Guest guest Posted March 11, 2006 Report Share Posted March 11, 2006 For the poll (Sorry I got locked out of Yahoo again and am too lazy to set up another account) We are: One doctor One MA/Receptionist (she does mostly receptionist work, takes vitals, draws up and administers immunizations, and does a few nurse visits for education on cholesterol and diabetes) One part time biller/office manager (Me. I spend 1-3 hours a day at the office.) We are adding another doctor in October, but probably not another MA. We are talking to yet another doctor who wants to work mornings who would bring most of her patient panel with her who would be starting in June. Between the two, I would lose my office and our 1200 sq ft. office will be stretching at the seams. As a side note - Last month we saw 10.5 pts. Per day. We sent out our 1000th invoice today. Yah. Ernie Orchards Family Medicine, Inc. From: [mailto: ] On Behalf Of L. Gordon Sent: Sunday, March 05, 2006 6:17 AM To: Subject: Re: Who is Solo-Solo? I've created a poll on staffing for the group. You can take the poll on our group web site: http://health.groups.yahoo.com/group//polls The poll will be open through 3/19 I'll email results. Gordon At 09:00 PM 3/4/2006, you wrote: Hi all; it looks like Tim is totally solo, it sounded like Pamela Wimble is; this is my area of highest interest to minimize headache especially at the beginning by not having other office staff; I'm lookig at a location opportunity that would allow me to have no staff. Any suggestions? Pro's Cons? -Shay Hosseinion --- Egly wrote: > Good work Tim! > > > > " Malia, MD " wrote: > Hi Folks -- > > It's time for me to do as some others have done and > pass along some happy > news... my new office officially opens in two days, > Monday March6! > > First, a giant " Thank You " to everyone for sharing > their experiences and > opinions on this list. Over these three years or so > I've learned a lot > from all of you. And until recently I didn't realize > it, but it's true, > the list does feel like a bit like family. > > Second, a warning... you should get another email > (likely on Sunday or so) > from me with a link to a Kodak site to view some > photos. You do not have > to register (unless you want to order photos...?) > and it's not junk email. > > The photos will be of my office and will range from > the barebones space I > started with last month to whatever it looks like > tomorrow after putting > in lots of hours this weekend. > > About the office... about 50 patients have already > had their medical > records copied and sent to me. I have about 25 > patients already > registered on RelayHealth. I have four patients > booked for Monday... for > five appts (one is a Workers Comp follow up who is > also diabetic so he's > got two appts to bill each with different > insurance). Interestingly, 3 of > the 4 patients are Deaf... but that is one of my > clinical interest areas > as I know sign language and have served large > numbers of Deaf patients for > many years. > > I have 10 appts booked on AppointmentQuest for the > next two weeks... five > were set up by the patient him/herself and the > others by me with patient > on the phone. I think that ratio is a good sign, > though I admit the > earliest registered patients may be more tech-savvy > so it may be a > statistical glitch. > > My technology stuff has held up pretty well through > my first week of > having all the pieces together... a " loaded " Toshiba > Tecra convertible > laptop-tablet with a port at the office for easy > connection to everything > there... HP color laser printer (on sale for > $299)... Panasonic scanner > (expensive, but it's worked GREAT so far -- dealer > is a local small > businessman who is has already referred his son to > me and has been a good > link to the local community, so the extra expense of > the machine has > already paid off as opposed to buying online) .... > EMR= AC... OneBox.com > for voice mails, faxes and some emails (has worked > great so far and VM is > fast with my DSL line and computer) ... single tel > line with all > calls/faxes sent to OneBox.com (btw, tel company rep > on the phone I've > worked with to set up line and DSL, after regular > calls back and forth, is > becoming my patient too!)... Treo 700W (new and I'm > just getting started > with it, but it's been good so far)... about to tie > in voice recognition > with local highly-recommended " training " company. > > I've tried to think about and come to good decisions > along the way for > where to spend money and thusfar I'm satisfied the > few times I've put out > larger sums. Each time I can see a reason and have > already seen some > benefit with referrals and good advise about other > businesses/resourses. > > I didn't realize it, but this world of small > business does run on > handshakes and relationships. A good financial deal > at one point may not > benefit you later. But a good relationship with a > colleague can keep > growing with time. Financial choices are not just > about the current > dollars but are " investments " for the future. At > this point however, I'm > mostly all set so there won't be many more outlays > of money. > > Anyway, I've not run the numbers but I'd estimate my > start up costs are > about $25,000 and I've been able to arrange for > some of that to delay > payment (no interest) which will help my early cash > flow but require me to > keep track and be sure I have cash available when > they come due. I've got > a $50,000 small business loan with a low interest > rate and my minimum > payment is 1% a month. I only pay what I take out > of it too... thus far > $20,000. My technology overhead (www, online > messaging, online > scheduling, cell phone, etc) is about $450/month and > I doubt I'll go over > the limits for use with the way I set the contracts. > I've got no staff... > one of my mottos is, " it's just me, the patients, > our computers and our > phones! " > > Now I've got to go and finish painting trim (have > put it off all week), > put up some shelving, paint a few last pieces of > funiture, move my last > two pieces of furniture and straighten up the > office...! > > I'm sure many of you recall the feeling, but right > now the office feels > like a jigsaw puzzle with all the pieces spread on > the table. At this > point they are all faced right-side-up but only > small bunches are all > attached... I've got the border and some bunches of > similar colors, but > really it is still not put together! ;-) > > Overall, this feels good! The mild anxiety is mixed > with joy. > > Thanks to you all for helping me get here. > I'll be sending the pictures and will share with the > group any thoughts or > observations about office or practice as time goes > on. > > 7:40... time to get to the office as I hit the > homestretch!!! > Tim > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2006 Report Share Posted March 11, 2006 Opps. I should have been more clear. I am not the doctor. My wife, Elise, is the doctor. I am just the biller/office. From: [mailto: ] On Behalf Of Gwen Hanson Sent: Friday, March 10, 2006 10:04 PM To: Subject: RE: Who is Solo-Solo? (and quick update) 10.5 patients a day in 2 hours a day??? How did you do that? Gwen Ernie Leland wrote: For the poll (Sorry I got locked out of Yahoo again and am too lazy to set up another account) We are: One doctor One MA/Receptionist (she does mostly receptionist work, takes vitals, draws up and administers immunizations, and does a few nurse visits for education on cholesterol and diabetes) One part time biller/office manager (Me. I spend 1-3 hours a day at the office.) We are adding another doctor in October, but probably not another MA. We are talking to yet another doctor who wants to work mornings who would bring most of her patient panel with her who would be starting in June. Between the two, I would lose my office and our 1200 sq ft. office will be stretching at the seams. As a side note - Last month we saw 10.5 pts. Per day. We sent out our 1000th invoice today. Yah. Ernie Orchards Family Medicine, Inc. From: [mailto: ] On Behalf Of L. Gordon Sent: Sunday, March 05, 2006 6:17 AM To: Subject: Re: Who is Solo-Solo? I've created a poll on staffing for the group. You can take the poll on our group web site: http://health.groups.yahoo.com/group//polls The poll will be open through 3/19 I'll email results. Gordon At 09:00 PM 3/4/2006, you wrote: Hi all; it looks like Tim is totally solo, it sounded like Pamela Wimble is; this is my area of highest interest to minimize headache especially at the beginning by not having other office staff; I'm lookig at a location opportunity that would allow me to have no staff. Any suggestions? Pro's Cons? -Shay Hosseinion --- Egly wrote: > Good work Tim! > > > > " Malia, MD " wrote: > Hi Folks -- > > It's time for me to do as some others have done and > pass along some happy > news... my new office officially opens in two days, > Monday March6! > > First, a giant " Thank You " to everyone for sharing > their experiences and > opinions on this list. Over these three years or so > I've learned a lot > from all of you. And until recently I didn't realize > it, but it's true, > the list does feel like a bit like family. > > Second, a warning... you should get another email > (likely on Sunday or so) > from me with a link to a Kodak site to view some > photos. You do not have > to register (unless you want to order photos...?) > and it's not junk email. > > The photos will be of my office and will range from > the barebones space I > started with last month to whatever it looks like > tomorrow after putting > in lots of hours this weekend. > > About the office... about 50 patients have already > had their medical > records copied and sent to me. I have about 25 > patients already > registered on RelayHealth. I have four patients > booked for Monday... for > five appts (one is a Workers Comp follow up who is > also diabetic so he's > got two appts to bill each with different > insurance). Interestingly, 3 of > the 4 patients are Deaf... but that is one of my > clinical interest areas > as I know sign language and have served large > numbers of Deaf patients for > many years. > > I have 10 appts booked on AppointmentQuest for the > next two weeks... five > were set up by the patient him/herself and the > others by me with patient > on the phone. I think that ratio is a good sign, > though I admit the > earliest registered patients may be more tech-savvy > so it may be a > statistical glitch. > > My technology stuff has held up pretty well through > my first week of > having all the pieces together... a " loaded " Toshiba > Tecra convertible > laptop-tablet with a port at the office for easy > connection to everything > there... HP color laser printer (on sale for > $299)... Panasonic scanner > (expensive, but it's worked GREAT so far -- dealer > is a local small > businessman who is has already referred his son to > me and has been a good > link to the local community, so the extra expense of > the machine has > already paid off as opposed to buying online) .... > EMR= AC... OneBox.com > for voice mails, faxes and some emails (has worked > great so far and VM is > fast with my DSL line and computer) ... single tel > line with all > calls/faxes sent to OneBox.com (btw, tel company rep > on the phone I've > worked with to set up line and DSL, after regular > calls back and forth, is > becoming my patient too!)