The Private Medical Practice Academy

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 in...

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 prov...

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 con...

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 s...

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 l...

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 statement
• 2021 Profit and Loss statement (so you can look at the year-over-year changes)
• Year end billing reports

To develop this year's strategic plan we need to do a post-mortem on the prior year. We n...

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...

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 w...

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 ...

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 ...

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 ABN
When you ...

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...

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) ...

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. Da...

 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...

 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...

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 ra...

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 benef...