Understanding your obligations surrounding employee taxes is crucial for operating a successful business, whether you're an employer or an aspiring entrepreneur. In this episode, we explore the four primary types of employee taxes: • Federal and State income taxWithheld by employerEmployer responsible for submitting• FICAFunds Social Security and MedicareEmployer responsibility is 7.65%• FUTAFederal unemployment taxPaid by employer to fund state unemployment programs• State Unemployment taxBased on employer payrollAnd number of unemployment claimsAs 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. 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." 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 Stark Law prohibits physicians from referring patients to entities in which they have a financial interest to prevent financial incentives from driving medical decision-making. The Anti-Kickback Statute prohibits the exchange of anything of value in exchange for referrals for services. Examples of Stark Law violations: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 what is required to be in compliance.Earn credits: https://earnc.me/HnuHBDWant 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." 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!

Insurance is one of those things you never want to need or use. But, unfortunately, when life happens having insurance can save you. Some types are pretty obvious but there are some you probably haven’t thought yet. That doesn’t mean you don’t need them. In this episode, I'll tell you the types of insurance your practice needs to mitigate its risks.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.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." 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!

Owning a private medical practice is a journey. Initially, you're focused on how to get the practice up and running. The next phase is how to best run the practice. Over time, you transition to how to grow and leverage the practice. And, at some point, you will want to leave the practice that you started. Having a roadmap definitely makes the journey easier. That's where having a business plan helps. One of the key considerations, from the start, needs to be "what does my exit look like."  Now I totally understand that this may be difficult to envision but many of your decisions will depend on where you want to head. You wouldn't get in the car without knowing where you are going. In today's episode, I speak with Eric Miller of Econologic Financial Advisors about the five most common options for exiting a private practice. Die with your boots on Just close your doors and turn off the lightsBring on partner physicians and selling them shares of the practiceSell the practice to private equity or other corporate entitySell the practice to a hospital systemIt'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.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." 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!

More patients equals more money. Right? Not necessarily.If you want to grow your practice, you're probably thinking how do I get more patients. But is that really the right question to ask?In today's episode, I had the pleasure of having Zed Williamson from TrackableMed back with me to address what you should be asking. For starters, increasing your practice's volume and revenue does not happen by chance. Here are some of the questions we address:What type of patient do I want to bring into my practice?Better insurance/payerNeed a specific procedureHave a certain diagnosisWhere do I find the patients that I want?Why do they want to see me? And how do I communicate that?Hint-it's not about you. It's about themAre there obstacles in your practice that limit your growth?SchedulingSpaceStaffingZed 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.comLast,  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.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." 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've probably heard me say that medicine is a business.  It takes work to run a successful business.   There are good days and bad days.  And, no matter how hard you try, like all business owners, you'll make mistakes. That's the truth. But with mistakes comes experience. The key  to running a successful private medical practice, or any business for that matter, is to learn from missteps. Ideally you learn how to grow from other people's mistakes rather than have to make them yourself.Today I chat with Dr. Christine Meyer of Christine Meyer and Associates about her journey from being an employed physician to starting her own practice and ultimately growing it to the 19 providers she has today.  While I want you to hear that it is really possible to have a phenomenally successful practice, the real goal of this episode is to talk about the mistakes she and I have both made along the way.Dr. Meyer and I discuss everything from hiring providers, to figuring out space requirements to managing staff, how and what to delegate and more. You'll hear about the common pitfalls that many practice owners experience and how to avoid them. One of the most important takeaways from my conversation with Dr. Meyer is, no matter what stage you are at in starting, running or growing your private practice, you need to be actively involved in the management and learn from every experience.More about Dr. Meyer:Dr. Meyer was born and raised in New Jersey to first-generation Egyptian parents. She received her Bachelor’s  from Rutgers University and MD from Hahnemann University School of Medicine (now Drexel University). Dr. Meyer  completed an Internal Medicine Residency at Thomas Jefferson University Hospital and is board certified in Internal Medicine.She met her husband, Dr. Christopher Meyer, on the first day of medical school.  In 2004, the Meyers realized their life-long dream to have a medical practice together. Christine Meyer, MD & Associates, and Healthy Steps Pediatrics are considered the premier primary-care practices in Chester County. Her most recent passion has been the launch and growth of her podcast, Tell Me More: Better Conversations in Healthcare, 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." 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!