... Treo 700W (new and I'm > just getting started > with it, but it's been good so far)... about to tie > in voice recognition > with local highly-recommended " training " company. > > I've tried to think about and come to good decisions > along the way for > where to spend money and thusfar I'm satisfied the > few times I've put out > larger sums. Each time I can see a reason and have > already seen some > benefit with referrals and good advise about other > businesses/resourses. > > I didn't realize it, but this world of small > business does run on > handshakes and relationships. A good financial deal > at one point may not > benefit you later. But a good relationship with a > colleague can keep > growing with time. Financial choices are not just > about the current > dollars but are " investments " for the future. At > this point however, I'm > mostly all set so there won't be many more outlays > of money. > > Anyway, I've not run the numbers but I'd estimate my > start up costs are > about $25,000 and I've been able to arrange for > some of that to delay > payment (no interest) which will help my early cash > flow but require me to > keep track and be sure I have cash available when > they come due. I've got > a $50,000 small business loan with a low interest > rate and my minimum > payment is 1% a month. I only pay what I take out > of it too... thus far > $20,000. My technology overhead (www, online > messaging, online > scheduling, cell phone, etc) is about $450/month and > I doubt I'll go over > the limits for use with the way I set the contracts. > I've got no staff... > one of my mottos is, " it's just me, the patients, > our computers and our > phones! " > > Now I've got to go and finish painting trim (have > put it off all week), > put up some shelving, paint a few last pieces of > funiture, move my last > two pieces of furniture and straighten up the > office...! > > I'm sure many of you recall the feeling, but right > now the office feels > like a jigsaw puzzle with all the pieces spread on > the table. At this > point they are all faced right-side-up but only > small bunches are all > attached... I've got the border and some bunches of > similar colors, but > really it is still not put together! ;-) > > Overall, this feels good! The mild anxiety is mixed > with joy. > > Thanks to you all for helping me get here. > I'll be sending the pictures and will share with the > group any thoughts or > observations about office or practice as time goes > on. > > 7:40... time to get to the office as I hit the > homestretch!!! > Tim > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2006 Report Share Posted March 11, 2006 Opps. I should have been more clear. I am not the doctor. My wife, Elise, is the doctor. I am just the biller/office. From: [mailto: ] On Behalf Of Gwen Hanson Sent: Friday, March 10, 2006 10:04 PM To: Subject: RE: Who is Solo-Solo? (and quick update) 10.5 patients a day in 2 hours a day??? How did you do that? Gwen Ernie Leland wrote: For the poll (Sorry I got locked out of Yahoo again and am too lazy to set up another account) We are: One doctor One MA/Receptionist (she does mostly receptionist work, takes vitals, draws up and administers immunizations, and does a few nurse visits for education on cholesterol and diabetes) One part time biller/office manager (Me. I spend 1-3 hours a day at the office.) We are adding another doctor in October, but probably not another MA. We are talking to yet another doctor who wants to work mornings who would bring most of her patient panel with her who would be starting in June. Between the two, I would lose my office and our 1200 sq ft. office will be stretching at the seams. As a side note - Last month we saw 10.5 pts. Per day. We sent out our 1000th invoice today. Yah. Ernie Orchards Family Medicine, Inc. From: [mailto: ] On Behalf Of L. Gordon Sent: Sunday, March 05, 2006 6:17 AM To: Subject: Re: Who is Solo-Solo? I've created a poll on staffing for the group. You can take the poll on our group web site: http://health.groups.yahoo.com/group//polls The poll will be open through 3/19 I'll email results. Gordon At 09:00 PM 3/4/2006, you wrote: Hi all; it looks like Tim is totally solo, it sounded like Pamela Wimble is; this is my area of highest interest to minimize headache especially at the beginning by not having other office staff; I'm lookig at a location opportunity that would allow me to have no staff. Any suggestions? Pro's Cons? -Shay Hosseinion --- Egly wrote: > Good work Tim! > > > > " Malia, MD " wrote: > Hi Folks -- > > It's time for me to do as some others have done and > pass along some happy > news... my new office officially opens in two days, > Monday March6! > > First, a giant " Thank You " to everyone for sharing > their experiences and > opinions on this list. Over these three years or so > I've learned a lot > from all of you. And until recently I didn't realize > it, but it's true, > the list does feel like a bit like family. > > Second, a warning... you should get another email > (likely on Sunday or so) > from me with a link to a Kodak site to view some > photos. You do not have > to register (unless you want to order photos...?) > and it's not junk email. > > The photos will be of my office and will range from > the barebones space I > started with last month to whatever it looks like > tomorrow after putting > in lots of hours this weekend. > > About the office... about 50 patients have already > had their medical > records copied and sent to me. I have about 25 > patients already > registered on RelayHealth. I have four patients > booked for Monday... for > five appts (one is a Workers Comp follow up who is > also diabetic so he's > got two appts to bill each with different > insurance). Interestingly, 3 of > the 4 patients are Deaf... but that is one of my > clinical interest areas > as I know sign language and have served large > numbers of Deaf patients for > many years. > > I have 10 appts booked on AppointmentQuest for the > next two weeks... five > were set up by the patient him/herself and the > others by me with patient > on the phone. I think that ratio is a good sign, > though I admit the > earliest registered patients may be more tech-savvy > so it may be a > statistical glitch. > > My technology stuff has held up pretty well through > my first week of > having all the pieces together... a " loaded " Toshiba > Tecra convertible > laptop-tablet with a port at the office for easy > connection to everything > there... HP color laser printer (on sale for > $299)... Panasonic scanner > (expensive, but it's worked GREAT so far -- dealer > is a local small > businessman who is has already referred his son to > me and has been a good > link to the local community, so the extra expense of > the machine has > already paid off as opposed to buying online) .... > EMR= AC... OneBox.com > for voice mails, faxes and some emails (has worked > great so far and VM is > fast with my DSL line and computer) ... single tel > line with all > calls/faxes sent to OneBox.com (btw, tel company rep > on the phone I've > worked with to set up line and DSL, after regular > calls back and forth, is > becoming my patient too!)... Treo 700W (new and I'm > just getting started > with it, but it's been good so far)... about to tie > in voice recognition > with local highly-recommended " training " company. > > I've tried to think about and come to good decisions > along the way for > where to spend money and thusfar I'm satisfied the > few times I've put out > larger sums. Each time I can see a reason and have > already seen some > benefit with referrals and good advise about other > businesses/resourses. > > I didn't realize it, but this world of small > business does run on > handshakes and relationships. A good financial deal > at one point may not > benefit you later. But a good relationship with a > colleague can keep > growing with time. Financial choices are not just > about the current > dollars but are " investments " for the future. At > this point however, I'm > mostly all set so there won't be many more outlays > of money. > > Anyway, I've not run the numbers but I'd estimate my > start up costs are > about $25,000 and I've been able to arrange for > some of that to delay > payment (no interest) which will help my early cash > flow but require me to > keep track and be sure I have cash available when > they come due. I've got > a $50,000 small business loan with a low interest > rate and my minimum > payment is 1% a month. I only pay what I take out > of it too... thus far > $20,000. My technology overhead (www, online > messaging, online > scheduling, cell phone, etc) is about $450/month and > I doubt I'll go over > the limits for use with the way I set the contracts. > I've got no staff... > one of my mottos is, " it's just me, the patients, > our computers and our > phones! " > > Now I've got to go and finish painting trim (have > put it off all week), > put up some shelving, paint a few last pieces of > funiture, move my last > two pieces of furniture and straighten up the > office...! > > I'm sure many of you recall the feeling, but right > now the office feels > like a jigsaw puzzle with all the pieces spread on > the table. At this > point they are all faced right-side-up but only > small bunches are all > attached... I've got the border and some bunches of > similar colors, but > really it is still not put together! ;-) > > Overall, this feels good! The mild anxiety is mixed > with joy. > > Thanks to you all for helping me get here. > I'll be sending the pictures and will share with the > group any thoughts or > observations about office or practice as time goes > on. > > 7:40... time to get to the office as I hit the > homestretch!!! > Tim > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2006 Report Share Posted March 12, 2006 We opened in August. To make the numbers a little more accurate, we see about 25% CUP (Our local for-profit Medicaid carrier, which has assigned us a lot of patients), 5% Medicaid, and 10% Medicare, 5% Tricare. The remaining 55% are from commercial insurers. We are no longer taking new CUP, Medicaid, Medicare, Tricare, or patients from our worse three commercial insurers. We intend to have our percentage of state and federal programs drop, as they reimburse the lowest and are the largest hassle for us. I mention the ratios because we tried to front load our lowest paying carriers, and having CUP, who assigns patients, has helped us quickly build that part of our practice. We will likely reopen to CUP just before we bring on our next doctor so that they can start with enough patients for us to be able to pay them. Ernie Re: Who is Solo-Solo? > > > > I've created a poll on staffing for the group. > You can take the poll on our group web site: > http://health.groups.yahoo.com/group//polls > The poll will be open