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 If you are an employed physician, chances are your employer purchases  malpractice insurance for you. Your first introduction to the complexities of malpractice insurance may come when you leave that employer and have to buy a "tail." And, if when you start your own practice you'll need to understand how to get the best malpractice insurance. Today, I chat with Jennifer Wiggins from Aegis Malpractice to help demystify malpractice insurance. Jennifer has over 16 years experience working for one of the country's largest malpractice insurers. In 2018, she left to start Aegis Malpractice, a broker specializing in malpractice insurance. Here are some highlights: 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. Jennifer and Aegis are offering a free, no obligation review of your current malpractice insurance policy. You can learn more at https://www.aegismalpractice.com and be sure to mention this podcast.If you'd like 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.   And, be sure to join my FB group, The Private Medical Practice Academy.Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors.Or 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.Reflect and earn CME here https://earnc.me/H64Hxk

Today I had a great chat with Dr. John Lin about how to think about choosing to be In-Network vs. Out-of-Network. We all know that dealing with health insurance companies can be very frustrating. But reimbursement rates are only a part of what makes dealing with these companies a headache.Trying to decide whether it makes sense for you and your practice to be In-Network or Out-of-Network has to be an informed calculation rather than an emotional decision.  Here are some of the topics we hit on: 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.If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

You’re a Medicare provider. And you know that the Centers for Medicare and Medicaid Services (CMS) runs Medicare. But did you know that CMS is just the umbrella organization? The actual administration is done by a Medicare Administrative Contractor (MAC.)   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 billing folks keep you abreast of any new LCDs or changes to an existing one.  You want to make sure that your billers are checking the MAC website regularly. While it may seem that an LCD is merely a billing thing, that’s a very simplistic and largely incorrect view. LCDs have a direct impact on how you practice medicine. The more informed you are the easier it is to evaluate how an LCD effects your practice and can respond pre-emptively.Here is a list of the MACs: https://www.cms.gov/files/document/macs-state-jun-2021.pdfIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.  

To start with, make a list of supplies that you everything you need:  drugs, syringes, gloves, paper for your exam table, cleaning supplies and more. Include how often you are using these supplies because we’ll need this info to figure out the quantities you need to order. You’ll want to develop an inventory system will help you track how often you use each item and when you need to reorder.  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 switch from one to another and the result is competition for members and greater incentives for providers.  Can I belong to more than one GPO?In case I haven’t been clear enough, you can belong to more than one GPO. You can belong to multiple GPOs and still buy from individual vendors. How much does it cost to join a GPO? Some GPOs are free, some charge a membership fee. The membership costs usually pay for themselves after the first order so the fees should not be your defining consideration.  If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

Here are some strategies that can help keep you on schedule.  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. Standardize your rooms by labeling the drawers and putting supplies in the same place in every room so you don’t have to search for things. Train your staff to check supplies and re-stock daily. Have a tray/cart stocked with supplies for  your most commonly performed procedures.  Understand that most  “practice management emergencies” that occur during the day are not true emergencies.   If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

To reduce the volume of after-hour phone calls, you need to have a policy that implements these strategies.Implement strategies that help reduce after-hour call volume without sacrificing patient care.  1. Set up your phone system's phone treeWhen 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 utilizers Track your after-hours calls to know who’s calling you and you'll  likely  discover a handful of patients  make up the majority of calls.  7. Differentiate patient versus consult calls If your practice accepts consult calls from the ER or inpatient units, you will want to set up your after-hours phone tree to include a separate option for these calls.  If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.  If you enjoy this podcast, please help spread the word and leave a review :)

When you run a private medical practice, you’re invariably going to need services and vendors outside of your practice.   What you need to know is that any person or organization that you hire to handle, use, distribute, or access protected health information is a Business Associate (BA) and that you need to have a Business Associate Agreement (BAA.)  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 Disciplinary action for persons responsible for a breach of confidential information Your Business Associate Agreement should be written so that it’s “evergreen,” meaning that it renews automatically and doesn’t require a new signature to remain valid.  While the business associate has the liability, you as the covered entity are still required to take reasonable steps to cure the breach or end the violation.  Download the Business Associate Security Questionnaire to help you do your due diligence in choosing a Business Associate.If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

We send and receive email every day so  it would seem natural to send emails to your patients. But what if the emails contain protected health information? How do you make email HIPAA compliant? 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. For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

Trying to figure out how the digital world fits into your private practice can seem very overwhelming. Today, I had a great conversation with Dr. Dana Corriel, a board certified internist, entrepreneur, digital stratgeist and the founder of doctorsonsocialmedia.com to get her insights. Here are some of the key points we discussed:  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.If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

I’m sure that you’ve heard the expression:  build it and they will come.  You started your private practice because you want to see patients. But how do you build your patient volume?In this episode, you'll learn 6 steps to accelerate your ramp-up.  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. If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

