Welcome to Cornerstone Healthcare Consulting & Management

Blog

Streamline Your Practice with Expert Medical Billing Consulting

by

Streamline Your Practice with Expert Medical Billing Consulting

Running a medical practice is no small feat. Between patient care, administrative duties, and staying compliant with ever-changing regulations, managing the intricacies of medical billing can often feel like navigating a labyrinth. Ensuring your billing process is both efficient and accurate is crucial to the financial health of your practice. That’s where we come in.

Why Medical Billing Consulting Matters

Medical billing is more than just invoicing; it is the backbone of your practice’s revenue cycle. Even minor errors can lead to significant financial losses, delayed payments, and compliance issues. Our unique service of medical billing consulting is designed to help healthcare providers and practices like yours identify inefficiencies and optimize billing processes, ensuring you can focus on what you do best—providing exceptional patient care.

Identifying Issues and Optimizing Your Billing Process

Is your medical practice facing persistent billing challenges? Are you uncertain if your current billing processes are optimized for maximum efficiency and accuracy? Our consulting services aim to address these concerns head-on.

Comprehensive Billing Review

Our team will conduct an in-depth review of your current billing procedures, identifying any issues or areas for improvement. We scrutinize everything from coding accuracy to claims submission, denial management, and compliance with industry standards.

Customized Solutions

Every medical practice is unique, and so are its billing needs. After a thorough assessment, we offer tailored recommendations designed to enhance your billing operations. Whether it’s streamlining workflows, implementing new software solutions, or improving staff training, we provide actionable insights that align with your practice’s specific requirements.

Working Alongside Your Current Billing Team

We understand that the continuity of your billing process is essential to maintaining cash flow and patient satisfaction. That’s why our consultants work alongside your existing billing team, providing support and guidance without disrupting ongoing operations.

Collaborative Approach

Our goal is to collaborate with your team, sharing our expertise while respecting their knowledge and experience. Together, we can implement best practices, troubleshoot issues, and foster a culture of continuous improvement.

On-Going Support

Our commitment to your success doesn’t have to end with the initial consultation. We can offer ongoing support to ensure that the changes we implement are effective and sustainable. This can includes periodic reviews, performance monitoring, and access to our consultants for any questions or concerns that may arise.

Beyond Consulting: Hiring and Transition Support

In some cases, our assessment may reveal the need for additional or new billing staff. Whether you require assistance with hiring a new billing team or wish to explore our outsourcing options, we are here to help.

Recruitment Assistance

Finding skilled medical billing professionals can be challenging. We leverage our extensive network and industry expertise to help you recruit qualified candidates who are a perfect fit for your practice.

Seamless Transitions

If you decide to transition to our billing services, we ensure a seamless handover, minimizing disruptions and maintaining continuity. Our team will handle the entire onboarding process, from training new staff to integrating with your existing systems.

The Benefits of Partnering with Us

When you choose our medical billing consulting services, you’re not just getting an advisor; you’re gaining a partner dedicated to the success of your practice. Here are some of the key benefits:

  • Increased Revenue: By optimizing your billing processes, we help you capture every dollar you’re entitled to, reducing denials and improving collections.
  • Enhanced Efficiency: Streamlined workflows and best practices mean your staff can focus on patient care rather than administrative headaches.
  • Compliance Assurance: Stay up-to-date with the latest regulations and avoid costly compliance issues.
  • Peace of Mind: With expert support and ongoing guidance, you can rest easy knowing your billing operations are in good hands.

Take the Next Step Towards a Healthier Practice

Don’t let billing challenges hinder your practice’s growth and efficiency. Our medical billing consulting services are designed to empower healthcare providers and medical practices with the tools and knowledge they need to thrive.

Ready to optimize your billing process and enhance your practice’s financial health? Contact us today to schedule a consultation and discover how our expert team can help you achieve your goals.

Independence in Medicine: A Case for Private Practice

by

Independence in Medicine a Case for Private Practice

In the evolving landscape of healthcare, the debate between the efficiency and effectiveness of privately owned medical practices versus health system-owned practices has become more relevant than ever. While each model presents its own set of advantages, it is the former—privately owned practices—that truly embody the essence of patient-centered care and the spirit of medical independence.

