THIS MONTH’S ADVISOR IS SONSORED BY…

Grow Your Medical Practice Profitably

Let the PROFIT EXPERTS Show You How

You are busy running your practice. You have patients but also employees – and costs. Many physicians find out too late that adding more billing does not always mean more profit. Our clients have thriving medical practices because they have a profit roadmap. They know how to easily maximize their profits, so they can focus on their patients. My name is Fred Parrish, Author of “The Profit Mentality,” Former Practice Management CFO/COO, Advisor and current CEO of The Profit Experts. My company can help maximize your profitability:

CONSULT: Real world advice, customized for you. For example, determine how the Affordable Care Act will affect your business and what you must do now to safeguard your practice.

ANALYZE: Using our model, identify the profit leaks in your practice. Simply, in just a few minutes, we can show you areas of concern – and options to fix.

PREDICT: Using historical data and our forecasting tools, run highly accurate “what if” scenarios to determine present and future profit impacts (staff, equipment, facilities, etc.) For example, what’s the financial impact of hiring a PA or adding a new piece of equipment

FREQUENTLY ASKED QUESTIONS: Q: I already have accounting software. Great, we’ll need that information into our database. We work “hand and glove” with your current software, giving you tools that complement and enhance your current system. Q: How difficult is the process and how much does it cost? It’s easy. We load your information, conduct the initial consultation, and you see the results immediately. The cost is a fraction of what you’d spend for traditional CFO services, only a few hundred dollars monthly. Q: What’s the ongoing process afterwards? We conduct a joint monthly online consultation with you to do a comparative analysis and review Q: What benefits should I expect long term? Increased profitability and cash flow – of course. But mostly peace of mind by knowing that your decisions are strategic, not reactive. Predictive knowledge that is accurate and highly useful really can maximize your profitability. Just call us at 214-383-0500 or email info@profit-experts.com to schedule a free 15 minute consultation. Stop hoping and guessing about your financial next steps. Profit Experts can show you the way!

Keep Calm and Buy Stocks By ACap Asset Management

News of recent market volatility alarmed some investors, sending them scrambling to manage loses. But it’s time to take a breath and avoid panic. Those with a solid financial plan and a diversified portfolio needn’t have worried.

So what is going on? The Dow Jones Industrial Average (Dow) is officially in a correction, which is defined as a 10

percent decline from its peak. The truth is that markets do not always go up, so it is perfectly natural and expected

for markets to decline occasionally. In developing and maintaining investment portfolios for our physician clients,

we at ACap Asset Management plan for down-markets as well. Not only do we protect against downturns through

strategic portfolio design and diversification, but we also capitalize on down days as buying opportunities. Because

we at ACap have been expecting this correction for some months now, we have been intentionally accumulating cash

in our clients’ accounts. We use the cash as an opportunity to buy in a down market. It’s like buying stock on sale. Who doesn’t like a good sale?

But why did the market take a downturn? While there’s really no clear answer to that question, the likely cause is simply consumer panic. As the market slowly declines, many investors panic and sell too, which fuels the fire.

Selling your investments in a panic is a bad idea. Those who sell their holdings in an acute down market are often

times left in a worse position than they would otherwise have been in if they had held their investments through the

market decline and waited for the markets to recover. Markets do recover. And while down markets are never

pleasant for investors in the short-term, they are good buying opportunities for the long-term term investor with at

least a 5-year holding period. Investing with a shorter time-frame does not always allow for the markets to react and

recover to the current world headlines.

So what can you do?

As is our philosophy, it is imperative when developing and maintaining your investment portfolio that you always

plan for a down market. At ACap Asset Management, we ensure that our clients’ portfolios are well balanced and ready for a down-market so they don’t have to panic. Not only do we invest for long-term growth, but we also use

down days like today as opportunities to buy assets on sale.

Short-term market news should not dictate long-term investment strategy. The biggest long-term risk is not daily

volatility, but rather, inflation. Inflation is the declining purchasing power of your cash while it sits uninvested in a

bank account. Unless your cash is earmarked for a specific short-term need warranting the need for cash, inflation

will have a far more negative impact on your wealth than market volatility. No one can predict the future, but we are

confident that the only way to beat inflation in the long-term (5 plus years) is through a well-diversified, equity

portfolio.

If you have any questions regarding your accounts or would like to schedule a consultation with us, please do not

hesitate to contact us at info@acapam.com.

MD PREFERRED PHYSICIAN CONSULTANTS

Drawing on personal experiences on all sides of health care –as a patient, a physician, a

family caregiver, a business owner and an entrepreneur – Dr. Vicki Rackner helps health care

professionals thrive in the era of ObamaCare.

This former surgeon and nationally noted authority in the doctor-patient relationship helps

clients achieve the personal, professional and financial goals that drew them to a career in

medicine. She offers a bridge between the world of medicine and the world of business.