In this episode, I had the pleasure of chatting with Wendy Margolin who owns Sparkr Marketing and is the founder of The Clinician’s Social Media Club. I asked Wendy to join me to discuss where social media fits into the private practice physician's business plan.  Here are some of the topics we discussed: 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. If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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 Notice of Privacy Practices is a form that many patients toss in the garbage but that can you into a lot of trouble and costs an enormous amount of money.  HIPAA guarantees a variety of patient rights--including a patient’s right to know how you’re going to use their Protected Health Information (PHI.) As part of that,  you are required to describe your office’s privacy practices in writing in an easy-to-read document called a Notice of Privacy Practices. 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?  Adults: All patients who are competent adults. Minors: The legal parent(s) may sign for non-emancipated children. Emancipated minor. The definition of an “emancipated minor” differs from state to state.  Know your state requirements to avoid getting into trouble. Next of Kin: The designated representative of a seriously ill or comatose patient. Legal guardian: The designated legal guardian of an incompetent patient. Executor or administrator: The legal executor or administrator of the estate of a deceased person.  If you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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

If you practice medicine, sooner or later you’ll get to the point that you want to fire a patient. Whatever the reason that you may have for terminating the physician-patient relationship, there needs to a clear and consistent policy and procedure for doing so or you're exposing yourself to hassles and unnecessary potential liability.  Once you have made the difficult decision to end the doctor-patient relationship, there are a number of steps you need to take: 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 You need to send out a termination letter to the patient.  Notify all office staff about the termination.  If you have more than one physician, you absolutely want to notify all practice physicians about the termination.   Your next step is to remove the patient from your roster of active patients.  After you have fired the patient, i.e. sent the termination letter, it’s imperative that you document All Post-Firing Encounters.  You need to use  a disclaimer for Emergency Care.  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 searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

New ventures require money. The question is always where does that money come from. It may come from your savings, a loan or other investors. Regardless of whether you are starting your own practice, buying into a practice or related business (ASC, Imaging Center, etc)--you will need to make a capital investment. In this episode, Dr. Brent Lacey and I discuss personal finances and financing your business ventures. Dr. Lacey is a gastroenterologist and founder of The Scope of Practice. He has coached hundreds of families to succeed in building personal wealth and stellar careers.  One of the important topics we address is money and your significant other. Money matters are often a source of strife in a relationship. And talking about money can make people uncomfortable.Join us as we have an in-depth conversation about how to address both personal and business related money issues.Dr. Lacey is hosting a free summit, Marriage and Money, M.D. on Nov 15-17, 2021. You can find out more by clicking here. You can join me in  The Private Medical Practice Academy membership to how to maximize your practice's success. Enrollment for the next cohort will open in January. Be sure to sign up for the waitlist.For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

What is the difference between an office manager and a practice manager. If you hire someone to help manage your practice—regardless of how small it is—that employee is a practice manager. What are the tasks that practice managers may be responsible for? Here's just a short list: 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 right hand person. You want someone with shared values who can embrace your vision. You want to be sure that your successful candidate is able to delegate tasks. You are hiring a practice manager to help run the practice. The ideal practice manager has excellent task delegation capabilities and must be able to judge when it’s best to handle a task on their own and when it’s better to delegate. For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

In this episode, I have the great pleasure of chatting with Dr. Cheng Ruan, the founder of Texas Center for Lifestyle Medicine. Dr. Ruan started out in an internal medicine practice before starting his extremely successful and lucrative lifestyle medicine practice. Here are some of the key points we touched on: 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/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

You need to hire someone for your front desk. But before you sit down to write the ad for that position you first need to understand what it is that you want that front office person to do. 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 when you are interviewing potential front desk candidates.  Just remember, this person is going to be the face of your practice. If you were the patient would you feel that this person is friendly, empathetic and respectful? Would you feel that they are genuine and genuinely interested?  You want the answer to be a resounding yes!For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

If you are like me, you never carry cash. I pay for EVERYTHING with my credit card. And, as a consumer, I get annoyed if a place doesn't take credit cards. I never actually think about the vendor side of things. I figure they bundle the cost of taking credit cards into whatever they're charging me. 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.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

If you are an out-of-network provider for an insurance company you may perceive that you can get better reimbursement--in large part because, in some states, you can balance bill the patient.  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 A disclaimer that coverage is subject to medical management requirements A disclaimer that the information is only an estimate and may be subject to change Review your contracts. Decide whether you want to go in-network and negotiate your rates.  In order to not be surprised by the No Surprises Act you need to prepare now. For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.

Submitting clean claims is key to maximizing your ability to collect the money that is due to you.  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—said another way—you’ll get your money faster.  If you want to learn how to implement the processes to increase your clean claim rate and maximize your practice’s revenue, join me in The Private Medical Practice Academy membership. https://www.thepracticebuildingmd.com/Work%20With%20Me#two-stepFor a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcastIf you'd like 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.    And, be sure to join my FB group, The Private Medical Practice Academy. Enroll in my course,  How To Start Your Own Practice and get the step-by-step process for opening your doors. Or 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.