The allure of large health systems, with their sprawling networks and comprehensive services, is undeniable. However, beneath the surface of these healthcare behemoths lies a complex bureaucracy that often dilutes the patient-physician relationship and stifles the autonomy of medical professionals. In contrast, privately owned practices offer a beacon of independence and personalized care, shining brightly in an industry increasingly dominated by consolidation.

Personalized Care at Its Best

At the heart of privately owned practices is the unwavering commitment to personalized care. These practices thrive on the close-knit relationships developed between patients and physicians, fostering an environment where care is not just a service but a partnership. In these settings, patients are not mere numbers in a system; they are individuals with unique stories, concerns, and health goals. This personal approach ensures that treatment plans are not only tailored to the specific needs of each patient but are also delivered with a level of compassion and understanding that is often lost in larger health system settings.

The Autonomy to Innovate and Adapt

Independence in medicine is not just about the freedom to provide care in a personalized manner; it is also about the ability to innovate and adapt swiftly to the changing healthcare landscape. Privately owned practices operate with a level of agility that is seldom found in their health system-owned counterparts. Without the burden of navigating through layers of bureaucracy, these practices can quickly implement new technologies, adapt to emerging health trends, and refine operational processes to enhance patient care and satisfaction.

Furthermore, this autonomy empowers physicians to make clinical decisions that are in the best interest of their patients, free from the influence of external pressures that often accompany health system affiliations. This independence is crucial for preserving the integrity of medical practice and ensuring that patient welfare remains the paramount concern.

Cultivating Community and Continuity

Privately owned practices are not just healthcare providers; they are integral members of their communities. By serving a more localized patient base, these practices cultivate a sense of community and belonging, contributing to the overall well-being of the areas they serve. This community-focused approach also facilitates continuity of care, enabling physicians to follow their patients through various stages of life and health challenges. Such continuity is essential for creating comprehensive health histories that can inform better healthcare outcomes.

A Sustainable Model for the Future

Critics of privately owned practices often cite financial sustainability as a concern, especially in an era where healthcare costs are rising, and regulatory demands are increasing. However, the resilience and adaptability demonstrated by these practices, even amidst the challenges posed by the COVID-19 pandemic, underscore their potential for sustainable operation. Through innovative care models, such as direct primary care, and leveraging technology to optimize efficiency, privately owned practices are charting a path toward a sustainable future in healthcare.

In conclusion, while the healthcare industry continues to grapple with the challenges of providing high-quality, accessible care, the case for privately owned practices remains compelling. Their commitment to personalized care, autonomy in clinical decision-making, community involvement, and adaptability not only positions them as a preferable choice for patients but also as a vital model for preserving the essence of independent medicine. As we look toward the future of healthcare, it is imperative that we support and champion the role of privately owned practices in maintaining the health and well-being of our communities.

Considering starting your own private medical practice? Let us assist you. Reach out to us today to begin your journey.

To Start or Not to Start: A Doctor’s Dilemma in the Healthcare Labyrinth

by

To Start or Not to Start: A Doctor’s Dilemma in the Healthcare Labyrinth

The labyrinth of healthcare can be a maze of frustration for many physicians. There comes a point in the career of some doctors where the systemic constraints, bureaucracy, and sometimes even ethical quandaries of institutional medicine prompt a serious question: should I start my own medical practice? It’s not just about pursuing the dream of independence; it’s a vision of healthcare that aligns with the Hippocratic Oath, the doctor’s conscience, and the community’s health needs. In this blog post, we’ll explore the considerations that doctors must assess when contemplating the leap into entrepreneurship and the potential pathways to success.

1. The Call for Change

The genesis of considering private practice often emerges from deep-seated dissatisfaction with the status quo of healthcare. Policies affecting physician autonomy, reduced face-time with patients due to administrative tasks, and the increasing pressure to ‘do more with less’ are common grievances that lead some physicians to take a stand or seek alternative paths.

The Current State of Healthcare

  • Assessing the challenges within the existing healthcare system such as insurance complexities, high overhead, and cumbersome EHR systems.
  • Understanding the impact of regulatory burdens on clinical decision-making and patient care.

The Power of Dissatisfaction

  • Reflecting on the aspects of institutional medicine that no longer align with personal or professional values.
  • Sharing anecdotes of when red tape impeded the provision of timely treatment and care to patients.

