On this page you will find forms, checklists and spreadsheets useful for starting up and managing a medical practice. Read the brief description following the document title for guidance on using the document.

To access any document, (1) right click with your mouse on the hyperlinked document title, (2) click "Save Target As" from the pop-up box, (3) save the file to your desktop, and (4) open the file in the appropriate application (either Excel or Word).

1. Checkist for Starting Up a New Medical Practice (Format: Excel): provides a list of essential tasks that must be performed prior to launching a medical practice in checklist format, including columns for "person responsible" and date started and completed.

2. Health Plan Assessment Matrix (Format: Excel): provides a matrix to perform a side-by-side comparison of health plans with respect to such benchmarks and criteria as collection rates, timely payment and more. If you have questions concerning how to use this matrix kindly contact reedt@rtacpa.com.

3. Practice Review Program (Format: MS Word): an actual work program that allows you to conduct a financial and operational assessment of a medical practice.

4. Sample Medical Practice Budget (Format: Excel): sample worksheet to assist in the budgeting process.

5. Record Retention List (format: MS Word): provides guidance on how long to retain medical office records, both financial and clinical.

6. Sample Practice Management Report (Format MS Excel): use this worksheet to summarize and manage vital practice data, including charges, collections, adjustments, collection ratios, accounts receivable agings, and clinical encounters.

7. Evaluation and Management Coding Analysis Worksheet for Group Practice (Format MS Excel): use this worksheet to compare E/M coding patterns for physicians in a group practice. Can be used to identify undercoding and overcoding situations.

8. Evaluation and Management Coding Analysis for Solo Medical Practice (Format MS Excel): use this worksheet to analyze E/M coding patterns for solo physician practitioner. Can be used to identify undercoding and overcoding situations.

9. Dashboard Indicators (Format MS Excel): use this worksheet to summarize medical practice benchmarks; also can be used as a financial management tool.

10. Monthly Production and Collection Budget Worksheet (Format MS Excel): use this worksheet to track actual monthly production and collections against related budgeted figures. Best used in conjunction with a "bottom up" budgeting process.

11. Cash Flow Projection Worksheet (Format: Excel): a worksheet you can use to project revenues and expenses for a medical practice; uses physician utilization figures to project revenues.

12. Office Relocation Checklist (Format: Excel): handy worksheet to use when moving a medical practice to new office space.

13. Valuation of Call Coverage (Format: Excel): used to value call and reduce compensation when a physician decides to remove himself from call coverage schedule

14. Employee Survey Form (Format: MS Word): used to obtain feedback from practice employees

15. Waiting Time in Reception Area Worksheet (Format: MS Word): use this form if a practice wants to analyze patient waiting times in the receiption area; an excellent patient satisfaction detection tool.

16. UCR Response Letter (Format: MS Word): if a charge is ever reduced by a payer because of "usual, customary, and reasonable" considerations, use this letter to send to a patient explaining UCR.

17. Employee Time Off Form (Format: MS Word): use this form when an employee wants to request time off from the medical practice.

18. Patient Insurance Verification Form (Format: MS Word): use to verify and document a patient's insurance coverage.

19. Denial Tracking Sheet (Format: Excel): a worksheet you can use to document and track why charges are being denied; excellent management and monitoring tool.

20. Patient Satisfaction Form (Format: MS Word): use this form to get feedback from your patients

21. Doctor Meeting Agenda Format (Format: MS Excel): use this form to create and document your physician meeting

22. Pediatric Surgical Associates IRS Case (Format: MS Word): summary of important tax case applicable to any C-Corporation group practice.

23. Practice Administrator Job Description (Format: MS Word): sample job description for physician practice admininstrator

24. Managed Care Contract Analysis Checklist (Format: MS Word): use this checklist to review managed care contracts

25. Managed Care Negotiation Checklist (Format: MS Word): use this handy checklist when negotiation or renegotiating a managed care relationship

26. Notice to Patients after Contract Termination (Format: MS Word): sample letter to send to patients after a managed care contract is terminated

27. Managed Care Contract Termination Letter (Format: MS Word): use this simple letter to send notice of contract termination

28. Sale of Practice Checklist (Format: MS Excel): use this checklist when selling a medical practice

29. Merger Implementation Checklist (Format: MS Word): simple checklist to use when merging medical practices

30. Billing and Collection Questionnaire (Format: MS Word): use this questionnaire to summarize and analyze the billing and collection process

31. Consultation Request Form (Format: MS Word): Use this form to request (and document) consultation by another physician

32. Patient Termination Letter (Format: MS Word): Use this form to terminate the physician/patient relationship. However, be sure to also check with your malpractice carrier to see if it has its own suggested termination letter

33. Annual Administrator Performance Review Form (Format: MS Word): Use this form to grade out an administrator’s performance and use to as a basis for a bonus