Practice Startup Questions

[Guest guest]

Welcome!I'll take on #3:  Space for new patients.  You can take this by ear.  What I have found is:

1.  New patients, like everyone, LOVE if they can be seen ASAP which surprises them.2.  New patients are most likely to no show, particularly if scheduled out more than a few days.  Not very likely in my experience, but more so than any of my established patients.  So, I have stopped scheduling long appointments with new patients and instead do a shorter (30 minute) get to know visit.  In my case (membership practice), if we have talked on the phone and the patient has already committed to joining (i.e. paid), then, of course, that is waived and I tend to schedule 2 hours depending on the situation.

3.  When practice is full or nearly full, you can hold new appointments a little farther out to allow access to current patients for same day/next day (some scheduling programs allow this flexibility automatically).  This will get patients who really are committed to your practice (which is generally good but occasionally selects for the desperate and needy ).

Have fun planning!

SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA  92617

PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax:  www.SharonMD.com

 

I just want to say what a blessing this group has been! I look forward to seeing emails from the listserve pop up on my phone as I always learn so much!

I am hoping to start my own IMP within the next two years (preferably as soon as possible). Here's some questions I have for the group (and please forgive my ignorance and naivety):

1) Is it legal to limit the amount of medicare/medicaid you will accept? That is, I want to limit my practice to 5 or 10% medicaid as it pays so poorly here (TN) but I have patients who have established with me in my current practice that I would like to continue to take care of but I want to be financially viable, which I can't be if I leave the doors wide open to all comers.

2) For those of you who have " niche servicess " within your practice - i.e. accupuncture, etc. how do you handle the open access for these patients for whom you are not providing PCP care with those patients for whom you are the PCP? I currently do manipulation (OMT) and plan on adding accupuncture services in the future.

3) With open access scheduling, how do you control your schedule in the beginning when the majority of your patients will be new? At what point do you restrict your new patient appts to maintain 24-48 hr availability for those who are established? I know it varies between practices, but what % of appts do you schedule out vs leave open?

4) I am currently employed and contracted with several plans some of which I will continue to accept when I am on my own...how is it handled when you continue to work under the plan in one practice while you are trying to open another practice? I have not yet told my current employer that I plan to leave as I want to have as much as possible thought out/arranged ahead of time before I make the leap. I do have to give 6 months notice and will do that, but I know the recredentialing can sometimes take awhile and I'd like to move as smoothly as possible from one to the other as I can't afford to take a large amount of time off.

Thanks for the input! I'm sure there will be a ton more questions as I pursue this journey!

[Guest guest]

Dear newbie, we are newbies too. we have so many questions and we always ask. I found this IMP list like an oasis because I can always find

many helping hands for my doubts.

Regarding questions number 1, I am not a lawyer but you make decisions regarding the limit of your patients.

We opened Orange Doc in November 2011 ( you see newbie). We are 2 mojicans jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc.

She loves kids and I told her follow your Passion so she makes my practice vibrant and active when I heard crying on her room.

I made the decision to not accept medicaid only for adults, I do as a secondary of medicare. I learned that medicaid always refused to pay me when is second in line.

We made the decision to allow medicaid only for kids, since there are a lot medicaid kids in the area. She only has to see 30% of her patient population to qualify for uncle sam money. I think you are the one making the decision to open or close the doors in that matter.

Deep in my heart I can tell you that I really do not care about uncle sam money. I think there is not such a thing like a free lunch. I think uncle same will make sure to make your life miserable in the future so you will pay with your blood for the pennies that he will give you. I think all the committees of the uncle sam will make sure that the quantity of requirements will quadruple and you or your office will have a hard time to full fill the requirements ( I think that the nature of the beast).

regarding your questions about the scheduling, I have appointments and also patient portal's appointments. I can tell you what I do:

New patients I spent like 45 minutes the first visit, I make sure I got all the info and questions answered. I want to know when was the last colon eval , mammo etc.

I make sure that I listen to them and give them undivided attention. Also I make a full physical exam,head to toes.

I noticed that when they come back to follow up I do not have to spent the same amount of time gathering the info. I am quicker with the F/Us.

Our plans is to see patients and not practice treadmill medicine, that is the goal of IMP type of practice.

We are getting fuller day by day, sometimes I have 1 patient in my schedule and them 5-7 call wants to be seeing. I can tell you that sometimes I see 12-11 patients in day.

We are open M,W and F only. I am doing urgent care and my wife still working as NICU RN. Our goal is to go to M-F soon and quit our side gigs,when? I do not know.

I can tell you that we were asking every month to the bank money to operate the clinic. I think that last time that I asked the bank money was in January. Orange Doc is paying itself ( except our salaries, we are not getting paid) every month.

My wife is holding the fort because she deals with the phone calls from every body, she does the billing and the pain in neck insurances. She does not have a lot of experience but she work hard to make sure we get paid. She also see her patients part time. We have no staff working for us for now.

I think we are going to have gaps for same day appointments for those patients that need to be seeing now.

Regarding the questions about the credentialing process, I was in your shoes before not wanting my employer to know about my plans,it is very stressful dealing with that.

I can tell you that my experience with corporate America is not the best. I think God bless me because I got laid off from a previous Urgent care where I got betrayed by my employer and then I found this new UC job and the guy was fulling around with me and he gave me a part time only.

I took the part time and bite the bullet and look around my town for the correct place until I found it. I made my corporation and I look for a person to help me with the credentialing part. I know a lot of people in the list would tell you that you can do it only via CAHQ something, I hire that person and she started the process since 08/2011. You have to have a physical location to start the process you can not use a P.O. Box. I spoke to my future land Lord and told him that I needed to rent the office 3 months before I open the doors and I asked him to give me those 3 moths free ( what the heck what I had to loose).

He did not give it to me for fee but he cut 50%

My credentialing person did all the paper work believe me it is worse then buying a house, do you have time for that? I did not so I hire her.

You have to create new contracts with the health insurances since you are working under a different umbrella or corporation.

I had to submit a form to Blue cross of FL to divorce a previous practice that takes time.

Basically you have to make sure that you have the time and money to be able to make the jump.

Dealing with the banks is another 200's pages story.

anyway my 1/2 cent. If you want contact me off the list and we can chat I can tell you my experiences.