Epidemics, Broken Windows and Your Profitability By FRED PARRISH

Copyright 2006 The Profit Institute, 214-383-0500, info@profit-experts.com

In his book The Tipping Point, Malcolm Gladwell addresses the factors that produce and sustain epidemics. He

states the est a to u de sta d the e e ge e of t e ds… is to thi k of the as epide i s. Ideas a d p odu ts a d essages a d eha io s sp ead just like i uses do.

To illustrate the power of environment, Gladwell uses the Broken Window theory1 that

describes conditions by which crime is propagated readily and continuously. It shows

i e is the i e ita le esult of diso de . If a i do is oke a d left u epai ed,

people walking by will conclude that no one cares and no one is in charge. Soon, more

windows will be broken and the sense of anarchy will spread from the building to the

st eet…, se di g a sig al that a thi g goes. Relati el i o p o le s su h as graffiti,

pu li diso de a d agg essi e pa ha dli g a e…, i itatio s to o e se ious i es. Application of this approach was responsible for the dramatic improvement in the New

York City crime rate during the early 1990s.

The same approach must be take ith ou usi ess. If a i do is oke a d left u epai ed ou staff ill get the idea that the e is o o e fo effi ie t, o de l ope atio . That it is oka to aste ti e o esou es. It’s okay to be haphazard about the way customers are a aged. As ith i e, diso de i the e i o e t is contagious and drains the company of cash.

Co side a o pa of 0 e plo ees. Let’s sa the e is a ite that osts $0. 0 ea h a d it is so ethi g that is consumed regularly in the business. If each employee were to waste only one of these items per day (drop it on

the floor to be discarded later, leave it out to be spoiled in some way, use it improperly or ineffectively to cause it

to be made unusable, etc.), does that seem like a ig deal? Ma e…?

I fa t, 0 e plo ees asti g that $0. 0 pe da e e da of the ea ould ost the o pa $ , . Gi e this operating style and the reality that there are hundreds of these $0.50 items to be managed during a normal

business day throughout the organization, you could easily take the $6,625 and multiply it by 10 – $66,250!

Given that profits (cash) cannot be generated without revenue, the a ilit to o ti uall eple ish the o pa ’s cash supply requires that revenue continually be generated at levels sufficient to cover the expenditures. The

amount of revenue e ui ed to epla e the $ , 0 is di e tl elated to the o pa ’s p ofit margin.

TThhee bboottttoomm lliinnee – profitability is the direct result of an organized, efficient operating environment and the

penalties for failure can be severe. Benjamin Franklin put it this way – e a e of little e pe ses; a s all leak ill si k a g eat ship. “et a e pe tatio fo p ofita ilit . “ea h out a d stop ou p ofit leaks!

1 formulated by criminologists James Wilson and George Kelling (The Atlantic Monthly; March 1982)

Company Profit Margin

Revenue Required for

Replacement

15% $441,667

10% $662,500

5% $1,325,000

Insurance Protection for Physicians – pt 2 By David I. Katz, AAMS®

connect with me on LinkedIn and Twitter

www.davidikatzauthor.com

Insurance Protection for Physicians pt 1

"One of the best ways to reduce the risk of a malpractice lawsuit is to treat every patient with courtesy and

respect."

-Kenneth Fox, a partner with McAloon & Friedman, P.C. in New York City Medical malpractice insurance protects against the financial risks faced by doctors and dentists. Some types of practices - cardiovascular surgery, and obstetrics-gynecology, for example - carry a higher risk of a malpractice lawsuit, and premiums reflect that difference. For example, a new obstetrician in New York might pay an annual premium of $100,000 to $200,000 for $1.3 million in primary insurance coverage. State laws vary widely in terms of malpractice insurance requirements. In some states, purchasing a policy is mandatory. In other states, a medical professional can post a bond as surety in the event of a malpractice lawsuit, or even drop coverage altogether. In addition, some state legislatures have set caps on damage awards in malpractice cases, reducing the potential financial risk to a practicing physician. New physicians and doctors who are changing affiliations should also have a clear understanding with the practice or hospital about how a malpractice lawsuit would be handled. Malpractice liability and insurance coverage may also be affected by the structuring or a group practice or collaborative arrangement, such as an accountable care organization (ACO). In a partnership, one physician or dentist may be considered liable for the actions of another partner, said Fox. However, the shareholders in a professional corporation or limited liability company would generally not be liable for another shareholder’s medical malpractice. Instead, a malpractice lawsuit might also be filed against the company as well as the practitioner. Asset Protection for Doctors and Dentists Effective asset protection may involve consultation with legal, tax and accounting professionals who can advise about the best ways to guard against the perils of malpractice or liability lawsuits or other financially devastating occurrences. It’s good for a new doctor or dentist to discuss their options with a legal professional early in their careers. Even if you have relatively few assets in your 30s, for instance, you can start making plans that can be adjusted as your financial situation improves through the years. When checking off the list of threats to their finances, it’s not just a potential malpractice claim that needs to be considered. There are other legal risks that should be addressed when doctors or dentists are married or in long-term partnerships.

