2.  -Group Project  -Production Reports  -Physician Employment  -Physician Contract  -HC Youtube  -Practice Exam

4.  1) Physician recruitment  2) Hiring of other office staff – LPNs/medical assistant/accountants/receptionist  3) Sample contracts for physicians  4) Contracts with hospitals  5) Hospital privileges  6) Contract with office space (rent/buy)  7) Insurance Credentialing  8) NPI numbers  9) Fee schedule – about 10 CPT codes  10) Schedule for physicians  11) Plan for how to grow patient base/how to receive more patients from local PCPs  Uninsured/unassigned/PCPs  PCPs in Southern Delaware that still do not utilize hospitalists to the extent of Christiana area  12) Mission statement  13) Hire a lawyer  14) Cell phones/pagers for physicians  15) Retention strategy  16) Flow charts for structure of organization  17) Use specific dates for process; especially with hospital privileges and/or credentialing  18) Immigration/J1 waiver application if applies  19 ) Website

5.   1- Dana  3- Deja  2-Theresa 4- Nancy   Medical Practice Name: Women’s Specialty Care   Details :  Specialty: OB-GYN  # Of Employees: 10  # Of Physicians: 6  # Of PA's :2  # Of MW‘s: 2  # Of Offices: 3  # Org Type: C-Corp 

6.  1- Diana  3- Hana  2- Devon 4- Cailin   Medical Practice Name: Community Care of New Castle County   Details :  Specialty: Family Medicine  # Of Employees: 14  # Of Physicians: 9  # Of PA's :3  # Of NP‘s: 3  # Of Offices: 2  # Org Type: LLC 

7.  1- Natalia  3- Irene  2-Norberto 4- Alyssa   Medical Practice Name: Pediatric Physician Care   Details :  Specialty: Pediatric  # Of Employees: 10  # Of Physicians: 6  # Of PA's :2  # Of MW‘s: 2  # Of Offices: 3  # Org Type: C-Corp 

9. Vitals Signs Service Date YTD 8/31/2009YTD 8/31/2010Change + -Change % New Patients437422-15-3.43% Established Patients145841593913559.29% New Physicals16099-61-38.13% Established Physicals982759-223-22.71% Home Visits15371116-421-27.39% New Rest Home Vistis1418428.57% Est Rest Home Vists71194923833.47% New Nursing Home206204-2-0.97% Established Nursing Home1858258973139.34% Initial Hospital Visits4795517215.03% Subsequent Hospital Visits26672745782.92% Con IP736-67-91.78% Con OP177101-76-42.94% Charges $4,159,916.76 $4,374,550.76 $214,634.005.16% Payments $2,410,445.63 $2,535,378.74 $124,933.115.18%

10. CHARGES Jan-09Feb-09Mar-09Apr-09May-09Jun-09Jul-09Aug-09Sep-09Oct-09Nov-09Dec-09 Dr 1183,149.00185,606.51185,621.79197,132.00165,398.00178,834.00167,711.57180,926.00196,810.00176,104.00191,416.00138,754.00 Dr. 295,044.0092,600.0086,523.0094,054.0082,283.00103,359.0090,444.0079,663.4987,724.9697,438.0087,376.0072,757.00 Dr. 335,251.5039,856.0043,282.7831,739.0035,133.0037,435.0016,763.0040,489.0037,097.0032,945.0054,416.0026,468.00 Dr. 449,552.0047,906.5030,134.0035,728.5841,110.0065,799.0027,804.0038,433.0758,060.0049,995.4852,648.2134,015.50 362,996.50365,969.01345,561.57358,653.58323,924.00385,427.00302,722.57339,511.56379,691.96356,482.48385,856.21271,994.50 CHARGESJan-10Feb-10Mar-10Apr-10May-10Jun-10Jul-10 201,459.00168,357.04195,438.59156,251.00148,633.01166,337.60178,895.00 Dr 1100,033.0094,349.0097,667.0091,674.0079,037.00112,439.0092,221.00 Dr. 241,708.4344,524.0035,057.0032,447.0023,142.2651,183.0037,802.00 Dr. 339,748.5327,258.4759,031.5047,337.4453,786.9654,016.0046,048.60 Dr. 40.0022,605.0036,010.0032,106.4447,719.0050,624.0038,751.00 382,948.96357,093.51423,204.09359,815.88352,318.23434,599.60393,717.60

11. MonthPractice Management SystemAccounting SystemDifference November-09 $ 302,913.34 $ 288,952.15 $ 13,961.19 December-09 $ 333,621.14 $ 322,062.92 $ 11,558.22 January-10 $ 218,306.21 $ 232,680.63 $ (14,374.42) February-10 $ 280,912.40 $ 295,597.61 $ (14,685.21) March-10 $ 322,844.06 $ 331,285.78 $ (8,441.72) April-10 $ 335,145.42 $ 342,283.99 $ (7,138.57) May-10 $ 294,694.11 $ 299,043.25 $ (4,349.14) TOTAL $ 2,088,436.68 $ 2,111,906.33 $ (23,469.65)

12. Practice Name

16. MedicareBlue CrossCoventry Turnaround Time For Correction Less Than 3 Days (for All) Turnaround Time For Payment 4 to 10 Days

18. EMR = With Standardized Coding X Efficiency Paper = Prior to EMR Differential = EMR - Paper

20. ● -Most employment relationships involve at least some “give and take” ● -With physician employment on the rise the line between medical staff rights and hospital employment obligations is becoming increasingly blurred. ● -Important to conduct your due diligence before getting hired. ● -In a perfect setting patient care should not be tied up in employment. ● -Physicians have the right to treat patients unfettered from outside pressures. ● -Physicians have obligations to serve their patients best interests.

21. ● Medical staff membership and employment are indeed two separate roles. ● Many hired physicians tend to overlook that the former often is a condition of the latter. ● So losing privileges could mean losing a job. ● Conversely, losing or leaving a hospital job often means that doctors will have to leave behind a medical staff membership. ● Experts caution that when an employee leaves a hospital employment it is not uncommon for hospital contracts to break bylaws that protect staff membership and clinical privileges. ●

22. ● Hospitals do share an interest in fairness ● Hospitals must balance patient care and liability concerns. ● Hospitals do not want to go through elaborate hearing processes that can take months before enforcing the ability to fire someone. ● If quality or safety issues arise and the doctor leaves or is terminated hospitals must be able to replace the doctor for continuity of care.

23. ● If an incident is reportable to the National Practitioner Data Bank or the State Medical Board it will allow the full peer review process to take its course. ● If nothing reportable is involved, an informal meeting with follow-up between the physician employee and a hospital administrator will suffice.

24. ● What if the employed physician's departure is not reportable? ● Involuntarily losing hospital privileges present issues... ● They may need to reveal on future employment, licensing, and credentialing applications. ● Report to Medical Liability Insurance Carriers. ● What if a Non-Compete Exists.... ● Physicians Should ask Three Questions.... ● 1- How do I get out? ● 2- What are my rights? ● 3- And what happens afterwards?

26.  Early 1900’s - technology advanced so cutting ice was very efficient  Refrigerator was invented  No need for tools and technology for ice cutting, no matter how efficient, because outdated by new technology