Adolfo

you can find us in Youtube : OrangeDoc

you can see our tour video of my practice .

www.orangedocfamilymedicine.com

To: Sent: Thursday, May 24, 2012 9:32 AMSubject: Practice Startup Questions

I just want to say what a blessing this group has been! I look forward to seeing emails from the listserve pop up on my phone as I always learn so much! :)I am hoping to start my own IMP within the next two years (preferably as soon as possible). Here's some questions I have for the group (and please forgive my ignorance and naivety):1) Is it legal to limit the amount of medicare/medicaid you will accept? That is, I want to limit my practice to 5 or 10% medicaid as it pays so poorly here (TN) but I have patients who have established with me in my current practice that I would like to continue to take care of but I want to be financially viable, which I can't be if I leave the doors wide open to all comers.2) For those of you who have "niche servicess" within your practice - i.e. accupuncture, etc. how do you handle the open access for these patients for whom you are not providing PCP care with those patients for whom you are

the PCP? I currently do manipulation (OMT) and plan on adding accupuncture services in the future.3) With open access scheduling, how do you control your schedule in the beginning when the majority of your patients will be new? At what point do you restrict your new patient appts to maintain 24-48 hr availability for those who are established? I know it varies between practices, but what % of appts do you schedule out vs leave open?4) I am currently employed and contracted with several plans some of which I will continue to accept when I am on my own...how is it handled when you continue to work under the plan in one practice while you are trying to open another practice? I have not yet told my current employer that I plan to leave as I want to have as much as possible thought out/arranged ahead of time before I make the leap. I do have to give 6 months notice and will do that, but I know the recredentialing can sometimes take awhile and

I'd like to move as smoothly as possible from one to the other as I can't afford to take a large amount of time off.Thanks for the input! I'm sure there will be a ton more questions as I pursue this journey!

[Guest guest]

Thanks for sharing your story, Adolfo!

I am assuming you can put an effective date on the new contracts?

What my concern is, I may have to stay on part time with my current employer (1

day a week) doing manipulation/sports medicine as that is my " niche " and they

don't have anyone else to do that as a way to " compensate " them for paying off a

huge chunk of my student loans. In my contract, I get x amount " forgiven " for

what they have paid on my behalf for every year I stay on. This was spread out

over 6 years. No way in hell I'm gonna make it 6 years so I'm on the hook for

whatever is left--at this point $125k. My thinking is, if I say I will stay on

1 day a week doing this for them, maybe we can work something out where I can

still leave and do my own practice and not have to get a loan to pay them off.

Back to my concern--what if we both take the same insurances--me in my IMP and

then working as a " specialist " there? How would that work?

>

> Dear newbie, we are newbies too. we have so many questions and we always ask.

I found this IMP list like an oasis because I can always find

> many helping hands for my doubts.

>  

> Regarding questions number 1, I am not a lawyer but you make decisions

 regarding the limit of your patients.

> We opened Orange Doc in November 2011 ( you see newbie). We are 2 mojicans

jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc.

> She loves kids and I told her follow your Passion so she makes my practice

vibrant and active when I heard crying on her room.

> I made the decision to not accept medicaid only for adults, I do as a

secondary of medicare. I learned that medicaid always refused to pay me when is

second in line.

> We made the decision to allow medicaid only for kids, since there are a lot

medicaid kids in the area. She only has to see 30% of her patient population to

qualify for uncle sam money. I think you are the one making the decision to open

or close the doors in that matter.

> Deep in my heart I can tell you that I really do not care about uncle sam

money. I think there is not such a thing like a free lunch. I think uncle same

will make sure to make your life miserable in the future so you will pay with

your blood for the pennies that he will give you. I think all the committees of

the uncle sam will make sure that the quantity of requirements will quadruple

and you or your office will have a hard time to full fill the requirements ( I

think that the nature of the beast).

>  

> regarding your questions about the scheduling, I have appointments and also

patient portal's appointments. I can tell you what I do:

> New patients I spent like 45 minutes the first visit, I make sure I got all

the info and questions answered. I want to know when was the last colon eval ,

mammo etc.

> I make sure that I listen to them and give them undivided attention. Also I

make a full physical exam,head to toes.

> I noticed that when they come back to follow up I do not have to spent the

same amount of time gathering the info. I am quicker  with the F/Us.

> Our plans is to see patients and not practice treadmill medicine, that is the

goal of IMP type of practice.

> We are getting fuller day by day, sometimes I have 1 patient in my schedule

and them 5-7 call wants to be seeing. I can tell you that sometimes I see 12-11

patients in day.

> We are open M,W and F only. I am doing urgent care and my wife still working

as NICU RN. Our goal is to go to M-F soon and quit our side gigs,when? I do not

know.

> I can tell you that we were asking every month to the bank money to operate

the clinic. I think that last time that I asked the bank money was in January.

Orange Doc is paying itself ( except our salaries, we are not getting paid)

every month.

> My wife is holding the fort because she deals with the phone calls from every

body, she does the billing and the pain in neck insurances. She does not have a

lot of experience but she work hard to make sure we get paid. She also see her

patients part time. We have no staff working for us for now.

> I think we are going to have gaps for same day appointments for those patients

that need to be seeing now.

>  

> Regarding the questions about the credentialing process, I was in your shoes

before not wanting my employer to know about my plans,it is very stressful

dealing with that.

> I can tell you that my experience with corporate America is not the best. I

think God bless me because I got laid off from a previous Urgent care where I

got betrayed by my employer and then I found this new UC job and the guy was

fulling around with me and he gave me a part time only.

> I took the part time and bite the bullet and look around my town for the

correct place until I found it. I made my corporation and I look for a person to

help me with the credentialing part. I know a lot of people in the list would

tell you that you can do it only via CAHQ something, I hire that person and she

started the process since 08/2011. You have to have a physical location to start

the process you can not use a P.O. Box. I spoke to my future land Lord and told

him that I needed to rent the office 3 months before I open the doors and I

asked him to give me those 3 moths free ( what the heck what I had to loose).

> He did not give it to me for fee but he cut 50%

> My credentialing person did all the paper work believe me it is worse then

buying a house, do you have time for that? I did not so I hire her.

> You have to create new contracts with the health insurances since you are

working under a different umbrella or corporation.

> I had to submit a form to Blue cross of FL to divorce a previous practice that

takes time.

> Basically you have to make sure that you have the time and money to be able to

make the jump.

>  

> Dealing with the banks is another 200's pages story.

>  

> anyway my 1/2 cent. If you want contact me off the list and we can chat I can

tell you my experiences.

> Adolfo

> you can find us in Youtube : OrangeDoc

> you can see our tour video of my practice .

> www.orangedocfamilymedicine.com

>  

>

>

> To:

> Sent: Thursday, May 24, 2012 9:32 AM

> Subject: Practice Startup Questions

>

>

>  

> I just want to say what a blessing this group has been! I look forward to

seeing emails from the listserve pop up on my phone as I always learn so much!

>

> I am hoping to start my own IMP within the next two years (preferably as soon

as possible). Here's some questions I have for the group (and please forgive my

ignorance and naivety):

>

> 1) Is it legal to limit the amount of medicare/medicaid you will accept? That

is, I want to limit my practice to 5 or 10% medicaid as it pays so poorly here

(TN) but I have patients who have established with me in my current practice

that I would like to continue to take care of but I want to be financially

viable, which I can't be if I leave the doors wide open to all comers.

