Archive for Starting a New Practice

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What’s Driving Your Medical Practice to Change?

12 Practice Models for 2016We’ve heard from many small independent practices of their desire to evaluate/change their practice model due to:

  • Ongoing Medicare quality program and commercial insurance fee reductions.
  • Increasing administrative expense related to pre-authorizations, denials, and patient collections due to high-deductible health plans.
  • Desire for more time with patients without sacrificing income.

Now you can weigh in on the discussion by participating in Kareo’s and the American Academy of Private Physicians’ (AAPP) annual survey which asks independent physicians for their perceptions of different practice models such as traditional fee-for-service, cash fee-for-service, concierge/retainer plans, telemedicine and more.

This description of the survey is posted on Kareo’s blog:

“Industry research has shown that many independent physicians are concerned about whether or not they can be adequately prepared from the growing shift to value-based reimbursement. As a result, they are testing or fully transitioning to other options like concierge, direct-pay, and virtual models. For the second year, Kareo has partnered with AAPP to investigate this trend more broadly, seeking to understand the challenges and benefits of each payment structure. Furthermore, this survey seeks to determine if a hybrid practice model, which takes into account various payment models, could solve issues of contention that physicians have with their current practice model.”

Healthcare providers and those who manage their practices can access the survey for a chance to win an Apple Watch, an iPad, or a one year AAPP membership. The survey is here: Private Practice Model Perspective 2016.

Want to learn more about different practice models. See my slide deck below “Twelve Practice Models for 2016”

Posted in: Day-to-Day Operations, Finance, Starting a New Practice

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Solo and Small Medical Practices Benefit from New Manage My Practice and The Billing Department Partnership

Manage My Practice and The Billing Department Join ForcesDurham, North Carolina and Falmouth, Maine: Today, Manage My Practice, LLC, a full-service consulting firm specializing in services to solo and small medical practices and The Billing Department, Inc., a company that provides revenue cycle management services to healthcare providers, announced a partnership to offer practice consulting, coding, medical billing and a range of other services to physicians and other healthcare providers nationally.

Of the decision to form a partnership to jointly provide high-quality coding and billing services, Mary Pat Whaley, founder and president of Manage My Practice said “I’ve been recommending The Billing Department to my clients for several years and they report back to me that The Billing Department’s services are always exceptional. It seemed a natural step that The Billing Department and Manage My Practice collaborate to offer a wider range of services together.”

Vanessa Higgins, founder and president of The Billing Department stated “ Manage My Practice is well-established as the premier consulting company specializing in solo and small medical practices in the United States today. It is a thrill to be able to partner with such a well-respected company to serve an often-overlooked market such as solo physicians and other small practice healthcare providers.”

Among the services the new partnership will offer are:

  • New Practice Start-up
  • End-to-end Revenue Cycle Management including Credit Card on File implementation
  • Consulting on medical practice organizational and operational issues
  • Professional Coding and Clinical Documentation Improvement for primary care and other specialties

About Manage My Practice: Mary Pat Whaley, FACMPE, CPC, founder and president of Manage My Practice, LLC, has 30+ years managing physician practices of all sizes and specialties in the private and public sectors In addition to her Board Certification in Medical Practice Management, she is also a Certified Professional Coder and a Fellow in the American College of Medical Practice Executives. Her company, Manage My Practice, LLC, a full-service practice management consulting firm, has assisted practices nationally and internationally since 2008.

About the Billing Department: Established in 1999, The Billing Department, Inc. has steadily grown. Providing practice and revenue cycle management services for healthcare providers nationwide, The Billing Department offers a fully-integrated, end-to-end solution which simplifies every step of the revenue cycle management process — from the initial scheduling of an appointment to the cumbersome billing process following each patient visit. The company’s ultimate goal is to reduce the expenses and increase the income of their clients.

Manage My Practice and The Billing Department Form Partnership

 

Mary Pat Whaley, FACMPE, CPC

Manage My Practice

www.managemypractice.com

(919) 370-0504

 

 

 

The Billing Department and Manage My Practice Partner

 

 

 

Vanessa Higgins

The Billing Department

www.billingdepartment.com

(877) 270-7191

 

Photo Credit: inabstracting via Compfight cc

Posted in: Collections, Billing & Coding, Headlines, Starting a New Practice

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12 Medical Practice Models for 2016

12 Practice Models for 2016In 2012, we wrote “Yes, You Can and Should Start a New Practice in 2013” and more than 13,000 people have viewed it since then. Despite what you may read on the internet, private medical practice is not dead, and physicians are starting new medical practices using new practice models every single day.

