Opening a Solo Medical Practice!

If you are a physician launching a solo practice, or at least considering starting a private medical practice, most likely it means it is time for you to do it.
The first thing on your mind should be a business plan, it is recommended to draft one on your own and then take it to a professional to handle the rest. Don’t handle the business plan on your own, you will not save money by doing that, in fact you will lose money in the long run. (nice things to have: attorney, accountant, banker, consultant, architect, contractor, IT resources, lots of friends and a ticket to Vegas, you never know when your next vacation will come!)
Next, you will need to find a financial source, yes, a bank is a great idea, and here is where a good business plan comes in handy.
Once the financials are in the works, you should have an idea of a location. I hope you picked a great name for your medical practice and created an entity). I am sure you have done some research on the type of office you would love to have and a target location. All that is left is to find suitable space. Your timing couldn’t be better, rents are down and the landlords would love to have you as a tenant.
Keep in mind, location plays an important part in marketing your practice.
You can also look into medical office buildings for space dedicated to medical tenants; it is a new trend in big cities. An easy place to make friends.
You can work with a realtor specializing in medical space, or you can look for yourself.
You will save money if you lease space that’s already built out; all you have to do is remodel.
Recommended, you hire a contractor that has experience with the build out of medical space, you will need help with the layout. The trick is to be efficient with space and keep in mind all the new technology.
While you are getting all set up in your actual space, there are major things to consider, one of which is your staff. Do you need a solid manager? How much can you pay? Don’t forget about marketing and your hours of operation.
These are just sum of the questions that need to be answered.

I hope this rough draft with help with some of your questions and I hope you will join us for continuation of Opening a Medical Office.

YSNY
Sr. Medical Practice Consultant
Real Practice Solutions, LLC in New York
http://www.realpracticesolutions.com

Let us increase your bottom line!

Does your office collect the right amount during a patients visit?

A recent survey released on June 15th, 2009 by NaviNet Inc., found that 49% of practices were unable to estimate the correct amount due at the time of visit, other then predetermined co-pay.

As a result a result according to McKinsey & Co. doctors collect only about half of the balance due from patients.

What practices don’t understand is that collecting at the time of service is one of the things that must be done, the way things are even insured patients are increasingly on the hook for an even-larger share of costs.

In 2008 the avarage patient deductible grew by about 10%. On 2009 the deductible grew by about 15%. This becomes a big loss in revenue and must be collected at time of service.

Proper front desk training and review must be done once a month.

- Confirming the patient’s eligibility coverage and benefits, must be done before patient is seen.

- Providing accurate estimates of patient out-of-pocket expenses for specific services.

- Explaining to the patient, why they are being charged for these services.

- Helping patients that cannot afford to pay the amount if full, by setting up an automated payment plan.

- Allowing the patient a call to speak with their insurance carrier regarding their benefits.

Keep in mind the best practice is to collect the money  that are owed from patients at time of service, before they leave the office.

Are your claims being underpaid, or not paid at all?

It is amazing how practice owners to not know where they stand when it comes to collecting their claims from the insurance carrier.

Some just think by having a biller on premises insures them that they will get paid!

I can asure you this is not the case. Billers on salary have no incentive that will drive them to get you the money that you deserve. Please keep that in mind.

Someone has to supervise the billing process that your practice has implemented. Someone has to check what was submitted/resubmitted and what was collected, also have to be familiar what is in your contract with the insurance carrier that you are billing. Not to mention the bills that go out directly to your patients.

You need someone that will keep track of what is going on.

It is easy to miss things in a busy practice, you might be thinking that you are saving money by having your front desk person do your billing and scheduling at the same time.

The bottom line you have to have someone in control, someone that will provide a detailed report to you that will show you what is happening with your money!

Please keep in mind that dealing with insurance carriers is not a simple process and also a time consuming process.

It is recommended to have a dedicated billing service that is motivated to see you get paid, a service that is up to date and has experience in dealing with the insurance world as it is today! 

