Understanding your obligations surrounding employee taxes is crucial for operating a successful business, whether you're an employer or an aspiring entrepreneur.

In this episode, we explore the four primary types of employee taxes:
• Federal and State income tax

• Withheld by employer
• Employer responsible for submitting

• FICA

• Funds Social Security and Medicare
• Employer responsibility is 7.65%

• FUTA

• Federal unemployment tax
• Paid by employer to fund state unemployment programs

• State Unemployment tax

• Based on employer payroll
• And number of unemployment claims

As an employer, you're no stranger to the deductions made from your employees' paychecks. Being on the opposite side of the table, though, offers a whole different viewpoint on employee taxes.

Given the difficulty and significance of correctly filing employee taxes, it is understandable that doing so might take a lot of time and effort. There are several choices that can help make life easier and guarantee compliance. The process can be streamlined by using payroll software, outsourcing human resources and payroll to HR companies or CPAs, or hiring a qualified practice manager. Always remember that it is strongly advised to visit a tax specialist or have someone educated about tax issues.

Remember, mastering employee taxes is a crucial aspect of running a successful business, ensuring compliance, and fostering a healthy employer-employee relationship. Join us on this insightful episode as we equip you with the knowledge and understanding necessary to navigate the intricate realm of employee taxes.

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Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The Stark Law prohibits physicians from referring patients to entities in which they have a financial interest to prevent financial incentives from driving medical decision-making. The Anti-Kickback Statute prohibits the exchange of anything of value in exchange for referrals for services.

Examples of Stark Law violations:

• A cardiologist refers patients to a diagnostic testing facility in which he has a financial interest.
• A physician is found to be billing Medicare for services provided by an unlicensed midlevel.

Other Exceptions to the Stark Law

• "In-office ancillary services" allows physicians to refer patients for certain designated health services provided in the same building where the physician's medical practice is located if the service is furnished under the direct supervision of the referring physician or another provider in the same group practice and that the arrangement complies with fair market value (FMV).
• Healthcare providers to give non-monetary compensation to physicians and their families up to the annual limit.
• FMV compensation allows providers to enter into financial relationships with other providers if does not take into account the volume or value of referrals.
• Academic medical centers that meet certain criteria may provide compensation to physicians who are engaged in teaching or research activities.
• Rural providers may be able to enter into certain financial relationships that would otherwise be prohibited under the Stark Law provided certain criteria are met.

Safe harbor provisions that provide exceptions to the Anti-Kickback Statute :

• Investments in entities that provide healthcare services if held for one year, and is not be tied to the volume or value of referrals.
• Office space or equipment rented between providers if the rental amount is consistent with FMV and is for a period of at least one year.
• Personal services and management contracts between healthcare providers if the compensation paid is at FMV and not be tied to the volume or value of referrals.

The key takeaways—you can’t do things that are tied to volume or referrals and any financial arrangement has to be at FMV.

I strongly urge you to discuss Stark and AntiKickback with your healthcare attorney so that you know

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Insurance is one of those things you never want to need or use. But, unfortunately, when life happens having insurance can save you. Some types are pretty obvious but there are some you probably haven’t thought yet. That doesn’t mean you don’t need them. In this episode, I'll tell you the types of insurance your practice needs to mitigate its risks.

• Medical malpractice insurance protects healthcare providers from claims of negligence and medical errors. You want to have a separate policy protecting your practice--not just the individual provider.

• General liability insurance covers your business from claims of property damage or bodily injury that may arise from accidents on your premises.

• Cyber liability insurance provides coverage for data breaches and other cyber threats that could compromise your patients' confidential information.

• Workers' compensation insurance is required by law in most states and provides coverage for your employees in case they are injured on the job.

• Business interruption insurance can provide financial protection if your business is forced to temporarily close due to an unexpected event such as a natural disaster or a pandemic.

• Employment practices liability insurance can protect your business from claims of discrimination, harassment, and wrongful termination brought by employees.

• Business overhead expense disability insurance can cover operating expenses such as rent, utilities, and employee salaries, even if the owner or key employee becomes disabled and unable to work.

Find an insurance professional who can bundle all of the business-related insurances. They can help you assess your needs (the amount of coverage, deductible, etc.) and bundling will give you the lowest cost.