>

> 2) For those of you who have " niche servicess " within your practice - i.e.

accupuncture, etc. how do you handle the open access for these patients for whom

you are not providing PCP care with those patients for whom you are the PCP? I

currently do manipulation (OMT) and plan on adding accupuncture services in the

future.

>

> 3) With open access scheduling, how do you control your schedule in the

beginning when the majority of your patients will be new? At what point do you

restrict your new patient appts to maintain 24-48 hr availability for those who

are established? I know it varies between practices, but what % of appts do you

schedule out vs leave open?

>

> 4) I am currently employed and contracted with several plans some of which I

will continue to accept when I am on my own...how is it handled when you

continue to work under the plan in one practice while you are trying to open

another practice? I have not yet told my current employer that I plan to leave

as I want to have as much as possible thought out/arranged ahead of time before

I make the leap. I do have to give 6 months notice and will do that, but I know

the recredentialing can sometimes take awhile and I'd like to move as smoothly

as possible from one to the other as I can't afford to take a large amount of

time off.

>

> Thanks for the input! I'm sure there will be a ton more questions as I pursue

this journey!

>

[Guest guest]

Thanks for the advice. I already have a location secured. I have a very good

accountant that I am working with and am leaning towards S-corp but all the

issues brought up in previous topics on listserve are valid points. I would

like to go ahead with securing new NPI,etc. but did not want to bring attention

to myself with current employer until I am ready to submit my notice.

Adolfo - loan gets repaid at $25k per year, contract for 6 years. I have

already discussed with attorney and I have right to terminate before then for

any reason with 6 months notice but they can demand repayment of any amount of

loan paid that has not been forgiven. So, if i stay 5 years, $125k forgiven, on

the hook for $25k. If I am going to leave, it is to my advantage to leave prior

to 5 years as the restrictions regarding patients/advertising, etc get stricter.

I do not have a non-compete, just a " no solicitation " but it is a small town and

i have very faithful patients because I actually take time to talk to them. I

am getting pushed to be a hamster and I don't like not having control which is

why i want to leave (and a multitude of other issues). I had posted about 6

months back if my story sounds familiar Just ready to do something about it

now.

Crystal Dyer

> > >

> > > Dear newbie, we are newbies too. we have so many questions and we always

> > ask. I found this IMP list like an oasis because I can always find

> > > many helping hands for my doubts.

> > > Â

> > > Regarding questions number 1, I am not a lawyer but you make decisions

> > Â regarding the limit of your patients.

> > > We opened Orange Doc in November 2011 ( you see newbie). We are 2

> > mojicans jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a

> > family doc.

> > > She loves kids and I told her follow your Passion so she makes my

> > practice vibrant and active when I heard crying on her room.

> > > I made the decision to not accept medicaid only for adults, I do as a

> > secondary of medicare. I learned that medicaid always refused to pay me

> > when is second in line.

> > > We made the decision to allow medicaid only for kids, since there are a

> > lot medicaid kids in the area. She only has to see 30% of her patient

> > population to qualify for uncle sam money. I think you are the one making

> > the decision to open or close the doors in that matter.

> > > Deep in my heart I can tell you that I really do not care about uncle

> > sam money. I think there is not such a thing like a free lunch. I think

> > uncle same will make sure to make your life miserable in the future so you

> > will pay with your blood for the pennies that he will give you. I think all

> > the committees of the uncle sam will make sure that the quantity of

> > requirements will quadruple and you or your office will have a hard time to

> > full fill the requirements ( I think that the nature of the beast).

> > > Â

> >

> > > regarding your questions about the scheduling, I have appointments and

> > also patient portal's appointments. I can tell you what I do:

> > > New patients I spent like 45 minutes the first visit, I make sure I got

> > all the info and questions answered. I want to know when was the last colon

> > eval , mammo etc.

> > > I make sure that I listen to them and give them undivided attention.

> > Also I make a full physical exam,head to toes.

> > > I noticed that when they come back to follow up I do not have to spent

> > the same amount of time gathering the info. I am quicker with the F/Us.

> >

> > > Our plans is to see patients and not practice treadmill medicine, that

> > is the goal of IMP type of practice.

> > > We are getting fuller day by day, sometimes I have 1 patient in my

> > schedule and them 5-7 call wants to be seeing. I can tell you that

> > sometimes I see 12-11 patients in day.

> > > We are open M,W and F only. I am doing urgent care and my wife still

> > working as NICU RN. Our goal is to go to M-F soon and quit our side

> > gigs,when? I do not know.

> > > I can tell you that we were asking every month to the bank money to

> > operate the clinic. I think that last time that I asked the bank money was

> > in January. Orange Doc is paying itself ( except our salaries, we are not

> > getting paid) every month.

> > > My wife is holding the fort because she deals with the phone calls from

> > every body, she does the billing and the pain in neck insurances. She does

> > not have a lot of experience but she work hard to make sure we get paid.

> > She also see her patients part time. We have no staff working for us for

> > now.

> > > I think we are going to have gaps for same day appointments for those

> > patients that need to be seeing now.

> > > Â

> >

> > > Regarding the questions about the credentialing process, I was in your

> > shoes before not wanting my employer to know about my plans,it is very

> > stressful dealing with that.

> > > I can tell you that my experience with corporate America is not the

> > best. I think God bless me because I got laid off from a previous Urgent

> > care where I got betrayed by my employer and then I found this new UC job

> > and the guy was fulling around with me and he gave me a part time only.

> > > I took the part time and bite the bullet and look around my town for the

> > correct place until I found it. I made my corporation and I look for a

> > person to help me with the credentialing part. I know a lot of people in

> > the list would tell you that you can do it only via CAHQ something, I hire

> > that person and she started the process since 08/2011. You have to have a

> > physical location to start the process you can not use a P.O. Box. I spoke

> > to my future land Lord and told him that I needed to rent the office 3

> > months before I open the doors and I asked him to give me those 3 moths

> > free ( what the heck what I had to loose).

> > > He did not give it to me for fee but he cut 50%

> > > My credentialing person did all the paper work believe me it is worse

> > then buying a house, do you have time for that? I did not so I hire her.

> > > You have to create new contracts with the health insurances since you

> > are working under a different umbrella or corporation.

> > > I had to submit a form to Blue cross of FL to divorce a previous

> > practice that takes time.

> > > Basically you have to make sure that you have the time and money to be

> > able to make the jump.

> > > Â

> >

> > > Dealing with the banks is another 200's pages story.

