to be or not to be truly solo

[Guest guest]

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA

with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day. what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program. when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person. each of us has their own definition of solo and efficiency and what works best. i believe the keys to being however one is,

relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family? most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others. there is no monopoly on how to do it, rather creeping incrementalism toward improvement. just my thoughts. LL

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RE Solo is how you define it.

I sort of did it in reverse.

Hosp replaced me, so I moved 9.5 miles away, and have been recruiting thru advertising, word of mouth over the past 15 months. Had been "replaced" Aug 2004, opened my place Dec 2004. Since I had access to several former staff from prior practice who'd quit or been "available," I decided to staff up the office initially to what I felt would be most reasonably efficient.

This has worked out sort of in reverse too-- now getting up to 10-11 pts THIS WEEK, YEH!, so will begin to be able to pay MYSELF and some debt down shortly. Did invest quite a bit, and have been, on staff salaries. Yes, I know that's not how many of you did it, but as Lawrence stated below, to each their own.

I decided early on that service for the pts, AND service (not overwork bludgeoning) for the staff (!) was the most important way for me to establish a long-term business. Hosp my way is still trying to "run the world" and a good number of primary care docs still work for a hospital owned practice or supported practice in some way. I've become more and more convinced that I will just NOT be able to see, attract some pts, and maybe that's for the good. But the pts who want good, personalized care, well, those will see me, and we'll be happy about it. Others won't be, and I'm quite happy about that too. There's just only a limited way to survive. Now that means I ended up taking only 1 of the 3 med assistance HMOs in the area, and we see them. Very time intensive, but after awhile, just another pt in the list. I loose on them, but there really aren't too many of those who are willing to follow up, etc. I see those that do, I consider it mainly my charity work considering the minimal payment we get in PA ($31 max).

I have a modest budget of about $10K/month. This includes about $4K for salary. I get done close to time. Have been using an EMR (SOAPware) since 1997, full use for each pt since Dec 2004. Like others have said, it's a great kick to see each pt and not have an associate in between seeing the pt for a follow up.

I envision ultimately expanding slowly with a like minded solo; staffing now is usually 2 FTE in office (yes, overstaffed compared to many of you), with outsourcing of payroll at $127/month, billing, accounting, it costs a fair amount, but expect to be well self-sufficient at 35 pts or less a week, and at baseline in productivity take home pay by national standards at 60 pts a week. I'm currently scheduled for 26 hours a week, so this is alittle over 2 pts/hour.

Those working on this "little project" should be VERY CAUTIOUS about contracts and how long it takes to get this all untangled. Most DO take 3-4 months, OR longer, up to 6 months. My medicare contract took over 9 months to get any money from, but was able to be retroactively submitted, so made up for it eventually.

Later, all

Dr Matt Levin

FP in east Pittsburgh

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

RE Solo is how you define it.

I sort of did it in reverse.

Hosp replaced me, so I moved 9.5 miles away, and have been recruiting thru advertising, word of mouth over the past 15 months. Had been "replaced" Aug 2004, opened my place Dec 2004. Since I had access to several former staff from prior practice who'd quit or been "available," I decided to staff up the office initially to what I felt would be most reasonably efficient.

This has worked out sort of in reverse too-- now getting up to 10-11 pts THIS WEEK, YEH!, so will begin to be able to pay MYSELF and some debt down shortly. Did invest quite a bit, and have been, on staff salaries. Yes, I know that's not how many of you did it, but as Lawrence stated below, to each their own.

I decided early on that service for the pts, AND service (not overwork bludgeoning) for the staff (!) was the most important way for me to establish a long-term business. Hosp my way is still trying to "run the world" and a good number of primary care docs still work for a hospital owned practice or supported practice in some way. I've become more and more convinced that I will just NOT be able to see, attract some pts, and maybe that's for the good. But the pts who want good, personalized care, well, those will see me, and we'll be happy about it. Others won't be, and I'm quite happy about that too. There's just only a limited way to survive. Now that means I ended up taking only 1 of the 3 med assistance HMOs in the area, and we see them. Very time intensive, but after awhile, just another pt in the list. I loose on them, but there really aren't too many of those who are willing to follow up, etc. I see those that do, I consider it mainly my charity work considering the minimal payment we get in PA ($31 max).

