Financial Mistakes Doctor’s Make

With all the day-to-day activity that goes on every day in your practice, sometimes you may lose sight of the things that can jeopardize your finances.  These are four things that can affect your practice financially. 

1.  Trusting your money with your employees

The front office is an opportunity for someone to take advantage of payments being made.  Usually there are one or two people, which are in charge of collecting payments from patients.  It is very easy for someone to accept $75.00 in cash and only claim the patient paid $30.00.  It is always good to assign two people to handle all payments, one to accept the payment and one to double-check the payment once it has been received.  One way to also help with this problem is to hire an outside billing service.  This is a good way to have a good check and balance system.  Let the employees know that there will be periodic checking on the books that is done randomly.

2.  Investing in a product

Plenty of doctor’s have been tempted to invest in a colleague’s “great” idea. This could lead to a lot of problems. Even if the idea does go well, it usually takes over 20 years to see a profit.   One notable case was when a physician invested $400,000 and lost it all.  Too many doctors fail to do any research on the product or finding out what the company’s financial status is prior to making the investment.

3.  Not having enough Malpractice insurance

It may be very tempting to take the policy with the lowest coverage and premiums to save money but in the long run it is not a good idea.  Buying a policy that has good coverage that you can afford can save you from losing your life savings if ever you are found liable in a lawsuit against you.  “Occurrence” coverage is more comprehensive than a “claims-made” policy, but that blanket protection costs a lot more.

4.  Investing in high-tech equipment

The medical community is always on the fast track for developing new and better equipment for physicians.  Some doctor’s fall into the trap of buying some of these new products without testing them, researching them or even asking other colleague’s their opinion.  Some products are very helpful and end up being worth the investment; some though can be costly and not much different from the old product.  This leaves you left with a very expensive product and not much use for it.  It is best to do your homework and decide if it is worth the money and if it will truly make a difference to your practice.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

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How Do You Know If Your Practice Is On Target?

Many physicians are overwhelmed with their day-to-day activities and are not aware if their practice is doing well or is in need of some fine tuning.  Below are five key areas of concern that should be looked into and followed up on to see how the practice is flowing.

1. Overhead

Calculate your overhead rate which includes staff and general operating costs by the total revenue the practice is bringing in.  Do some research on other practices similar to yours and see if they are comparable.  If your overhead rate is higher than the average for your specialty, consider reviewing all the cost that are involved within your practice and see if there are areas where you can reduce expenses.

2.  How productive is your practice

It’s a good idea from time to time to check the amount of referrals you are getting every month.  Make a spreadsheet of all referring doctors and see where possibly there is a drop in referrals or you are seeing an increase in referrals for a specific doctor.  By a physician taking 10 minutes out of their day to call a physician to remind them of your practice and also thank them for referring patients in the past, this could generate future referrals for the practice.

3.  Access the practices financial situation

Start by calculating a net collection rate.  When you enter into a contract with an insurance company, you agree to take a contractual adjustment from your submitted charges.  The net collection rate tells you whether you are collecting the remainder of your submitted charges once the adjustment has been made.  Calculate your net collection rate.  It should be 97% or greater to ensure a healthy bottom line.

4.  Avoid unnecessary hospital admissions or ER Visits

Evaluate a one month period and calculate the number of ER visits and admissions that were avoidable or potentially avoidable.  If your practice has a high level of preventable visits and admissions, create a quality plan to expand continuity of care, transition management, and care outreach.  Track this over time by checking it on a quarterly basis, with the goal of reducing your practice’s rate to zero.

5.  Survey referring physicians and patients

Many offices now use a patient survey or referring physician survey to evaluate their practice better.  This could be something that could be e-mailed or mailed with a return postage envelope to patients and referring doctors.  It can be done unanimously to protect their privacy as well.  This is an excellent tool to use to find out what’s really going on with the practice.  This data can be analyzed and put into good use to further make changes within the practice to help it run better.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

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Are Physicians Earning What They Deserve?

