USING TIME IN YOUR DOCUMENTATION PLEASE RETURN YOUR SEATS AND TRAY TABLES TO THEIR UPRIGHT AND LOCKED POSITON WHILE WE PREPARE FOR TAKEOFF! The above photo was taken on Don’s cell phone when his flight decompressed at 28,000 feet and the masks deployed.

NO - YOU WON’T BE SLEEPING AT THIS SEMINAR!

E & M CODING - TIME FACTORS $ COUNSELING ( ) $ PROLONGED SERVICE ( ) $ HOSPITAL & SNF DISCHARGE (99238 & AND 99315/99316) $ CRITICAL CARE (99291 & 99292)

COUNSELING & COORDINATION OF CARE - TIME FACTORS $ Minutes $ Minutes $ Minutes $ Minutes $ Minutes “_____ Minutes SPENT COUNSELING ABOUT _________” Total Minutes + The physician may document time spent with the patient in conjunction with the medical decision-making involved and a description of the coordination of care or counseling provided. Documentation must be in sufficient detail to support the claim. Medicare IOM 100-4,

PROLONGED SERVICE - TIME FACTORS $ Minutes $ Minutes $ Minutes $ Minutes $ Minutes PROLONGED SERVICE IS ABOVE & BEYOND NORMAL TIMES - WITH MEDICAL NECESSITY min - Out-pt Ea. Addt’l 30 min. Out-pt min - In-pt Ea. Addt’l 30 min. In-pt

HOSPITAL DISCHARGE - TIME FACTORS Hospital Discharge Day Management; 30 minutes or less Hospital Discharge Day Management; More than 30 minutes. Included in Hospital Discharge: Final examination(s), Discussion of hospital stay with patient and/or family, instructions for continuing care to all relevant caregivers, preparation of discharge record, prescriptions, home health, DME, and referrals forms, CMS now requires a face-to-face encounter on the day of discharge (or, face to something else for gastro docs)

CRITICAL CARE - TIME FACTORS Critical Care minutes Critical Care - Additional 30 minutes Patient must be critical: Patient has at least one organ or body area unstable and stands a likely chance of losing life, limb or permanent impairment of health if IMMEDIATE medical care is not rendered ANY PLACE OF SERVICE MUST BE TREATING CRITICAL CONDITION ICU/ CCU. NICU - NOT AUTOMATICALLY CRITICAL CARE CODES

THANK YOU! – Now, if you’re primary care and you want to increase your annual profits in your practice by at least $100,000 per year – call Don’s cell at We will schedule a one hour free phone call with you, your physicians and your office managers. At the end of the call – we may recommend one or more of the 3 ways we increase your net profits by $100,000 to $600,000 per year. Our guarantee is that if we do not increase your net profits by at least $100K a year – you do not pay us a penny. We teach you how to use PQRI to irease your Medicare and non Medicare payments while providing better care to your patients than you provide now. WHO IS Don Self, Keith LaBonte & MEDICAL SOURCE, INC? We are reimbursement consultants specializing in Primary Care offices. We are published to more than 250,000 medical offices each month in different magazines, such as GERIATRICS, MEDICAL MANAGER, STAT, BILLING & CODING NETWORK and others. We have a website at that gets more than 22,000 hits per day & a NEW exciting, 9000 page website at Don and Keith are the ONLY consultants in the country that have a guarantee that we will show you how to increase the NET profits of your primary care practice by at least $100,000 per year – or you do not pay us. We are the ONLY consultants that will give you a ONE HOUR free phone consultation to primary care providers. At the end of that hour, we will tell you how much we guarantee that you will increase your annual income and what our fee will be to help you do this, if any. We help you increase your practice net income by 3 ways:

THANK YOU! – Now, if you’re primary care and you want to increase your annual profits in your practice by at least $100,000 per year – call Don’s cell at We will schedule a one hour free phone call with you, your physicians and your office managers. At the end of the call – we may recommend one or more of the 3 ways we increase your net profits by $100,000 to $600,000 per year. Our guarantee is that if we do not increase your net profits by at least $100K a year – you do not pay us a penny. We teach you how to use PQRI to irease your Medicare and non Medicare payments while providing better care to your patients than you provide now. WHO IS Don Self, Keith LaBonte & MEDICAL SOURCE, INC? NUMBER ONE WAY WE HELP: You may or may not need a fee/code/charge analysis of your practice where we analyze what you’re charging, what codes you are using, your E&M documentation, which areas you are giving away services when the carriers expect to pay for them, how you may be flagging audits and more. This generates a 40 plus page report. Our usual fee for a 1-3 provider practice is $6,000. This generally increases a 2 provider practice net income by $60,000 per year. Our usual guarantee is that it will increase your net income by at least $50,000 per year – or you don’t pay us. In some offices, we guarantee $100K more – but we do not perform this until we have spent the first FREE hour on the phone with the doctors and manager to determine whether you need this or not.

THANK YOU! – Now, if you’re primary care and you want to increase your annual profits in your practice by at least $100,000 per year – call Don’s cell at We will schedule a one hour free phone call with you, your physicians and your office managers. At the end of the call – we may recommend one or more of the 3 ways we increase your net profits by $100,000 to $600,000 per year. Our guarantee is that if we do not increase your net profits by at least $100K a year – you do not pay us a penny. We teach you how to use PQRI to irease your Medicare and non Medicare payments while providing better care to your patients than you provide now. WHO IS Don Self, Keith LaBonte & MEDICAL SOURCE, INC? NUMBER TWO WAY WE HELP: A one hour, free phone analysis of your diagnostics you are now performing, which ones you should be performing for your patient base, which ones you should be performing for your insurance mix, whether you are miscoding and leaving yourselves wide open for fines and penalties by following coding advice you received from salespeople and more. This generally increases a 2 provider practice net income by $125,000 per year. There is no charge for this phone analysis. Again – this doesn’t happen until we spend a free hour on the phone with the doctor and manager determining whether they need this free additional hour.

THANK YOU! – Now, if you’re primary care and you want to increase your annual profits in your practice by at least $100,000 per year – call Don’s cell at We will schedule a one hour free phone call with you, your physicians and your office managers. At the end of the call – we may recommend one or more of the 3 ways we increase your net profits by $100,000 to $600,000 per year. Our guarantee is that if we do not increase your n0K a year – you do not pay us a penny. We teach you how to use PQRI to irease your Medicare and non Medicare payments while providing better care to your patients than you provide now. WHO IS Don Self, Keith LaBonte & MEDICAL SOURCE, INC? NUMBER THREE WAY WE HELP: A one hour free phone analysis of your clinical lab potential, what tests you are now ordering, whether you’re using an outside lab, whether someone has lied to you and told you that a waived lab in your office is not profitable, whether you should be doing any non waived tests or not, and the profit potential for changing how you do your lab. This generally increases a 2 provider practice net income by $180,000 per year. There is no charge for this phone analysis. There is a reason why so many state and national physician associations have us speak at their conventions. There is a reason why thousands of physicians have increased their income by following our advice. Act now and see if we can increase the MONTHLY net profits of your practice by at least $10,000 to $20,000 over the next 12 months. Don Selfc ofc Keith LaBonte c ofc