through 3/19 > I'll email results. > Gordon > At 09:00 PM 3/4/2006, you wrote: > > > > Hi all; it looks like Tim is totally solo, it sounded > like Pamela Wimble is; this is my area of highest > interest to minimize headache especially at the > beginning by not having other office staff; I'm lookig > at a location opportunity that would allow me to have > no staff. > > Any suggestions? Pro's Cons? > -Shay Hosseinion > > --- Egly wrote: > > > Good work Tim! > > > > > > > > " Malia, MD " wrote: > > Hi Folks -- > > > > It's time for me to do as some others have done and > > pass along some happy > > news... my new office officially opens in two days, > > Monday March6! > > > > First, a giant " Thank You " to everyone for sharing > > their experiences and > > opinions on this list. Over these three years or so > > I've learned a lot > > from all of you. And until recently I didn't realize > > it, but it's true, > > the list does feel like a bit like family. > > > > Second, a warning... you should get another email > > (likely on Sunday or so) > > from me with a link to a Kodak site to view some > > photos. You do not have > > to register (unless you want to order photos...?) > > and it's not junk email. > > > > The photos will be of my office and will range from > > the barebones space I > > started with last month to whatever it looks like > > tomorrow after putting > > in lots of hours this weekend. > > > > About the office... about 50 patients have already > > had their medical > > records copied and sent to me. I have about 25 > > patients already > > registered on RelayHealth. I have four patients > > booked for Monday... for > > five appts (one is a Workers Comp follow up who is > > also diabetic so he's > > got two appts to bill each with different > > insurance). Interestingly, 3 of > > the 4 patients are Deaf... but that is one of my > > clinical interest areas > > as I know sign language and have served large > > numbers of Deaf patients for > > many years. > > > > I have 10 appts booked on AppointmentQuest for the > > next two weeks... five > > were set up by the patient him/herself and the > > others by me with patient > > on the phone. I think that ratio is a good sign, > > though I admit the > > earliest registered patients may be more tech-savvy > > so it may be a > > statistical glitch. > > > > My technology stuff has held up pretty well through > > my first week of > > having all the pieces together... a " loaded " Toshiba > > Tecra convertible > > laptop-tablet with a port at the office for easy > > connection to everything > > there... HP color laser printer (on sale for > > $299)... Panasonic scanner > > (expensive, but it's worked GREAT so far -- dealer > > is a local small > > businessman who is has already referred his son to > > me and has been a good > > link to the local community, so the extra expense of > > the machine has > > already paid off as opposed to buying online) ... > > EMR= AC... OneBox.com > > for voice mails, faxes and some emails (has worked > > great so far and VM is > > fast with my DSL line and computer) ... single tel > > line with all > > calls/faxes sent to OneBox.com (btw, tel company rep > > on the phone I've > > worked with to set up line and DSL, after regular > > calls back and forth, is > > becoming my patient too!)... Treo 700W (new and I'm > > just getting started > > with it, but it's been good so far)... about to tie > > in voice recognition > > with local highly-recommended " training " company. > > > > I've tried to think about and come to good decisions > > along the way for > > where to spend money and thusfar I'm satisfied the > > few times I've put out > > larger sums. Each time I can see a reason and have > > already seen some > > benefit with referrals and good advise about other > > businesses/resourses. > > > > I didn't realize it, but this world of small > > business does run on > > handshakes and relationships. A good financial deal > > at one point may not > > benefit you later. But a good relationship with a > > colleague can keep > > growing with time. Financial choices are not just > > about the current > > dollars but are " investments " for the future. At > > this point however, I'm > > mostly all set so there won't be many more outlays > > of money. > > > > Anyway, I've not run the numbers but I'd estimate my > > start up costs are > > about $25,000 and I've been able to arrange for > > some of that to delay > > payment (no interest) which will help my early cash > > flow but require me to > > keep track and be sure I have cash available when > > they come due. I've got > > a $50,000 small business loan with a low interest > > rate and my minimum > > payment is 1% a month. I only pay what I take out > > of it too... thus far > > $20,000. My technology overhead (www, online > > messaging, online > > scheduling, cell phone, etc) is about $450/month and > > I doubt I'll go over > > the limits for use with the way I set the contracts. > > I've got no staff... > > one of my mottos is, " it's just me, the patients, > > our computers and our > > phones! " > > > > Now I've got to go and finish painting trim (have > > put it off all week), > > put up some shelving, paint a few last pieces of > > funiture, move my last > > two pieces of furniture and straighten up the > > office...! > > > > I'm sure many of you recall the feeling, but right > > now the office feels > > like a jigsaw puzzle with all the pieces spread on > > the table. At this > > point they are all faced right-side-up but only > > small bunches are all > > attached... I've got the border and some bunches of > > similar colors, but > > really it is still not put together! ;-) > > > > Overall, this feels good! The mild anxiety is mixed > > with joy. > > > > Thanks to you all for helping me get here. > > I'll be sending the pictures and will share with the > > group any thoughts or > > observations about office or practice as time goes > > on. > > > > 7:40... time to get to the office as I hit the > > homestretch!!! > > Tim > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2006 Report Share Posted March 12, 2006 We opened in August. To make the numbers a little more accurate, we see about 25% CUP (Our local for-profit Medicaid carrier, which has assigned us a lot of patients), 5% Medicaid, and 10% Medicare, 5% Tricare. The remaining 55% are from commercial insurers. We are no longer taking new CUP, Medicaid, Medicare, Tricare, or patients from our worse three commercial insurers. We intend to have our percentage of state and federal programs drop, as they reimburse the lowest and are the largest hassle for us. I mention the ratios because we tried to front load our lowest paying carriers, and having CUP, who assigns patients, has helped us quickly build that part of our practice. We will likely reopen to CUP just before we bring on our next doctor so that they can start with enough patients for us to be able to pay them. Ernie Re: Who is Solo-Solo? > > > > I've created a poll on staffing for the group. > You can take the poll on our group web site: > http://health.groups.yahoo.com/group//polls > The poll will be open through 3/19 > I'll email results. > Gordon > At 09:00 PM 3/4/2006, you wrote: > > > > Hi all; it looks like Tim is totally solo, it sounded > like Pamela Wimble is; this is my area of highest > interest to minimize headache especially at the > beginning by not having other office staff; I'm lookig > at a location opportunity that would allow me to have > no staff. > > Any suggestions? Pro's Cons? > -Shay Hosseinion > > --- Egly wrote: > > > Good work Tim! > > > > > > > > " Malia, MD " wrote: > > Hi Folks -- > > > > It's time for me to do as some others have done and > > pass along some happy > > news... my new office officially opens in two days, > > Monday March6! > > > > First, a giant " Thank You " to everyone for sharing > > their experiences and > > opinions on this list. Over these three years or so > > I've learned a lot > > from all of you. And until recently I didn't realize > > it, but it's true, > > the list does feel like a bit like family. > > > > Second, a warning... you should get another email > > (likely on Sunday or so) > > from me with a link to a Kodak site to view some > > photos. You do not have > > to register (unless you want to order photos...?) > > and it's not junk email. > > > > The photos will be of my office and will range from > > the barebones space I > > started with last month to whatever it looks like > > tomorrow after putting > > in lots of hours this weekend. > > > > About the office... about 50 patients have already > > had their medical > > records copied and sent to me. I have about 25 > > patients already > > registered on RelayHealth. I have four patients > > booked for Monday... for > > five appts (one is a Workers Comp follow up who is > > also diabetic so he's > > got two appts to bill each with different > > insurance). Interestingly, 3 of > > the 4 patients are Deaf... but that is one of my > > clinical interest areas > > as I know sign language and have served large > > numbers of Deaf patients for > > many years. > > > > I have 10 appts booked on AppointmentQuest for the > > next two weeks... five > > were set up by the patient him/herself and the > > others by me with patient > > on the phone. I think that ratio is a good sign, > > though I admit the > > earliest registered patients may be more tech-savvy > > so it may be a > > statistical glitch. > > > > My technology stuff has held up pretty well through > > my first week of > > having all the pieces together... a " loaded " Toshiba > > Tecra convertible > > laptop-tablet with a port at the office for easy > > connection to everything > > there... HP color laser printer (on sale for > > $299)... Panasonic scanner > > (expensive, but it's worked GREAT so far -- dealer > > is a local small > > businessman who is has already referred his son to > > me and has been a good > > link to the local community, so the extra expense of > > the machine has > > already paid off as opposed to buying online) ... > > EMR= AC... OneBox.com > > for voice mails, faxes and some emails (has worked > > great so far and VM is > > fast with my DSL line and computer) ... single tel > > line with all > > calls/faxes sent to OneBox.com (btw, tel company rep > > on the phone I've > > worked with to set up line and DSL, after regular > > calls back and forth, is > > becoming my patient too!)