will be able to  write the job description for each position you need to fill and how many man hours are required. Then you'll know how many full-time equivalents (FTEs) you need.

The first step we are going to consider is  your referral process.

For patients who self-refer:

• How does that patient make that first appointment? 
• Do they schedule directly using one of the online scheduling services or do enter their data through a portal on your website? 
• How does that integration happen with your practice management software? 

And to go along with this—the patient may have created an appointment, but someone needs to make sure that a patient record is created in the EMR and populated with the correct demographic and insurance info.

For patients referred by another provider: 

• How does that referral come in? 
• Is it on a referral form that the other physician’s office faxes to your office?  
• How is that referral form going to get to the potential referral source? 
• Can the referral source complete a form on your website that gets transmitted to your office? 
• Do they have to print out the form and fax it? Or do they fill out the form and efax it?

Ultimately, someone has to convert that referral into an appointment. And create a patient record in your EMR. 

Do you want to review medical records before the initial visit? 

• How are you going to educate your referral sources to send the relevant medical records with the referral? 
• How do the records get to your office? 

How does that referral in turn convert to a scheduled patient?  

• Online scheduling software 
• Through your EHR  portal 
• Does someone call the patient to make the appointment? 

How is the amount that the patient owes

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

When Hurricane Katrina hit Louisiana in August 2005, I had 7 providers and 30 staff members. At that time, I didn’t know what to anticipate nor did I have a well-designed plan. The good news is I learned some very valuable lessons and I’m going to share them with you.

Lesson 1: Identify the decision maker 

• And then, decide when the determination to close is going to be made and communicate that. 

Lesson 2: Clearly communicate with your staff

Once you've made the decision, you need to have a communication plan 

If everybody is still at work, here are some options: 

• You can have a 5 minute staff meeting where you communicate the plan. 
• You can send out an email.   
• You also want to know what each person's plan is so that you can plan accordingly. It’s hard to reopen if you have no staff or providers available.

If a decision whether to remain open or close is made after hours: 

• You need to have a list with every member of your staff’s contact information including cell phone number, home phone and email address.
• Identify who is responsible for contacting providers and staff. 
• If there are more than a couple of people to contact, create a phone tree. 

Lesson 3: Let your patients know the plan

If you are going to remain open, there are a number of ways you can let your patients know what’s happening. 

• Post on your website.
• Use your social media channels to post notifications. 
• Change the auto attendant message on your phone to convey the information. 
• Use your patient reminder software to either call or text people with a status update. 
• Don’t be surprised if many of your patients cancel or no-show. 

If the decision is to close your office, you will want to add some additional steps. 

• Set up a pre-recorded automated message using your patient reminder software. 
• The message should also instruct the patient on how their appointment is going to be rescheduled.  
• You need a written protocol for how to imp

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Here are the highlights: 

• Entrance to your space:.  You need very clear signage to your business 
• Your waiting room 
  • Paint over wallpaper
  • Carpets, drapes, upholstered furniture and acoustic ceiling tiles decrease sound absorption.
  • Seating-fabric (durable, stain resistant and washable) chairs 
  • Distractions-reading materials and medical TV services
• Front Desk
  • Work chairs--ergonomics are the key
  • Equipment layout--position so your staff can reach everything 
• Exam Rooms
  • Exam table--comfort and easy to adjust are the most important features 
  • Two side chairs 
  • An adjustable stool 
  • EHR-desktop vs. portable
  • Waste receptacles and Sharps 
• Break Room-yes you need one
  • Coffee maker
  • Fridge
  • Microwave
• General Office Space-create open workspaces
• Your office-the one room you can decorate any way you like

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

First impression--your waiting room
Your waiting room is where your patients get their first impression, so you are going to want it to be inviting. How big does your waiting room need to be?  The optimal size depends on a few factors, including the number of providers in the practice, your visit volume and the overall efficiency of the practice.  

Next—Think through your operational needs

Long before you ever go to look for space, sit down and write out every step of your clinic flow. How do patients move from one part of your space to another? How much staff will you have? What are their roles? How many patients will you see in an hour? What equipment will you have? How much space does it take up?

Traffic flow & accessibility in the clinic
Productivity is enhanced with every step you save. Having a circular traffic flow that leads from the waiting room, through reception to exam rooms, and back out the reception is a particularly effective layout. 

How many exam rooms do I need? 

As a general rule, the optimal number of exam rooms to start with is 3. One room for the patient who being teed up for you to see, one for you to be in and one for the patient you just saw and who needs to be checked out. Now obviously that does not take into account any other factors like having a room for procedures, x-rays or non-invasive testing. You will need to take those additional services into consideration when deciding on the number of rooms.  

An exam room should be at least 10 feet by 10 feet. You’ll want each room should have enough space to comfortably accommodate you, an assistant, your patient and at least one family member. You will also need to think about wheelchair accessibility. 

Workstations
This is where thinking through your work flow is so absolutely important. I’m sure that you have been to medical offices where all of the office equipment is grouped together in the receptionist area, there’s one space as the nurses’ station and another for the doctors’ work area. If you critically evaluate th

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Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

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One of the first things you want to understand the difference between grey shell and vanilla shell and the impact on your lease rate and tenant allowance.   Most landlords offer some type of allowance to finish the space and this needs to be negotiated into the lease or purchase terms. Typically, the longer the lease term, the more generous your landlord is going to be.

