How to Avoid Medical Integration Fraud

In the last several years, chiropractic medical integration centers have been highly scrutinized by various regulatory bodies as well as medical boards and governmental agencies. This page is created to provide general public information on how to avoid medical integration fraud and keep you aware of potential pitfalls. Consultants of America is dedicated to help you avoid any mistake. Our ethical program is set up to help you develop a successful center using the highest levels of ethics.

WE AVOID MISTAKES!

The medical integration clinics are indeed very complex and involve many intricate details. We realize the importance of a successful practice and since mistakes can be costly and sometimes irreversible, we recommend the following steps to avoid integration fraud:

NEGOTIATIONS:

The very best terms for your doctors, your staff and key people will have to be negotiated. Allow our experienced experts to take the necessary steps and refer you to the professionals who can assist you in making all the right decisions.

LEGAL and ACCOUNTING:

A most important part of this initial set-up will unequivocally require qualified legal and accounting support. Adept professionals will need to analyze and review all issues to design a sound and safe structure to minimize your liabilities and maximize your potential.

MD’s, DC’s, PT’s:

Whether your office needs an MD or NP, an associate DC or PT, Consultants of America will assist and coach you in finding these professionals for your integration medical center and even help you replace them when necessary.

PURCHASES:

To properly and effectively establish your new successful chiropractic medical integration clinic, many items need to be acquired. Our contacts and relationships with various vendors will facilitate your transactions and allow you special discounts.

HIRING:

Specialists, doctors, and therapists are a market of their own. Our team can assist and coach you in finding the most appropriate health care professionals in the least amount of time at the most reasonable rate.

TRAINING & COACHING:

Teaching new concepts to staff can be very tedious considering the complexities of medical integration. Your staff needs to be trained properly from the beginning to avoid unnecessary mistakes and confusing information.

Know the legal barriers

With some kind of reform imminent in health care, medical practitioners are looking for ways to save their practices… or even to continue to practice, for that matter. Those involved with sports medicine or alternative care have a viable option to adapt to reform, and that is to join forces with their colleagues.
If you would like more information on integrating your clinic we invite you to visit our How to Avoid Fraud page for much more indepth information.

Joining forces

There has been increasing interest in recent years in combining the various disciplines that deal with diagnosis, treatment and management of sports injuries as well as alternative and holistic health care. It may appear to be straightforward venture between different health care professionals, but there is more than meets the eye. There are several approaches to achieve that use a variety of legal, corporate and contractual configurations.

Why combine?

There are a number of reasons why several practitioners would want to combine their practices. First, some advantages for patients:

  • A “one-stop shopping” convenience… a patient not having to go to several locations at different times to get the necessary diagnosis and treatment.
  • The access and collegiality of practice with other similarly specialized professionals create a synergy that inevitably redounds to the benefit of the patient, promoting a more in-depth, careful and considered analysis and response to a consultation and discussion.
  • The combination of practices will usually be less costly to the patient consumers of the professional services provided by the joint enterprise. With lower overhead the enterprise could charge lower fees.
  • There could be less travel time and expense to the patient and a single site convenience for patients with limited mobility due to disability.

One legal entity is ideal

The paradigm of any successful combination would be one single legal entity in which all of the treating professionals participate as equity owners, thus sharing in the proceeds of not only their own professional labors, but the labors of their colleagues as well (please note that it may be different in separate states and expert legal advice must be sought).

Assumptions for this single entity:

There possibly could be one bill sent out from the entity which reflects the work of any one or any combination of the various professionals.

There would also possible be one chart for any patient treated which could also reflect the effort and input of all the various treating professionals.

Although this model assumes one physical location, multiple locations can, in some circumstances, be an advantage especially if the business objective of the professional combination is to replicate a number of self-contained comprehensive treatment facilities.

Overhead can be decreased, ranging from simply sharing rent in a space that is larger, better situated, and more well equipped or better laid out than any one practitioner could afford, to sharing in the use of some expensive or infrequently used piece of equipment, such as imaging equipment or other testing equipment or even the office computer.

The most significant attraction of any combination is the possibility of enjoying the benefits and pleasures of not only pooling the costs or burdens of professional practice, but also the income or the positive side of the business of health care.

Before describing some of the approaches, it will be useful to first define clearly what is sought by the professionals in the combination and then to outline the potential problems to be encountered so the need and reason for the complications, cost and difficulty of a recommended approach can be set in context.

(This article was written by a licensed professional attorney and reproduced here with his permission. Please see legal disclaimer).

Please note that Consultants of America nor its agents are licensed to practice law.  The information provided here is strictly to be used as a reference. Appropriate legal counsel must be consulted for any and all decisions regarding the set up of a medically integrated center.

Medical Integration Guide

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