2. Counting the Cost

Starting a medical practice is not just a professional decision; it is a financial and personal commitment that requires deep reflection on the trade-offs involved. From patient load and potential earnings to work-life balance and risk mitigation, preparing a thorough assessment of these costs is critical.

Financial Feasibility

  • Breaking down the set-up costs of a new medical practice, including real estate, equipment, and staff.
  • Discussing the complexities of billing, insurance, and overhead in a private practice model.

Return on Independence

  • Weighing the potential benefits of increased control over patient care, practice management, and earnings.
  • Delving into the potential for broader impact on patient health and community wellness through an independent practice.

3. The Entrepreneurial Mindset

Transitioning from a purely clinical role to the multifaceted one of a physician-entrepreneur requires a shift in mindset. It demands a willingness to engage with business concepts, from marketing and finance to legal and HR considerations.

Preparing to be a Business Owner

  • Evaluating the need for a business advisor/consultant.
  • Recognizing the importance of branding, marketing, and patient experience in a private practice.

Putting Patients First

  • Discussing strategies for maintaining a patient-centric focus in a private practice environment.
  • Exploring the potential for more innovative and personalized care delivery models in an independent setting.

4. Overcoming Adversity

The entrepreneurial path is rarely without its hardships, and for physicians starting a private practice, this journey can be particularly fraught. Navigating regulatory hurdles, dealing with unexpected challenges, and weathering the uncertainties of self-employment are all part of the process.

Regulatory Resilience

  • Gaining insight on how to stay informed and compliant with the myriad of healthcare laws and regulations.
  • Understanding the importance of building a strong network of legal and financial advisors.

Acknowledging Risk

  • Exploring risk management strategies and the role of insurance in a private medical practice.
  • Addressing the fear of failure and the psychological toll it can take on a physician-entrepreneur.

5. Community and Collaboration

Building a successful medical practice doesn’t happen in isolation. Engaging with the community and forming partnerships with other healthcare providers can multiply the impact and reach of a new practice.

Strengthening Ties

  • Fostering relationships with local community organizations, patient advocacy groups, and other healthcare professionals.
  • Exploring collaborative care models and the benefits of a multidisciplinary approach in private practice.

Leveraging Technology

  • Harnessing the power of digital health solutions to enhance patient engagement, streamline operations, and improve outcomes.
  • Discussing the opportunities presented by telemedicine and other virtual care platforms in a modern medical practice.

6. Ethical Considerations

The prospect of starting a private practice raises ethical questions for many physicians. How can one maintain ethical practice in a for-profit environment? How can patient trust be preserved in the face of financial interests?

The Hippocratic Ethos

  • Revisiting the Hippocratic Oath and its relevance to contemporary medical entrepreneurship.
  • Developing a clear set of ethical principles to guide decision-making in a private practice.

Transparency and Trust

  • Establishing clear communication with patients about the financial aspects of their care.
  • Exploring pricing models that foster transparency and trust, such as direct primary care or concierge medicine.

7. The Path to Patient-Centered Care

Ultimately, the decision to start a private practice should be driven by a commitment to delivering the highest standard of patient care. This section will explore how an independent model can offer more opportunities to put the patient at the center of the healthcare experience.

Reducing Administrative Burdens

  • Implementing systems and processes that minimize paperwork and maximize face-time with patients.
  • Examining the potential for increased patient comfort and satisfaction in a private, unencumbered practice environment.

Innovating for Better Outcomes

  • Highlighting the role of innovation in addressing patient needs and improving health outcomes.
  • Reviewing examples of successful private practices that have introduced novel care delivery methods or treatment options.

8. Learning from Experience

The best way to prepare for the challenges and opportunities that come with starting a private practice is to learn from those who have gone before.

Case Studies

  • Talking with physicians who have transitioned to private practice and the lessons they’ve learned.
  • Learning about the variety of practice types, including small independent clinics, specialty centers, and concierge services.

Mentorship and Networking

  • Understanding the value of mentorship and the power of professional networks in the entrepreneurial process.
  • Seek out and learn from the experiences of established physician-entrepreneurs.

9. The Future of Independent Medicine

Looking ahead, what does the future hold for independent medical practices? How can they thrive in an ever-evolving healthcare landscape? Anticipating future trends and preparing to adapt will be crucial for the longevity of any practice.