... Treo 700W (new and I'm > > just getting started > > with it, but it's been good so far)... about to tie > > in voice recognition > > with local highly-recommended " training " company. > > > > I've tried to think about and come to good decisions > > along the way for > > where to spend money and thusfar I'm satisfied the > > few times I've put out > > larger sums. Each time I can see a reason and have > > already seen some > > benefit with referrals and good advise about other > > businesses/resourses. > > > > I didn't realize it, but this world of small > > business does run on > > handshakes and relationships. A good financial deal > > at one point may not > > benefit you later. But a good relationship with a > > colleague can keep > > growing with time. Financial choices are not just > > about the current > > dollars but are " investments " for the future. At > > this point however, I'm > > mostly all set so there won't be many more outlays > > of money. > > > > Anyway, I've not run the numbers but I'd estimate my > > start up costs are > > about $25,000 and I've been able to arrange for > > some of that to delay > > payment (no interest) which will help my early cash > > flow but require me to > > keep track and be sure I have cash available when > > they come due. I've got > > a $50,000 small business loan with a low interest > > rate and my minimum > > payment is 1% a month. I only pay what I take out > > of it too... thus far > > $20,000. My technology overhead (www, online > > messaging, online > > scheduling, cell phone, etc) is about $450/month and > > I doubt I'll go over > > the limits for use with the way I set the contracts. > > I've got no staff... > > one of my mottos is, " it's just me, the patients, > > our computers and our > > phones! " > > > > Now I've got to go and finish painting trim (have > > put it off all week), > > put up some shelving, paint a few last pieces of > > funiture, move my last > > two pieces of furniture and straighten up the > > office...! > > > > I'm sure many of you recall the feeling, but right > > now the office feels > > like a jigsaw puzzle with all the pieces spread on > > the table. At this > > point they are all faced right-side-up but only > > small bunches are all > > attached... I've got the border and some bunches of > > similar colors, but > > really it is still not put together! ;-) > > > > Overall, this feels good! The mild anxiety is mixed > > with joy. > > > > Thanks to you all for helping me get here. > > I'll be sending the pictures and will share with the > > group any thoughts or > > observations about office or practice as time goes > > on. > > > > 7:40... time to get to the office as I hit the > > homestretch!!! > > Tim > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2006 Report Share Posted March 12, 2006 Ernie - I like that you have been open to poorer patients and have a plan that helps you financially (at least at the start) and helps them get the care they need. I respect that you are finding a way to serve those who come to you (even if they are being " assigned " ) and are willing to have a portion of your practice from some of the worse payors. Good luck finding financial success and serving all your patients with the balance of insurances you work with. Tim > We opened in August. To make the numbers a little more accurate, we see > about 25% CUP (Our local for-profit Medicaid carrier, which has assigned > us a lot of patients), 5% Medicaid, and 10% Medicare, 5% Tricare. The > remaining 55% are from commercial insurers. We are no longer taking new > CUP, Medicaid, Medicare, Tricare, or patients from our worse three > commercial insurers. We intend to have our percentage of state and > federal programs drop, as they reimburse the lowest and are the largest > hassle for us. I mention the ratios because we tried to front load our > lowest paying carriers, and having CUP, who assigns patients, has helped > us quickly build that part of our practice. We will likely reopen to > CUP just before we bring on our next doctor so that they can start with > enough patients for us to be able to pay them. > Ernie > > Re: Who is Solo-Solo? >> >> >> >> I've created a poll on staffing for the group. >> You can take the poll on our group web site: >> http://health.groups.yahoo.com/group//polls >> The poll will be open through 3/19 >> I'll email results. >> Gordon >> At 09:00 PM 3/4/2006, you wrote: >> >> >> >> Hi all; it looks like Tim is totally solo, it sounded >> like Pamela Wimble is; this is my area of highest >> interest to minimize headache especially at the >> beginning by not having other office staff; I'm lookig >> at a location opportunity that would allow me to have >> no staff. >> >> Any suggestions? Pro's Cons? >> -Shay Hosseinion >> >> --- Egly wrote: >> >> > Good work Tim! >> > >> > >> > >> > " Malia, MD " wrote: >> > Hi Folks -- >> > >> > It's time for me to do as some others have done and >> > pass along some happy >> > news... my new office officially opens in two days, >> > Monday March6! >> > >> > First, a giant " Thank You " to everyone for sharing >> > their experiences and >> > opinions on this list. Over these three years or so >> > I've learned a lot >> > from all of you. And until recently I didn't realize >> > it, but it's true, >> > the list does feel like a bit like family. >> > >> > Second, a warning... you should get another email >> > (likely on Sunday or so) >> > from me with a link to a Kodak site to view some >> > photos. You do not have >> > to register (unless you want to order photos...?) >> > and it's not junk email. >> > >> > The photos will be of my office and will range from >> > the barebones space I >> > started with last month to whatever it looks like >> > tomorrow after putting >> > in lots of hours this weekend. >> > >> > About the office... about 50 patients have already >> > had their medical >> > records copied and sent to me. I have about 25 >> > patients already >> > registered on RelayHealth. I have four patients >> > booked for Monday... for >> > five appts (one is a Workers Comp follow up who is >> > also diabetic so he's >> > got two appts to bill each with different >> > insurance). Interestingly, 3 of >> > the 4 patients are Deaf... but that is one of my >> > clinical interest areas >> > as I know sign language and have served large >> > numbers of Deaf patients for >> > many years. >> > >> > I have 10 appts booked on AppointmentQuest for the >> > next two weeks... five >> > were set up by the patient him/herself and the >> > others by me with patient >> > on the phone. I think that ratio is a good sign, >> > though I admit the >> > earliest registered patients may be more tech-savvy >> > so it may be a >> > statistical glitch. >> > >> > My technology stuff has held up pretty well through >> > my first week of >> > having all the pieces together... a " loaded " Toshiba >> > Tecra convertible >> > laptop-tablet with a port at the office for easy >> > connection to everything >> > there... HP color laser printer (on sale for >> > $299)... Panasonic scanner >> > (expensive, but it's worked GREAT so far -- dealer >> > is a local small >> > businessman who is has already referred his son to >> > me and has been a good >> > link to the local community, so the extra expense of >> > the machine has >> > already paid off as opposed to buying online) ... >> > EMR= AC... OneBox.com >> > for voice mails, faxes and some emails (has worked >> > great so far and VM is >> > fast with my DSL line and computer) ... single tel >> > line with all >> > calls/faxes sent to OneBox.com (btw, tel company rep >> > on the phone I've >> > worked with to set up line and DSL, after regular >> > calls back and forth, is >> > becoming my patient too!)... Treo 700W (new and I'm >> > just getting started >> > with it, but it's been good so far)... about to tie >> > in voice recognition >> > with local highly-recommended " training " company. >> > >> > I've tried to think about and come to good decisions >> > along the way for >> > where to spend money and thusfar I'm satisfied the >> > few times I've put out >> > larger sums. Each time I can see a reason and have >> > already seen some >> > benefit with referrals and good advise about other >> > businesses/resourses. >> > >> > I didn't realize it, but this world of small >> > business does run on >> > handshakes and relationships. A good financial deal >> > at one point may not >> > benefit you later. But a good relationship with a >> > colleague can keep >> > growing with time. Financial choices are not just >> > about the current >> > dollars but are " investments " for the future. At >> > this point however, I'm >> > mostly all set so there won't be many more outlays >> > of money. >> > >> > Anyway, I've not run the numbers but I'd estimate my >> > start up costs are >> > about $25,000 and I've been able to arrange for >> > some of that to delay >> > payment (no interest) which will help my early cash >> > flow but require me to >> > keep track and be sure I have cash available when >> > they come due. I've got >> > a $50,000 small business loan with a low interest >> > rate and my minimum >> > payment is 1% a month. I only pay what I take out >> > of it too... thus far >> > $20,000. My technology overhead (www, online >> > messaging, online >> > scheduling, cell phone, etc) is about $450/month and >> > I doubt I'll go over >> > the limits for use with the way I set the contracts. >> > I've got no staff... >> > one of my mottos is, " it's just me, the patients, >> > our computers and our >> > phones! " >> > >> > Now I've got to go and finish painting trim (have >> > put it off all week), >> > put up some shelving, paint a few last pieces of >> > funiture, move my last >> > two pieces of furniture and straighten up the >> > office...! >> > >> > I'm sure many of you recall the feeling, but right >> > now the office feels >> > like a jigsaw puzzle with all the pieces spread on >> > the table. At this >> > point they are all faced right-side-up but only >> > small bunches are all >> > attached... I've got the border and some bunches of >> > similar colors, but >> > really it is still not put together! ;-) >> > >> > Overall, this feels good! The mild anxiety is mixed >> > with joy. >> > >> > Thanks to you all for helping me get here. >> > I'll be sending the pictures and will share with the >> > group any thoughts or >> > observations about office or practice as time goes >> > on. >> > >> > 7:40... time to get to the office as I hit the >> > homestretch!!! >> > Tim >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2006 Report Share Posted March 12, 2006 Why would Medicaid be the first one you plan to reopen with? Does it really pay better than any of your commercials or Medicare? Also, do you really only have 10% Medicare? Are you in a college town oir similar " young setting " ? That seems very low. > > > Date: 2006/03/12 Sun PM 02:15:32 EST > To: < > > Subject: RE: RE: Who is Solo-Solo? (and quick update) > > We opened in August. To make the numbers a little more accurate, we see > about 25% CUP (Our local for-profit Medicaid carrier, which has assigned > us a lot of patients), 5% Medicaid, and 10% Medicare, 5% Tricare. The > remaining 55% are from commercial insurers. We are no longer taking new > CUP, Medicaid, Medicare, Tricare, or patients from our worse three > commercial insurers. We intend to have our percentage of state and > federal programs drop, as they reimburse the lowest and are the largest > hassle for us. I mention the ratios because we tried to front load our > lowest paying carriers, and having CUP, who assigns patients, has helped > us quickly build that part of our practice. We will likely reopen to > CUP just before we bring on our next doctor so that they can start with > enough patients for us to be able to pay them. > Ernie > > Re: Who is