> > > Â

> >

> > > anyway my 1/2 cent. If you want contact me off the list and we can chat

> > I can tell you my experiences.

> > > Adolfo

> > > you can find us in Youtube : OrangeDoc

> > > you can see our tour video of my practice .

> > > www.orangedocfamilymedicine.com

> > > Â

> > >

> > > From: impnewbie <crystalsdyer@>

> >

> > > To:

> > > Sent: Thursday, May 24, 2012 9:32 AM

> > > Subject: Practice Startup Questions

> > >

> > >

> > > Â

> > > I just want to say what a blessing this group has been! I look forward

> > to seeing emails from the listserve pop up on my phone as I always learn so

> > much!

> > >

> > > I am hoping to start my own IMP within the next two years (preferably as

> > soon as possible). Here's some questions I have for the group (and please

> > forgive my ignorance and naivety):

> > >

> > > 1) Is it legal to limit the amount of medicare/medicaid you will accept?

> > That is, I want to limit my practice to 5 or 10% medicaid as it pays so

> > poorly here (TN) but I have patients who have established with me in my

> > current practice that I would like to continue to take care of but I want

> > to be financially viable, which I can't be if I leave the doors wide open

> > to all comers.

> > >

> > > 2) For those of you who have " niche servicess " within your practice -

> > i.e. accupuncture, etc. how do you handle the open access for these

> > patients for whom you are not providing PCP care with those patients for

> > whom you are the PCP? I currently do manipulation (OMT) and plan on adding

> > accupuncture services in the future.

> > >

> > > 3) With open access scheduling, how do you control your schedule in the

> > beginning when the majority of your patients will be new? At what point do

> > you restrict your new patient appts to maintain 24-48 hr availability for

> > those who are established? I know it varies between practices, but what %

> > of appts do you schedule out vs leave open?

> > >

> > > 4) I am currently employed and contracted with several plans some of

> > which I will continue to accept when I am on my own...how is it handled

> > when you continue to work under the plan in one practice while you are

> > trying to open another practice? I have not yet told my current employer

> > that I plan to leave as I want to have as much as possible thought

> > out/arranged ahead of time before I make the leap. I do have to give 6

> > months notice and will do that, but I know the recredentialing can

> > sometimes take awhile and I'd like to move as smoothly as possible from one

> > to the other as I can't afford to take a large amount of time off.

> > >

> > > Thanks for the input! I'm sure there will be a ton more questions as I

> > pursue this journey!

> > >

> >

> >

> >

>

>

>

> --

> * Pratt*

>

[Guest guest]

i have open access in my office with two providers both in one day. my slots as

doc do fill up quickly but since patients stack up for me their wait is more

days because of their preference.

but truly if they want to be seen same day, they can be... it has decreased

weekend calls tremendously...

> >

> > Dear newbie, we are newbies too. we have so many questions and we always

ask. I found this IMP list like an oasis because I can always find

> > many helping hands for my doubts.

> > Â

> > Regarding questions number 1, I am not a lawyer but you make decisions Â

regarding the limit of your patients.

> > We opened Orange Doc in November 2011 ( you see newbie). We are 2 mojicans

jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc.

> > She loves kids and I told her follow your Passion so she makes my practice

vibrant and active when I heard crying on her room.

> > I made the decision to not accept medicaid only for adults, I do as a

secondary of medicare. I learned that medicaid always refused to pay me when is

second in line.

> > We made the decision to allow medicaid only for kids, since there are a lot

medicaid kids in the area. She only has to see 30% of her patient population to

qualify for uncle sam money. I think you are the one making the decision to open

or close the doors in that matter.

> > Deep in my heart I can tell you that I really do not care about uncle sam

money. I think there is not such a thing like a free lunch. I think uncle same

will make sure to make your life miserable in the future so you will pay with

your blood for the pennies that he will give you. I think all the committees of

the uncle sam will make sure that the quantity of requirements will quadruple

and you or your office will have a hard time to full fill the requirements ( I

think that the nature of the beast).

> > Â

>

> > regarding your questions about the scheduling, I have appointments and also

patient portal's appointments. I can tell you what I do:

> > New patients I spent like 45 minutes the first visit, I make sure I got all

the info and questions answered. I want to know when was the last colon eval ,

mammo etc.

> > I make sure that I listen to them and give them undivided attention. Also I

make a full physical exam,head to toes.

> > I noticed that when they come back to follow up I do not have to spent the

same amount of time gathering the info. I am quicker with the F/Us.

>

> > Our plans is to see patients and not practice treadmill medicine, that is

the goal of IMP type of practice.

> > We are getting fuller day by day, sometimes I have 1 patient in my schedule

and them 5-7 call wants to be seeing. I can tell you that sometimes I see 12-11

patients in day.

> > We are open M,W and F only. I am doing urgent care and my wife still working

as NICU RN. Our goal is to go to M-F soon and quit our side gigs,when? I do not

know.

> > I can tell you that we were asking every month to the bank money to operate

the clinic. I think that last time that I asked the bank money was in January.

Orange Doc is paying itself ( except our salaries, we are not getting paid)

every month.

> > My wife is holding the fort because she deals with the phone calls from

every body, she does the billing and the pain in neck insurances. She does not

have a lot of experience but she work hard to make sure we get paid. She also

see her patients part time. We have no staff working for us for now.

> > I think we are going to have gaps for same day appointments for those

patients that need to be seeing now.

> > Â

>

> > Regarding the questions about the credentialing process, I was in your shoes

before not wanting my employer to know about my plans,it is very stressful

dealing with that.

> > I can tell you that my experience with corporate America is not the best. I

think God bless me because I got laid off from a previous Urgent care where I

got betrayed by my employer and then I found this new UC job and the guy was

fulling around with me and he gave me a part time only.

> > I took the part time and bite the bullet and look around my town for the

correct place until I found it. I made my corporation and I look for a person to

help me with the credentialing part. I know a lot of people in the list would

tell you that you can do it only via CAHQ something, I hire that person and she

started the process since 08/2011. You have to have a physical location to start

the process you can not use a P.O. Box. I spoke to my future land Lord and told

him that I needed to rent the office 3 months before I open the doors and I

asked him to give me those 3 moths free ( what the heck what I had to loose).

> > He did not give it to me for fee but he cut 50%

> > My credentialing person did all the paper work believe me it is worse then

buying a house, do you have time for that? I did not so I hire her.

> > You have to create new contracts with the health insurances since you are

working under a different umbrella or corporation.

> > I had to submit a form to Blue cross of FL to divorce a previous practice

that takes time.

> > Basically you have to make sure that you have the time and money to be able

to make the jump.

> > Â

>

> > Dealing with the banks is another 200's pages story.

> > Â

>

> > anyway my 1/2 cent. If you want contact me off the list and we can chat I

can tell you my experiences.

