Managed Care Oversight You have payer relationships so I ask: How is your current managed care oversight? While your medical practice may be compliant with billing regulations and coding, this does not mean that your payer is compliant and has paid you correctly per your contract. Providers know that Fraud and Abuse has been one of the largest areas of focus for payers and the government over the past 20
Medicare Secondary Payer Background Medicare law and regulations require all entities that bill Medicare for services or items given to Medicare beneficiaries to decide whether Medicare is the primary payer for those services or items before submitting a claim to Medicare. (See Section 1862(b)(2) of the Social Security Act and regulations at 42 CFR 489.20g.) When you find another insurer as the primary payer, bill that insurer first. (Page 16
OSHA Overview Remember OSHA? Seems like we’ve forgotten about it. However, like HIPAA, your medical practice has to be in compliance – Are you? Here is a brief overview of the bloodborne pathogen rules under OSHA. When reading what OSHA requires employers to do, ask yourself – Am I doing these things? What are bloodborne pathogens? Bloodborne pathogens are infectious materials in blood that can cause disease in humans, including
Accounts Payable and Internal Controls The vital role that internal controls play within any well managed medical practice is widely recognized. Knowledgeable practice managers are well aware that poor controls in this single area can result in far more dire consequences than simply dampened earnings. The following are questions that provide you with a quick means to identify and evaluate common internal accounting controls related to your own payables processing
Individual 401(k) Simply put, an Individual or Solo 401(k) is a retirement account designed for the self-employed, or business owners with no full-time employees, like a solo physician practice. An Individual 401(k) plan offers many of the same benefits of a traditional 401(k) with a few distinct differences. A traditional 401(k) is offered by a company allowing employees to save for retirement by contributing to their own accounts directly from
SEP IRA vs Solo 401(k): Which Should You Choose? How do you multiply your net worth? Let the government help. Here’s how: With both the SEP IRA and the solo 401(k) retirement plans, your investment in your tax-favored retirement creates tax deductions for the money you invest in the plan, grows tax-deferred inside the plan, and suffers taxes only when you take the money from the plan. Example. You invest
Physician Merger Due Diligence You and another or a group of physicians are considering a merger with each other. In any medical practice merger, the most important part of the merger process is conducting your due diligence. The initial funding for this due diligence process should first be estimated and funded. The treasurer responsibilities should be assigned for reporting of these premerger costs. The merger committee next establishes its methodology
Medicare Wellness Visits Medicare covers wellness visits, and your patients pay nothing if you accept assignment. The Part B deductible doesn’t apply. You should recommend the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV) to get your patients off to a healthy start this year and generate extra revenue for your physician office. The Welcome to Medicare Visit The IPPE or the “Welcome to Medicare” preventive visit is a
Key Physician Practice Pre-Merger Decisions During the merger process, the physicians as a group will need to make numerous key pre-merger decisions about certain aspects and elements of the new group practice. Many of these key pre-merger decision areas are listed below. Some of these decisions are so important that a failure to properly address them could cause harm to the potential success of the merger. Some potential physician practice
Home Office Deduction If you have an office outside your personal home—say, downtown—can you have a tax-deductible office inside your home for the same trade or business that will allow for a home office deduction? The answer is, yes! But who says that? The IRS says that. I’ll show you where the IRS says that! IRS Publication 587: The IRS says this: Your home office (and home office deduction) will