Due to the constant rising costs in insurance coverage and rising overhead costs, many physicals are starting to wonder if they are earning what they deserve.  A study was done by the internet site Medscape which received over 15,000 responses from doctors from 22 different specialties to hear what these physicians have to say. 

In one aspect of the survey it compared what men versus women earn.  The study showed that men earn more and it was due to them putting in more hours.  Most of the women studied said that they chose part-time or shorter hours in order to be able to spend time with their families but also still have a career. 

One area of specialty that seemed to love their jobs the most is Dermatologists which had an overall satisfaction score of 80% and even more interesting is that they would chose the same specialty if they had to do it all over again. 

Primary care physicians had the lowest overall satisfaction score of only 54% and when asked if they would choose this specialty again only 43% said they would.  Pediatricians and primary care physicians are key in the overall success of healthcare reform.  These specialties should be of paramount importance to keep them well paid and be satisfied with their career choice.

The specialty that showed they earned the most was Orthopedic surgeons and radiologists.   The study showed that these two specialties earned a median income of $350,000.  The lowest paid physicians where pediatricians which earned  $148,000 median and primary care physicians earned $159,000. 

Another aspect of the study compared private practice versus employment.  This showed that doctors that have their own private practice earn more than employed doctors.  Physicians that have their own private practice earn a median of $275,000 and hospital employed physicians earned a median of $200,000.  Even though physicians that have their own private practice earn more than employed physicians, they still feel less fairly-compensated.  This is most likely due to working more hours and they have to contend with insurance carriers, staff issues and office expenses which can cause stress because they always have to worry about ways to attain a steady income.

Physicians in a private practice may think that being employed will free them from hours of administrative duties and they may have more freedom and time.  On the other hand, employed physicians have to attend meetings and creating reports.  Most employed physicians also have to spend a great deal of time with paperwork and other tasks related to their position.  All these facts are definitely something to consider when deciding to set up your own private practice or to be employed.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

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Billing and Collections During Hard Economic Times Part II

As we discussed in the preceding article the fact that it’s getting harder and harder to collect patient balances.  This can definitely be frustrating, time consuming and often unsuccessful.  The Commercial Collection Agency Association showed that after 3 months of an outstanding bill, the probability of collecting is 73%, after 6 months 57% and 29% after a year.  When the amount of the bill is minimal the figures are even less. 

Staff should be well trained as to how to collect payment from patients.  When visiting a retail store and you decide on what you’re going to purchase, do you walk past the registers and say “bill me”, that would and could never happen.  So why do physicians allow this to happen in their offices? 

One way to tactfully implement payment is due upon service, is setting up signs in the office where they can clearly be seen.  Staff members should also be trained as to how to ask for payment.  Such as “how would you like to pay?”  Then the staff member should start to write out a receipt to show the patient that payment is due.  Reminding patients when confirming appointments is another opportunity to inform them of the policy.

Consider accepting credit cards and debit cards.  This is a good way to collect payment due to the fact you have the assurance in a matter of seconds if the payment went through.  One suggestion is due to some patient’s having high deductibles and it’s difficult to figure out what the exact bill will be, have the front desk take an imprint of the credit card and bill half the amount and then let them know that they will be billed the remainder and will receive a statement when they learn of the final amount from the insurer. 

Sometimes it becomes necessary to use a collection agency.  It’s best to come up with a plan in this case.  How many statements should go out before action must be taken?  Some physicians send up to 6 statements.  It should suffice to send 3 statements over a 3 month period.  One method used by a physician’s office was to send the 3rd statement as a certified letter; this ensures that it has reached the appropriate address with a person’s signature showing that the statement was received.  A phone call after the 2nd statement would do well also.  After the 3rd statement is sent, give the patient 15 days to respond with an actual date printed on the statement of the day it will be sent to collections. 

Collection agencies generally charge a percentage of the monies collected.  Most companies fees range from 12% to 50%.  It would do well for you and the patient to not have it get to that point but if necessary there are many good collections agencies to choose from.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

Click here to read testimonies regarding MariAnn Medical Billing Service

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