> > Adolfo

> > you can find us in Youtube : OrangeDoc

> > you can see our tour video of my practice .

> > www.orangedocfamilymedicine.com<http://www.orangedocfamilymedicine.com/>

> > Â

> >

> > From: impnewbie <crystalsdyer@>

>

> > To:

<mailto:%40yahoogroups.c\

om>

> > Sent: Thursday, May 24, 2012 9:32 AM

> > Subject: Practice Startup Questions

> >

> >

> > Â

> > I just want to say what a blessing this group has been! I look forward to

seeing emails from the listserve pop up on my phone as I always learn so much!

> >

> > I am hoping to start my own IMP within the next two years (preferably as

soon as possible). Here's some questions I have for the group (and please

forgive my ignorance and naivety):

> >

> > 1) Is it legal to limit the amount of medicare/medicaid you will accept?

That is, I want to limit my practice to 5 or 10% medicaid as it pays so poorly

here (TN) but I have patients who have established with me in my current

practice that I would like to continue to take care of but I want to be

financially viable, which I can't be if I leave the doors wide open to all

comers.

> >

> > 2) For those of you who have " niche servicess " within your practice - i.e.

accupuncture, etc. how do you handle the open access for these patients for whom

you are not providing PCP care with those patients for whom you are the PCP? I

currently do manipulation (OMT) and plan on adding accupuncture services in the

future.

> >

> > 3) With open access scheduling, how do you control your schedule in the

beginning when the majority of your patients will be new? At what point do you

restrict your new patient appts to maintain 24-48 hr availability for those who

are established? I know it varies between practices, but what % of appts do you

schedule out vs leave open?

> >

> > 4) I am currently employed and contracted with several plans some of which I

will continue to accept when I am on my own...how is it handled when you

continue to work under the plan in one practice while you are trying to open

another practice? I have not yet told my current employer that I plan to leave

as I want to have as much as possible thought out/arranged ahead of time before

I make the leap. I do have to give 6 months notice and will do that, but I know

the recredentialing can sometimes take awhile and I'd like to move as smoothly

as possible from one to the other as I can't afford to take a large amount of

time off.

> >

> > Thanks for the input! I'm sure there will be a ton more questions as I

pursue this journey!

> >

>

>

>

>

> --

> Pratt

>

[Guest guest]

What automated system do you use, ?

> >

> > Dear newbie, we are newbies too. we have so many questions and we always

> ask. I found this IMP list like an oasis because I can always find

> > many helping hands for my doubts.

>

> > Â

> > Regarding questions number 1, I am not a lawyer but you make decisions Â

> regarding the limit of your patients.

>

> > We opened Orange Doc in November 2011 ( you see newbie). We are 2 mojicans

> jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc.

> > She loves kids and I told her follow your Passion so she makes my practice

> vibrant and active when I heard crying on her room.

>

> > I made the decision to not accept medicaid only for adults, I do as a

> secondary of medicare. I learned that medicaid always refused to pay me when

> is second in line.

>

> > We made the decision to allow medicaid only for kids, since there are a

> lot medicaid kids in the area. She only has to see 30% of her patient

> population to qualify for uncle sam money. I think you are the one making

> the decision to open or close the doors in that matter.

> > Deep in my heart I can tell you that I really do not care about uncle sam

> money. I think there is not such a thing like a free lunch. I think uncle

> same will make sure to make your life miserable in the future so you will

> pay with your blood for the pennies that he will give you. I think all the

> committees of the uncle sam will make sure that the quantity of requirements

> will quadruple and you or your office will have a hard time to full fill the

> requirements ( I think that the nature of the beast).

>

> > Â

>

>

> > regarding your questions about the scheduling, I have appointments and

> also patient portal's appointments. I can tell you what I do:

> > New patients I spent like 45 minutes the first visit, I make sure I got

> all the info and questions answered. I want to know when was the last colon

> eval , mammo etc.

> > I make sure that I listen to them and give them undivided attention. Also

> I make a full physical exam,head to toes.

>

> > I noticed that when they come back to follow up I do not have to spent the

> same amount of time gathering the info. I am quicker with the F/Us.

>

>

> > Our plans is to see patients and not practice treadmill medicine, that is

> the goal of IMP type of practice.

> > We are getting fuller day by day, sometimes I have 1 patient in my

> schedule and them 5-7 call wants to be seeing. I can tell you that sometimes

> I see 12-11 patients in day.

> > We are open M,W and F only. I am doing urgent care and my wife still

> working as NICU RN. Our goal is to go to M-F soon and quit our side

> gigs,when? I do not know.

> > I can tell you that we were asking every month to the bank money to

> operate the clinic. I think that last time that I asked the bank money was

> in January. Orange Doc is paying itself ( except our salaries, we are not

> getting paid) every month.

> > My wife is holding the fort because she deals with the phone calls from

> every body, she does the billing and the pain in neck insurances. She does

> not have a lot of experience but she work hard to make sure we get paid. She

> also see her patients part time. We have no staff working for us for now.

> > I think we are going to have gaps for same day appointments for those

> patients that need to be seeing now.

>

> > Â

>

>

> > Regarding the questions about the credentialing process, I was in your

> shoes before not wanting my employer to know about my plans,it is very

> stressful dealing with that.

> > I can tell you that my experience with corporate America is not the best.

> I think God bless me because I got laid off from a previous Urgent care

> where I got betrayed by my employer and then I found this new UC job and the

> guy was fulling around with me and he gave me a part time only.

> > I took the part time and bite the bullet and look around my town for the

> correct place until I found it. I made my corporation and I look for a

> person to help me with the credentialing part. I know a lot of people in the

> list would tell you that you can do it only via CAHQ something, I hire that

> person and she started the process since 08/2011. You have to have a

> physical location to start the process you can not use a P.O. Box. I spoke

> to my future land Lord and told him that I needed to rent the office 3

> months before I open the doors and I asked him to give me those 3 moths free

> ( what the heck what I had to loose).

> > He did not give it to me for fee but he cut 50%

> > My credentialing person did all the paper work believe me it is worse then

> buying a house, do you have time for that? I did not so I hire her.

> > You have to create new contracts with the health insurances since you are

> working under a different umbrella or corporation.

> > I had to submit a form to Blue cross of FL to divorce a previous practice

> that takes time.

> > Basically you have to make sure that you have the time and money to be

> able to make the jump.

>

> > Â

>

>

> > Dealing with the banks is another 200's pages story.

>

> > Â

>

>

> > anyway my 1/2 cent. If you want contact me off the list and we can chat I

> can tell you my experiences.

> > Adolfo

> > you can find us in Youtube : OrangeDoc

> > you can see our tour video of my practice .