While hopefully you will never need to make a claim against any of your insurance policies, the cost of having the insurance is trivial compared to what it will cost to deal with any of these events without insurance.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Are you afraid of getting audited by insurance companies or Medicare? Do you get anxious when one of the payers sends you a request to audit 5 of your charts? Have you heard horror stories of the Feds knocking on a physician's door? Don't worry--you are not alone.

But not all audits are created equal.

Today David Vaughn joins me to discuss what you need to know about the different types of payer audits. David is both an attorney and certified professional coder and has been my healthcare attorney for 20+ years. David has been instrumental in helping my practice's billing compliance.

Here are some of the topics we discussed during our conversation:

• the difference between a benign audit and the one you should be worried about
• what to do if you get audited
• what your liability is with regard to coding
• the importance of self-audit
• how denials may give you insight into your audit risk
• the difference between federal payers and private payers
• in-network vs. out-of-network audit risks

If you are in private practice you will not want to miss this episode!

More about David Vaughn: David is one of a limited number of healthcare attorneys in the United States who is also a Certified Professional Coder®, certified by the American Academy of Professional Coders® (“AAPC®”).

David has served on the Legal Advisory Board of the AAPC and has written several coding and compliance books and manuals. He is also a national speaker on the legal implications of billing and coding. He also has a national healthcare law practice, and has represented over 2,000 physicians in approximately 40 states in over 10 physician disciplines. His practice consists of representing providers in federal and state prosecutions, qui tam cases, and Medicare and third-party payer audits. He also conducts audits and provides education to providers.

You can reach David at david@lalawfirm.net.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Today I had a great chat with Dr. John Lin about how to think about choosing to be In-Network vs. Out-of-Network. We all know that dealing with health insurance companies can be very frustrating. But reimbursement rates are only a part of what makes dealing with these companies a headache.

Trying to decide whether it makes sense for you and your practice to be In-Network or Out-of-Network has to be an informed calculation rather than an emotional decision. Here are some of the topics we hit on:

• What is the demographics of your practice?
  • Can you "afford" to lose that patient population?
• What percentage of your payor mix does the insurance company make up?
• How much time (% of an FTE) does it take you and your staff to get prior authorizations and payment for this insurance company?

One of the key points of our discussion is that being In-Network or Out-of-Network is not an all or none decision. Both Dr. Lin and I started our practices In-Network with most payors in order to get our practices full. And then, with time and experience, evaluated and re-evaluated each payor and their contracts to decide whether it was beneficial to our practices.

You'll want to listen to our discussion of the decision-making process as you consider these choices for yourself.

Dr. Lin is a private practice urologist in Gilbert, Arizona. He is also an immigrant, operates multiple businesses, is an angel investor, and is a very grateful winner. He is an avid student of efficient practice management and frequently speaks on coding, billing, practice management, and online reputation management.

Urologists from across the U.S. and the U.K. have visited his practice to learn about practice efficiencies.

Dr. Lin consults for numerous physicians who are starting and running successful practices.

He believes in sharing knowledge and paying it forward.

Dr. Lin helps urology practices throughout the U.S. as the host of The Thriving Urology Practice Facebook Group. He runs multiple YouTube channels. You can also find him on all the popular social media channels as @jclinmd.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

You’re a Medicare provider. And you know that the Centers for Medicare and Medicaid Services (CMS) runs Medicare. But did you know that CMS is just the umbrella organization? The actual administration is done by a Medicare Administrative Contractor (MAC.)

What is a MAC?
A MAC is a private health care insurer that’s been awarded a geographic jurisdiction to process claims for Medicare Fee-For-Service beneficiaries.

CMS relies on the network of MACs to serve as the primary operational contact between the Medicare Fee-For-Services program and providers enrolled in the program. Some of the activities the MACs include:

• Processing claims, enrolling providers, handling 1st stage appeals redetermination requests, responding to provider inquiries, educating providers about Medicare billing requirements, reviewing medical records for selected claims and establishing local coverage determinations

One of the functions of each MAC is to establish local coverage determinations (LCD.) An LCD is a determination of whether a particular item or service is going to be covered on a contractor–wide basis.