“Medical professionals at an early stage in their careers should keep it simple, holding their investments in the

name of the husband and wife as tenants by the entirety, for instance. You can always transfer the assets to

another type of legal structure, such as a trust, in the future.”

— Kristen E. Simmons, Oshins & Associates, LLC in Las Vegas, Nevada Business Asset Protection Ownership of assets within a medical practice can also be problematic in the event of a malpractice or liability judgment. One protective strategy is to create a limited liability company (LLC) to hold the non-practice assets. As a medical practice becomes more successful, there is usually a greater need to protect the business assets as much as possible. Some doctors and dentists invest commercial real estate and in expensive equipment, which can also be owned by a separate entity and then leased to the practice to protect those assets. That’s something to discuss with an attorney familiar with these types of asset protection issues. Protecting personal and business assets against loss is a vital aspect of long-term financial planning. No one wants to lose savings or funds in a natural disaster—or an unfavorable malpractice judgment. At the same time, many medical professionals want to protect the financial well-being of their spouses, partners and children through

various types of insurance.

~ excerpt from A Financial Prescription for Doctors and Dentists by David I. Katz About the author: In his 22-year career as a financial advisor, David I. Katz has worked extensively with doctors, dentists and their families, helping them put together solid financial plans for retirement. He knows the financial pitfalls – including poorly constructed trust plans, expensive divorces and costly lawsuits – that are among the top financial concerns for medical professionals. David I. Katz is available to speak to medical groups and schools about financial planning for doctors and dentists. David I. Katz is an Accredited Asset Management Specialist (AAMS®) and Accredited Investment Fiduciary (AIF®) who holds life and health insurance licenses. Katz’s honors include: • recognized by Medical Economics Magazine in 2011, 2012, 2013 and 2014 as one of the "Best Financial Advisers for Doctors" • named one of the "Best Financial Advisors for Dentists 2012, 2013and 2014" by Dental Product Reports • selected as a "5 Star Wealth ManagerSM Award Winner" by Five Star Professionals in 2012, 2013 and 2014

Collision of the Plans By: Anthony J. Ogorek, Ed.D., CFP Ogorek Wealth Management LLC

www.ogorek.com There are any numbers of people who are pitching ways to get rich. They know that there is no magic to saving regularly and then investing intelligently. So actually leveling with you will not be effective. They need to provide you with a shortcut. Now that has appeal to people. Shortcuts have been used for years to not only sell us dubious propositions, but to make the purveyors wealthy. For instance, you may recall sure fire weight loss schemes that require just taking a pill; or wearing a garment that will melt the pounds off of you, or offer you a return that you know is too good to be true. In a sense you can’t blame us for falling for shortcuts since we all have limited time, and want superlative results. In our experience financial shortcuts may not just disappoint you, but can cause permanent damage to your financial health. Creating and maintaining a financial plan can be a real effort. The payoff is that you have reasonable assurances that you will not outlive your money, and are managing the full array of risks that can tank your lifestyle. People without a plan often substitute a number for a plan. In other words they boil their future financial security down to a number or two. They may say that they need $1 million in assets and a 5% annual return to hit their retirement objectives. That is their plan. This motivation is so powerful that even some people who already have successful financial plans persist in ignoring their plan and pushing for their number. The danger with this approach is that you may be forcing yourself to accept more risk than necessary to meet your objectives. You may also deprive yourself of one of the most important things in life, peace of mind. Constantly worrying about the future is nobody’s idea of a good time. It is also no fun when you realize that your number forced you to live much more frugally than necessary. I am all for simplification, but mapping out the next 20 or 30 years requires more than a number and a hoped for return on your portfolio.

REAL ESTATE ADVISOR Tips & Tools from the world of today’s Realtor

If you are a physician and you and your spouse are preparing to purchase a residential property you need to give some serious thought to how you plan to title your home. Many homeowners don't even realize they have options until they show up at closing. In past articles I have discussed the importance of making any home purchase part of a long term financial plan prepared and supported by the services of a professional advisor. This is a case in point. Most buyers believe that the primary purpose of the title is to assure that you actually own the property free and clear and that upon the death of a spouse, the property passes to the other spouse without going through probate. There are actually three types of concurrent ownership recognized by all states: joint tenancy, tenancy in common and tenancy by the entirety. The most common title for married couples is joint tenancy. The partners own the property together, and if one of us dies, the other gets it without the property passing through probate. The survivor files an affidavit saying the other titleholder has died and attaches a death certificate and that is it. But if one of you is a doctor with the risk of malpractice claims, you may want the spouse not at risk to own the property or better yet you may want to consider tenancy by the entirety. Tenancy by the entirety can only be used by married couples. It allows spouses to own property together as a single legal entity. And here is why a married physician should consider this approach. Under a tenancy by the entirety, creditors of one partner may not attach and sell the interest of a debtor spouse. That means that if the physician is sued for a malpractice claim and has a judgment rendered against him, the claimant cannot attach the home. Another important difference between a tenancy by the entirety and a joint tenancy is that a tenant by the entirety may not sell or give away his or her interest in the property without the consent of the other tenant. Upon the death of one of the spouses, the property still goes to the surviving. Keep in mind that a tenancy by the entirety cannot be reduced to a joint tenancy by a conveyance of property. Generally, the couple must divorce or jointly agree to amend the title to the property to cancel a tenancy by the entirety. How you structure your title is definitely something to consider well in advance of closing.