> > www.orangedocfamilymedicine.com <http://www.orangedocfamilymedicine.com/>

>

> > Â

> >

> > From: impnewbie <crystalsdyer@>

>

>

> > To:

> <mailto:%40yahoogroups.com>

> > Sent: Thursday, May 24, 2012 9:32 AM

> > Subject: Practice Startup Questions

> >

> >

>

> > Â

>

> > I just want to say what a blessing this group has been! I look forward to

> seeing emails from the listserve pop up on my phone as I always learn so

> much!

> >

> > I am hoping to start my own IMP within the next two years (preferably as

> soon as possible). Here's some questions I have for the group (and please

> forgive my ignorance and naivety):

> >

> > 1) Is it legal to limit the amount of medicare/medicaid you will accept?

> That is, I want to limit my practice to 5 or 10% medicaid as it pays so

> poorly here (TN) but I have patients who have established with me in my

> current practice that I would like to continue to take care of but I want to

> be financially viable, which I can't be if I leave the doors wide open to

> all comers.

> >

> > 2) For those of you who have " niche servicess " within your practice - i.e.

> accupuncture, etc. how do you handle the open access for these patients for

> whom you are not providing PCP care with those patients for whom you are the

> PCP? I currently do manipulation (OMT) and plan on adding accupuncture

> services in the future.

> >

> > 3) With open access scheduling, how do you control your schedule in the

> beginning when the majority of your patients will be new? At what point do

> you restrict your new patient appts to maintain 24-48 hr availability for

> those who are established? I know it varies between practices, but what % of

> appts do you schedule out vs leave open?

> >

> > 4) I am currently employed and contracted with several plans some of which

> I will continue to accept when I am on my own...how is it handled when you

> continue to work under the plan in one practice while you are trying to open

> another practice? I have not yet told my current employer that I plan to

> leave as I want to have as much as possible thought out/arranged ahead of

> time before I make the leap. I do have to give 6 months notice and will do

> that, but I know the recredentialing can sometimes take awhile and I'd like

> to move as smoothly as possible from one to the other as I can't afford to

> take a large amount of time off.

> >

> > Thanks for the input! I'm sure there will be a ton more questions as I

> pursue this journey!

> >

>

>

>

>

> --

> Pratt

>

[Guest guest]

Thanks .I'm opening my IMP next year and am considering either Practice Fusion or Amazing Charts.How does the cost of your EMR and reminder system compare?

Mike ElliottBuffalo, NY

 

With my automated reminder system I can make appointments a year in advance and rarely have a missed appointment.  Of course I leave slots open for daily patient needs.  I suspect that much of what open access is about is based on not having an automated way of communicating with patients.  With my system, patients get up to four reminders beginning a week before an appointment with multiple opportunities to cancel or reschedule.  The success of advanced scheduling depends on how well you remind patients.

  Neighbors, MD

Huntsville, Alabama Solo using FlexMedical EMR/Billing since 2/2009

Attested MU in 2011 

 From: [mailto: ] On Behalf Of Kennedy, Jim

Sent: Thursday, May 24, 2012 6:45 PMTo: Subject: RE: Re: Practice Startup Questions

   ,

Open access is really not booking any appointments until the day you open your books. You are really doig advanced access. Seems like a moot or insignificant point, buty it is not. The problem with " saving appointments slots " rather than open access is that there is always creep and then you end up with ovefbookingand no slots. Maybe you are better than elsewhere I have been.

We stick to advanced access and never make appointments more than a day or two out. Often I come in with one appointment and leave having seen 10-15. I never had no shows, and can usually handle " walk-ins " better known as appointmentless patients. We wil schedule anything any time, no restirctions on type of visit.

Has worked for 7 years, getting " todays work done today. "  

From: [ ] On Behalf Of Pratt [kpratt.1022@...]

Sent: Thursday, May 24, 2012 11:20 AMTo: Subject: Re: Re: Practice Startup Questions

  Welcome, Newbie!

 You will need to establish some sort of organization for your new office - corporation, partnership, sole proprietorship - and then you need to apply for an NPI for that organization (unless you opt to do Sole Prop, which I am NOT sure how you bill for that).  Then, when bills go out for your new office, they get paid to your new organization.  When bills go out for your current organization, then they get paid under their organizational NPI. 

 You can limit your practice (and, in fact, you should) to any % of patients you want per insurance.  So, if you reach your 10% limit, then you close to new patients for that type of insurance.  I will advise, however, that you might want to beware of this when you first start out.  There will be attrition.  Some patients will come to you, and never come back, or may come infrequently, so in reality, even though by sheer numbers you hit 10%, if those patients do not frequent your office, then in $$, the % will be lower.  Our practice closed for a bit to new Medicare patients, but we are now accepting all new patients.  We do not take Medicaid, either as primary or secondary insurance.  We are also not contracted for all plans for all insurers (Blue Shield of CA has just come out with some very unreasonable contracts that we were not willing to contract with).  It is up to the PATIENT to determine whether or not we are participating in their plan or not because it is much too difficult for us to keep track for them.

 Open Access scheduling takes a lot of finesse.  Something I am still trying to teach our assistants.  We try to schedule not more than 4 extended visits per day (new patients or physicals), and we try to leave open 4-6 slots per day for same-day visits.  Sometimes, we have wide open days (last week on Monday, we had 9 slots go unused, but today we are completely booked, and it is only 10:15am, and tomorrow I am limited to 4 walk-in slots, which the staff will have to be very careful about booking - we have a total of 18 slots per day, with extended visits using 2-3 slots each).  If you are doing your own scheduling, you will get to know which patients require more or less time, and you can try to fit them in accordingly.  We have patients now who were patients from the beginning of our practice, when they could say exactly the day and time they wanted to come in and we could accommodate that, but even though we can still offer them a same-day appt, they get torqued when they can't come in when they dictate.  Just a caution...

 You do not necessarily need to re-credential if you are already credentialed with most insurance companies.  Contact the Provider Rep and tell them your plans and find out what you need to do.  First things first, you need to determine the type of organization that you want to open, and then sign contracts.  But since you, the provider, are already credentialed, it should be a little quicker than if you were relocating to another state and starting from scratch.

 Lots of info here.....read, re-read, listen to what everyone on the IMP list has to offer, and pick and choose what you think will work best for you.  And don't be afraid to make changes as time goes by so that you are happy :-)

 Good luck in your new endeavour!!

  Pratt

  Thanks for sharing your story, Adolfo! I am assuming you can put an effective date on the new contracts?