Before an LCD can be put in place, there's a whole process:

• The Proposed LCD describes the MAC’s proposed determination regarding coverage, non-coverage or limited coverage for a particular item or service. The public announcement begins with the date the proposed LCD is published on the Medicare Coverage Database.
• After the proposed LCD is published, the MAC has to provide a minimum of 45 calendar days for public comment.
• The MAC has to establish a Contractor Advisory Committee to discuss the quality of evidence used to make a determination. You can volunteer to be part of the CAC.
• The MAC holds open meetings to discuss the review of the evidence and the rationale for the proposed LCD.
• Once these steps are completed, the final LCD and the response to comment is published. This marks the beginning of the required notice period of a minimum 45 calendar days before the LCD can take effect.

There is an LCD reconsideration process. As a physician you can request a revision to an LCD—either in its entirety or any provision.

An LCD can definitely throw a wrench into your revenue cycle management if it takes you by surprise. It’s imperative that your bil

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

To start with, make a list of supplies that you everything you need: drugs, syringes, gloves, paper for your exam table, cleaning supplies and more. Include how often you are using these supplies because we’ll need this info to figure out the quantities you need to order.

You’ll want to develop an inventory system will help you track how often you use each item and when you need to reorder.

Before I talk about where to buy supplies—buying for your practice is no different than buying anything else. You need to comparison shop. There is tremendous variability in pricing.

You can buy from individual vendors. Create an excel spreadsheet –put the item name in each row and the vendor in the column so that you can compare prices of vendors. You will also want to consider buying from a General Purchasing Organization (GPO).

How do GPOs source and negotiate prices for products and services?

GPOs help source and negotiate prices for drugs, medical devices, and other products and services for healthcare providers. GPOs don’t take own or take possession of the product. They are the middlemen.

If GPOs are middlemen, how do they save healthcare providers money?

It is simply an economy of scale issue. It takes time and effort fr a supplier to negotiate a price for every item it sells with every healthcare provider that wants to purchase that item. GPOs can decrease costs by lowering transaction costs and prices through joint negotiation.

How much can I save with a GPO?
GPOs can save providers 10% to 18%.

How else can a GPO benefit me?
As a small private practice, you may discover that it is difficult to obtain certain products at the scale you need them. Joining a GPO can help you procure the product because they have a steady inventory and a lower per unit cost on each order.

GPOs pre-screen vendors to reduce the risk of working with a problematic supplier. GPOs also has access to more member reviews. You can save time and manpower because your staff doesn’t have to screen each vendor for every purchase.

How to choose a GPO?
You will need to vet any GPO that you want to join. Start by asking other medical practices that you know. There are many large national, regional and local GPOs. Combine that with the ability to join multiple GPOs, easily

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Here are some strategies that can help keep you on schedule.

• Get to clinic before your first scheduled patient. Preferably you get to clinic early. If you show up at 8 am, your first patient is at 8am and then you first need put out whatever this morning’s fire is, you start the day off behind and you will be all day long. The other advantage to getting in early is to huddle with your MA so that you have a game plan for potential bottlenecks.
• Create a block schedule. Train your scheduler the rules of the block schedule.
• Communicate scheduling issues with your scheduler. If you have a patient that always takes more time, schedule them in a longer slot.
• Don't routinely double book. If it takes you 15 min to see a follow-up and you put 2 patients in every 15 min slot you will invariably run behind.
• There will be times that you have to double-book. Have a code so you don't double book one of those patients that always takes longer.
• When you enter the room, set an agenda by greeting the patient, and asking them what they are here for today. The better you define and manage the expectations of the visit, the greater the patient satisfaction.
• Set the timer on your phone. The vibrating phone is a gentle reminder that time is up.
• Have a plan with your MA-instant message, a knock on the door, a "call."
• Do your absolute best to not answer calls in the middle of clinic. Use HIPAA compliant email and text messaging for quick questions. If you must talk on the phone, set up a time—before patients, after patients or as a scheduled appointment.
• Have information about diseases and procedures ready to print during the visit. Discussing the patient handout(s) and then handing it to the patient at discharge with improve patient comprehension, decrease phone calls to your office and improve patient satisfaction and outcomes.
• Most EMRs have instant messaging. If yours doesn’t, install a HIPAA compliant instant messaging application. We all know how questions, unplanned tests and procedures can disrupt your otherwise perfectly flowing day. With instant messaging you can be in an EMR chart and have a separate window open for instant messages to communicate with your staff without leaving the room.
• Create a list of supplies that every exam room should be stocked with.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!