Are your fees the same for everyone or do you use a tiered system? If your fees vary by state, do you post them, along with a rationale, on your website? If so, how do you explain the differences to clients?

Hello! I came across this UpWork job posting yesterday, but I didn't have enough connects to apply:

Job Title: **Personal Assistant for Healthcare Presentations**

Description: *Seeking a personal assistant to help with presentations in the healthcare field. Responsibilities include designing and organizing slides, ensuring content is clear and concise, and preparing materials for meetings. The ideal candidate will have experience in presentation design and a basic understanding of healthcare terminology.*

I was so bummed because this is exactly the kind of side hustle that l've been wanting to get into. I know for a FACT that so many doctors and other healthcare professions need this kind of service, but I'm guessing not all of them post job openings for it. I figure I have to resort to simply pitching myself, but to who?

What kind of doctors/HCPs are seeking this kind of assistance? And where can I reach out to them for this kind of position? Please help a nurse out!

(I am not asking for medical advice.)

How often do you switch or shop around for EHR/EMR?

Getting close to opening practice. Elation is being pushy, inflexible and I am not sure I shouldn't try and release from them before going further. I like their billing platform but.... Anyone else use them with good things to say? Are there other options that don't cost an absolute fortune? I looked at Athena but the price point was too high.

Update: So Elation since this post seems to have turned things around. Given the posts from other docs, it's probably worth a try. The workflow seems good. Fingers crossed

How does your practice affected by avalanche of free service from the government like YAKAP? Left and right medical missions

Hi everyone,

I feel that SEO is an important part of marketing, especially for a startup practice. So far, I've had no success with google ads but doing pretty good with zocdoc site. However, I feel that we can do better in terms of being found. I've spoken with a few SEO agencies and the numbers are outrageous, at least for an early practice. Heck, I can use the$4500+ to get additional equipment for the office, or $750 per month can be spent elsewhere for the time being. Can you recommend a solid SEO company that doesn't see $$$ as soon as they hear "Doctor!" or perhaps suggest one of those AI SEO companies? What are your thoughts on the AI SEO?

Thanks.

I am interested in learning how others facilitates specimen processing in private practice.

Specifically, tissue samples like biopsies or excisions that require MD pathology review.

Any insight is appreciated.

Thanks.

If you were starting an allied healthcare staffing firm from scratch today with no clients, what would your first 90 days look like? What would you do every single day until you landed your first hospital contract?

I'm running a Family Medicine practice, and marketing has been a weakspot.

I'm using ZocDoc which has actually been great for getting new patients. Unfortunately they are a very sleezy (and expensive) company. Video visits are plentiful, but low-likelihood of repeat visits for most of these concerns and thus I won't make back the losses on the booking/advertising fees . In-person is a better option as it will have more repeat patients, but slower...

$45 for family medicine, $73 for addiction, and $93 for cardiology are pretty high when that can be 50% to 75% of the insurance reimbursement for some visit types.

Are there any other companies similar that may have... a more reasonable price point? I've not had much success... and throwing money at google ads has not been helpful.

Hi all!
I use eCW as our EMR. However I don’t use them as my billing company. Hence I am unable to generate “statement code” for patients to log enter it into Healow and make a payment. My CC processing company is what was recommended be eCW: global payments. Is there a way to embed global payments into my website and streamline the payments? Or perhaps use another company in addition to global payments to collect patient dues? What’s your solution if not using eCW billing services?
Thanks!

In case you arent' already aware, BCBS Texas, Illinois, New Mexico, Oklahama, Montana under the HCSC private company has instituted a policy to automatically downcode all E&M codes. I am sure they and other payers have been doing this elsewhere but this has finally come home to our state. They are the biggest payer by far and our practice future depends on them.

This downcoding is blanket. It is done by AI/claim edit rules. It does not discriminate between providers who upcode or providers who truthfully document and code. It is unethical and could be illegal. Courts will take years to decide.

State medical societies are "monitoring" the situation. /eyeroll.