Solo-Solo? > > > > > > > > I've created a poll on staffing for the group. > > You can take the poll on our group web site: > > http://health.groups.yahoo.com/group//polls > > The poll will be open through 3/19 > > I'll email results. > > Gordon > > At 09:00 PM 3/4/2006, you wrote: > > > > > > > > Hi all; it looks like Tim is totally solo, it sounded > > like Pamela Wimble is; this is my area of highest > > interest to minimize headache especially at the > > beginning by not having other office staff; I'm lookig > > at a location opportunity that would allow me to have > > no staff. > > > > Any suggestions? Pro's Cons? > > -Shay Hosseinion > > > > --- Egly wrote: > > > > > Good work Tim! > > > > > > > > > > > > " Malia, MD " wrote: > > > Hi Folks -- > > > > > > It's time for me to do as some others have done and > > > pass along some happy > > > news... my new office officially opens in two days, > > > Monday March6! > > > > > > First, a giant " Thank You " to everyone for sharing > > > their experiences and > > > opinions on this list. Over these three years or so > > > I've learned a lot > > > from all of you. And until recently I didn't realize > > > it, but it's true, > > > the list does feel like a bit like family. > > > > > > Second, a warning... you should get another email > > > (likely on Sunday or so) > > > from me with a link to a Kodak site to view some > > > photos. You do not have > > > to register (unless you want to order photos...?) > > > and it's not junk email. > > > > > > The photos will be of my office and will range from > > > the barebones space I > > > started with last month to whatever it looks like > > > tomorrow after putting > > > in lots of hours this weekend. > > > > > > About the office... about 50 patients have already > > > had their medical > > > records copied and sent to me. I have about 25 > > > patients already > > > registered on RelayHealth. I have four patients > > > booked for Monday... for > > > five appts (one is a Workers Comp follow up who is > > > also diabetic so he's > > > got two appts to bill each with different > > > insurance). Interestingly, 3 of > > > the 4 patients are Deaf... but that is one of my > > > clinical interest areas > > > as I know sign language and have served large > > > numbers of Deaf patients for > > > many years. > > > > > > I have 10 appts booked on AppointmentQuest for the > > > next two weeks... five > > > were set up by the patient him/herself and the > > > others by me with patient > > > on the phone. I think that ratio is a good sign, > > > though I admit the > > > earliest registered patients may be more tech-savvy > > > so it may be a > > > statistical glitch. > > > > > > My technology stuff has held up pretty well through > > > my first week of > > > having all the pieces together... a " loaded " Toshiba > > > Tecra convertible > > > laptop-tablet with a port at the office for easy > > > connection to everything > > > there... HP color laser printer (on sale for > > > $299)... Panasonic scanner > > > (expensive, but it's worked GREAT so far -- dealer > > > is a local small > > > businessman who is has already referred his son to > > > me and has been a good > > > link to the local community, so the extra expense of > > > the machine has > > > already paid off as opposed to buying online) ... > > > EMR= AC... OneBox.com > > > for voice mails, faxes and some emails (has worked > > > great so far and VM is > > > fast with my DSL line and computer) ... single tel > > > line with all > > > calls/faxes sent to OneBox.com (btw, tel company rep > > > on the phone I've > > > worked with to set up line and DSL, after regular > > > calls back and forth, is > > > becoming my patient too!)... Treo 700W (new and I'm > > > just getting started > > > with it, but it's been good so far)... about to tie > > > in voice recognition > > > with local highly-recommended " training " company. > > > > > > I've tried to think about and come to good decisions > > > along the way for > > > where to spend money and thusfar I'm satisfied the > > > few times I've put out > > > larger sums. Each time I can see a reason and have > > > already seen some > > > benefit with referrals and good advise about other > > > businesses/resourses. > > > > > > I didn't realize it, but this world of small > > > business does run on > > > handshakes and relationships. A good financial deal > > > at one point may not > > > benefit you later. But a good relationship with a > > > colleague can keep > > > growing with time. Financial choices are not just > > > about the current > > > dollars but are " investments " for the future. At > > > this point however, I'm > > > mostly all set so there won't be many more outlays > > > of money. > > > > > > Anyway, I've not run the numbers but I'd estimate my > > > start up costs are > > > about $25,000 and I've been able to arrange for > > > some of that to delay > > > payment (no interest) which will help my early cash > > > flow but require me to > > > keep track and be sure I have cash available when > > > they come due. I've got > > > a $50,000 small business loan with a low interest > > > rate and my minimum > > > payment is 1% a month. I only pay what I take out > > > of it too... thus far > > > $20,000. My technology overhead (www, online > > > messaging, online > > > scheduling, cell phone, etc) is about $450/month and > > > I doubt I'll go over > > > the limits for use with the way I set the contracts. > > > I've got no staff... > > > one of my mottos is, " it's just me, the patients, > > > our computers and our > > > phones! " > > > > > > Now I've got to go and finish painting trim (have > > > put it off all week), > > > put up some shelving, paint a few last pieces of > > > funiture, move my last > > > two pieces of furniture and straighten up the > > > office...! > > > > > > I'm sure many of you recall the feeling, but right > > > now the office feels > > > like a jigsaw puzzle with all the pieces spread on > > > the table. At this > > > point they are all faced right-side-up but only > > > small bunches are all > > > attached... I've got the border and some bunches of > > > similar colors, but > > > really it is still not put together! ;-) > > > > > > Overall, this feels good! The mild anxiety is mixed > > > with joy. > > > > > > Thanks to you all for helping me get here. > > > I'll be sending the pictures and will share with the > > > group any thoughts or > > > observations about office or practice as time goes > > > on. > > > > > > 7:40... time to get to the office as I hit the > > > homestretch!!! > > > Tim > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2006 Report Share Posted March 12, 2006 Why would Medicaid be the first one you plan to reopen with? Does it really pay better than any of your commercials or Medicare? Also, do you really only have 10% Medicare? Are you in a college town oir similar " young setting " ? That seems very low. > > > Date: 2006/03/12 Sun PM 02:15:32 EST > To: < > > Subject: RE: RE: Who is Solo-Solo? (and quick update) > > We opened in August. To make the numbers a little more accurate, we see > about 25% CUP (Our local for-profit Medicaid carrier, which has assigned > us a lot of patients), 5% Medicaid, and 10% Medicare, 5% Tricare. The > remaining 55% are from commercial insurers. We are no longer taking new > CUP, Medicaid, Medicare, Tricare, or patients from our worse three > commercial insurers. We intend to have our percentage of state and > federal programs drop, as they reimburse the lowest and are the largest > hassle for us. I mention the ratios because we tried to front load our > lowest paying carriers, and having CUP, who assigns patients, has helped > us quickly build that part of our practice. We will likely reopen to > CUP just before we bring on our next doctor so that they can start with > enough patients for us to be able to pay them. > Ernie > > Re: Who is Solo-Solo? > > > > > > > > I've created a poll on staffing for the group. > > You can take the poll on our group web site: > > http://health.groups.yahoo.com/group//polls > > The poll will be open through 3/19 > > I'll email results. > > Gordon > > At 09:00 PM 3/4/2006, you wrote: > > > > > > > > Hi all; it looks like Tim is totally solo, it sounded > > like Pamela Wimble is; this is my area of highest > > interest to minimize headache especially at the > > beginning by not having other office staff; I'm lookig > > at a location opportunity that would allow me to have > > no staff. > > > > Any suggestions? Pro's Cons? > > -Shay Hosseinion > > > > --- Egly wrote: > > > > > Good work Tim! > > > > > > > > > > > > " Malia, MD " wrote: > > > Hi Folks -- > > > > > > It's time for me to do as some others have done and > > > pass along some happy > > > news... my new office officially opens in two days, > > > Monday March6! > > > > > > First, a giant " Thank You " to everyone for sharing > > > their experiences and > > > opinions on this list. Over these three years or so > > > I've learned a lot > > > from all of you. And until recently I didn't realize > > > it, but it's true, > > > the list does feel like a bit like family. > > > > > > Second, a warning... you should get another email > > > (likely on Sunday or so) > > > from me with a link to a Kodak site to view some > > > photos. You do not have > > > to register (unless you want to order photos...?) > > > and it's not junk email. > > > > > > The photos will be of my office and will range from > > > the barebones space I > > > started with last month to whatever it looks like > > > tomorrow after putting > > > in lots of hours this weekend. > > > > > > About the office... about 50 patients have already > > > had their medical > > > records copied and sent to me. I have about 25 > > > patients already > > > registered on RelayHealth. I have four patients > > > booked for Monday... for > > > five appts (one is a Workers Comp follow up who is > > > also diabetic so he's > > > got two appts to bill each with different > > > insurance). Interestingly, 3 of > > > the 4 patients are Deaf... but that is one of my > > > clinical interest areas > > > as I know sign language and have served large > > > numbers of Deaf patients for > > > many years. > > > > > > I have 10 appts booked on AppointmentQuest for the > > > next two weeks... five > > > were set up by the patient him/herself and the > > > others by me with patient > > > on the phone. I think that ratio is a good sign, > > > though I admit the > > > earliest registered patients may be more tech-savvy > > > so it may be a > > > statistical glitch. > > > > > > My technology stuff has held up pretty well through > > > my first week of > > > having all the pieces together... a " loaded " Toshiba > > > Tecra convertible > > > laptop-tablet with a port at the office for easy > > > connection to everything > > > there... HP color laser printer (on sale for > > > $299)... Panasonic scanner > > > (expensive, but it's worked GREAT so far -- dealer > > > is a local small > > > businessman who is has already referred his son to > > > me and has been a good > > > link to the local community, so the extra expense of > > > the machine has > > > already paid off as opposed to buying online) ... > > > EMR= AC... OneBox.com > > > for voice mails, faxes and some emails (has worked > > > great so far and VM is > > > fast with my DSL line and computer) ... single tel > > > line with all > > > calls/faxes sent to OneBox.com (btw, tel company rep > > > on the phone I've > > > worked with to set up line and DSL, after regular > > > calls back and forth, is > > > becoming my patient too!)