What kind of practice is right for you? Here are 12 common and not-so-common medical practice models for independent physicians and other practitioners.

Read more about our new practice start-up services hereFor more information, contact us here or call (919) 370.0504.

 

 

 

 

Posted in: Starting a New Practice

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Is This Physician Crazy? She Walked Away From a “Big Five” Payer Contract!

Feel All Alone Contracting With Payers?I recently helped a physician start a new practice and we began applying for enrollment with the Big Five insurance companies. The physician was stunned to find:

  • Insurance companies regularly “lost” her applications and we had to submit the same information numerous times. Some companies require an online application which provides no ability to track. They will not accept paper applications which can be tracked by the delivery service.
  • She was offered contracts with no fee schedule attached. When we asked for the fee schedule, we were told it was available in the physician portal. When we went to the physician portal, we were told that only enrolled physicians have access to the portal.
  • Contracts she received made reference to the physician adhering to the rules of the Provider Manual. When we asked for a copy of the Provider Manual, we were told it was available in the physician portal. You guessed it – only enrolled physicians have access to the portal.
  • Some insurance companies routinely took 90-120 days or more to complete the application process, then another 60-90 days to enter the contract into the system so physician claims would be paid. This means that a physician may not be able to get paid by one or more payers for 6-7 months after opening a practice.

The physician ultimately decided to walk away from the most egregious of the payers.

After having numerous potential new patients call the practice to find out if she was contracted with this payer, she had to tell them that she would not be contracting with this payer.

Here’s the letter she wrote to the Insurance Company Representative:

Good Afternoon:

Thank you for your follow-up note.  I am uncertain why, but the information you provided, once again, is in direct conflict with the data provided by our local physician’s organization as well as the objective data of looking at pricing vs reimbursement for the ___ vaccination.

I have included for your review comments made by an 18-year veteran of contract negotiations, Ron Howrigon.  It appears being evasive and obtuse in how you negotiate with physicians is an intentional cultural value.

The tenets of our practice require honesty, good-faith and integrity from all of our partners in healthcare.  This article and our experience with you suggests a different and unacceptable organizational value displayed by your company.

At this time, given the disorganized credentialing process, the poor interactions with your company and the vexatious conversation with you, we will not be partnering with you.  We have notified all of our patients insured by your company that we will not be accepting your plans in our practice.  This is a values and ethics-based decision.  We regret you and your company have chosen to conduct yourselves with such hostility and disregard for physicians and the important work we do on behalf of our patients.

Sincerely,

Physician in a New Practice

Posted in: Collections, Billing & Coding, Starting a New Practice

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Before Starting a New Medical Practice Ask Yourself These 10 Questions

Starting a New Medical Practice: Who's the Boss?

 

 

 

 

 

 

 

 

  1. Can I go without any income from a new practice for 3-6 months?
  2. Do I have another income stream or can I continue to work part-time at the hospital or at an urgent care while I’m building my practice?
  3. Can I envision starting my practice by myself (no receptionist or medical assistant)?
  4. Do I have an existing patient base which will be interested in joining my practice?
  5. Is the community in which I want to work underserved or overserved in my specialty?
  6. Do I have a cash component to my practice that can help defray expenses while I’m building my practice?
  7. Will I be able to count on unpaid help from my spouse, family or friends to get things started?
  8. Will I be satisfied to start my practice by leasing space from another practice, or at a less-prestigious location that might not be my forever-location?
  9. Am I willing to shop for gently used and refurbished furniture and equipment for my medical practice?
  10. Will I be satisfied to use one of the free EHRs, even if it doesn’t have all the bells and whistles?
  11. Bonus Question: Do I have saved or can I borrow $20K to cover my expenses for the first 3-6 months?

Starting a new medical practice is not easy. No one should tell you that it is.

But, if you want to put in the work, make the decisions, and ultimately, practice the way you want to, then a solo practice may be a fit for you.

You may have to call your friends and family together to help you, you may have to work someplace else while you’re building your practice, but the good news is, you are the boss of you.

Posted in: Innovation, Quality, Starting a New Practice

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