DoctorsManagement, LLC’s Post

There is a large institution that I know of that doesn't negotiate physician contracts. You have to accept the non-compete as written, there is no sign-on bonus, and no matter how good you are at negotiating, they won't budge. I don't want to get sued, so I won't say who they are. But here's the dealio. When I read these contracts, I tell clients they suck. They have terrible provisions, there are not the usual assurances I see in physician agreements, and I outline the deficiencies in detail so they will know what they are getting into. That's all I can do. Not just here in this state, but elsewhere, clients are saying "thanks for the warning" and signing them anyway. This is how hospitals, large groups, and integrated systems get away with it. The only way we are going to get movement is if physicians can collectively start saying no to bad contracts, and then the institutions will be forced to make reasonable edits to their agreements. I understand everyone needs a job, and I get it. But if there are no doctors signing up for these jobs, there will be movement. That's how leverage works. To the systems that see doctors as professionals, work hard to make sure the contracts are fair and reasonable, I applaud you. I work with you. I can get beyond these reasonable things. I can't ever get behind some overbearing agreement at below market rates with tons of clawbacks, no sign-on bonuses, no termination provisions that make sense, and they try to hold doctors hostage for years after they leave just to protect some imaginary business interest. www.guardmypractice.com

A Physician's compensation contract often uses RVUs to calculate the rate of payment.  The Practice Expense (PE) component of RVU Physician Compensation covers essential practice costs. Read on to learn more. #EmploymentLaw #PracticeExpense

Is it time to revisit the structure of your practice with a related ASC? Physician bonuses can be allowed if structured correctly based on the latest OIG Advisory Opinion. Read Holland & Knight LLP article below. We can assist in structuring a compensation plan that works with your practice and work with great attorneys like the ones at H&K to make sure it is compliance with the OIG. #bdo #bdohealthcare #healthcare

I am puzzled by the focus on reducing physician reimbursements by CMS when the majority of their reimbursements go to hospitals and sectors with limited transparency. It would be beneficial for CMS to clarify this perspective to the public who contribute through taxes. In 2023, CMS disclosed 15.64 million records, totaling $12.75 billion in payments and ownership interests. The detailed breakdown includes: - General Payments: $3.29 billion - Research Payments: $8.12 billion - Ownership/Investment Interest: $1.34 billion #CMS #PhysicianReimbursements #Transparency #HealthcarePayments #PublicAccountability #healthcarefinance #physicianreimbursement #hospitalreimburment #openpaymentprogram

In medical practice, like any other business, cash flow is king. However, for medical practitioners who have mixed billing across public and private services, it can quickly become a minefield. The good news is that there are ways to smooth cash flow bumps and ensure you can continue to deliver for your patients and build your practice. Read our latest blog to learn more: https://lnkd.in/e2csATvE #AptWealthPartners #CashFlow #FinancialPlanningForBusiness

🔍Maximizing Accuracy & Reimbursement: The Importance of CPT Modifiers🔍 In the realm of healthcare billing and coding, CPT (Current Procedural Terminology) modifiers play a critical role in ensuring accuracy and fairness. Today, I want to shed light on the importance of understanding and utilizing CPT modifiers effectively. CPT modifiers are two-digit codes appended to CPT procedure codes to provide additional information about the service rendered. They help in: ✨ Adding Clarity: Modifiers clarify circumstances that alter the description of a procedure or service, such as indicating multiple procedures performed during the same visit. ✨ Avoiding Denials: Correct use of modifiers can prevent claim denials by accurately reflecting the complexity or uniqueness of a procedure or service. ✨ Enhancing Reimbursement Accuracy: Modifiers influence reimbursement rates by adjusting payment based on specific conditions or circumstances of the service provided. Whether it's indicating a bilateral procedure, a service performed by a different provider, or a distinct procedural service, CPT modifiers ensure that healthcare billing reflects the true nature of patient care. Check out the most recent fact sheet I read by CMS!  ➡ https://lnkd.in/gAFm6Ws3 #CPTModifiers #HealthcareBilling #MedicalCoding #RevenueCycleManagement #HealthcareFinance #PatientCare #LinkedInHealthcare