David Zilber

Practice Management Consultant

http://www.realpracticesolutions.com

Practice owners know that most returned insurance claims often become Unpaid Insurance Claims.

Carriers deny claims for just any old reason now days!

You need a professional to deal with the insurance claims, someone that is willing to spend time to go after the rejected claims and get you results.

Most of the time the problem is in-house. Too busy to correct and resubmit the claim, not that a devoted staff member ignores the returned claim, but puts the claim aside hoping it will go away. After all there is work involved to resubmit the claim and keep an eye on it.

Some of the older providers, or their managers, may be afraid of change when it comes to electronic billing and using a billing service. They may be set in their ways, and don’t want to change, until the day comes when they realize they aren’t collecting as much as they could/should be. You don’t see the problem until you look for it, or until someone points it out.

Some of the providers that are starting out may think they don’t have enough volume to justify using an outside service. This is not true, a new provider would be wise to use an outside service, rather then pay an employee.

New regulations have changed the way we submit claims to all government carriers, and there are more changes on the way.

There are two simple ways medical practices make money. The source is Insurance and the Patient.

“Some doctors spend more time filling out forms than taking care of patients.” – Dr. C. Everette Koop, former Surgeon General.

          When filing claims using paper forms, you are decreasing your cash flow, anyone can see that.

 Turn around time can take up to 60 days, if you ever get paid.

-There is a very high rejection rate. The National rejection rate is about 35%.

-The cost of the average paper claim is about $12 – American Medical Association Survey

          Given the new electronic Claim Submission System and using a Billing Service you can easily increase your cash flow and productivity.

-Average rejection rate from a billing service with well trained staff is under 3%.

-Your billing costs in some cases can be lowered by 50%.

-You would see faster payment of claims. The Average is 14 to 20 days in most cases.

          I am not saying that you can’t achieve the same results in-house, given above average paid billing staff, with proper training, the right support staff and up to date hardware and software. Don’t forget, you will need a dedicated manager to keep an eye on it all.

Yes, there is an initial investment and time needed, to set up proper in-house billing system, but it can be done.

          Your other option is to let the professionals handle it, in most cases they have everything setup and most billing services are well motivated, because they don’t get paid, if you don’t get paid.

I am sure you can think of ways to increase your bottom line, when your staff can concentrate on other aspects of the business and you have extra space to work with, when you are no longer doing your own billing.

What a relief!

Posted by a Practice Management Consultant at Real Practice Solutions, LLC. in New York.

We specialize in making your practice work more efficiently and more profitably.
http://www.realpracticesolutions.com

Some things about HIPAA and OSHA that you need to know in today’s medical practice, or when you are opening a new practice.

The most important Aspect of HIPAA is the privacy protection act.

The HIPAA privacy rule went into effect on April 14, 2003 for “covered entities”

“A physician practice is almost always a covered entity, subject to the HIPAA Privacy Rule.” As such, the practice must implement policies, procedures, and forms to comply with HIPAA requirements.

The Privacy rule applies to health plans, health care clearinghouses, and health care providers. It applies to employers to the extent when they operate in one or more of those capacities.

Your medical practice should have:

• Notice of Privacy – to advise patients about the practice’s HIPAA compliance policies.
• Preset agreements with outside entities that will need access to client information, while providing services on the behalf of the practice.
• You must maintain a system to handle patient information, providing security of patient information in physical and/or electronic form.
• Establish a system that allows patients access to their records.
• Establish a process for patients to use in filing complaints and for dealing with complaints.

These are just some of the things to think about when it comes to HIPAA.

OSHA ensures safe and healthful workplace.

The parctice manager/owner has to make sure that the staff knows where/what your emergency procedures are.

On the list should be Emergency exits, Emergency Phone Numbers, First Aid, All the Required Posters(HAZ-Mat, Hazards, Fire Extinguishers …)

Your staff should know where the nearest eyewash station is, and they should be educated in sterileparctices and decontamination procedures.