I have a modest budget of about $10K/month. This includes about $4K for salary. I get done close to time. Have been using an EMR (SOAPware) since 1997, full use for each pt since Dec 2004. Like others have said, it's a great kick to see each pt and not have an associate in between seeing the pt for a follow up.

I envision ultimately expanding slowly with a like minded solo; staffing now is usually 2 FTE in office (yes, overstaffed compared to many of you), with outsourcing of payroll at $127/month, billing, accounting, it costs a fair amount, but expect to be well self-sufficient at 35 pts or less a week, and at baseline in productivity take home pay by national standards at 60 pts a week. I'm currently scheduled for 26 hours a week, so this is alittle over 2 pts/hour.

Those working on this "little project" should be VERY CAUTIOUS about contracts and how long it takes to get this all untangled. Most DO take 3-4 months, OR longer, up to 6 months. My medicare contract took over 9 months to get any money from, but was able to be retroactively submitted, so made up for it eventually.

Later, all

Dr Matt Levin

FP in east Pittsburgh

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Correction-- 10-11 pts a day! this week, goal is 35 for break even! Sorry about confusion!

Dr Matt Levin

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Correction-- 10-11 pts a day! this week, goal is 35 for break even! Sorry about confusion!

Dr Matt Levin

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Wow, the maximum you can make on a

Medicaid patient in PA is $31? Even for a 99214? I definitely would not be

able to keep seeing those. We have made as much as $70 on certain Medicaid

visits: a 99214 + some OMT + a rapid strep test. Average though is maybe $45.

$31 a visit makes it tough to run a low volume practice.

Re:

to be or not to be truly solo

RE Solo is how you define it.

I sort of did it in reverse.

Hosp replaced me, so I moved 9.5

miles away, and have been recruiting thru advertising, word of mouth over the

past 15 months. Had been " replaced " Aug 2004, opened my place

Dec 2004. Since I had access to several former staff from prior practice

who'd quit or been " available, " I decided to staff up the office

initially to what I felt would be most reasonably efficient.

This has worked out sort of in

reverse too-- now getting up to 10-11 pts THIS WEEK, YEH!, so will begin to be

able to pay MYSELF and some debt down shortly. Did invest quite a bit,

and have been, on staff salaries. Yes, I know that's not how many of you

did it, but as Lawrence stated below, to each their own.

I decided early on that service for

the pts, AND service (not overwork bludgeoning) for the staff (!) was the most

important way for me to establish a long-term business. Hosp my way is

still trying to " run the world " and a good number of primary care

docs still work for a hospital owned practice or supported practice in some

way. I've become more and more convinced that I will just NOT be able to

see, attract some pts, and maybe that's for the good. But the pts who

want good, personalized care, well, those will see me, and we'll be happy about

it. Others won't be, and I'm quite happy about that too. There's

just only a limited way to survive. Now that means I ended up taking only

1 of the 3 med assistance HMOs in the area, and we see them. Very time

intensive, but after awhile, just another pt in the list. I loose on

them, but there really aren't too many of those who are willing to follow up,

etc. I see those that do, I consider it mainly my charity work

considering the minimal payment we get in PA ($31 max).

I have a modest budget of about

$10K/month. This includes about $4K for salary. I get done close to

time. Have been using an EMR (SOAPware) since 1997, full use for each pt

since Dec 2004. Like others have said, it's a great kick to see each pt

and not have an associate in between seeing the pt for a follow up.

I envision ultimately expanding

slowly with a like minded solo; staffing now is usually 2 FTE in office (yes,

overstaffed compared to many of you), with outsourcing of payroll at $127/month,

billing, accounting, it costs a fair amount, but expect to be well

self-sufficient at 35 pts or less a week, and at baseline in productivity take

home pay by national standards at 60 pts a week. I'm currently scheduled

for 26 hours a week, so this is alittle over 2 pts/hour.