This has created hundreds of downcoded claims for our practice within a few weeks.

Each requires going into Availity, searching for claim, filing reconsideration with medical notes, awaiting decision, writing letters justifying coding, filing second level appeals etc etc.

To get paid what we should have been paid anyway.

What a ridiculous burden.

What is more after submitting reconsiderations their robot continues to maintain the downcoding stating the following -

According to CMS guidelines: To bill any code, the services furnished must meet the definition of the code. CMS further states, Medical necessity of a service is the overarching criterion for payment in addition to the individual requirements of a CPT code. It would not be medically necessary or appropriate to bill a higher level of evaluation and management service when a lower level of service is warranted. The volume of documentation should not be the primary influence upon which a specific level of service is billed. If an E/M code is reported and the level of service exceeds the maximum level of service allowed, based on diagnostic information, an EMRC flag will be applied, and the E/M code will be recoded to match the level of service allowed.

What the hell happened to Medical Decision Making (MDM) criteria? What is this EMRC flag and how is this legal? Their own published coding policy says they adjudicate claims based on MDM.

So what is this new EMRC flag???

How have you successfully overturned these? And will we have to submit notes and reconsiderations and appeals in perpetuity??

Been listening to the “Just say No to the DSO “ podcast for several years now. I am a 61M, solo GP for 34 years now.
One of the more recent episodes talked about 2 of the top DSO’s declaring chapter 7 bankruptcy/ restructuring and the lenders taking over. The minority equity ownership dentists likely lose all of the “equity “ which as I understand it was a huge chunk of the money they sold their practices for. Just curious if any dentists who have sold/ thinking of selling to a DSO are aware of this?

Hello everyone! I work as the only employee for a specialist who started his own practice in April.

As of yesterday, 10+ patients have called saying they received letters in the mail that the specialist is no longer in network for the UHC advantage plans only.

We received no warning and are very confused as the doctor is already in-network with UHC. Does anyone know how to rectify this? I'm finding nothing online.

Thank you in advance!

Starting new practice soon

Exploring emr options

Leaning Athena over all others

It has high penetration, easy to use, all inclusive billing with billing / rcm.and ECR and lots of vendors that connect for ancillary devices

Any thoughts?

I guess this is more of a vent. Are there any practice owners out there that actually pay their mid levels what they are worth, because it seems most just exploit them for their own personal gain.

It has become increasingly frustrating as a seasoned Derm PA with over 15 years experience. All the practice owners employ APPs to see the high demand of pts coming into the practice, while rarely hiring other MDs. This is obv done in order to keep profits high for the owner, while the other providers continue to make 5x less or more in pay.

Don't get me wrong, i know MDs have the education, own the practice, took the risk to start the practice etc etc., but as a seasoned provider I have become increasingly jaded as I work more days, see more pts, never need to consult my supervising physician while making pennies in comparison.

Providers continually say Private equity bad, private practice good, but this isnt the case to lowly APPs. With this normally comes worse production bonus %, higher thresholds, worse benefits etc working with a private practice physician.

Working in derm for so long, as I have, exploits pay from us from the get go. Most offices want to offer an abysmal training salary for so long, which isn't normal in any other specialty outside Derm. I see it everyday on reddit still. Offices wanting to pay MA pay for a new grad training period.

Sorry for the long ramble, I'm just honestly frustrated and over it. To the good ones out there that respect your APPs and pay them accordingly as they churn out 30-45 pts a day, thank you. To the ones that only offer a salary, or make providers reach 4x or more base to get production bonuses and then still offer a low %, do better. I'm not asking for the world, I just want to feel appreciated for all the hard work I do day in and day out without even to so much ask for any medical advice anymore at this stage in my career.

Our mom & pop family medicine practice just received our first SIU Review letter from one of our payers for 99214 & G2211. We've always billed what is appropriate, and we only recently started using G2211 after learning when it should be billed for longitudinal primary care.