https://www.disabilityquotes.com/mdpps.cfm

Personal Finance

Tips & Tools from the world of financial planning

If you have trouble telling the difference between a CFA, CFP®, CIC, ChFC or any of the other financial

certifications, welcome to the club. Here are a few definitions that may help you find a financial advisor that is right

for you:

Certified Financial Planner® (CFP®)

Those with the CFP® designation have demonstrated competency in all areas of financial planning. Candidates

complete studies on over 100 topics, including stocks, bonds, taxes, insurance, retirement planning and estate

planning. The program is administered by the Certified Financial Planner Board of Standards Inc.

Chartered Financial Consultant (ChFC)

Individuals with the ChFC designation have demonstrated their thorough knowledge of financial planning. The

ChFC program is administered by the American College. In addition to successful completion of an exam on areas of

financial planning, including income tax, insurance, investment and estate planning, candidates are required to have

a minimum three years of experience in a financial industry position.

Certified Investment Management Analyst (CIMA)

This designation focuses on asset allocation, ethics, due diligence, risk measurement, investment policy and

performance measurement. Only individuals who are investment consultants with at least three years of

professional experience are eligible to try to obtain this certification, which signifies a high level of consulting

expertise. The Investment Management Consultants Association offers the CIMA courses.

Certified Public Accountant (CPA)

Professionals holding the CPA designation have passed examinations on accounting and tax preparation, but their

title does not indicate training in other areas of finance.

Personal Financial Specialist (PFS)

Those CPA holders who are interested in gaining expertise in financial planning in order to supplement their

accounting careers need to become certified as personal finance specialists (PFS). The PFS designation is awarded

by the American Institute of Certified Public Accountants to those who have taken additional training and already

have a CPA designation.

Chartered Financial Analyst (CFA®)

This designation is offered by the CFA Institute. To obtain the CFA charter, candidates must successfully complete

three separate exams and gain at least three years of qualifying work experience, among other requirements. In

passing these exams, candidates demonstrate their competence, integrity and extensive knowledge in accounting,

ethical and professional standards, economics, portfolio management and security analysis.

Chartered Investment Counselor (CIC)

Given by the Investment Counsel Association, this is a designation that CFA charter holders who are currently

registered investment advisors can study for. The focus of the CIC program is portfolio management. In addition to

proving their high-level expertise in portfolio management, these individuals must also adhere to a strict code of

ethics and provide character references.

Good luck and happy hunting.

How do I hire the right clinical staff? By Lance Liberti, l_liberti@msn.com

Over the past decade I have been a practice owner and practice manager, as well as a consultant to hundreds of

medical service practices of varying scopes nationwide and one of the most common questions I am asked is “How

do I hire the right clinical staff?”.

While there are many factors to consider when hiring clinical staff such as; education, experience, professional

licensure, “culture fit”, and more there are deeper questions that must be asked in the medical space. In this industry we deal with many regulatory bodies and governing agencies specific to our field such as The Joint Commission

(JCAHO), The Agency for Healthcare Administration (AHCA), Office of Inspector General (OIG), and The Food &

Drug Administration (FDA), just to name a few… and this is on top of the “usual suspects” such as the Occupational Safety & Health Administration (OSHA). Additionally, we have countless legislative requirements to comply with

such as The Healthcare Insurance Portability & Accountability Act (HIPPA), The Health Information Technology for

Economic and Clinical Health (HITECH), The Physician Quality Reporting System (PQRS), The Meaningful Use

section of The Affordable Care Act (or “Obamacare” as it is more commonly referred to), and more… In an industry were the stakes are so high (very literally “life and death” at times) and the penalties for data breach, ethics violations, and other infractions so severe you MUST weed out new hire candidates that have the potential to put

your organization at risk, or cause damage. There is no easy way to do this other than asking the “hard questions” some of which I will share below.

*If the above agencies or listed regulations are unfamiliar to you and you are a practice owner, administrator, or

Physician please call 855-854-6332 or visitwww.integrativepracticesolutions.com right now for a FREE

compliance evaluation. Failure to comply with these agencies and regulations can result in reduction of insurance

payments from federally funded programs such as Medicare and Medicaid, suspension or revocation of your clinic

or professional license, fines, penalties, and civil or criminal prosecution. IPS, Inc. and I specialize in helping

individuals and organizations navigate these oft complex waters with a proven track record of success.

