1. Starting Your own Practice
Presented by:
Dale Rothenberg, CHBC
Exec. Vice President, Partner
DoctorsManagement, LLC

2. 6 Months before opening Obtain State Medical License
Select an Attorney
Select an Accountant
Determine Practice Entity
Choose an appropriate Practice Name
Develop a Logo
Determine Financial Resources Available
Develop a Budget and Cash Flow projections
Determine Appropriate Physician Compensation

3. 5 months before opening
Apply for Federal Employer Identification Number
Apply for State Unemployment and Income tax numbers
Determine practice Location
Prepare Commercial Loan Proposal (if needed)
Open practice checking account
Decide on Lab Complexity – Waived or Moderate
Finalize office layout
Determine Site and or Office improvements Needed
Negotiate Leasehold Arrangements
Reserve Office phone and fax Numbers

4. 5 Months Con’t 20. Obtain NPI numbers
21. Initiate Enrollment with Commercial and Government Payers
Obtain Federal and State Narcotics Licenses
Review Managed Care Contracts

5. 4 Months before opening Arrange for Proper Insurance Coverage
General Business Liability
Malpractice
Worker’s Compensation
Health
Disability
Life
25. Compile List of In- House Lab Tests
Aquire a Telephone System
Obtain pager and other Communication services as necessary
Determine Office and Medical Equipment Needed (Place order)
Decide on Medical Records and Billing system

6. 4 Months con’t
30. Determine Office hours and Scheduling system 31. Select and purchase needed Computers 32. Arrange for Employee Computer system Training

7. 3 months before opening
33. Place Ads, Conduct interviews and Hire Practice Manager 34. Determine Fee schedule 35. Order Stationary, Business Cards 36. Order Clinical and Office Supplies 37. Order CPT and ICD-9 coding books 38. Design Encounter form (Charge slip) 39. Decide on Accounts Payable system 40. Develop Appropriate Marketing Strategy 41. Develop Practice Web Site

8. 2 months before opening
42. Meet with Potential Referral Sources 43. Develop Personnel Policy Manual 44. Obtain Regional Wage Scale 45. Develop Employee Job Descriptions 46. Acquire Required Federal and State Employment Law Posters 47. Develop Patient Information Brochure 48. Develop Office policy Operations Manual 49. Arrange for Payroll Service 50. Develop OSHA, HIPAA & CLIA Compliance plans

9. 1 month before opening
51.Place ads, interview, Hire Front and Back Office Staff 52.Order Lab Supplies 53. Create Personnel Files 54. Order Reception Area Publications 55. Arrange for Janitorial and Laundry and Security services 56. Select Collection Agency 57. Apply for CLIA Certificate 58. Announce Practice Opening and Plan for Open House 59. Assemble Patient Registration Packet.

10. 2 weeks before opening
Start Accepting Appointments
Staff Training

11. Hourly Wage Comparison
Job Title Hourly Rate Relative Value
Administrator $
Bookkeeper $
Collections Supervisor $
Data Entry Clerk $
Front Desk Clerk $
Insurance Supervisor $
LPN $
Medical Assistant $
Office Manager $
Receptionist $

13. NSCHBC Data Family Practice (2010)
Charges $864259
Adjustments $275,224
Collections $559, % Adjusted Collection Ratio
Personnel $178,836 32% 1Mid level, 4staff
Supplies $ 44, %
Facility $ 40, %
Equipment $ 16, %
General Admin $ 78,224 14%
Total Overhead $358, %
Profits $201, %

14. Concierge Medicine Also known as “Boutique” or Personalized” Practices
Non reimbursable fee for 24/7 access, same day appointments and a greater degree of personalized attention. Average $1800
Lower hospitalization rates?
In ,400 private physicians . American Academy of Private Physicians
350 to 500 patients vs 2500 patients in traditional practice
More focus on education and prevention not reactive and episodic care
More money for the doctor means more time for the patient.
Less Staff means lower overhead
Critics argue it will exacerbate the physician shortage providing care to elitist type patients.
Some physicians were “burned out” and chose the concierge route.

15. Thank you!