... Treo 700W (new and I'm > > > just getting started > > > with it, but it's been good so far)... about to tie > > > in voice recognition > > > with local highly-recommended " training " company. > > > > > > I've tried to think about and come to good decisions > > > along the way for > > > where to spend money and thusfar I'm satisfied the > > > few times I've put out > > > larger sums. Each time I can see a reason and have > > > already seen some > > > benefit with referrals and good advise about other > > > businesses/resourses. > > > > > > I didn't realize it, but this world of small > > > business does run on > > > handshakes and relationships. A good financial deal > > > at one point may not > > > benefit you later. But a good relationship with a > > > colleague can keep > > > growing with time. Financial choices are not just > > > about the current > > > dollars but are " investments " for the future. At > > > this point however, I'm > > > mostly all set so there won't be many more outlays > > > of money. > > > > > > Anyway, I've not run the numbers but I'd estimate my > > > start up costs are > > > about $25,000 and I've been able to arrange for > > > some of that to delay > > > payment (no interest) which will help my early cash > > > flow but require me to > > > keep track and be sure I have cash available when > > > they come due. I've got > > > a $50,000 small business loan with a low interest > > > rate and my minimum > > > payment is 1% a month. I only pay what I take out > > > of it too... thus far > > > $20,000. My technology overhead (www, online > > > messaging, online > > > scheduling, cell phone, etc) is about $450/month and > > > I doubt I'll go over > > > the limits for use with the way I set the contracts. > > > I've got no staff... > > > one of my mottos is, " it's just me, the patients, > > > our computers and our > > > phones! " > > > > > > Now I've got to go and finish painting trim (have > > > put it off all week), > > > put up some shelving, paint a few last pieces of > > > funiture, move my last > > > two pieces of furniture and straighten up the > > > office...! > > > > > > I'm sure many of you recall the feeling, but right > > > now the office feels > > > like a jigsaw puzzle with all the pieces spread on > > > the table. At this > > > point they are all faced right-side-up but only > > > small bunches are all > > > attached... I've got the border and some bunches of > > > similar colors, but > > > really it is still not put together! ;-) > > > > > > Overall, this feels good! The mild anxiety is mixed > > > with joy. > > > > > > Thanks to you all for helping me get here. > > > I'll be sending the pictures and will share with the > > > group any thoughts or > > > observations about office or practice as time goes > > > on. > > > > > > 7:40... time to get to the office as I hit the > > > homestretch!!! > > > Tim > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2006 Report Share Posted March 13, 2006 The Medicare/Medicaid secondary crossover is automatic in Washington. The problem is that Medicaid doesn’t pay you anything. They just send an EOB stating that any payment is over their contracted amount. We could open to Medicare and commercial secondaries, but our reimbursement is better from CUP (Medicaid HMO) and Elise likes working with the CUP patients. (CUP patients tend to have some job or are in school, but they just don’t make enough to pay for commercial insurance. Some would be hard to classify as functional in society, but definitely trying.) We would more likely reopen to CUP than Medicare at this point, as they both satisfy our desire to serve the underserved, but CUP reimburses better. Ernie From: [mailto: ] On Behalf Of Egly Sent: Monday, March 13, 2006 5:16 AM To: Subject: RE: RE: Who is Solo-Solo? (and quick update) Ernie: You do not have to take secondary insurance. I only take secodary that cross over automatically. You can get a list from your medicare carrier or check with each new insurance. Ernie Leland wrote: Medicaid HMO pays the best of the government plans for us. It is also the lowest hassle factor of the government plans. It pays less than the commercial plans we closed to, but I would rather feel good about supporting the lower income members of our community than helping the lowest paying commercial companies pay significantly less than their competitors. Medicare visits were 12.71% of our billed fees last month. We closed to Medicare after about three and a half months. We sent about 30 Medicare pts letters from Elise's residency panel. Only about half of them followed us because the residency/hospital has a medication patient assistance program that they needed to be able to pay for their meds. We now have a panel of about 40 Medicare pts. We were worried about the number of hospital visits we would end up with. (We have had 5 Medicare hospitalizations and 2 peds, no others.) At the time that we closed, we were seeing a spike in Medicare visits where it represented more like 40% of our visits. Since then Elise has stabilized the Medicare pts and we see them much less often. We could reopen, but most of the calls we get are Medicare/Medicaid secondary which are at the top of my list for hating to deal with, top of my list for most likely not to get reimbursed for, and top of my list because the way our Medicaid works it is the same as forgiving the deductible and co-pay for Medicare which just ticks me off. We have about 430 patients right now. Ernie Re: Who is Solo-Solo? > > > > > > > > I've created a poll on staffing for the group. > > You can take the poll on our group web site: > > http://health.groups.yahoo.com/group//polls > > The poll will be open through 3/19 > > I'll email results. > > Gordon > > At 09:00 PM 3/4/2006, you wrote: > > > > > > > > Hi all; it looks like Tim is totally solo, it sounded > > like Pamela Wimble is; this is my area of highest > > interest to minimize headache especially at the > > beginning by not having other office staff; I'm lookig > > at a location opportunity that would allow me to have > > no staff. > > > > Any suggestions? Pro's Cons? > > -Shay Hosseinion > > > > --- Egly wrote: > > > > > Good work Tim! > > > > > > > > > > > > " Malia, MD " wrote: > > > Hi Folks -- > > > > > > It's time for me to do as some others have done and > > > pass along some happy > > > news... my new office officially opens in two days, > > > Monday March6! > > > > > > First, a giant " Thank You " to everyone for sharing > > > their experiences and > > > opinions on this list. Over these three years or so > > > I've learned a lot > > > from all of you. And until recently I didn't realize > > > it, but it's true, > > > the list does feel like a bit like family. > > > > > > Second, a warning... you should get another email > > > (likely on Sunday or so) > > > from me with a link to a Kodak site to view some > > > photos. You do not have > > > to register (unless you want to order photos...?) > > > and it's not junk email. > > > > > > The photos will be of my office and will range from > > > the barebones space I > > > started with last month to whatever it looks like > > > tomorrow after putting > > > in lots of hours this weekend. > > > > > > About the office... about 50 patients have already > > > had their medical > > > records copied and sent to me. I have about 25 > > > patients already > > > registered on RelayHealth. I have four patients > > > booked for Monday... for > > > five appts (one is a Workers Comp follow up who is > > > also diabetic so he's > > > got two appts to bill each with different > > > insurance). Interestingly, 3 of > > > the 4 patients are Deaf... but that is one of my > > > clinical interest areas > > > as I know sign language and have served large > > > numbers of Deaf patients for > > > many years. > > > > > > I have 10 appts booked on AppointmentQuest for the > > > next two weeks... five > > > were set up by the patient him/herself and the > > > others by me with patient > > > on the phone. I think that ratio is a good sign, > > > though I admit the > > > earliest registered patients may be more tech-savvy > > > so it may be a > > > statistical glitch. > > > > > > My technology stuff has held up pretty well through > > > my first week of > > > having all the pieces together... a " loaded " Toshiba > > > Tecra convertible > > > laptop-tablet with a port at the office for easy > > > connection to everything > > > there... HP color laser printer (on sale for > > > $299)... Panasonic scanner > > > (expensive, but it's worked GREAT so far -- dealer > > > is a local small > > > businessman who is has already referred his son to > > > me and has been a good > > > link to the local community, so the extra expense of > > > the machine has > > > already paid off as opposed to buying online) ... > > > EMR= AC... OneBox.com > > > for voice mails, faxes and some emails (has worked > > > great so far and VM is > > > fast with my DSL line and computer) .... single tel > > > line with all > > > calls/faxes sent to OneBox.com (btw, tel company rep > > > on the phone I've > > > worked with to set up line and DSL, after regular > > > calls back and forth, is > > > becoming my patient too!)