When it comes to hiring clinical licensed staff I have interviewed for positions ranging from Nurse to Neurosurgeon,

yet regardless of the level of license, the following questions are always necessary to ask:

Disciplinary Actions – Looking into the cleanliness of one’s medical or nursing license is an absolute must during the hiring process. Not only will past license actions effect the credibility of the institution they represent but this

can also effect the ability to credential the new hire with medical and nursing boards, as well as with third party insurance payers.

“Have you ever received a warning letter or been cited for misconduct by any state or federal licensing board, professional board or association? If yes, please explain in detail.”

Litigation History (Medical Malpractice) – While this matter will be addressed in most background checks,

asking the question provides the new hire candidate an opportunity to explain a past litigation if its outcome was negative. Additionally, if a candidate does not disclose a past litigation history and one is discovered upon the

background check it is a great means to disqualify what could be a dishonest and potentially troublesome applicant from employment consideration. I recommending asking this question specifically as most employment applications

only address the applicant’s criminal legal history. Based upon its severity claims of Medical Malpractice can be civil or criminal. The impact of this questions answer goes beyond assessing ones honesty, it also effects the potential

future employment costs of the candidate as those with past Malpractice claims will be more costly to insure on future policies. That said this can be mitigated by asking the applicant to carry their own individual malpractice

policy in the event they do have a negative record and you still wish to extend an offer of employment to them (this potential solution may not be applicable if your organization carries a group malpractice policy).

“Have you ever been threatened with, or faced litigation for Medical Malpractice or misconduct? If yes, what was the outcome?”

Board Certification – It is not safe to assume that the healthcare provider sitting across from you during the

interview is Board Certified just because they demonstrate a command of the subject matter or area of practice. In

the past Board Certification was not a “make or break” credential for a Physician and many could find quality employment without it. However in today’s rapidly evolving healthcare marketplace effected by numerous legislative actions, coding determinations and formularies, even mergers and acquisitions of smaller payers by the industry giants, it is a must have for most positions. Why? Certain major third party payers, most notably Blue Cross & Blue

Shield (BCBS), do not allow new providers to participate in their network unless they have Board Certification. If your healthcare clinic or facility accepts Medicare and Medicaid only, not to worry Board Certification is not a

requirement for new providers with Federal Payers (yet). However, if a significant portion of your payer mix consists of private payers ask this question during the interview and follow up by verifying this status with the state Nursing

Board or Medical Board.

“Are you presently board certified in (insert specialty)?

If the new hire candidate is not presently board certified it may be worth asking follow up questions to ascertain where they stand in this matter. A clinician that is not yet certified, but may soon be, can be a relative bargain acquisition to the practice, group, or facility.

“Do you plan to sit for your board examination and when?”

“If you have taken the boards in the past and failed, what was your most recent score?”

License Status – This one is a bit of a “no-brainer” but I wanted to include it anyway. While board certification is typically performed at a national level, Nursing and Medical licenses, much like firearms permits, are state specific. However unlike firearms permits, no state will honor another states Nursing, Radiographic, Medical, or Chiropractic

licenses. Therefore it is important to ask if the candidate is licensed in your particular state.

“Are you presently licensed to practice (insert specialty) in the state of (insert state)? If no, have you applied with the state for your license and passed any and all associated requirements including but not limited to examination?”

If the candidate is not licensed in the state of your practice, group, or facility the opportunity may present itself to

hire the candidate in a non-licensed capacity to build your bench and have access to a future licensed provider. You may also benefit from extending an internship, residency, or preceptorship if the applicant is a recent graduate. This

is especially valuable if your practice, group, or facility has plans for future expansion.

Network Status – Clinicians that are actively, or have previously been credentialed with insurance payers, present many advantages to those that have not. If a clinician is actively credentialed your organization may have the option

of billing under the providers individual provider ID number (PIN) with private payers, or their Provider Transaction Access Number (PTAN) with the Centers for Medicare and Medicaid Services. Also, if a clinician is

actively credentialed under a particular specialty there is no need to ascertain if the panel for said specialty is open or closed with the third party payer.

“Are you presently an in-network provider with any third party payers, Medicare, or Medicaid? If more than one, please list.”

If the applicant does not currently hold network participating status, it is worth exploring if the applicant has ever

held this status in the past as many insurers such as Medicare will not treat a former participating provider as a new applicant (in this case on page 3 of Medicare form 855i check box three “reactivating” not box one “new enrollee”). This simple difference can reduce provider credentialing time from months to weeks resulting in significantly enhanced billing potential for the host facility. *If you are a group, facility, or do not plan to bill under the providers

individual policy with Medicare you will also have to file a Medicare form 855r Application for Reassignment of Medicare Benefits.

“Have you ever been credentialed as an in-network provider with any third party payers, Medicare, or Medicaid? If more than one, please list.”

You may find more information on, and copies of Medicare and Medicaid provider credentialing forms

here: www.cms.gov/Medicare/Provider-Enrollment-and-

Certification/MedicareProviderSupEnroll/EnrollmentApplications.html

*If your practice, group, or facility requires credentialing services, or detailed advice on insurance credentialing, please contact IPS, Inc. at 855-854-6332 or visitwww.integrativepracticesolutions.com for more

information.