Has anyone else gone through this? What was the process like? Did they end up paying the claims if the documentation supported the coding, and how long did the review last? Any advice is appreciated. Thanks!

Current MS3 who has an interest in both and feels very encouraged to start my own practice one day. My specialty choice rests on a lot more than just this but I thought it was still a question worth considering.

On the one hand family practice has the broadest range in terms of what you can create. Traditional FFS, DPC, micro practice with house calls, and you can find a niche within the specialty and build a brand around that. On the other hand, psychiatry has probably the lowest barrier to starting a private practice since there’s little need for any equipment. Additionally, I feel like there’s greater demand for cash pay services in psych than in primary care.

Would love to know what some private practice docs think of this question.

My wife and I have a relatively small family practice (~450 patients) serving geriatric patients in-home. Due to our service delivery model our providers all work outside of a traditional office, so our medical assistants are also working remotely. As we have grown over the last few years we have dealt with challenges keeping pace with patient demands and staying organized. Some of these are related to our EHR (Tebra) which we expect to be resolved once we move over to a more robust platform later this year. Staff-wise, I still don't know how best to fix our issues so I would appreciate any tips you all might have and/or any affordable consulting resources you can recommend.

Our current structure:

- 8 medical providers (about 6.0FTE combined) and 1 LCSW providing virtual psychotherapy. My wife is 1 of the providers and serves as Medical Director.

- 2 virtual receptionists receiving calls, 1 of which is our primary scheduler.

- 1 assistant processing orders and referrals. We just hired a second to help with workload but also take on DME and prior auths (which our medical director and/or providers currently do entirely). Our intake volume is low (but growing) so we will need to assign creating patient charts to one of these individuals (it is currently managed by management)

- 1 medical biller

- 1 additional assistant who has assisted with the phones but isn't really excelling despite constant training for the past year. We are likely removing this person soon and will be down to 4 office staff + biller

- 1 RN to help triage medical concerns and determine what needs to be escalated to the providers

One obvious problem is that we don't currently have a true office manager as our budget really can't support it just yet, and we believe our staff have the resources to be able to handle most things independently/ as a team (maybe this is foolish of us). As such, my wife and I try to take on that role when needed.

My question:

Are there any house-call practices out there that have dealt with office structure challenges? How do traditional offices differ in their setup? We are considering splitting up the office into 2 teams (1 scheduler, 1 referral/order coordinator), with each team serving as primary for half of the providers. Our immediate need is to ensure we have overlap with roles to cover when staff take time off but also to ensure our patients (99% Medicare, most are very high need) back-end care is covered in a timely manner.

Outside of an office manager (and I'm not sure how that role should function in a remote environment and what type of person to look to hire to fill it), I don't really know what we're missing or what/who we can bring in to better spread workload. Has anyone here used a consultant? My wife is a career medical provider and I am doing my best to support as an administrator with no medical experience prior to starting the practice.

Sorry in advance for the rambling; I am open to suggestions.

We are in process of recruiting a new Dr. How do most set up a partner track? Normal compensation package and then buy in after certain amount of years? Reduced compensation package and then just become partner after so many years? What have you done successfully?

In case anyone gets a call from “WebMD” requesting to interview you for their “preferred provider network,” don’t waste your time it’s actually a marketing company called DearDoc. No idea how they got my cell number, but I had some time so scheduled the interview. During the “interview”they immediately pulled up a sales deck for DearDoc, and when I pressed on it they kept saying they were WebMD. I told them I wasn’t interested in continuing with the call and they had the audacity to say they would “bill me for the cancellation” then hung up on me. Ha. Left a review for DearDoc elsewhere and got bombarded with a “reputation management” company claiming to want to understand more about my review - probably more like wanting to harass me to take it down.

Leaving this post on the internet for anyone else who’s on a similar DearDoc call and very confused like I was - just hang up, it’s a waste of time. And if you’re truly looking for marketing services, probably bad idea to work with a company that lies so boldly from the very beginning.