Starting Your Own Medical Practice: Essential Steps for Success

1. Practice Startup Steven D. Atwood, M.D., FACPInternal Medicine, Springfield, Missouri satwood@pol.net http://www.adultmedicine.com/presentations/practice-startup.ppt

2. Private Practice Will Not Go The Way of the Dinosaur • not assembly line • personal and private • big vs. small • perks--access, costs Why Key Traits for Success • hard worker • multi-task • communicate • well trained • Like Raising a Child

3. Guide Through Process of Going Out on Your OwnHelp for the Established Physician Wanting to Start a Practice

4. Initial Steps • These May Take Several Months to Complete • License • Hospital Staff Privileges

5. Phase 1

6. Phase 1 1. Phone Number

7. Phase 1 2. Post Office Box

8. Phase 1 3. Lease

9. Phase 1 4. Business Card

10. Phase 1 5. Pager-- Cell Phone

11. Phase 1 6. Liability Insurance

12. Phase 1 7. Furniture

13. Phase 1 8. Applications

14. Applications takes 4 Weeks, retroactive, separate form for electronic claim submission takes 4 Weeks, retroactive, online user--confirm pt. covered standardized form , not retroactive will need a site review to go active number must be on every Medicare claim with lab this is how insurance companies will identify you

15. Phase 1 9. Temp Agencies

16. Phase 1 • Trusted Helper • Multi-Task-- Notebook or Palm PC

17. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab

18. Phase 2 • Registration • Office Superbill • Hospital Superbill • Encounter Form • Problem Sheet • Med Sheet • Message Form • Coag Flow Sheet • Lab Flow Sheet • Letter Template • Fax Template • Application for Employment • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab

19. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • Licensing Board • DEA • AMA • Hospitals • Managed Care Networks • Insurance Companies

20. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab 3. W-9

21. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab 4. Kinko’s

22. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • Colwell • Medical Arts Press • Office Depo

23. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • Moore Medical • Henry Schein • Local Pharmacy

24. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab Include a PictureLocation & Office Phone

25. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • Line of Credit--$50K & take as needed • Second Mortgage on Home

26. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • See who hospital uses • Ask other docs in your area • Disposable

27. Phase 2 • Forms • Form Letter • W-9 • Kinko's • Paper Supplies • Med Supplies • Newspaper Ad • Bank • Gowns • Lab • Hospitals • National– Quest, LabCorp

28. Real Life Adventures

29. Real Life Adventures • Telephone Company Keeps Giving Old Number • Prior Operator Forgets How to Reach You • Old Patients Contacted to Change Docs • Restrictive Covenant

30. Real Life Adventures • Participating Provider Block • Participating Provider Delay • Participating Provider Notification Forgotten • Employed Paid Better than Independent

31. Real Life Adventures • Old Billing Office Absorbs Your Checks • You Forget to Apply to RR Medicare • Insurance Companies not Pay for First 3 Months

32. First Quarter • Phone Book Ad • Website or Office Brochure • Software Word Processor, Quicken, QuickPay Scheduling vs Colwell Schedule Book Billing Software EMR ?? • Network Computers--- (all plug & play)

33. First Quarter • All-in-One Machine– Fax / Copy / Print / Scan • Fax to Computer—HotFax • Dictation– Digital ?better quality sound smaller dictaphone send and receive dictation 24/7 no staff space, no staff benefits, guaranteed 24h turn around

34. First Quarter Marketing Rotary Church Physician Meetings Physician Staff Lounge Staff Cafeteria Don’t be a Wall Flower

35. First Quarter Marketing Easy Access for Patient phone / appointments Freebies sample meds, no charge visit Call and Check on Patient the Next Day Predictable Hospital Rounds

36. First Year • Clearing House for Electronic Claims • Pension Plan for Office • Cafeteria Plan for Staff • Collection Agency • Group Health

37. Best Time Savers • Cell Phone as a Pager • Message Pad • Problem List / Med Sheet

38. Best Cost Savers • Health Insurance via Staff using Cafeteria Plan • Cell Phone as a Pager • Faxes Received and Saved by Computer

39. Hardest Thing • Managing Staff– short-handed because of sick kids, snow days • foul-ups because staff • forgot the routine system

40. Best Thing • More Flexibility to Do What is Best for Your Patient • Ability to Quickly Fix Things • eg. Computer problem phone equipment deficiency • need new fax machine

41. The End