What my concern is, I may have to stay on part time with my current employer (1 day a week) doing manipulation/sports medicine as that is my " niche " and they don't have anyone else to do that as a way to " compensate " them for paying off a huge chunk of my student loans. In my contract, I get x amount " forgiven " for what they have paid on my behalf for every year I stay on. This was spread out over 6 years. No way in hell I'm gonna make it 6 years so I'm on the hook for whatever is left--at this point $125k. My thinking is, if I say I will stay on 1 day a week doing this for them, maybe we can work something out where I can still leave and do my own practice and not have to get a loan to pay them off.

Back to my concern--what if we both take the same insurances--me in my IMP and then working as a " specialist " there? How would that work?

>> Dear newbie, we are newbies too. we have so many questions and we always ask. I found this IMP list like an oasis because I can always find> many helping hands for my doubts.

>  > Regarding questions number 1, I am not a lawyer but you make decisions  regarding the limit of your patients.

> We opened Orange Doc in November 2011 ( you see newbie). We are 2 mojicans jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc. > She loves kids and I told her follow your Passion so she makes my practice vibrant and active when I heard crying on her room.

> I made the decision to not accept medicaid only for adults, I do as a secondary of medicare. I learned that medicaid always refused to pay me when is second in line.

> We made the decision to allow medicaid only for kids, since there are a lot medicaid kids in the area. She only has to see 30% of her patient population to qualify for uncle sam money. I think you are the one making the decision to open or close the doors in that matter.

> Deep in my heart I can tell you that I really do not care about uncle sam money. I think there is not such a thing like a free lunch. I think uncle same will make sure to make your life miserable in the future so you will pay with your blood for the pennies that he will give you. I think all the committees of the uncle sam will make sure that the quantity of requirements will quadruple and you or your office will have a hard time to full fill the requirements ( I think that the nature of the beast).

>   > regarding your questions about the scheduling, I have appointments and also patient portal's appointments. I can tell you what I do:

> New patients I spent like 45 minutes the first visit, I make sure I got all the info and questions answered. I want to know when was the last colon eval , mammo etc. > I make sure that I listen to them and give them undivided attention. Also I make a full physical exam,head to toes.

> I noticed that when they come back to follow up I do not have to spent the same amount of time gathering the info. I am quicker  with the F/Us.

> Our plans is to see patients and not practice treadmill medicine, that is the goal of IMP type of practice. > We are getting fuller day by day, sometimes I have 1 patient in my schedule and them 5-7 call wants to be seeing. I can tell you that sometimes I see 12-11 patients in day.

> We are open M,W and F only. I am doing urgent care and my wife still working as NICU RN. Our goal is to go to M-F soon and quit our side gigs,when? I do not know. > I can tell you that we were asking every month to the bank money to operate the clinic. I think that last time that I asked the bank money was in January. Orange Doc is paying itself ( except our salaries, we are not getting paid) every month.

> My wife is holding the fort because she deals with the phone calls from every body, she does the billing and the pain in neck insurances. She does not have a lot of experience but she work hard to make sure we get paid. She also see her patients part time. We have no staff working for us for now.

> I think we are going to have gaps for same day appointments for those patients that need to be seeing now. >  

> Regarding the questions about the credentialing process, I was in your shoes before not wanting my employer to know about my plans,it is very stressful dealing with that.

> I can tell you that my experience with corporate America is not the best. I think God bless me because I got laid off from a previous Urgent care where I got betrayed by my employer and then I found this new UC job and the guy was fulling around with me and he gave me a part time only.

> I took the part time and bite the bullet and look around my town for the correct place until I found it. I made my corporation and I look for a person to help me with the credentialing part. I know a lot of people in the list would tell you that you can do it only via CAHQ something, I hire that person and she started the process since 08/2011. You have to have a physical location to start the process you can not use a P.O. Box. I spoke to my future land Lord and told him that I needed to rent the office 3 months before I open the doors and I asked him to give me those 3 moths free ( what the heck what I had to loose).

> He did not give it to me for fee but he cut 50% > My credentialing person did all the paper work believe me it is worse then buying a house, do you have time for that? I did not so I hire her.> You have to create new contracts with the health insurances since you are working under a different umbrella or corporation.

> I had to submit a form to Blue cross of FL to divorce a previous practice that takes time.> Basically you have to make sure that you have the time and money to be able to make the jump.

>   > Dealing with the banks is another 200's pages story.

>   > anyway my 1/2 cent. If you want contact me off the list and we can chat I can tell you my experiences.

> Adolfo> you can find us in Youtube : OrangeDoc > you can see our tour video of my practice . > www.orangedocfamilymedicine.com

>  > >

> To: > Sent: Thursday, May 24, 2012 9:32 AM> Subject: Practice Startup Questions

> > >   > I just want to say what a blessing this group has been! I look forward to seeing emails from the listserve pop up on my phone as I always learn so much!

> > I am hoping to start my own IMP within the next two years (preferably as soon as possible). Here's some questions I have for the group (and please forgive my ignorance and naivety):> > 1) Is it legal to limit the amount of medicare/medicaid you will accept? That is, I want to limit my practice to 5 or 10% medicaid as it pays so poorly here (TN) but I have patients who have established with me in my current practice that I would like to continue to take care of but I want to be financially viable, which I can't be if I leave the doors wide open to all comers.

> > 2) For those of you who have " niche servicess " within your practice - i.e. accupuncture, etc. how do you handle the open access for these patients for whom you are not providing PCP care with those patients for whom you are the PCP? I currently do manipulation (OMT) and plan on adding accupuncture services in the future.

> > 3) With open access scheduling, how do you control your schedule in the beginning when the majority of your patients will be new? At what point do you restrict your new patient appts to maintain 24-48 hr availability for those who are established? I know it varies between practices, but what % of appts do you schedule out vs leave open?

> > 4) I am currently employed and contracted with several plans some of which I will continue to accept when I am on my own...how is it handled when you continue to work under the plan in one practice while you are trying to open another practice? I have not yet told my current employer that I plan to leave as I want to have as much as possible thought out/arranged ahead of time before I make the leap. I do have to give 6 months notice and will do that, but I know the recredentialing can sometimes take awhile and I'd like to move as smoothly as possible from one to the other as I can't afford to take a large amount of time off.

> > Thanks for the input! I'm sure there will be a ton more questions as I pursue this journey!>

-- Pratt

[Guest guest]

Oh, sorry! Your are correct, I meant

> > >

> > > Dear newbie, we are newbies too. we have so many questions and we always

> > ask. I found this IMP list like an oasis because I can always find

> > > many helping hands for my doubts.

> >

> > > Â

> > > Regarding questions number 1, I am not a lawyer but you make decisions Â

> > regarding the limit of your patients.

> >

> > > We opened Orange Doc in November 2011 ( you see newbie). We are 2

> mojicans

> > jejejejeje, my wife Ardiana ( my rock) a pediatric NP and I a family doc.