If your practice or facility accepts Workman’s Compensation claims, many states such as Pennsylvania, Georgia and Virginia, require employers to post and provide Physician Panels for injured workers to choose from for their care.

These panels can be difficult to gain entry to, and as with traditional insurance, some panels may be temporarily or permanently closed. For this reason a clinician with existing participation on local, regional, or national Workman’s Compensation panels can be a highly valuable asset to many practices, groups, and facilities.

“Are you presently a member of any local, regional, or national Workman’s Compensation panels? If yes, please list the panels and if they are affiliated with any local employers.”

As with board certification, if the applicant is not actively credentialed it may be worthwhile to hire the candidate in a non-billable capacity to build your bench and have access to a future credentialed provider. Additionally, some

clinicians such as Nurse Practitioners and Physicians Assistants can be billed “Incident To” a supervising physician. In this case the supervisory physician’s credentials are submitted for billing to the third party payer and therefore the claim will fall under the oversight physician’s network status, not the “Incident To” provider.

*Please be advised “Incident To” billing is an extraordinarily complex process and requires a multitude of rules and regulations to be followed. Additionally, these guidelines vary widely by state, as well as by the type of mid-

level provider being utilized. Please contact IPS, Inc. at 855-854-6332 or visit www.integrativepracticesolutions.com for more information, or consult with a licensed Healthcare

Attorney in your state. Hospital Privileges – This is another factor that will affect your ability to credential the new medical provider

with certain third party payers. Many payers, again BCBS is a prime example, do not offer network participation status to new providers that do not have local hospital privileges. If you administer or own a facility setting, such as

an Ambulatory Surgical Center (ASC), this question becomes even more critical as (admission privileges) are required to legally performance certain outpatient surgical and pain management procedures.

“Do you currently hold privileges at a local hospital? If yes, what level of privileges and at what hospitals do you hold them?”

The types of privileges the physician may hold include:

Admitting – allow a doctor to admit a patient to the hospital. Courtesy – allow a doctor to occasionally admit and/or to visit and treat patients in the hospital. Surgical – allow a doctor to perform surgery in the hospital’s operating room, outpatient surgery area, and/or associated Ambulatory Surgical Centers (ASC’s).

If the applicant does not currently hold hospital privileges and this is a necessary requirement for the position they can be gained through application. That said as with any credentialing process, there are limiting factors. Residency

restrictions can be implied by the hospital offering privileges, among other requirements. Additionally, most hospital have a privileges committee that meets at specific intervals of time, frequency and duration. These variables

can significantly delay a new application for privileges so we recommend you contact your local hospital administrator and ask these questions prior to making a hiring decision on an applicant without existing privileges.

Should you have to request privileges for a provider in my personal experience I have found enhanced speed and outcomes working with smaller community hospitals, religious hospitals, rural hospitals (RHC’s), and the like that need additional admitting providers to fill their beds as badly as you may need privileges to credential with certain insurance payers. Also worth noting some large hospitals such as University of Pittsburg Medical Center (UPMC) for example, own and operate their own health plans (health insurance companies). In most cases if you do not have

privileges at the associated hospital you will not meet credentialing requirements to accept their health plans as a network provider.

CAQH – stands for the Council for Affordable Quality Healthcare. It is an American non-profit organization that

collaborates with healthcare providers, trade associations, and insurers to catalog licensed healthcare providers

relevant data for the purpose of credentialing with certain third party insurance payers and select Workman’s Comp Panels. The data cataloged includes the provider’s medical license number, continuing education requirements met, PIN, and other information that can “fast track” the credentialing process for your practice, group, or facility. As such I always ask the new hire candidate:

“Do you presently maintain an up to date CAQH account? If yes, you may be asked to provide your

login credentials to our insurance department upon hire for credentialing purposes. Do you object

to providing this data if offered the position of (insert job title)?”

Restrictive Covenants – While this question is important regardless of what positon is being interviewed for, it

becomes even more critical when dealing with clinical staff as some may continue to hold other positions, active or

advisory, even after accepting the position you are hiring for. Additionally, some restrictive covenants can “survive” termination, meaning even though the provider may no longer be actively employed by the former employer it still

holds dominion over where and/or what type of position the clinician may hold elsewhere. This becomes especially

true for hospitalists, or those that have recently left a large group (in these cases it is common for a separation

agreement to have been executed, which I like to request a copy of). Because of these nuances I like to pose a series

of questions as follows:

“Are you currently employed by any other healthcare facility, group, hospital, ASC, home health

agency, nursing home or ALF (Assisted Living Facility), pharmaceutical company, pharmacy,

ORF (Outpatient Rehabilitation Facility), University, private organization, or other?”

“Are you currently or have you even been a party to a clinical research study, case study, trial, or

similar?”

“Do you sit on any board of directors, advisory’s boards, or hold any other administrative or

consultative position with any agency, organization, or employer private, public, or otherwise

with or without pay?”