In this episode, I'll outline the key steps you need to develop your practice's strategic plan for the new year.The first step: doing a review of the past year. For this you will need a few things:2022 Profit and Loss statement2021 Profit and Loss statement (so you can look at the year-over-year changes)Year end billing reportsTo 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 DateAdd a new physician and/or midlevel to my practiceAdd a new revenue streamHave X% year over year growth in Revenue &/or VolumeExamples of possible quarterly goals:Increase volume by X%Develop standard operating procedures for front desk (or whatever needs work)Decrease average days in ARDecrease number of days until claims are submittedDecrease days to complete chartsIncrease front desk collectionsMine 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/tkXPliWant 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." 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 never know when your mother-in-law will turn out to be a valuable asset to your practice. Mine was a lab technologist who had started up and ran multiple medical labs.  When we told her that I had decided to start my own practice, one of her first questions was "what labs are you planning to do?" followed by you need a CLIA Waiver.Say what? I had no idea what that was or how to get one. The test said was CLIA Waived. Doesn't that mean that you don't need a CLIA?A CLIA Waived test just means that there are fewer associated rules to follow. You still need to apply for and get a CLIA Waiver. Even for real simple stuff like doing point-of-care lab tests in the office. You want to do a UA or a rapid strep test. Or maybe a urine drug screen or pregnancy test. In this episode of The Private Medical Practice Academy, I chat with Dr. Heather Signorelli, a pathologist who has started and ran multiple labs. We discuss CLIA (Clinical Laboratory Improvement Amendments--in case you were wondering) and the different CLIA programs and their requirements.Apply for a CLIA: https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/How_to_Apply_for_a_CLIA_Certificate_International_LaboratoriesHow to get a CLIA waiver: https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/Downloads/HowObtainCertificateofWaiver.pdfCLIA Waived tests: https://www.cdc.gov/clia/docs/tests-granted-waived-status-under-clia.pdfIf you are doing any labs in your office or are thinking about adding them, you won't want to miss this episode! Also, remember--you can earn 1 AMA PRA Category 1 CME for completing the reflection after listening to the podcast. Click here to reflect and unlock credits & more.  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." 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!

Finding space for your medical practice can seem very intimidating.  So when someone asked me for a consultant in the Dallas-Ft. Worth area to help them figure out where to look for space for their new office I realized that I need to address this topic head on.  You don't need to pay a consultant for this. You need a commercial realtor. That's why I invited Colin Carr, the founder of Carr Healthcare, to join me today to discuss the nuts and bolts of finding a lease space for your practice.  In this episode we cover some of the topics you are frequently asking about. Here's just a sample of what we discussed.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 moreIf 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)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." 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!

Drug and Device reps often drop into medical offices--usually uninvited. And they seem to always to be there at the most inopportune times. Most annoying is when they camp out in the back waiting for you. It's no wonder that many physicians have disdain for Drug and Device reps.If this is your attitude, you're missing out on a great (free) opportunity to grow your practice.In this episode, I chat with Omar Khateeb who helps med tech companies grow sales and drive product adoption using social media.  Omar is an interesting guy. His dad is a vascular surgeon and Omar went to med school before becoming a device rep. Omar ultimately transitioned to marketing and teaching reps how to interact with physicians.Drug and device reps can help you grow your practice in multiple ways. They can:help you assess your draw areagive you insight into your competition and  community in generalhelp market youdo research for you--about reimbursement, new procedures, demographicshelp you recruit new physicianshelp you determine where to open a satellite clinichelp you with social media postshelp you with social media content including testimonials, videos of proceduresKey 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 themBe explicit in what your needs and wants areUnderstand they may not have dollars to spend but they have timeEmpower them to help youBe 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!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." 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!