Reducing the Loss of Employed Physician Groups is Imperative for Hospitals Financial Viability. * The average loss per health system employed physician is over $250,000 annually and is increasing. * Physician salaries are increasing due to the shortage of providers while Medicare has adjusted its physician fee schedule: one and one quarter percent (1.25%) (Becker’s ASC 11-2023) in comparison to a four and one-half percent (4.5%) increase in supporting a practice. * Hospitals and health systems cannot afford to lose this amount of money on their employed physician practices and remain financially viable. * Hospitals nationally have employed practices which are approaching financial self-sufficiency. * These better-performing practices have common characteristics: - Employed physician groups own multi-specialty groups. - Physicians drive practice performance through a physician dominated governance structure. - Compensation is based on individual provider production. - Accurate information is provided to compare physician performance to their peers and national information. - Culture is healthy and physicians feel valued and appreciated. * Physicians are the marketing channel that supports hospitals and health systems. The growth in hospital employment of physicians has been accelerating and can be expected to continue to grow. However, hospitals and health systems cannot afford to grow their employed physician network without improving their financial performance. If you are interested in learning more, feel free to reach out. Please see Lumina Heath Partners at https://lnkd.in/gHQnRaVi

Independent contract physicians: Know their value and are satisfied with their agreement. Employed physicians: Don't know their value and leave time and/or money on the table.   Independent contract physicians: Choose their schedule so they can perform at their best when working. Employed physicians: Take the schedule they are given, squeezing in their personal life as an afterthought.   Independent contract physicians: Ask for what they want/need, and receive what they ask for. Employed physicians: Take what they are given.   So remember, You're already caring for patients, balancing risk, and working hard. Why not get more in return for your efforts? Contact me for Details: ✉ acyril@mplthealthcare.com 📞 (954) 507-4834

Physicians, are you maximizing your income and receiving every dollar that you’ve earned? A question that more physicians must ask themselves as optimizing medical billings can significantly improve revenue without having to work more or harder than you already are. Never has this been more important than now, given the current environment of escalating costs and minimal fee increases. To further our mission of promoting holistic financial health for Canadian Physicians, we collaborated with medical billing experts at DoctorCare to put together a comprehensive guide to help physicians master revenue optimization, including bonus tips on practice management. Read full article here: https://bit.ly/pwadrcare

On March 21, 2024, the Commonwealth Court broke new ground with respect to the ability of a claimant’s attorney to receive 20% of Claimant’s medical benefits. In P. Williams v City of Philadelphia (WCAB) 277 C.D.2023, https://lnkd.in/e5sHs3fd the WCJ had disallowed an open ended 20% attorney fee on medical expenses. The WCJ had logically held that “because Claimant’s future medical bills are unknown and speculative, she could not comprehend or anticipate when she executed the Fee Agreement the actual amounts she could be required to reimburse her medical providers.” The Board affirmed. The Commonwealth Court reversed on this issue, holding that Claimant demonstrated through her testimony that she understood the implications of paying a 20% fee on medical. Unfortunately, the Court went further. The Court acknowledged its prior decision in Righter v WCAB wherein it “suggested” that under Section 306(f.1)(7), [the balance billing provision] a medical provider would not be precluded from seeking the 20% balance directly from the Claimant. However, in P. Williams the Court boldly stated that: “Section 306(f.1)(7)’s prohibition on “balance billing” is not limited to only the difference between a provider’s normal fee and the Medicare approved reimbursement rate. Rather, it prohibits a provider from billing a claimant for any costs related to care provided under the Act and any amounts reflecting the difference between the provider’s charge and the amount paid.” The Court then went further to say that the provider’s remedy is to seek fee review. This decision will no doubt create a tension with the Act and Regulations limiting an Employer’s liability to pay medical benefits pursuant to what we have come to know as fee scheduling. By suggesting that a provider seek fee review to obtain its 20% signals that the Employer/Carrier may be held responsible for that balance which would be contrary to the Act and contrary to the Cost Containment Regulations.