Because tenant improvements are part of the lease agreement and negotiated along with the rental rate and lease term, the tenant improvement allowance does not have to be repaid. 

And, when you are comparing different properties, key in mind that you need to look at the total cost of the rental package. And obviously, lease rate, lease duration and amount of tenant allowance are all linked.

As a tenant, your goals for negotiating tenant improvements should be to 1) get an allowance sufficient to cover planned improvements, and 2) maintain a high amount of control of the build-out.

In order to negotiate, we need to understand how tenant improvement allowances are typically calculated. The average tenant improvement allowance amount is based on a negotiated dollar amount per square foot.  depending on the property condition and the state of the real estate market.

Alternatively, you may ask for a turnkey buildout rather than an allowance per square foot. In this case, the property owner is responsible for financing and completing all the negotiated improvements before you move in.  However, this method is usually negotiated along with a higher rental rate because the owner takes the risk of the upfront improvement costs.

Here are some other details you are going to want to consider:

When negotiating over construction details you want to put in language that speaks to liability for delays and cost overruns. As delays cause you to incur holdover costs and office set-up inconveniences, you’ll want accountability for delays from the landlord if the landlord is managing the construction.

The date of first rent paid can be a contentious negotiation point, as landlords will expect rent as soo

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

•  Gross lease is the simplest lease form. The tenant simply pays a stated amount each month.   The landlord takes care of everything else; the rate does not change. Any increase in the cost of these items is simply absorbed by the landlord. 
• Triple net lease is almost the reverse of the gross lease. There is a quoted base rent but that’s all you get. The tenant’s responsible for all the costs incurred in order to operate the space.  The landlord also will provide some of the services needed for the common area and the   costs associated with maintaining these areas are known as the common area maintenance charges (CAM). These CAM charges the expenses not specific to a tenant. They are split on a pro rata basis.
• Full service lease is similar to the gross lease except that it contains provisions to pass on escalating costs to the tenant. The landlord quotes a rate that includes paying the taxes, insurance premiums, utilities, and CAM. In order to protect themselves from escalating costs the landlord will include either a base year or expense stop.  A base year approach, the landlord represents that the quoted rate will include the costs that were incurred for taxes, insurance and CAM equal to what was spent in a given year.  An expense stop is similar to a base year except that instead of using the actual number for a given year the landlord simply quotes an amount. If the expenses are higher than that the expense stop amount the tenant has to pay their prorata share of the increase. 
• Gross industrial lease which is similar to the triple net lease except that the lease rate includes the payment of taxes and insurance. And, the tenant is responsible for paying any increase over the amount of taxes and insurance for a given year much like a base year. 

One of the major differences between the four types of lease relates to repairs and maintenance.  In the full service lease and gross lease the landlord is responsible for repairs and maintenanc

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

1.   How soon do you want to move into the space? 

Let’s say that you want to start your practice or business in the next 6 months.  If you want to buy the space, you’ll need to go through the due diligence, get financing, and do the buildout you want--a process that's likely to take more than 6 months.

 On the other hand, if you are looking to rent, you’re likely to find the space in a much shorter time period. The only significant time-limiting factor is the time that you’ll need for tenant improvements.

2.   Do you know where the best location is for your new business? 

You need to think about things like the ease of getting to your location, getting into your parking lot, getting to your space and more. Look, you could have the nicest space but if it’s a pain to get to, you’ll lose patients. People follow the path of least resistance. If it’s a hassle to turn into your parking lot or there isn’t enough parking spots, people will get turned off. 

3.   Do you understand your clinic flow? 

When you are starting a new practice or related business, you need really understand your business’ flow. You need to walk it, do it –exactly as you would once you move in so you can identify the limitations. I can’t stress enough how important it is to do this. You can think it, and you’ll fool yourself into thinking you have every step down. I’m here to tell you that unless you physically walk through each step and write it down, you will miss something. And you want to know what you’re missing before you move in—especially if you are buying a place.

4.   Fourth, how much space do you need? 

When you are first starting out, how much space do I need is one of the hardest questions to answer. On one hand, you want to have enough space to function efficiently. You want to utilize all the space that you have. On the other hand, you don’t want to have more space than you need. 

Yet, you want to have enough space so that your business can grow and expand without you having to move. You don’t want lack of space to limit your productivity.

5.   Lets talk money. 

Remember that you will have other start

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

But I want you to take a step back to realize that you are literally making a decision that's going to potentially cost you 10-20% of your professional fees from that payor for the next 10-20  years.

Why? Because you are establishing your base rate. So when you go back to renegotiate your rates in the future--the initial (low) rate is where you are starting from.

Once you get your initial contract offer, you are likely going to want to negotiate the details. In this episode, I am going to tell you the first steps to getting better rates.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

• Choose your company name
• Check the Secretary of State website for your state to determine if the name is available. 
• Obtain the domain name(s) for your company
• Talk to your CPA and determine whether you want to have an LLC or an S-Corporation
• Complete the Articles of Incorporation (sometimes called Articles of Organization) on the Secretary of State website and any other required steps for becoming incorporated
• Apply for an EIN (Employer Identification Number)--your business tax ID. Here is the link to get your EIN https://www.irs.gov/businesses/small-businesses-self-employed/apply-for-an-employer-identification-number-ein-online
• Apply for a business NPI (different than your individual NPI). Here is the link: https://nppes.cms.hhs.gov/webhelp/nppeshelp/MAIN%20PAGE.html If you are a sole proprietor you don't need this (yet).

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!