binding contract

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.
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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.

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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.

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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.

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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.

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5 Important Key Factors to Consider for Medical Integration

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Should you consider medical integration? You have been in practice for some time and you are wondering what you can do to increase your income? After all, health care practitioners have encountered many challenges in the last several years and it has indeed been become more difficult to practice. Notwithstanding the fact that expenses have gone up due to the cost of living as well as a sharp increase in employees’ salaries.


As of today, it is fair to say that medical integration has been around for quite some time. Although it seems there are many legal pitfalls, the medical integration is still the most valuable option for any doctor who wishes to high volume of patients while increasing the clinic revenue.

After all it makes good sense! A broader scope of practice attracts many more patients who then generate more billing hence more revenue.


There are 5 key point however that you will need to consider operating a successful medical integrative center.


1. Your Philosophy: Make sure you know what you want and clearly delineate what services you will offer currently so as not to compromise your values.


2. Set a Concrete Budget: Have a reasonable set amount of money to cover the budget of any expenditures and avoid unnecessary stress. The average amount you will need to have access to is approximately $4,000-$5,000 per month for about 3 months from the starting date. After that time, collections from the extra revenue will help cover the newly added expenses.


3. Staff Training: Realize that your staff who has been loyal to you up unto that time, may not understand why you want to convert your clinic into a multi-discipline center. They may not appreciate the advantages or the potential increase in collections. Spend time outlining your plan and clearly explaining your vision. Let your staff realize that by broadening your scope of practice, you will help more people and therefor make your community a healthier place to live. To date, less than 10% of the U.S. population (about 330 million) visit a chiropractor. With medical integration you would have access to over 90% of the population.


4. Implement a Staff Benefit Package: If you want everyone in the office to be excited and help you turn your visionary dream into a reality, you must create a financial benefit plan for everyone. Create a physical chart showing your staff how the increased revenue will allow for everyone to get a raise and expand their potential future income. A motivated staff will go the extra mile to ensure the medical integration’s success by building and maintaining an enthusiastic team to produce great outcome results.


5. Take Your Time: Medical integration is not a “fly by night” option to make quick money. You need to clearly define your philosophy, while instituting solid management protocols. Your new center needs to be organized on compelling, ethical fundamentals combined with integrity, honesty and all based sound business structure.

10 rules

10 Rules to Ensure the Success of Your Medically Integrated Center

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Although there are many variables that contribute to a medically integrated center, there is one aspect that remains the key component. It is integrity!

When integrating a medical center, doctors must be committed to offer their patient an alternative choice without jeopardizing their philosophy. Most clinics owners are well intention and truly mean well. Unfortunately, with the increase in management demand, the high pressure from the forever increasing expenses and the challenging management of the newly added professional medical staff, the clinic owner often becomes disappointed and regretful.

To ensure measurable success the clinic will require to establish a strong relationship with the local community. By nurturing a professional network of physicians and other specialists based on integrity, will generate many referrals and provide the newly established integrated center with all the patient loads it needs to thrive. However, building such a network requires diligence and discipline.

The clinic owner should follow the following recommendations:

1. Render all services within the specific scope of practice of the newly health care practitioners.

2. All treatments must be clearly based on medical necessity.

3. All fees must be within a usual customary rate reflecting the demographic areas.

4. Each referral should be sent back to the referring doctor for follow ups.

5. A complete list of patient referrals should be maintained to track marketing results.

6. Any patient complaint or concern must be attended efficiently and professionally.

7. Any addition of other services or ancillaries must be shared in a courteous and friendly manner.

8. The staff must maintain constant open communication with referring doctors regarding any patient treatment.

9. Referred patients should be given priority for appointments as a courtesy for the referral.

10. All team doctors must attempt to meet on a timely basis to strengthen the relationship.

These 10 basic rules will ensure the professional relationship between referring physicians to maintain and nurture for many years. The professional respect extended within the medical community will help your clinic grow greatly and successfully.

marketing

How to Successfully Market for Your Medical Integrated Clinic

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A successful medical integrated center will attract many new patients, given its broad scope of practice and diversified healthcare treatment options.

However, how will most of your new potential patients know about your clinic services?

Today’s fast paced world of advanced technology and high-tech media requires innovative marketing. Below is a short list of the most popular social media tools used to attract large number of new patients:

1. A well-designed website- It is reported that today over 90% of the adult population has a smartphone. This gives everyone accesses to the internet at any place. Which means at any time, a potential patient searches for any information they use the internet to find information and look for a list of services using a cell phone or a tablet. This is where a dynamic website is vital. Therefore, it behooves you to have not only an attractive well-designed website, but one that must certainly be mobile friendly as well.

2. SEO- With great SEO, your website will maintain a prime location and will be easily accessed. A professional organic placement will connect your site to many search engines.

3. Google Ad Words- Using Google Ad Words, and Google re-marketing will allow your ads follow any potential patient interested to visit your office.

4. Customer Relationship Management Email Campaign (CRM) – CRM is the ability to nurture each potential lead and convince the lead to schedule an appointment. A good CRM automated campaign will also maintain your current active patients and generate internal referrals as well as reactivate non active patients.

5. Comp-Tracker- Technology today is so advanced that using Comp Tracker Software, the doctor will be able to track your local competition’s AdWords as well as establish a proper marketing strategy. Comp-Tracker will generate a comprehensive report about your competition activities on the internet including the budget spent by your competitors.