Those working on this " little

project " should be VERY CAUTIOUS about contracts and how long it takes to

get this all untangled. Most DO take 3-4 months, OR longer, up to 6

months. My medicare contract took over 9 months to get any money from,

but was able to be retroactively submitted, so made up for it eventually.

Later, all

Dr Matt Levin

FP in east Pittsburgh

to be or not to be truly solo

i've gone from wanting to be the only one in the

office to starting with one MA, to now having two MA's, one who primarily does

administrative work including sending bills to the biller, reviewing faxes,

putting them into pdf for my review and then filing them electronically after i

do, scanning records and attaching them to the electronic chart, and the

other who does primarily front office/patient preparation including

checking insurance, collecting copays, giving injections and

drawing blood. they both answer the phone, take messages, do

referrals, and send chart notes when appropriate. and since they both

have the MA qualification and certification, they can cross-cover each other

for patient services. i spend very little time on the phone now, and i am

left to concentrate on being a doctor, and to see the patients.

there was an increase in efficiency with the addition of the administrative MA,

and now, since the original MA with whom i started left for another job and has

been replaced by a very efficient person, the overall efficiency of the office

has practically doubled, as has the number of patients seen during a day, from

approximately 5-6 to 10+/day.

what a difference! part of the

improved efficiency includes replacing telephones without intercoms to

ones which have them built in, and upgrading the voice recognition dictation

program.

when i am asked to describe my practice, it is a solo

office, since i am the only doctor. i quite frankly don't feel able to

handle the entire office by myself, and i enjoy having at least one MA. i

am also the IT consultant, office equipment supplier, general handyman,

payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and

efficiency and what works best.

i believe the keys to being however one is,

relates to whether one is doing a good job, and

to answer the questions, does one provide the standard of care,

see patients in a timely fashion, do the appropriate preventive care, and have

improved outcomes? do patients have a better state of health

since coming to see me? are patients satisfied with the care they

receive? is this done in a manner which rewards me appropriately

(subject to interpretation)?. does one have enough time for oneself and

one's family?

most of us have a steep learning curve, since this

kind of stuff isn't taught in medical school or in residency, and we are taught

to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping

incrementalism toward improvement.

just my thoughts.

LL

Yahoo!

Mail

Bring photos to life! New

PhotoMail makes sharing a breeze.

[Guest guest]

Wow, the maximum you can make on a

Medicaid patient in PA is $31? Even for a 99214? I definitely would not be

able to keep seeing those. We have made as much as $70 on certain Medicaid

visits: a 99214 + some OMT + a rapid strep test. Average though is maybe $45.

$31 a visit makes it tough to run a low volume practice.

Re:

to be or not to be truly solo

RE Solo is how you define it.

I sort of did it in reverse.

Hosp replaced me, so I moved 9.5

miles away, and have been recruiting thru advertising, word of mouth over the

past 15 months. Had been " replaced " Aug 2004, opened my place

Dec 2004. Since I had access to several former staff from prior practice

who'd quit or been " available, " I decided to staff up the office

initially to what I felt would be most reasonably efficient.

This has worked out sort of in

reverse too-- now getting up to 10-11 pts THIS WEEK, YEH!, so will begin to be

able to pay MYSELF and some debt down shortly. Did invest quite a bit,

and have been, on staff salaries. Yes, I know that's not how many of you

did it, but as Lawrence stated below, to each their own.

I decided early on that service for

the pts, AND service (not overwork bludgeoning) for the staff (!) was the most

important way for me to establish a long-term business. Hosp my way is

still trying to " run the world " and a good number of primary care

docs still work for a hospital owned practice or supported practice in some

way. I've become more and more convinced that I will just NOT be able to

see, attract some pts, and maybe that's for the good. But the pts who

want good, personalized care, well, those will see me, and we'll be happy about

it. Others won't be, and I'm quite happy about that too. There's

just only a limited way to survive. Now that means I ended up taking only

1 of the 3 med assistance HMOs in the area, and we see them. Very time

intensive, but after awhile, just another pt in the list. I loose on

them, but there really aren't too many of those who are willing to follow up,

etc. I see those that do, I consider it mainly my charity work

considering the minimal payment we get in PA ($31 max).