“Do you currently engage in private practice, own, or operate your own company providing

health care services, administrative, or consultative services in any capacity similar to (insert

your organization name)?”

“Is your employment with (insert company name) for the position of (insert job title) restricted or

diminished in any capacity by any current or former non-compete, separation agreement, or

other restrictive covenants, of any contract written, verbal, or otherwise conveyed? If yes, please

provide a copy of said covenant for consideration and inclusion in your personnel file should the

position of (insert job title) be extended to you.”

I hope you find the contents of this article helpful as you conduct future interviews and hiring processes for medical

providers. That being said, this is a complex topic and the information contained in this article is only a sample of

the knowledge I have gained over more than a decade of professional experience in this field. If you have additional

questions, concerns, or if you require assistance in recruiting, interviewing, hiring, training, credentialing, or billing

for medical providers please call 855-854-6332 or visitwww.integrativepracticesolutions.com for a no-cost

consultation (and some friendly advice).

Legal Disclaimer: The information contained in this article is provided for informational purposes only, and should not be construed as legal

advice on any subject matter. You should not act or refrain from acting on the basis of any content included in this site without seeking legal or

other professional advice. The contents of this site contain general information and may not reflect current legal developments or address your

situation. We disclaim all liability for actions you take or fail to take based on any content of this article.

THE RECRUITER’S CORNER Tips and Tools from Today’s Physician Recruiter

Creating an effective résumé is an art form and not a science. One can find literally dozens upon dozens of templates on the Internet. And of course many of these templates are completely inappropriate for physicians. My goal today is not to suggest a template or format but rather to suggest that there are a number of things that you should leave off your resume no matter what style you chose. Here are some items that are best left in the waste bin.

1. Employers generally are not interested in what employment goals you have set for yourself. Starting your

resume off with what amounts to a mission statement serves little purpose and may actually disqualify you

for a position. Employers are going to review your resume to help them determine if they want to pursue

your candidacy. They are really not interested at this stage of the game in your aspirations and dreams. If

you must put a statement at the top of your resume, make it a summary of your skill sets and

accomplishments

2. Keep it relevant. Tracing your employment history back to your first job as a teenage baby sitter is not going

to endear you to an interviewer with limited time. And positions that hold no relevance to the position for

which you are applying is probably not needed either. Focus on your employment record for the last ten

years. Obviously if there are gaps in your employment, you will need to address the reasons. Focus on your

experience, education and skills that show you are a good match for the job description.

3. Please don’t put your picture on your resume. Only bad things can flow from the practice. Employers

should not and cannot take appearance into account when determining who they will bring in for an

interview. Your height, weight, age and race have no place on the resume either. Remember, the objective of

a resume and accompanying cover letter is to get an in person interview. Anything that might derail and

invitation should be left on the cutting floor.

4. Tell the truth, the whole truth and nothing but the truth. You don’t need to embellish your

accomplishments. You are either qualified for the opportunity or you’re not. You can count on an employer doing a thorough background check and inaccuracies are going to be caught and will probably derail your

candidacy. And in the final analysis, taking a job for which you are not qualified can only lead to bad things,

up to failure and discharge.

5. Stating at the bottom of your resume that references are available upon request is unnecessary. Further,

don’t include references with your initial resume and cover letter. Employers will assume that you have

references available and when the interview process has reached the serious stage they will request them.

One of the secrets to an effective resume is brevity. Anything that takes up space without purpose should be left off the document

NEW HEALTHCARE OPPORTUNITIES

Provided by MedicalMatch.org

Emergency Medicine - Atlanta, GA - EmergiNet

You a k o Atla ta as the u offi ial apital of the “outh, ut the e’s o e to this it tha its southe lo atio . If ou ake ou ho e i the Pea h Cit , ou’ll fi d a u de ia le i of “outhe ha , sophisti atio a d t aditio s.

Atlanta continues its eputatio as a t a spo tatio hu ith the o ld’s la gest ai po t a d eas a ess to I-75 & I-85.

Whe it o es to Atla ta’s eputatio fo g o th a d i o atio , health a e tops the list as the it ’s fa ilities e pa d and improve services across the metro area. Serving some of the fastest growing hospitals is EmergiNet.

EmergiNet has positions available for BC/BP, EM residency trained physicians for work in hospitals surrounding the

Atlanta metropolitan area. We work as a team emphasizing quality emergency care, dedicated customer service,

professional and personal growth. Highlights include: Fee-for-se i e odel ha i g ost MD’s sta ti g at a ou d $ 0k with no ceiling; Profit sharing plan after first year including tax-deferred compensation to supplement 401k(100% vested

immediately); Physician-centric practice owned and run by physicians; All facilities located within 30 minute drive from

downtown Atlanta.