6. Facebook- By creating extensive focused campaigns, Facebook has the ability to generate considerable amount of leads at a very low cost. With a well-designed Facebook campaign your ads will create a live interaction leading to many new patients for your center.

7. Instagram- Much like Facebook, Instagram targets a younger population effectively.  

8. Twitter- A popular way to increase interest by scheduling short sentences at reasonable intervals for free.

9. Webinars online (WOL): This method is the ability for offering webinars online. This rather innovative method allows leads to view the information at any time. When properly set up, these leads are then prompted to a landing page with a call to action button to schedule and appointment for the clinic.

10. Voice Blast- Timely calls to all your patients’ database to make important announcements and promotional offers. A professional health care marketing company such as Attitude Marketing, www.theattitudemarketing.com can for a very reasonable fee design a comprehensive marketing package that will guarantee you unprecedented success.

11. MediRoom: For a negligible monthly fee, the clinic offers invaluable information to patients while waiting in the reception room. This method of patient education has been highly successful in increasing patient retention while generating many referrals.

Many of the services listed in this article, can be purchased from Attitude Marketing specializing in medically integrated clinics www.theattitudemarketing.com

qualification

Do I Qualify for Medical Integration?

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Qualifying for medical integration is a very important questions that cannot be dismissed.
Even though medical integration sounds attractive you probably wonder if you will succeed in integrating your clinic. Many doctors have jumped onto the “medical integration wagon”, only to realize that they were not well prepared to handle the complexities and challenges that come with medical integration.


Here is a list of a few areas that need to be carefully examined before opening a medically integrated center:


1.     Philosophy: If your practice currently treats a number of patients who believe in you and your philosophy’s approach to health care, you must ensure that you and your staff are prepared to embrace the new treatment protocols so that your patients will easily follow through with your recommendations and advice. Therefore, understanding and being well anchored in the “philosophy of your practice” is a critical point to be fully entertained.


2.     Management: An integrated medical center by its very nature requires more staff and greater management skills. You need to adapt to having various health care personnel work well with each other to ensure a greater success. You will also need to learn how to clearly delineate treatment protocols so that your patients know what treatment they are receiving and from whom. A successful medical integrated center does require a well-trained and dedicated management team.


3.     Budget: Medical Integration will need to be adequately funded to be successful. One of the most often complaint you hear from those who tried and did not succeed at medically integrating their clinic, is that they did not have a soundly prepared financial budget. It is highly recommended that you meet with your financial advisor or accountant and create a strategic business plan with projections of collections and purchasing of expenditures. This will not only give you a piece of mind but also ensure the successful development of your medical integration.


4.     Patient Load: Your Revenue will be dictated by how many new services you offer to each patient and how much you are collecting for each service provided. If this is not a new clinic you should be typically treating about 100-125 office visits per week to be able and properly integrate your clinic successfully. The new health care practitioners will need time to build up referrals generated from their services. In the meantime, the current patient load who will need medical services based on medical necessity, will be the first patients who will be referred to keep the clinic profitable.


5.     Marketing: By far one of the most important components of a truly successful medical center is advertising. Your patient’s demographics as well as your whole town need to be aware of your new medical center and its added services. Indeed, your clinic is unique and its approach to health care can be very attractive if it is marketed properly. A well designed integrated medical center offers an innovated holistic approach to health care complimented by allopathic medical services. This exclusive and particular healthcare is very attractive to many people. However, the message needs to be broadcasted by using the best extensive marketing tools available today. Undeniably, the internet, Facebook, Instagram, Twitter, Yelp and so many other available social media applications and platforms can be very beneficial to promote your center and increase your patients’ volume exponentially. Thus, it is critical that you work with a reputable and experienced marketing firm who has a track record with current active medical integrated centers. As a final note, it behooves you to be prepared and be aware of what you will be needing because starting an integrated medical center has shown to be rewarding and beneficial while offering a beneficial alternative to all patients. It goes without saying that medical integrated centers are much more lucrative than solo practitioner clinics due to the fact that they treat a much greater volume of patients compared to a solo practice.

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A Definition of the Term Medical Integration

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What is the term “medical integration” mean?


The concept is quite old since it combines the expertise of several practitioners working together, namely a medical doctor, chiropractor, physical therapist and any other type of health care practitioners.

Today, the medical integration model is vital given the current challenging world of global economics.
Indeed, we must do our utmost as a nation and certainly as health care practitioners, to help as many people as possible while maintaining reasonable fees for services rendered. Medical integration is no longer a novel idea created to divert the current type of care or even change the economic situation of the practitioners.

To the contrary the advantage and certainly the strength of an integrated medical center is that all practitioners join forces in combining their expertise and giving the patient their ultimate treatment to appropriately treat their condition, and all this can be done without affecting any practitioner’s philosophy.  


What is even more encouraging is when medical integration adds the combination of a wellness approach, we now have an even greater innovated concept. As an example, before a patient receives any type of invasive treatment or is prescribed a series of painful and expensive remedy or even medicated with many possible side effects, the patient is offered the opportunity of a natural approach such as chiropractic, including any holistic approach and combining a wellness component by giving the patient the ability to choose from any alternative options.


Today, there are many well documented articles which clearly support the concept of giving the body the “opportunity to heal itself naturally with time” by strengthening the immune system without causing any other possible side effect to the rest of the body. This concept of preventative health care when included in an integrated medical center will help patients understand the need to stay healthy, maintain a proper diet, exercise and living a healthy life.