I have a modest budget of about

$10K/month. This includes about $4K for salary. I get done close to

time. Have been using an EMR (SOAPware) since 1997, full use for each pt

since Dec 2004. Like others have said, it's a great kick to see each pt

and not have an associate in between seeing the pt for a follow up.

I envision ultimately expanding

slowly with a like minded solo; staffing now is usually 2 FTE in office (yes,

overstaffed compared to many of you), with outsourcing of payroll at $127/month,

billing, accounting, it costs a fair amount, but expect to be well

self-sufficient at 35 pts or less a week, and at baseline in productivity take

home pay by national standards at 60 pts a week. I'm currently scheduled

for 26 hours a week, so this is alittle over 2 pts/hour.

Those working on this " little

project " should be VERY CAUTIOUS about contracts and how long it takes to

get this all untangled. Most DO take 3-4 months, OR longer, up to 6

months. My medicare contract took over 9 months to get any money from,

but was able to be retroactively submitted, so made up for it eventually.

Later, all

Dr Matt Levin

FP in east Pittsburgh

to be or not to be truly solo

i've gone from wanting to be the only one in the

office to starting with one MA, to now having two MA's, one who primarily does

administrative work including sending bills to the biller, reviewing faxes,

putting them into pdf for my review and then filing them electronically after i

do, scanning records and attaching them to the electronic chart, and the

other who does primarily front office/patient preparation including

checking insurance, collecting copays, giving injections and

drawing blood. they both answer the phone, take messages, do

referrals, and send chart notes when appropriate. and since they both

have the MA qualification and certification, they can cross-cover each other

for patient services. i spend very little time on the phone now, and i am

left to concentrate on being a doctor, and to see the patients.

there was an increase in efficiency with the addition of the administrative MA,

and now, since the original MA with whom i started left for another job and has

been replaced by a very efficient person, the overall efficiency of the office

has practically doubled, as has the number of patients seen during a day, from

approximately 5-6 to 10+/day.

what a difference! part of the

improved efficiency includes replacing telephones without intercoms to

ones which have them built in, and upgrading the voice recognition dictation

program.

when i am asked to describe my practice, it is a solo

office, since i am the only doctor. i quite frankly don't feel able to

handle the entire office by myself, and i enjoy having at least one MA. i

am also the IT consultant, office equipment supplier, general handyman,

payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and

efficiency and what works best.

i believe the keys to being however one is,

relates to whether one is doing a good job, and

to answer the questions, does one provide the standard of care,

see patients in a timely fashion, do the appropriate preventive care, and have

improved outcomes? do patients have a better state of health

since coming to see me? are patients satisfied with the care they

receive? is this done in a manner which rewards me appropriately

(subject to interpretation)?. does one have enough time for oneself and

one's family?

most of us have a steep learning curve, since this

kind of stuff isn't taught in medical school or in residency, and we are taught

to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping

incrementalism toward improvement.

just my thoughts.

LL

Yahoo!

Mail

Bring photos to life! New

PhotoMail makes sharing a breeze.

[Guest guest]

RE $31/ managed care MA pt.

Yes, this is the max, even for 99214.

I ended up not opting for strep testing as costs for doing standards in the state standards make it not cost effective.

So, really not a high-volume MA practice, no way. I'm accepting only 1 of the managed care MA plans, as I discussed.

Since you've added other services, looks like you too may be taking home very low amount for MA pt. Does the strep test get reimbursed at a reasonable level compared to cost?

Dr Matt Levin

Pittsburgh area of Western PA (suburban/rural)

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

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[Guest guest]

I’d have to check but I think I

recall that rapid streps are one of the few waived tests that actually

reimburse pretty well (vs cholesterols, A1C, & PT/INR). Does Medicaid

there even recognize a 99214 vs a 99212 or are they just paying you the same no

matter how you code it? Some states automatically downcode anything higher

than a 99213.

Re:

to be or not to be truly solo

RE $31/ managed care MA pt.

Yes, this is the max, even for

99214.