I’m frequently asked about the benefits of hiring employees versus having independent contractors.  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 TestThe “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 TestCourts 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 ResponsibilitiesAs 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 ClearMost 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.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." 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 I started my medical practice I quickly learned that there's much more to accounting than quickbooks.  My CPA firm, with its extensive healthcare experience, has served a phenomenal business advisors. In this episode of The Private Medical Practice Academy,  Jeremy Klibert CPA and I discuss some of the pressing questions that private practice physicians have.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.comClick here to reflect and unlock credits & more: https://earnc.me/bGHo7sWant 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." 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 to offer a service to a patient but you aren’t sure that Medicare will reimburse you. Is there something you can do to increase the chances of getting paid? The answer is an advanced beneficiary notice of non-coverage (ABN). 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 ABNWhen 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 for to you. Medicare Advantage plans and commercial insurers do not follow CMS but ratheWant 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." 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!

We've all heard, "First impressions matter." Calling your office to schedule an appointment is your patient's first interaction with you and your practice. That call defines whether the patient schedules an appointment. And, their attitude toward future interactions with you and your office. Today, Zed Williamson from TrackableMed joins me to discuss how your staff can improve the impression patients get when they call your office.  One of the most valuable suggestions is to train your staff to answer the phone with a full-on smile. Now this may seem silly but if you try it you'll see the difference in the tone of your voice.Between automated phone attendants and online scheduling tools, patients have precious little interaction with your office. Those initial few words of greeting can make or break your success. Other valuable tips from this episode include:Call your own office as a secret shopperHave calls answered by a live personIf someone is put on hold, tell them how long it will beFill the dead space so they know they're still connectedAs 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-solutionsWant 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." 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!

One of my greatest frustration with practicing medicine is poor patient compliance. You spend time educating the patient and discussing the treatment plan. When you see them back in follow up you discover they haven't followed through. If you are lucky, they are the same. Unfortunately, sometimes they are worse.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.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." 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!

Are you afraid of getting audited by insurance companies or Medicare? Do you get anxious when one of the payers sends you a request to audit 5 of your charts?  Have you heard horror stories of the Feds knocking on a physician's door? Don't worry--you are not alone. But not all audits are created equal.Today David Vaughn joins me to discuss what you need to know about the different types of payer audits. David is both an attorney and certified professional coder and has been my healthcare attorney for 20+ years. David has been instrumental in helping my practice's billing compliance.Here are some of the topics we discussed during our conversation: the difference between a benign audit and the one you should be worried aboutwhat to do if you get auditedwhat your liability is with regard to codingthe importance of self-audithow denials may give you insight into your audit riskthe difference between federal payers and private payersin-network vs. out-of-network audit risksIf 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.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." 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!

In 2015, the Centers for Medicare & Medicaid Services (CMS) introduced Chronic Care Management (known as CCM) with the intent of improving the care of patients with chronic conditions. CCM offers physicians an opportunity to be compensated for the work that they were doing between office visits including but of course, not limited to calls, education, coordination, and pre-authorizations. In 2020, CMS rolled out Principal Care Management (PCM). 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 providedThe Involvement and work of the billing practitionerAnd The extent of care planning performedWondering 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 disease-specific care plan.The condition requires frequent adjustments in medication regimeWant 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." 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 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. Here are some highlights:Difference between claims-made and occurrence malpractice insuranceWhen do you need a tail?How often you should shop your malpractice insuranceThe key elements of a malpractice policyAttorneys and who decides when to settle a caseWhy your practice needs a malpractice policy (and not just the individual physicians)How to choose a malpractice carrierDo you need a broker and if so, how do you which oneWe 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/H64HxkWant 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." 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 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.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." 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’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 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." 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!