Predicting Healthcare Trends

  • Discussing the potential impact of policy changes, technological advancements, and shifts in patient expectations on independent practices.
  • Identifying emerging areas of opportunity, such as personalized medicine or holistic approaches to health.

Sustainability and Growth

  • Reviewing strategies for sustainable growth in a private practice, including expansion, succession planning, and development of ancillary services.
  • Considering the potential for independent practices to lead in areas of healthcare innovation.

10. Making the Decision

Finally, we circle back to the pivotal question: should you start your own practice? Armed with the insights and perspectives covered in this blog post, you’ll be better equipped to weigh the pros and cons, understand the challenges, and envision the benefits of such a venture.

The Personal Reflection

  • Conduct a deep self-assessment and consider your motivations, values, and aspirations.
  • Possess a decision-making framework that takes into account professional, financial, and personal factors.

Taking the Plunge

  • Review a step-by-step guide to the process of starting a medical practice, from business planning to patient outreach.
  • Addressing common fears and doubts.

Starting a medical practice is not a decision to be taken lightly. It requires vision, courage, and a commitment to the highest ideals of medicine. By engaging with the considerations outlined in this blog post and learning from the experiences of others, physicians can chart a course that leads not only to professional fulfillment but also to positive change in healthcare delivery.

Considering taking the leap but require assistance? We’re here to help! As your medical practice startup consultants, we offer comprehensive turnkey solutions. Eager to begin? Reach out to us for a complimentary consultation today!

How to Open a Medical Practice

by

Starting your own medical practice can be an exciting and rewarding endeavor, but it also requires careful planning and execution. Here are a few things to consider in order to successfully open a medical practice:

1. Setup Legal Entity

Each state has their own laws on what is required with respect to the type of legal entity required for a medical practice. Additionally, these laws also specify who can legally own a practice.

2. Choose a Location

Select a convenient and accessible location for your practice. Consider factors like demographics, competition, zoning laws, and the availability of necessary infrastructure and resources, as well as whether you intend to own or lease the space.

3. Complete Payor Credentialing

Research what the insurance companies require for credentialing. Complete and submit required applications well in advance of opening. Approval can take up to 6 months!

4. Set Up Your Finances

Determine your startup costs, secure funding through investors or loans, and establish business banking and accounting systems. Ensure you have adequate insurance coverage as well.

5. Hire and Train Your Team

Recruit qualified medical and administrative staff to support the day-to-day operations of your practice. Provide comprehensive training to ensure a smooth patient experience.

6. Invest in the Right Equipment and Technology

Equip your practice with the necessary medical equipment, supplies, and technology to deliver high-quality care and streamline your operations.

7. Develop Policies and Procedures

Establish clear policies and procedures for patient intake, appointment scheduling, billing, record-keeping, and other essential functions.

8. Market Your Practice

Develop a comprehensive marketing plan to attract new patients and build your brand. This may include a website, social media presence, local advertising, and community outreach.

  1. Choose an EMR and Billing System. Implement a billing system to ensure that you can accurately bill patients and insurance companies for your services. This may involve hiring a billing specialist or using a third-party billing service. Choose an EMR that is right for you.

10. Continuously Improve and Adapt

Monitor your practice’s performance, gather patient feedback, and make adjustments as needed to optimize your operations and better serve your patients.

Opening a medical practice requires a significant investment of time, effort, and resources, but with careful planning and execution, you can build a thriving and successful healthcare business.

Does it feel a bit overwhelming? Looking for a startup medical practice consultant? We provide a turnkey solution for all your startup needs. Having experience opening multiple practices across various states and specialties, let us help you! We have established relationships with each of the vendors needed above.

Need help after opening? We can assist with that, too! Whether you need us to manage the entire back-office or just provide medical billing, we can help!

Interested in learning more? On our website, you can schedule a FREE consultation. We look forward to hearing from you!

How to Open a Medical Practice

What is Direct Primary Care?

by

In recent years, there has been a growing interest in alternative healthcare models that prioritize patient-centered care and direct access to healthcare providers. One such model gaining popularity is Direct Primary Care (DPC). In this blog post, we will explore what DPC is, how it differs from traditional healthcare, and the benefits it offers to patients.

Understanding Direct Primary Care

Direct Primary Care is a healthcare model that focuses on the relationship between the patient and their primary care physician. With DPC, patients pay a monthly membership fee directly to their physician, bypassing the traditional fee-for-service model that involves insurance companies.