> > > She loves kids and I told her follow your Passion so she makes my

> practice

> > vibrant and active when I heard crying on her room.

> >

> > > I made the decision to not accept medicaid only for adults, I do as a

> > secondary of medicare. I learned that medicaid always refused to pay me

> when

> > is second in line.

> >

> > > We made the decision to allow medicaid only for kids, since there are a

> > lot medicaid kids in the area. She only has to see 30% of her patient

> > population to qualify for uncle sam money. I think you are the one making

> > the decision to open or close the doors in that matter.

> > > Deep in my heart I can tell you that I really do not care about uncle

> sam

> > money. I think there is not such a thing like a free lunch. I think uncle

> > same will make sure to make your life miserable in the future so you will

> > pay with your blood for the pennies that he will give you. I think all the

> > committees of the uncle sam will make sure that the quantity of

> requirements

> > will quadruple and you or your office will have a hard time to full fill

> the

> > requirements ( I think that the nature of the beast).

> >

> > > Â

> >

> >

> > > regarding your questions about the scheduling, I have appointments and

> > also patient portal's appointments. I can tell you what I do:

> > > New patients I spent like 45 minutes the first visit, I make sure I got

> > all the info and questions answered. I want to know when was the last

> colon

> > eval , mammo etc.

> > > I make sure that I listen to them and give them undivided attention.

> Also

> > I make a full physical exam,head to toes.

> >

> > > I noticed that when they come back to follow up I do not have to spent

> the

> > same amount of time gathering the info. I am quicker with the F/Us.

> >

> >

> > > Our plans is to see patients and not practice treadmill medicine, that

> is

> > the goal of IMP type of practice.

> > > We are getting fuller day by day, sometimes I have 1 patient in my

> > schedule and them 5-7 call wants to be seeing. I can tell you that

> sometimes

> > I see 12-11 patients in day.

> > > We are open M,W and F only. I am doing urgent care and my wife still

> > working as NICU RN. Our goal is to go to M-F soon and quit our side

> > gigs,when? I do not know.

> > > I can tell you that we were asking every month to the bank money to

> > operate the clinic. I think that last time that I asked the bank money was

> > in January. Orange Doc is paying itself ( except our salaries, we are not

> > getting paid) every month.

> > > My wife is holding the fort because she deals with the phone calls from

> > every body, she does the billing and the pain in neck insurances. She does

> > not have a lot of experience but she work hard to make sure we get paid.

> She

> > also see her patients part time. We have no staff working for us for now.

> > > I think we are going to have gaps for same day appointments for those

> > patients that need to be seeing now.

> >

> > > Â

> >

> >

> > > Regarding the questions about the credentialing process, I was in your

> > shoes before not wanting my employer to know about my plans,it is very

> > stressful dealing with that.

> > > I can tell you that my experience with corporate America is not the

> best.

> > I think God bless me because I got laid off from a previous Urgent care

> > where I got betrayed by my employer and then I found this new UC job and

> the

> > guy was fulling around with me and he gave me a part time only.

> > > I took the part time and bite the bullet and look around my town for the

> > correct place until I found it. I made my corporation and I look for a

> > person to help me with the credentialing part. I know a lot of people in

> the

> > list would tell you that you can do it only via CAHQ something, I hire

> that

> > person and she started the process since 08/2011. You have to have a

> > physical location to start the process you can not use a P.O. Box. I spoke

> > to my future land Lord and told him that I needed to rent the office 3

> > months before I open the doors and I asked him to give me those 3 moths

> free

> > ( what the heck what I had to loose).

> > > He did not give it to me for fee but he cut 50%

> > > My credentialing person did all the paper work believe me it is worse

> then

> > buying a house, do you have time for that? I did not so I hire her.

> > > You have to create new contracts with the health insurances since you

> are

> > working under a different umbrella or corporation.

> > > I had to submit a form to Blue cross of FL to divorce a previous

> practice

> > that takes time.

> > > Basically you have to make sure that you have the time and money to be

> > able to make the jump.

> >

> > > Â

> >

> >

> > > Dealing with the banks is another 200's pages story.

> >

> > > Â

> >

> >

> > > anyway my 1/2 cent. If you want contact me off the list and we can chat

> I

> > can tell you my experiences.

> > > Adolfo

> > > you can find us in Youtube : OrangeDoc

> > > you can see our tour video of my practice .

> > > www.orangedocfamilymedicine.com <http://www.orangedocfamilymedicine.com/>

>

> >

> > > Â

> > >

> > > From: impnewbie <crystalsdyer@>

> >

> >

> > > To:

> > <mailto:%40yahoogroups.com>

> > > Sent: Thursday, May 24, 2012 9:32 AM

> > > Subject: Practice Startup Questions

> > >

> > >

> >

> > > Â

> >

> > > I just want to say what a blessing this group has been! I look forward

> to

> > seeing emails from the listserve pop up on my phone as I always learn so

> > much!

> > >

> > > I am hoping to start my own IMP within the next two years (preferably as

> > soon as possible). Here's some questions I have for the group (and please

> > forgive my ignorance and naivety):

> > >

> > > 1) Is it legal to limit the amount of medicare/medicaid you will accept?

> > That is, I want to limit my practice to 5 or 10% medicaid as it pays so

> > poorly here (TN) but I have patients who have established with me in my

> > current practice that I would like to continue to take care of but I want

> to

> > be financially viable, which I can't be if I leave the doors wide open to

> > all comers.

> > >

> > > 2) For those of you who have " niche servicess " within your practice -

> i.e.

> > accupuncture, etc. how do you handle the open access for these patients

> for

> > whom you are not providing PCP care with those patients for whom you are

> the

> > PCP? I currently do manipulation (OMT) and plan on adding accupuncture

> > services in the future.

> > >

> > > 3) With open access scheduling, how do you control your schedule in the

> > beginning when the majority of your patients will be new? At what point do

> > you restrict your new patient appts to maintain 24-48 hr availability for

> > those who are established? I know it varies between practices, but what %

> of

> > appts do you schedule out vs leave open?

> > >

> > > 4) I am currently employed and contracted with several plans some of

> which

> > I will continue to accept when I am on my own...how is it handled when you

> > continue to work under the plan in one practice while you are trying to

> open

> > another practice? I have not yet told my current employer that I plan to

> > leave as I want to have as much as possible thought out/arranged ahead of

> > time before I make the leap. I do have to give 6 months notice and will do

> > that, but I know the recredentialing can sometimes take awhile and I'd

> like

> > to move as smoothly as possible from one to the other as I can't afford to

> > take a large amount of time off.

> > >

> > > Thanks for the input! I'm sure there will be a ton more questions as I

> > pursue this journey!

> > >

> >

> >

> >

> >

> > --

> > Pratt

> >

>