EmergiNet provides a full range of clinical and administrative professional services to the facilities we serve. Our mission

is to maximize patient care and facility resources, as well as educate, facilitate and integrate the delivery of health care

within the community. We continually seek ways to enhance the level of excellence and quality in the services we

provide to our clients. To review this and other opportunities E-mail CV to Neil Trabel, ntrabel@emerginet.com;

fax 770-994-4747; or call 770-994-9326, ext. 319. Please visit www.emerginet.com for more information.

Staff Physician Needed – Toledo, OH – The Pediatric Center

Staff Physician needed immediately to join an established Pediatric practice. You will be joining a medical staff that

includes 3 physicians, 6 mid-level providers, supported by 12 nurses. The practice is affiliated with 5 hospitals. Our

physicians round on newborns only. We do not attend c-sections. We utilize pediatric hospitalists and/or specialists for

patient admissions. Mid-level providers are on call for parents/patients.

Diagnostic or Interventional Radiologist – Providence, RI

A great opportunity for Diagnostic or Interventional Radiologists to join a well-established Imaging Network in

Providence, Rhode Island. The group is open to a Diagnostic; Interventional or any other subspecialty you possess.

Excellent compensation offered along with generous benefits. In addition, there would be an opportunity to teach and

or do research, if desired. One year to partnership for an experienced Radiologist and Two years for a new grad. There

is no buy-i …! 1:6 call. Providence has a lot to offer and is just under 45 minutes to Boston.

OBGYN – Indiana

Exceptional opportunity to join a busy, vibrant team Call 1:6. State of the art Medical Center. Very competitive

compensation and comprehensive benefits including Educational Loan Assistance, Signing Bonus, Paid Malpractice, Paid

CME, Relocation, and much more. This city offers excellent public and private schools, University/Colleges and airport.

Enjoy an abundance of cultural and recreational activities including water sports, low tax base, safe neighborhoods, low

cost of living, and more. Enjoy an exceptional quality of life. Indiana is among the top 3 places in the nation in which to

practice medicine due to its favorable malpractice climate. (Medical Economics)

Family Practice – Greenville, IL

Greenville Regional Hospital, a 42-bed full-service hospital located in Greenville, Illinois, is seeking a BC/BE Family

Medicine Physician to join their team. The ideal candidate will be interested in performing the full range of Family

Medicine, have the ability and desire to build long-lasting relationships with patients and be a part of the community.

Greenville Regional Hospital is hospital employed, outpatient only; competitive salary with productivity bonuses;

relocation reimbursement and sign-on bonus offered; student loan repayment options; full benefits package including

malpractice and tail coverage; rural background or preference for rural medicine is a plus.

Greenville, Illinois is located approximately 45 minutes east of St. Louis, Missouri. The home

of Greenville College, Greenville is a modern small town that offers solid, Midwestern values and an intellectual feel.

The community is close to a major metropolitan area and access to cultural events, shopping, sports and other

amenities, yet its residents are able to embrace the advantages of a rural setting with a lack of congestion, pollution and

crime.

Family Practice – Illinois

Excellent opportunity to join a very busy practice adding to their team due to continued growth. State of the art, award

winning health system. Very competitive compensation and comprehensive benefits including flexible insurance plan,

generous vacation, flexible retirement plan, relocation, Academic appointment available, and much more. Located in a

vibrant city with excellent public and private schools and numerous cultural and recreational activities. Easy access to

Chicago.

Primary Care – Cincinnati, OH

Primary Care Cincinnati, Ohio One of the top integrated health systems in Greater Cincinnati is seeking physicians

trained in Family Practice, Internal Medicine, Emergency Medicine, Internal Medicine/Pediatrics or Occupational

Medicine to practice in one or more of their facilities. These physicians will staff a Priority Care facility for internal

primary care patients, as well as community urgent care illnesses. Employed opportunities located in Cincinnati, Ohio

Full-time and part-time positions are available No inpatient or call responsibilities Flexible 2015 start dates New state of

the art facilities with fully equipped lab and x-ray services Complete benefit package with malpractice, long term

disability, medical/dental coverage, relocation, retirement plan with matching employer funding. Competitive

guaranteed base with bonus incentives Weekend and holiday pay differential. To learn more, contact Arleen Richardson

arleen.richardson@rmmedicalsearch.com

Job #21463

Dermatology – Quincy, Illinois

Blessing Hospital is seeking a Dermatologist for a full-time employed position with Blessing Physician Services

in Quincy, IL. Must be Board Certified or Board Eligible in Dermatology. The candidate must have a solid work ethic and

dedication to providing comprehensive healthcare to patients and their families. The ideal candidate will strive to

become an active member of the community, as well as uphold the core values of the hospital.

MD Preferred Services is the only comprehensive online resource center for doctors. Each year MD Preferred

identifies and promotes uniquely qualified, "doctor friendly", community based preferred professionals from a

wide range of disciplines including: Attorneys, Realtors®, Mortgage Lenders, Insurance Agents, Accountants,

Commercial Bankers, Financial Planners & Practice Management Services, who are committed to serving the

healthcare demographic and offering a superior service experience.