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What are some of the “top” legal considerations dealing with medical integration?

What are some of the “top” legal considerations dealing with medical integration?

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  1. Kickbacks situation
  2. Practice of medicine without a license
  3. The practice of Physical Therapy without a license
  4. Luring the patients to an entity which renders unethical practice and unnecessary treatment
  5. Providing unnecessary care and over utilization of billing procedures, which affect the clinic considerably.  There are eighty-two (82) pending investigations in the country today, and I represent thirty-three (33) of them as an expert witness.  Thirty-one (31) from a defending standpoint and two (2) from a prosecuting standpoint.  Therefore, I have learned in all these past ten years, that MDP clinics are difficult to handle, but if done properly can be extremely successful and very lucrative.
How long do you think the medical integration trend will last?

How long do you think the medical integration trend will last?

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Medical integration is here to stay. Indeed, as the years of technology and with the advancement of the internet with revolutionary new all of the “newly” people in general have gotten accustomed to “instant gratification”.

It will last until the middle of the next administration comes on board, since President Clinton will not attempt at this point to change the system because it is his last term.  If there are to be any changes at all, it will not be until in the middle of the next administration.  At the same time, the changes that will occur will not affect the MDP’s negatively.  By that time, I believe that the clinics that were properly converted into multi-disciplinary clinics will be well set and will still be in business.  Those, that were not put together properly and that made mistakes, will probably not last.  Others will be able to compete in any market, managed or capitated.

How difficult is it to find an MD/DO or NP/PA to work in my integrated medical center?

How difficult is it to find an MD/DO or NP/PA to work in my integrated medical center?

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Years ago, finding a professional health care provider often required hiring a qualified recruiter. Although there are many advantages working with a head hunter, many doctors find it easier and certainly much less costly to act on their own.

Indeed, today the internet has unlimited possibilities for anyone willing to spend a reasonable time searching to find the best candidate. It is fair to say however, that in smaller towns, given the finite demographics, the choices are more challenging and narrower.

Interestingly enough, we often find that when our clients are able to tap into their own personal and professional resources, they find truly competent candidates. As a matter of fact, working with an acquaintance has many advantages; namely that since there already exist a familiar trust given the “relationship”, it often creates a symbiotic environment to work in. Undeniably, professionals closely collaborating together, create an atmosphere of confidence and a spirit of security. This in turn greatly enhances patient outcome results.

Nonetheless, collaborating with a qualified health care provider is critical to the growth and success of a clinic. Unfortunately, many unscrupulous consultants too often advise their clients to hire “anyone” who is licensed irrespective of their qualifications, just so that they can begin generating more services and earn more money quicker. Anyone who is seriously considering opening up an integrated medical center should make finding a health care professional a crucial priority since it will determine the future of the clinic.

 

In conclusion, in my last twenty six years of consulting, I had privileged to encounter countless cities all over the nation (to date 1256+ centers in 45 states) and can honestly say that ALL our clients have always found health care providers to work in their clinics.

With Medical Integration, What is the Expected Increase in Collection for the First Few Months?

With Medical Integration, What is the Expected Increase in Collection for the First Few Months?

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Before exploring the clinic’s overall collections, it is very important that a clinic ensures that it meets the minimum requirements to succeed. As mentioned in other related articles and blogs, past historical statistical data clearly shows that prior to considering medical integration, a clinic should meet the following criteria to reinforce the chances of success: (These average numbers may differ depending on each particular situation).

  • 100-125 Office Visits per week
  • 12-18 New patients per month
  • 20K-25K collections per month
  • Clinic space of 800-1000 Sq. ft.

Next, assuming that you meet the minimum recommended requirements, and that the initial set up protocols have been properly implemented, i.e. legal infrastructure, contracted medical personnel, new billing and coding, etc.… and that the designated medical patients have been appropriately scheduled, the clinic should experience an increase of about 15% in collections for the first quarter. This increase should keep growing monthly by 3%-5% over the next few months.

It is critical to realize that a prudently measured progressive growth over a reasonable time period will allow control of the clinic’s expenses. Indeed, many clinics have failed in the past due to the fact that their unwise forecasting caused their expenses to spiral out of control within a short time period.  

Therefore, I must again reiterate that to enjoy your return on investment (ROI) all above considerations must be seriously implemented.

 

Here are 4 Rules to Choose the Most Qualified Consultant for Your Medical Integration

Here are 4 Rules to Choose the Most Qualified Consultant for Your Medical Integration

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Medical Integration is a very complex combination of protocols, proper documentation, concept, coding strategies, new marketing, re-branding of clinic, management skills and a whole lot more business theory which need thorough and detailed attention from an expert consultant who has established as many clinics as possible. Hence, the need to properly and prudently choose the most qualified consultant.


Rule #1 Legalities- The medical center must be established by a qualified adept healthcare attorney who will be able to guide the owner of the clinic and ensure that all possible risks are minimized. Over the last couple decades, adept consultants have amassed a massive amount of information and therefore have been able to assist  doctors handle all various possible complications. An experienced consultant will be able to help with issues such as the main health care provider being absent or leaving unexpectedly, the setup of a reasonable and appropriate compensation package, the issues of billing responsibilities…
Even though as a qualified health care attorney would be able to research and advise all these topics thoroughly, an experienced consultant can offer a invaluable recommendations and suggestions.


Rule #2 Experience- In the world of Medical Integration complexities of infrastructures and hundreds of possible pitfalls demand that the consultant has extensive knowledge as an integration coach. It is not the setting up of the integration which is so critical. It is the ability for the consultant to be able to guide and mentor throughout the development. An adept consultant who has gone through many ups and downs throughout his career is the most qualified person to choose, given his massive amount of understanding of the integration.


Rule #3 Ethics- Integrated centers are highly scrutinized and continuously questioned. One of the reasons is the fact that medical integrated center earns a great amount of revenue and with proper expansion the revenues continue to grow rapidly. By offering services ethically, honestly and with integrity, such concerns can be easily dismissed. A clinic which treats patients ethically will also gain tremendous respect from the medical community and generate many more referrals. Thus, it is vital for the clinic’s success to have a consultant who’s experiences and approach to life are based on ethics and integrity to advise clients accordingly.


Rule #4 References- By far one of the best ways to find out about a consultant is by references.

When speaking to any references provided, here is a short list of questions to ask about the consultant:


Q1. Does the consultant have an honest reputation?
Q2. Is the consultant a person on integrity?
Q3. Is the consultant very knowledgeable in the field of management of medical integration?
Q4. Is the consultant always accessible for answers?
Q5. What is the number of centers the consultant has integrated?
Q6. How many years has the consultant practice as a consultant to doctors?

Integration requires attention to details and preparation. Before making such a decision make sure you know what you are getting into and be well prepared so you can maximize your success.