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The Private Medical Practice Academy

The Private Medical Practice Academy

How to start, run, grow and leverage your private medical practice.

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Top 5 Things My Healthcare CPA Wants You to Know with Jeremy Kilbert, CPA

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 [email protected] 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.   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.
September 6, 2022

Why You Need An ABN

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 rather have their own set of rules. Some require an ABN. Some don't. Others have their own version of an ABN. Read your contracts to  determine what is required. 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 :)
August 24, 2022

Don’t Let Calling Your Office Be A Nightmare with Zed Williamson

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-solutionsIf 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.   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.
August 9, 2022

Improve Patient Care and Generate Revenue: Remote Monitoring

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.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.   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.
July 26, 2022

Understanding Payer Audits With David Vaughn JD, CPC

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 [email protected] 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.   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.
July 12, 2022

Add Chronic Care Management (CCM) and Principal Care Management (PCM) To Your Practice

 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 regimens, and/or the management of this condition is unusually complex due to the patient’s comorbidities.The condition requires ongoing communication and care coordination between the relevant providers who are involved in the patient’s care.The condition requires at least 30 minutes of PCM services per calendar month.To incorporate CCM and/or PCM into your practice, you will need to develop processes for implementation, tracking and billing. Tracking time and then using the appropriate codes is probably the most difficult part. You have to document the name of the staff member, the time spent, what they did specifically and their credentials. 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.   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 every
July 5, 2022

The Private Medical Practice Academy

Learn the nuts and bolts of how to start, run and grow your own private medical practice. I'll also talk about how to leverage your practice by adding vertically-integrated services. Using the tips discussed in this podcast you will make more money and take better care of your patients.
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Host

Sandra Weitz

Sandra Weitz

Dr. Weitz is a fellowship-trained, board certified pain management specialist who started and ran a multidisciplinary, multimodality practice with 11 providers. She did a surgery internship, anesthesia residency and pain management fellowship at UCSF. Dr. Weitz stayed on faculty at UCSF as the Director of the Pain Service. After 5 years in academics, she grew frustrated with the red tape, lack of control and limited income potential.

Dr. Weitz recognized that the only way to control the quality of medicine she practiced and her financial potential was to start her own private practice. Dr. Weitz bought a lot and built a 25,000 square foot medical office building to house her clinic and multi-specialty ambulatory surgery center. Dr. Weitz started, ran and grew multiple horizontally and vertically integrated medical businesses related to her medical practice in order to improve patient satisfaction and outcomes as well as generate revenue. She has syndicated shares in businesses to other physicians, sold businesses to publicly traded companies and private equity.

Now, Dr. Weitz teaches other physicians how to start, run, grow and leverage their own private practices. Her goal is to teach physicians the business of medicine so that they can have successful, lucrative medical practices that can be leveraged into other related revenue streams. In addition to The Private Medical Practice Academy podcast, Dr. Weitz has a Facebook group, The Private Medical Practice Academy to provide a supportive community for physicians at all stages of the private practice success path. She also offers consulting through her Private Medical Practice Academy Membership and on a one-on-one basis.

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