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

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

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

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

5. 5 Phase 1

6. 6 1. Phone Number Phase 1

7. 7 2. Post Office Box Phase 1

8. 8 3. Lease Phase 1

9. 9 4. Business Card Phase 1

10. 10 5. Pager-- Cell Phone Phase 1

11. 11 6. Liability Insurance Phase 1

12. 12 7. Furniture Phase 1

13. 13 8. Applications Phase 1

14. 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. 15 9. Temp Agencies Phase 1

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

17. 17 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab

18. 18 1. Registration 2. Office Superbill 3. Hospital Superbill 4. Encounter Form 5. Problem Sheet 6. Med Sheet 7. Message Form 8. Coag Flow Sheet 9. Lab Flow Sheet 10. Letter Template 11. Fax Template 12. Application for Employment Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab

19. 19 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab 1.Licensing Board 2.DEA 3.AMA 4.Hospitals 5.Managed Care Networks 6.Insurance Companies

20. 20 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab 3. W-9

21. 21 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab 4. Kinko’s

22. 22 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab 1. Colwell 2.Medical Arts Press 3.Office Depo

23. 23 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab 1.Moore Medical 2.Henry Schein 3.Local Pharmacy

24. 24 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab Include a Picture Location & Office Phone

25. 25 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab Line of Credit-- $50K & take as needed Second Mortgage on Home

26. 26 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab See who hospital uses Ask other docs in your area Disposable

27. 27 Phase 2 1.Forms 2.Form Letter 3.W-9 4.Kinko's 5.Paper Supplies 6.Med Supplies 7.Newspaper Ad 8.Bank 9.Gowns 10.Lab Hospitals National– Quest, LabCorp

28. 28 Real Life Adventures

29. 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. 30 Real Life Adventures Participating Provider Block Participating Provider Delay Participating Provider Notification Forgotten Employed Paid Better than Independent

31. 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. 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. 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. 34 First Quarter Marketing Rotary Church Physician Meetings Physician Staff Lounge Staff Cafeteria Don’t be a Wall Flower

35. 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. 36 First Year Clearing House for Electronic Claims Pension Plan for Office Cafeteria Plan for Staff Collection Agency Group Health

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

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

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

40. 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. 41 The End