... Treo 700W (new and I'm > > > just getting started > > > with it, but it's been good so far)... about to tie > > > in voice recognition > > > with local highly-recommended " training " company. > > > > > > I've tried to think about and come to good decisions > > > along the way for > > > where to spend money and thusfar I'm satisfied the > > > few times I've put out > > > larger sums. Each time I can see a reason and have > > > already seen some > > > benefit with referrals and good advise about other > > > businesses/resourses. > > > > > > I didn't realize it, but this world of small > > > business does run on > > > handshakes and relationships. A good financial deal > > > at one point may not > > > benefit you later. But a good relationship with a > > > colleague can keep > > > growing with time. Financial choices are not just > > > about the current > > > dollars but are " investments " for the future. At > > > this point however, I'm > > > mostly all set so there won't be many more outlays > > > of money. > > > > > > Anyway, I've not run the numbers but I'd estimate my > > > start up costs are > > > about $25,000 and I've been able to arrange for > > > some of that to delay > > > payment (no interest) which will help my early cash > > > flow but require me to > > > keep track and be sure I have cash available when > > > they come due. I've got > > > a $50,000 small business loan with a low interest > > > rate and my minimum > > > payment is 1% a month. I only pay what I take out > > > of it too... thus far > > > $20,000. My technology overhead (www, online > > > messaging, online > > > scheduling, cell phone, etc) is about $450/month and > > > I doubt I'll go over > > > the limits for use with the way I set the contracts. > > > I've got no staff... > > > one of my mottos is, " it's just me, the patients, > > > our computers and our > > > phones! " > > > > > > Now I've got to go and finish painting trim (have > > > put it off all week), > > > put up some shelving, paint a few last pieces of > > > funiture, move my last > > > two pieces of furniture and straighten up the > > > office...! > > > > > > I'm sure many of you recall the feeling, but right > > > now the office feels > > > like a jigsaw puzzle with all the pieces spread on > > > the table. At this > > > point they are all faced right-side-up but only > > > small bunches are all > > > attached... I've got the border and some bunches of > > > similar colors, but > > > really it is still not put together! ;-) > > > > > > Overall, this feels good! The mild anxiety is mixed > > > with joy. > > > > > > Thanks to you all for helping me get here. > > > I'll be sending the pictures and will share with the > > > group any thoughts or > > > observations about office or practice as time goes > > > on. > > > > > > 7:40... time to get to the office as I hit the > > > homestretch!!! > > > Tim > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2006 Report Share Posted March 13, 2006 That is very admirable that you take on the underserved the way you do. It is getting very difficult to find docs that will take any new Medicaid in our community. Re: Who is Solo-Solo? > > > > > > > > I've created a poll on staffing for the group. > > You can take the poll on our group web site: > > http://health.groups.yahoo.com/group//polls > > The poll will be open through 3/19 > > I'll email results. > > Gordon > > At 09:00 PM 3/4/2006, you wrote: > > > > > > > > Hi all; it looks like Tim is totally solo, it sounded > > like Pamela Wimble is; this is my area of highest > > interest to minimize headache especially at the > > beginning by not having other office staff; I'm lookig > > at a location opportunity that would allow me to have > > no staff. > > > > Any suggestions? Pro's Cons? > > -Shay Hosseinion > > > > --- Egly wrote: > > > > > Good work Tim! > > > > > > > > > > > > " Malia, MD " wrote: > > > Hi Folks -- > > > > > > It's time for me to do as some others have done and > > > pass along some happy > > > news... my new office officially opens in two days, > > > Monday March6! > > > > > > First, a giant " Thank You " to everyone for sharing > > > their experiences and > > > opinions on this list. Over these three years or so > > > I've learned a lot > > > from all of you. And until recently I didn't realize > > > it, but it's true, > > > the list does feel like a bit like family. > > > > > > Second, a warning... you should get another email > > > (likely on Sunday or so) > > > from me with a link to a Kodak site to view some > > > photos. You do not have > > > to register (unless you want to order photos...?) > > > and it's not junk email. > > > > > > The photos will be of my office and will range from > > > the barebones space I > > > started with last month to whatever it looks like > > > tomorrow after putting > > > in lots of hours this weekend. > > > > > > About the office... about 50 patients have already > > > had their medical > > > records copied and sent to me. I have about 25 > > > patients already > > > registered on RelayHealth. I have four patients > > > booked for Monday... for > > > five appts (one is a Workers Comp follow up who is > > > also diabetic so he's > > > got two appts to bill each with different > > > insurance). Interestingly, 3 of > > > the 4 patients are Deaf... but that is one of my > > > clinical interest areas > > > as I know sign language and have served large > > > numbers of Deaf patients for > > > many years. > > > > > > I have 10 appts booked on AppointmentQuest for the > > > next two weeks... five > > > were set up by the patient him/herself and the > > > others by me with patient > > > on the phone. I think that ratio is a good sign, > > > though I admit the > > > earliest registered patients may be more tech-savvy > > > so it may be a > > > statistical glitch. > > > > > > My technology stuff has held up pretty well through > > > my first week of > > > having all the pieces together... a " loaded " Toshiba > > > Tecra convertible > > > laptop-tablet with a port at the office for easy > > > connection to everything > > > there... HP color laser printer (on sale for > > > $299)... Panasonic scanner > > > (expensive, but it's worked GREAT so far -- dealer > > > is a local small > > > businessman who is has already referred his son to > > > me and has been a good > > > link to the local community, so the extra expense of > > > the machine has > > > already paid off as opposed to buying online) ... > > > EMR= AC... OneBox.com > > > for voice mails, faxes and some emails (has worked > > > great so far and VM is > > > fast with my DSL line and computer) .... single tel > > > line with all > > > calls/faxes sent to OneBox.com (btw, tel company rep > > > on the phone I've > > > worked with to set up line and DSL, after regular > > > calls back and forth, is > > > becoming my patient too!)... Treo 700W (new and I'm > > > just getting started > > > with it, but it's been good so far)... about to tie > > > in voice recognition > > > with local highly-recommended " training " company. > > > > > > I've tried to think about and come to good decisions > > > along the way for > > > where to spend money and thusfar I'm satisfied the > > > few times I've put out > > > larger sums. Each time I can see a reason and have > > > already seen some > > > benefit with referrals and good advise about other > > > businesses/resourses. > > > > > > I didn't realize it, but this world of small > > > business does run on > > > handshakes and relationships. A good financial deal > > > at one point may not > > > benefit you later. But a good relationship with a > > > colleague can keep > > > growing with time. Financial choices are not just > > > about the current > > > dollars but are " investments " for the future. At > > > this point however, I'm > > > mostly all set so there won't be many more outlays > > > of money. > > > > > > Anyway, I've not run the numbers but I'd estimate my > > > start up costs are > > > about $25,000 and I've been able to arrange for > > > some of that to delay > > > payment (no interest) which will help my early cash > > > flow but require me to > > > keep track and be sure I have cash available when > > > they come due. I've got > > > a $50,000 small business loan with a low interest > > > rate and my minimum > > > payment is 1% a month. I only pay what I take out > > > of it too... thus far > > > $20,000. My technology overhead (www, online > > > messaging, online > > > scheduling, cell phone, etc) is about $450/month and > > > I doubt I'll go over > > > the limits for use with the way I set the contracts. > > > I've got no staff... > > > one of my mottos is, " it's just me, the patients, > > > our computers and our > > > phones! " > > > > > > Now I've got to go and finish painting trim (have > > > put it off all week), > > > put up some shelving, paint a few last pieces of > > > funiture, move my last > > > two pieces of furniture and straighten up the > > > office...! > > > > > > I'm sure many of you recall the feeling, but right > > > now the office feels > > > like a jigsaw puzzle with all the pieces spread on > > > the table. At this > > > point they are all faced right-side-up but only > > > small bunches are all > > > attached... I've got the border and some bunches of > > > similar colors, but > > > really it is still not put together! ;-) > > > > > > Overall, this feels good! The mild anxiety is mixed > > > with joy. > > > > > > Thanks to you all for helping me get here. > > > I'll be sending the pictures and will share with the > > > group any thoughts or > > > observations about office or practice as time goes > > > on. > > > > > > 7:40... time to get to the office as I hit the > > > homestretch!!! > > > Tim > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2006 Report Share Posted March 15, 2006 RE Taking Medicaid In Western PA, Medicaid almost only pays $31/visit, ANY LENGTH VISIT. I consider it charity pay. If I were busier, I couldn't afford to do it. Getting paid this low level is almost business suicide for ANY medical practice. I say that any pt who wants to see me under MA can sign up with the 1 MA HMO I now take, but I don't see how anyone can run a practice at that level. Hospitals end up charging $10/tylenol to keep up, how can I? Dr Matt Levin FP, east of Pittsburgh Re: Who is Solo-Solo?> > > > > > > > I've created a poll on staffing for the group.> > You can take the poll on our group web site:> > http://health.groups.yahoo.com/group//polls> > The poll will be open through 3/19> > I'll email results.> > Gordon> > At 09:00 PM 3/4/2006, you wrote:> > > > > > > > Hi all; it looks like Tim is totally solo, it sounded> > like Pamela Wimble is; this is my area of highest> > interest to minimize headache especially at the> > beginning by not having other office staff; I'm lookig> > at a location opportunity that would allow me to have> > no staff.> > > > Any suggestions? Pro's Cons?> > -Shay Hosseinion> > > > --- Egly wrote:> > > > > Good work Tim!> > > > > > > > > > > > " Malia, MD" wrote:> > > Hi Folks --> > > > > > It's time for me to do as some others have done and> > > pass along some happy> > > news... my new office officially opens in two days,> > > Monday March6!> > > > > > First, a giant "Thank You" to everyone for sharing> > > their experiences and> > > opinions on this list. Over these three years or so> > > I've learned a lot> > > from all of you. And until recently I didn't realize> > > it, but it's true,> > > the list does feel like a bit like family.> > > > > > Second, a warning... you should get another email> > > (likely on Sunday or so)> > > from me with a link to a Kodak site to view some> > > photos. You do not have> > > to register (unless you want to order photos...?)> > > and it's not junk email.> > > > > > The photos will be of my office and will range from> > > the barebones space I> > > started with last month to whatever it looks like> > > tomorrow after putting> > > in lots of hours this weekend.> > > > > > About the office... about 50 patients have already> > > had their medical> > > records copied and sent to me. I have about 25> > > patients already> > > registered on RelayHealth. I have four patients> > > booked for Monday... for> > > five appts (one is a Workers Comp follow up who is> > > also diabetic so he's> > > got two appts to bill each with different> > > insurance). Interestingly, 3 of> > > the 4 patients are Deaf... but that is one of my> > > clinical interest areas> > > as I know sign language and have served large> > > numbers of Deaf patients for> > > many years.