I ended up not opting for strep

testing as costs for doing standards in the state standards make it not cost

effective.

So, really not a high-volume MA

practice, no way. I'm accepting only 1 of the managed care MA plans, as I

discussed.

Since you've added other services,

looks like you too may be taking home very low amount for MA pt. Does the

strep test get reimbursed at a reasonable level compared to cost?

Dr Matt Levin

Pittsburgh area of Western PA

(suburban/rural)

to be or not to be truly solo

i've gone from wanting to be the only one in the

office to starting with one MA, to now having two MA's, one who primarily does administrative

work including sending bills to the biller, reviewing faxes, putting them into

pdf for my review and then filing them electronically after i do, scanning

records and attaching them to the electronic chart, and the other who

does primarily front office/patient preparation including checking

insurance, collecting copays, giving injections and

drawing blood. they both answer the phone, take messages, do

referrals, and send chart notes when appropriate. and since they both

have the MA qualification and certification, they can cross-cover each other

for patient services. i spend very little time on the phone now, and i am

left to concentrate on being a doctor, and to see the patients.

there was an increase in efficiency with the addition of the administrative MA,

and now, since the original MA with whom i started left for another job and has

been replaced by a very efficient person, the overall efficiency of the office

has practically doubled, as has the number of patients seen during a day, from

approximately 5-6 to 10+/day.

what a difference! part of the

improved efficiency includes replacing telephones without intercoms to

ones which have them built in, and upgrading the voice recognition dictation

program.

when i am asked to describe my practice, it is a solo

office, since i am the only doctor. i quite frankly don't feel able to

handle the entire office by myself, and i enjoy having at least one MA. i

am also the IT consultant, office equipment supplier, general handyman,

payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and

efficiency and what works best.

i believe the keys to being however one is,

relates to whether one is doing a good job, and

to answer the questions, does one provide the standard of care,

see patients in a timely fashion, do the appropriate preventive care, and have

improved outcomes? do patients have a better state of health

since coming to see me? are patients satisfied with the care they

receive? is this done in a manner which rewards me appropriately

(subject to interpretation)?. does one have enough time for oneself and

one's family?

most of us have a steep learning curve, since this

kind of stuff isn't taught in medical school or in residency, and we are taught

to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping

incrementalism toward improvement.

just my thoughts.

LL

Yahoo!

Mail

Bring photos to life! New

PhotoMail makes sharing a breeze.

[Guest guest]

I’d have to check but I think I

recall that rapid streps are one of the few waived tests that actually

reimburse pretty well (vs cholesterols, A1C, & PT/INR). Does Medicaid

there even recognize a 99214 vs a 99212 or are they just paying you the same no

matter how you code it? Some states automatically downcode anything higher

than a 99213.

Re:

to be or not to be truly solo

RE $31/ managed care MA pt.

Yes, this is the max, even for

99214.

I ended up not opting for strep

testing as costs for doing standards in the state standards make it not cost

effective.

So, really not a high-volume MA

practice, no way. I'm accepting only 1 of the managed care MA plans, as I

discussed.

Since you've added other services,

looks like you too may be taking home very low amount for MA pt. Does the

strep test get reimbursed at a reasonable level compared to cost?

Dr Matt Levin

Pittsburgh area of Western PA

(suburban/rural)

to be or not to be truly solo

i've gone from wanting to be the only one in the

office to starting with one MA, to now having two MA's, one who primarily does administrative

work including sending bills to the biller, reviewing faxes, putting them into

pdf for my review and then filing them electronically after i do, scanning

records and attaching them to the electronic chart, and the other who

does primarily front office/patient preparation including checking

insurance, collecting copays, giving injections and

drawing blood. they both answer the phone, take messages, do

referrals, and send chart notes when appropriate. and since they both

have the MA qualification and certification, they can cross-cover each other

for patient services. i spend very little time on the phone now, and i am

left to concentrate on being a doctor, and to see the patients.

there was an increase in efficiency with the addition of the administrative MA,

and now, since the original MA with whom i started left for another job and has

been replaced by a very efficient person, the overall efficiency of the office

has practically doubled, as has the number of patients seen during a day, from

approximately 5-6 to 10+/day.