DPC physicians typically limit their patient panels to a few hundred, allowing for more personalized care and longer appointment times. Patients are encouraged to have a continuous and ongoing relationship with their DPC physician, who becomes their primary source of medical care. This model is especially beneficial for individuals with chronic conditions or complex healthcare needs.

How Direct Primary Care Differs from Traditional Healthcare?

Membership-based: Unlike traditional healthcare, where patients rely on insurance to cover their medical expenses, DPC operates on a membership-based system. Patients pay a set monthly fee directly to their DPC physician, who provides unlimited primary care services without additional charges.

Enhanced Access: DPC promotes easy and direct access to healthcare providers. Patients can schedule longer appointments, consult with their DPC physician via phone or email, and even receive same-day or next-day appointments. This accessibility eliminates the need for unnecessary emergency room visits and improves overall patient satisfaction.

Transparent Pricing: DPC offers transparent pricing, with no surprise bills or hidden fees. Patients are aware of the monthly fee upfront, giving them the freedom to budget for their medical care without worrying about deductibles, copays, or coinsurance typically associated with insurance-based healthcare.

Comprehensive Care: DPC physicians focus on providing comprehensive primary care services. They emphasize preventive care, screenings, and patient education to promote overall wellness. Additionally, DPC physicians have more time to spend with patients, enabling them to address concerns comprehensively and create personalized treatment plans.

Benefits of Direct Primary Care

Cost-Effective: DPC can be a cost-effective alternative to traditional healthcare, especially for individuals without comprehensive insurance coverage. The fixed monthly fee often covers routine check-ups, preventive care, and basic lab tests, reducing out-of-pocket expenses for patients.

Patient-Centered Care: DPC allows for a more personalized and patient-centered approach to healthcare. Longer appointment times and direct access to healthcare providers foster stronger relationships and enable physicians to truly know and understand their patients’ individual healthcare needs.

Reduced Administrative Burden: DPC physicians can focus more on patient care rather than administrative tasks. Without the complexities of insurance billing and extensive paperwork, DPC physicians can spend more time with patients, resulting in higher-quality care and improved patient outcomes.

Enhanced Preventive Care: With the increased availability of appointments and longer consultations, DPC physicians have more opportunities to focus on preventive care and early intervention. This approach promotes better health outcomes and reduces the likelihood of costly, avoidable medical complications.

Is Direct Primary Care Right for You?

Direct Primary Care offers a refreshing alternative to the traditional insurance-based healthcare model. It prioritizes patient-provider relationships, accessibility, and affordability. However, it may not be suitable for everyone.

At Cornerstone, we have clients who have chosen the DPC model and love it! Our blog page a couple interviews with DPC clients, detailing their experiences. Click here to check them out!

Interested in exploring a practice model that works for you? Contact us to schedule a consultation today!

What is Direct Primary Care?

First Direct Primary Care Practice in Rochester, NY!

by

Missy Starowitz, owner of Cornerstone Healthcare Consulting, interviews Dr. Laura Petrescu of Athena Direct Primary Care & Lifestyle Medicine, the first Direct Primary Care (DPC) practice in Rochester, NY! Click on the video below to watch!

Whether you’re a small business owner, a physician in Residency training or someone seeking a new primary care physician, this video is for you. Tune in as Dr. Petrescu answers the following questions:

1.) Tell us about Athena DPC & Lifestyle Medicine

 2.) What is DPC? How is it different from concierge medicine?

3.) What is lifestyle medicine?

4.) What made you decide to open your own practice, using the DPC model?

5.) Are there ways for Athena DPC to work with small businesses?  

Interested to be patient of Dr. Petrescu? Check out her website at athenadirectcare.com where you can also schedule an appointment. Or give the practice a call at 585-662-5510

About Cornerstone Healthcare Consulting & Management: Cornerstone Healthcare Consulting provides multiple consulting services to physicians and medical practices. To learn more or schedule your free consultation, please visit their website at http://www.cornerstonehealthcareconsulting.com

Follow Cornerstone on social media: Instagram: @healthcarecornerstone

Linkedin: https://www. www.linkedin.com/company/cornerstonehealthcareconsulting

Facebook: https://www.facebook.com/cornerstonehealthcareconsulting

First Direct Primary Care Practice in Rochester, NY