> > > > > > I have 10 appts booked on AppointmentQuest for the> > > next two weeks... five> > > were set up by the patient him/herself and the> > > others by me with patient> > > on the phone. I think that ratio is a good sign,> > > though I admit the> > > earliest registered patients may be more tech-savvy> > > so it may be a> > > statistical glitch.> > > > > > My technology stuff has held up pretty well through> > > my first week of> > > having all the pieces together... a "loaded" Toshiba> > > Tecra convertible> > > laptop-tablet with a port at the office for easy> > > connection to everything> > > there... HP color laser printer (on sale for> > > $299)... Panasonic scanner> > > (expensive, but it's worked GREAT so far -- dealer> > > is a local small> > > businessman who is has already referred his son to> > > me and has been a good> > > link to the local community, so the extra expense of> > > the machine has> > > already paid off as opposed to buying online) ...> > > EMR= AC... OneBox.com> > > for voice mails, faxes and some emails (has worked> > > great so far and VM is> > > fast with my DSL line and computer) ... single tel> > > line with all> > > calls/faxes sent to OneBox.com (btw, tel company rep> > > on the phone I've> > > worked with to set up line and DSL, after regular> > > calls back and forth, is> > > becoming my patient too!)... Treo 700W (new and I'm> > > just getting started> > > with it, but it's been good so far)... about to tie> > > in voice recognition> > > with local highly-recommended "training" company.> > > > > > I've tried to think about and come to good decisions> > > along the way for> > > where to spend money and thusfar I'm satisfied the> > > few times I've put out> > > larger sums. Each time I can see a reason and have> > > already seen some> > > benefit with referrals and good advise about other> > > businesses/resourses.> > > > > > I didn't realize it, but this world of small> > > business does run on> > > handshakes and relationships. A good financial deal> > > at one point may not> > > benefit you later. But a good relationship with a> > > colleague can keep> > > growing with time. Financial choices are not just> > > about the current> > > dollars but are "investments" for the future. At> > > this point however, I'm> > > mostly all set so there won't be many more outlays> > > of money.> > > > > > Anyway, I've not run the numbers but I'd estimate my> > > start up costs are> > > about $25,000 and I've been able to arrange for> > > some of that to delay> > > payment (no interest) which will help my early cash> > > flow but require me to> > > keep track and be sure I have cash available when> > > they come due. I've got> > > a $50,000 small business loan with a low interest> > > rate and my minimum> > > payment is 1% a month. I only pay what I take out> > > of it too... thus far> > > $20,000. My technology overhead (www, online> > > messaging, online> > > scheduling, cell phone, etc) is about $450/month and> > > I doubt I'll go over> > > the limits for use with the way I set the contracts.> > > I've got no staff...> > > one of my mottos is, "it's just me, the patients,> > > our computers and our> > > phones!"> > > > > > Now I've got to go and finish painting trim (have> > > put it off all week),> > > put up some shelving, paint a few last pieces of> > > funiture, move my last> > > two pieces of furniture and straighten up the> > > office...!> > > > > > I'm sure many of you recall the feeling, but right> > > now the office feels> > > like a jigsaw puzzle with all the pieces spread on> > > the table. At this> > > point they are all faced right-side-up but only> > > small bunches are all> > > attached... I've got the border and some bunches of> > > similar colors, but> > > really it is still not put together! ;-)> > > > > > Overall, this feels good! The mild anxiety is mixed> > > with joy.> > > > > > Thanks to you all for helping me get here.> > > I'll be sending the pictures and will share with the> > > group any thoughts or> > > observations about office or practice as time goes> > > on.> > > > > > 7:40... time to get to the office as I hit the> > > homestretch!!!> > > Tim> > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2006 Report Share Posted March 15, 2006 RE Taking Medicaid In Western PA, Medicaid almost only pays $31/visit, ANY LENGTH VISIT. I consider it charity pay. If I were busier, I couldn't afford to do it. Getting paid this low level is almost business suicide for ANY medical practice. I say that any pt who wants to see me under MA can sign up with the 1 MA HMO I now take, but I don't see how anyone can run a practice at that level. Hospitals end up charging $10/tylenol to keep up, how can I? Dr Matt Levin FP, east of Pittsburgh Re: Who is Solo-Solo?> > > > > > > > I've created a poll on staffing for the group.> > You can take the poll on our group web site:> > http://health.groups.yahoo.com/group//polls> > The poll will be open through 3/19> > I'll email results.> > Gordon> > At 09:00 PM 3/4/2006, you wrote:> > > > > > > > Hi all; it looks like Tim is totally solo, it sounded> > like Pamela Wimble is; this is my area of highest> > interest to minimize headache especially at the> > beginning by not having other office staff; I'm lookig> > at a location opportunity that would allow me to have> > no staff.> > > > Any suggestions? Pro's Cons?> > -Shay Hosseinion> > > > --- Egly wrote:> > > > > Good work Tim!> > > > > > > > > > > > " Malia, MD" wrote:> > > Hi Folks --> > > > > > It's time for me to do as some others have done and> > > pass along some happy> > > news... my new office officially opens in two days,> > > Monday March6!> > > > > > First, a giant "Thank You" to everyone for sharing> > > their experiences and> > > opinions on this list. Over these three years or so> > > I've learned a lot> > > from all of you. And until recently I didn't realize> > > it, but it's true,> > > the list does feel like a bit like family.> > > > > > Second, a warning... you should get another email> > > (likely on Sunday or so)> > > from me with a link to a Kodak site to view some> > > photos. You do not have> > > to register (unless you want to order photos...?)> > > and it's not junk email.> > > > > > The photos will be of my office and will range from> > > the barebones space I> > > started with last month to whatever it looks like> > > tomorrow after putting> > > in lots of hours this weekend.> > > > > > About the office... about 50 patients have already> > > had their medical> > > records copied and sent to me. I have about 25> > > patients already> > > registered on RelayHealth. I have four patients> > > booked for Monday... for> > > five appts (one is a Workers Comp follow up who is> > > also diabetic so he's> > > got two appts to bill each with different> > > insurance). Interestingly, 3 of> > > the 4 patients are Deaf... but that is one of my> > > clinical interest areas> > > as I know sign language and have served large> > > numbers of Deaf patients for> > > many years.> > > > > > I have 10 appts booked on AppointmentQuest for the> > > next two weeks... five> > > were set up by the patient him/herself and the> > > others by me with patient> > > on the phone. I think that ratio is a good sign,> > > though I admit the> > > earliest registered patients may be more tech-savvy> > > so it may be a> > > statistical glitch.> > > > > > My technology stuff has held up pretty well through> > > my first week of> > > having all the pieces together... a "loaded" Toshiba> > > Tecra convertible> > > laptop-tablet with a port at the office for easy> > > connection to everything> > > there... HP color laser printer (on sale for> > > $299)... Panasonic scanner> > > (expensive, but it's worked GREAT so far -- dealer> > > is a local small> > > businessman who is has already referred his son to> > > me and has been a good> > > link to the local community, so the extra expense of> > > the machine has> > > already paid off as opposed to buying online) ...> > > EMR= AC... OneBox.com> > > for voice mails, faxes and some emails (has worked> > > great so far and VM is> > > fast with my DSL line and computer) ... single tel> > > line with all> > > calls/faxes sent to OneBox.com (btw, tel company rep> > > on the phone I've> > > worked with to set up line and DSL, after regular> > > calls back and forth, is> > > becoming my patient too!)... Treo 700W (new and I'm> > > just getting started> > > with it, but it's been good so far)... about to tie> > > in voice recognition> > > with local highly-recommended "training" company.> > > > > > I've tried to think about and come to good decisions> > > along the way for> > > where to spend money and thusfar I'm satisfied the> > > few times I've put out> > > larger sums. Each time I can see a reason and have> > > already seen some> > > benefit with referrals and good advise about other> > > businesses/resourses.> > > > > > I didn't realize it, but this world of small> > > business does run on> > > handshakes and relationships. A good financial deal> > > at one point may not> > > benefit you later. But a good relationship with a> > > colleague can keep> > > growing with time. Financial choices are not just> > > about the current> > > dollars but are "investments" for the future. At> > > this point however, I'm> > > mostly all set so there won't be many more outlays> > > of money.> > > > > > Anyway, I've not run the numbers but I'd estimate my> > > start up costs are> > > about $25,000 and I've been able to arrange for> > > some of that to delay> > > payment (no interest) which will help my early cash> > > flow but require me to> > > keep track and be sure I have cash available when> > > they come due. I've got> > > a $50,000 small business loan with a low interest> > > rate and my minimum> > > payment is 1% a month. I only pay what I take out> > > of it too... thus far> > > $20,000. My technology overhead (www, online> > > messaging, online> > > scheduling, cell phone, etc) is about $450/month and> > > I doubt I'll go over> > > the limits for use with the way I set the contracts.> > > I've got no staff...> > > one of my mottos is, "it's just me, the patients,> > > our computers and our> > > phones!"> > > > > > Now I've got to go and finish painting trim (have> > > put it off all week),> > > put up some shelving, paint a few last pieces of> > > funiture, move my last> > > two pieces of furniture and straighten up the> > > office...!> > > > > > I'm sure many of you recall the feeling, but right> > > now the office feels> > > like a jigsaw puzzle with all the pieces spread on> > > the table. At this> > > point they are all faced right-side-up but only> > > small bunches are all> > > attached... I've got the border and some bunches of> > > similar colors, but> > > really it is still not put together! ;-)> > > > > > Overall, this feels good! The mild anxiety is mixed> > > with joy.> > > > > > Thanks to you all for helping me get here.> > > I'll be sending the pictures and will share with the> > > group any thoughts or> > > observations about office or practice as time goes> > > on.> > > > > > 7:40... time to get to the office as I hit the> > > homestretch!!!> > > Tim> > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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