what a difference! part of the

improved efficiency includes replacing telephones without intercoms to

ones which have them built in, and upgrading the voice recognition dictation

program.

when i am asked to describe my practice, it is a solo

office, since i am the only doctor. i quite frankly don't feel able to

handle the entire office by myself, and i enjoy having at least one MA. i

am also the IT consultant, office equipment supplier, general handyman,

payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and

efficiency and what works best.

i believe the keys to being however one is,

relates to whether one is doing a good job, and

to answer the questions, does one provide the standard of care,

see patients in a timely fashion, do the appropriate preventive care, and have

improved outcomes? do patients have a better state of health

since coming to see me? are patients satisfied with the care they

receive? is this done in a manner which rewards me appropriately

(subject to interpretation)?. does one have enough time for oneself and

one's family?

most of us have a steep learning curve, since this

kind of stuff isn't taught in medical school or in residency, and we are taught

to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping

incrementalism toward improvement.

just my thoughts.

LL

Yahoo!

Mail

Bring photos to life! New

PhotoMail makes sharing a breeze.

[Guest guest]

RE CLIA waved vs proficiency testing.

I'd have to have any staffer do 3 tests each quarter to pass our state's proficiency testing.

If I didn't do something like 30 tests a quarter, AND get paid for them, wouldn't be worth it.

And it isn't.

Wish I could, but I can't, blame CLIA for this one, just the Dept of Health in PA.

Not even the commercial labs OR the hospitals do rapid strep tests my area. Rot...

Dr Matt Levin

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

RE CLIA waved vs proficiency testing.

I'd have to have any staffer do 3 tests each quarter to pass our state's proficiency testing.

If I didn't do something like 30 tests a quarter, AND get paid for them, wouldn't be worth it.

And it isn't.

Wish I could, but I can't, blame CLIA for this one, just the Dept of Health in PA.

Not even the commercial labs OR the hospitals do rapid strep tests my area. Rot...

Dr Matt Levin

to be or not to be truly solo

i've gone from wanting to be the only one in the office to starting with one MA, to now having two MA's, one who primarily does administrative work including sending bills to the biller, reviewing faxes, putting them into pdf for my review and then filing them electronically after i do, scanning records and attaching them to the electronic chart, and the other who does primarily front office/patient preparation including checking insurance, collecting copays, giving injections and drawing blood. they both answer the phone, take messages, do referrals, and send chart notes when appropriate. and since they both have the MA qualification and certification, they can cross-cover each other for patient services. i spend very little time on the phone now, and i am left to concentrate on being a doctor, and to see the patients. there was an increase in efficiency with the addition of the administrative MA, and now, since the original MA with whom i started left for another job and has been replaced by a very efficient person, the overall efficiency of the office has practically doubled, as has the number of patients seen during a day, from approximately 5-6 to 10+/day.

what a difference! part of the improved efficiency includes replacing telephones without intercoms to ones which have them built in, and upgrading the voice recognition dictation program.

when i am asked to describe my practice, it is a solo office, since i am the only doctor. i quite frankly don't feel able to handle the entire office by myself, and i enjoy having at least one MA. i am also the IT consultant, office equipment supplier, general handyman, payroll manager, hr manager, and the everything else person.

each of us has their own definition of solo and efficiency and what works best.

i believe the keys to being however one is, relates to whether one is doing a good job, and to answer the questions, does one provide the standard of care, see patients in a timely fashion, do the appropriate preventive care, and have improved outcomes? do patients have a better state of health since coming to see me? are patients satisfied with the care they receive? is this done in a manner which rewards me appropriately (subject to interpretation)?. does one have enough time for oneself and one's family?

most of us have a steep learning curve, since this kind of stuff isn't taught in medical school or in residency, and we are taught to deny ourselves in preference to others.

there is no monopoly on how to do it, rather creeping incrementalism toward improvement.

just my thoughts.

LL

Yahoo! MailBring photos to life! New PhotoMail makes sharing a breeze.