Starting a medical practice / Jeffery P. Daigrepont.

Format:

Book

Author/Creator:

Daigrepont, Jeffery P.

Contributor:

Mink, Lauretta.

American Medical Association.

Series:

Practice success series

Language:

English

Subjects (All):

Medicine--Practice.

Medicine.

Practice Management, Medical--organization & administration.

United States.

Facility Design and Construction.

Professional Practice--legislation & jurisprudence.

Medical Subjects:

Practice Management, Medical--organization & administration.

United States.

Facility Design and Construction.

Professional Practice--legislation & jurisprudence.

Physical Description:

xvi, 186 pages : illustrations ; 28 cm.

Edition:

Second edition.

Place of Publication:

[Chicago] : AMA Press, [2003]

Summary:

Whether you're establishing a solo practice or joining a group, beginning the practice of medicine requires considerable forethought. With new and updated information, Starting a Medical Practice, Second Edition helps physicians ask the right questions before they begin the process, and gives them the business insights they need to get their practices running smoothly from the outset. This guide begins with discussions and exercises that assist physicians in setting professional goals and determining practice structure. It then addresses the operational details of medical practice management, including leasing office space, purchasing equipment, and integrating technology. Chapters on managing personnel, developing policies and procedures, and financing and marketing the practice also are included, as well as information on tax, licensing, insurance and compliance requirements. Today's physicians enter practice with enthusiasm and idealism, but often become overwhelmed by the business side of providing health care. Starting a Medical Practice, Second Edition offers timely principles and practical advice to help them plan an efficient and successful transition into the practice of medicine.

Contents:

Factors Influencing Your Decision 1

Table 1-1 Practice Style Decision-Maker 2

Helping Ensure Your Success 3

Where to Look for Employment Opportunities 4

Where to Find Information Concerning a Geographic Location 4

How to Determine the Area's Need for a Physician 4

Table 1-2 Time Line for Starting to Practice Medicine 5

Table 1-3 Location Decision Scorecard 10

Selecting Professional Assistance 11

Legal Assistance 11

Accounting Assistance 11

Other Advisors to Consider 13

2 Choosing an Organizational Structure 17

Types of Medical Practices 17

Sole Proprietorship 18

Figure 2-1 Sole Proprietorship

Advantages and Disadvantages 19

Control 19

Liability 20

Continuity and Transferability 20

Taxes 20

Pros and Cons 20

Partnership 20

Types of Partnerships 21

Figure 2-2 Partnership

Advantages and Disadvantages 22

Control 23

Liability 23

Continuity and Transferability 23

Taxes 24

Pros and Cons 24

Corporate Practice 24

Figure 2-3 Corporate Practice

Advantages and Disadvantages 25

Control 26

Liability 27

Continuity and Transferability 27

Taxes 27

Pros and Cons 28

Other Business Models and Alternatives 28

Limited Liability Corporation 28

Control 29

Liability 29

Continuity and Transferability 29

Taxes 29

Office-Sharing Arrangements 30

Comparing Legal Entities 31

Table 2-1 Comparison of Legal Entities 31

3 Selecting Your Professional Path 33

Choosing a Structure 33

Recent Trends in Physician Employment Initiatives 33

Table 3-1 Practice Option Grid 34

Group Practice

To Join or Not to Join? 35

Finding Information and Opportunities in Group Practice 36

Employment Contract 36

Understanding Restrictive Covenants 39

Income Distribution and Expense Allocation 40

Income Distribution 40

Methods of Expense Allocation 40

Compensation 41

Group Practice Questionnaire 41

Figure 3-1 Group Practice Questionnaire 41

4 Regulations and Licensing Requirements 47

Regulations for Starting a Medical Practice 47

Employer Identification Number (EIN) 47

State Tax Identification Number 48

State Medical License 48

Medical Staff Privileges 48

Federal Narcotics License/Drug Enforcement Administration Number 49

State Narcotics License 49

Universal Provider Identification Number (UPIN) 49

Medicare Provider Number 50

Medicaid Provider Number 50

Retired Railroad Employees' Coverage 51

Business License 51

Laboratory License 51

Table 4-1 CLIA Test Categories 52

Table 4-2 In-house Lab Compliance Checklist 52

General Regulatory Issues and Agencies 53

Center for Medicare and Medicaid Services (CMS) 54

Health Insurance Portability and Accountability Act (HIPAA) 54

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 54

Office of Inspector General (OIG) 54

Department of Justice (DOJ) 55

Occupational Safety and Health Administration (OSHA) 55

Department of Labor (DOL) 55

Equal Employment Opportunity Commission (EEOC) 56

5 Society Memberships/Practice Affiliations 57

Medical Society Membership 57

American Medical Association (AMA) 58

National Specialty Societies 58

State and Regional Medical Organizations 58

Local Medical Societies 58

Table 5-1 The Federation of Medicine 59

Civic Groups 60

Other Practice Affiliations 60

Managed Care Organizations (MCOs) 60

Table 5-2 House of Delegates of the AMA 61

Call Group Affiliation 62

Physician Referral Service 62

Emergency Room Coverage 62

6 Instituting Operational Procedures and Processes 65

Establishing a Fee Schedule 65

RBRVS in a Nutshell 66

Figure 6-1 The Complete RBRVS Formula 66

Cost of Providing a Service versus Practice Fees 67

Figure 6-2 An Example of a Breakeven Chart 67

Purchasing Supplies 68

Table 6-1 Tips for Purchasing Supplies 69

Accounts Payable 69

Chart of Accounts 69

Paying Bills 70

Table 6-2 The Payment Process 70

7 Equipping Your Practice with Information Technology 71

Using Technology in Your Practice 71

Figure 7-1 Workflow Comparison for Paper Chart versus Electronic Medical 72

The Paperless Office 72

Standalone Systems 75

Figure 7-2 Client/Server Model 76

The Application Service Provider (ASP) Approach 77

Figure 7-3 ASP Client Model 80

Internet/Web-based Application 80

Selecting the Right Kind of Technology 81

Purchasing Your Solution 81

8 Identifying Insurance Requirements 83

Professional Liability Insurance 83

Choosing a Professional Liability Carrier 84

Purchasing Coverage for Malpractice Claims 84

Business Insurance 85

Commercial General Liability Coverage (CGL) 85

Property Insurance 86

Computer Coverage 86

Business Interruption Insurance 86

Employee Dishonesty Insurance 86

Equipment Breakdown Coverage 86

Umbrella Policy 87

Workers' Compensation Insurance 87

Purchasing Insurance Policies 87

Figure 8-1 Insurance Plan Assessment 88

9 Financing the Medical Practice 91

Financing Options 91

The Pro Forma 92

Figure 9-1 Pro Forma Initial Questionnaire 94

10 Selecting and Leasing Space and Purchasing Equipment 99

Selecting an Office Location 99

Negotiating a Favorable Lease 99

Table 10-1 Office Space Planning Checklist 100

What to Look for in an Office Lease 101

Acquiring Equipment 103

Leasing versus Purchasing 103

Telephone System 104

Medical Devices 105

Copy Machines 105

Fax Machines and Printers 106

Computers 106

Furniture 106

11 Managing Personnel 109

Employment Laws 109

Title VII of the Civil Rights Act of 1964 109

Age Discrimination in Employment Act (ADEA) 110

Americans with Disabilities Act of 1990 (ADA) 110

Fair Labor Standards Act of 1938 (FLSA) 110

Equal Pay Act 111

Rights of Military Personnel 111

Discrimination for Sexual Orientation 111

Workplace Privacy 112

Equal Employment Opportunity Commission (EEOC) 112

Employment Classifications 112

Exempt Status 112

Nonexempt Status 113

Wage Records Requirements 114

At-Will Contracts 114

Posting Requirements 115

Workers' Compensation 116

OSHA Workplace Requirements 116

Hiring Employees 117

Setting a Salary Range 117

Sources for Developing a Pool of Candidates 118

Placing an Effective Classified Advertisement 118

Preparing for the Interview 118

Interviewing Questions 119

Checking References 119

Orientation or Trial Period 120

Personnel Files 120

Performance Appraisals and Salary Reviews 121

Salary Reviews 122

Counseling, Discipline, and Termination 122

The Employee Handbook 123

Handbook Format 123

Table 11-1 Sample Table of Contents 124

Sample Job Descriptions 125

Figure 11-1 Job Description

Office Manager 125

Figure 11-2 Job Description

Medical Assistant, Clinical 126

12 Developing Policies and Procedures 127

Developing a Policies and Procedures Manual 127

Types of Appointment Schedules 128

Figure 12-1 Sample Policy

Appointment Scheduling 129

Table 12-1 Ten Tips for Efficient Scheduling 130

13 Billing and Reimbursement Protocols 131

Collecting from Patients 131

Collecting at the Time of Service 132

Collecting from Third-Party Payers 132

Interfacing with Insurance Companies 132

Indemnity Plans 133

Managed Care Plans 133

Discounted Fee-for-Service Plans 133

Capitated Plans 134

Workers' Compensation Insurance 134

Insurance Filing and Follow-up 135

Billing the Patient 136

Using a Collection Agency 137

Table 13-1 Patient Billing and Follow-up Schedule 138

Using Credit Cards to Enhance Collections 138

Figure 13-1 Checklist for Selecting a Collection Agency 139

Writing a Collection Policy for Your Practice 140

Table 13-2 Policies and Procedures for Handling Collections 140

14 Loss Prevention and Risk Management 143

Critical Tasks in Risk Management 143

Addressing

Areas of Risk through Operational Improvements 145

Scheduling 145

Billing and Collections 146

Environment 146

Medical Equipment 147

Emergencies 147

Confidentiality 147

Handling Patient Complaints 148

Termination of the Patient/Physician Relationship 148

Rights of the Patient 149

Figure 14-1 Sample Discharge Letter 150

Consent to Treatment 150

Informed Consent to Treatment 151

Fraud and Abuse 151

The Medical Record 152

Authorization to Release Records 152

Medical Records Documentation 154

Documentation to Support Level of Service 154

Figure 14-2 Medical Records Checklist Form 155

Charting the Patient's Progress 155

Organizing the Patient File 156

Figure 14-3 Sample Patient's Chart Map 156

15 Building Your Practice through Marketing 159

Developing Marketing Strategies 159

The Marketing Budget 159

The Marketing Plan 160

Practice Building Guidelines for the Future 161

Building Patient Satisfaction 163

Practice Services and Amenities 163

Figure 15-2 Patient Satisfaction Survey 164

Standards of Patient Service for Medical Staff 165

Yellow Pages Advertising 166

Creating a Medical Practice Brochure 167

How to Create a Brochure 167

Brochure Contents 167

Appendix A Professional Associations 171.

Notes:

Rev. ed. of: Starting a medical practice / Lauretta Mink. c1996.

Includes index.

Related Work:

Mink, Lauretta. Starting a medical practice.

ISBN:

1579472966

OCLC:

50769380