We recomend speaking to a healthcare consultant, or an occupational safety & health consultant about these procedures.

Posted by a Practice Management Consultant at Real Practice Solutions, LLC. in New York.

We specialize in making your practice work more efficiently and more profitably.
http://www.realpracticesolutions.com

Medical Practice Management

 Starting/relocating or joining a new Medical Practice can be overwhelming at times.

The check list below can get you on the way, we do recommend at least some professional help along the way.

• Physical Location in medical office condition with phone service in place
• Office manager and/or Practice Management Consultant
• Check for all required Licenses
• Federal Tax ID
• Workers Compensation Insurance
• Professional Liability Insurance
• Hospital Privileges
• Credentialing Precess
• Security Set up
• Fax Service
• Internet Services (T lines, Cable, DSL)
• IT system and backup
• IT service
• Web Site
• Advertising and Marketing
• Business cards and Appointment cards
• Answering Service
• Staffing
• Front Desk Set Up
• Risk Management
• Emergency plan/training
• Waste Disposal
• Compliance
• Reception Room set up (magazines, publications)
• Electronic records
• Scheduling System
• Billing (in-house or billing service)
• Collection Services
• Dry Run
• Evaluation

These are some of the things that need to be covered to have a successful start in a new practice, assuming you have an attorney, banker, accountant, and all your consulting help in place. Yes you will need the consulting help to get things up and running.

Tip: If you have the budget, start with good quality equipment it will bring you money in the long run, and please get an office decorator!

Don’t forget patients hate to wait, if they do you have to make them comfortable.

Posted by a Practice Management Consultant at Real Practice Solutions, LLC. in New York.

We specialize in making your practice work more efficiently and more profitably.
http://www.realpracticesolutions.com

Whether you are starting a new practice or growing an existing practice you need a plan of attack.

Dwindling insurance reimbursements coupled with rising medical expenses pose a serious threat to every physician practice, something you can’t ignore.

The right practice management is one of the most important steps you can take to insure your success.
During the establishment of your new practice, or an addition of a new location, there are many planning, operational, administrative and management tasks that need to be addressed.
Something to consider would be to bring in a practice management consultant to get things up and running.

Who is handling your credentialing process?
Lets hope it is a practice management consultant, or someone that has experiense with the process. Credentialing can be a long and tidious process that can be simplified, if you let the right person handle it. It has to be done the right way to avoid complications.
Yes, there is an initial expence, but just think how much time and money you can save by doing things the right way from the start. It will also free up your time to handle the things you yourself must be able to do.

Some physicians are conflicted about whether they should have in-house billing, or outsource this process.
Yes, you can do your billing in-house, you will need to dedicate space, time and resources.
Can you find the right practice manager that will be able to handle a busy practice, stay on top of all personal, most importantly your front desk (because that is where most problems start in the office), stay on top of all the administartion needs and on top of that billing.
Can you afford a practice manager of that caliber, can you afford a few mistakes(major/minor) in today’s economy.
If you are not able to hire a dedicated professional biller and a good practice manager, I would highly suggest that you outsource your billing to a professional.
Yes, trust is an issue, but I am sure you will be able to find the right billing company to work with. In addition if you for some reason don’t like the billing company that you are with, there is no reason not to switch and as soon as possible.

There are some companies that handle the billing aspect and can also provide valueble addvice on your practice management.
Practice management and billing go hand and hand. One affects the outcome of the other.

Proper billing process starts as soon as the patient walks into, or calls your office.

Outsourcing your billing, will also free up your very valuable and price space, which can be utilized with additional testing equiment and/or examination room and so on.

Evaluation and additional planning should be done monthly to optimize your goals.

Posted by a Practice Management Consultant at Real Practice Solutions, LLC. in New York.

We specialize in making your practice work more efficiently and more profitably.
http://www.realpracticesolutions.com