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!

In 2015, the Centers for Medicare & Medicaid Services (CMS) introduced Chronic Care Management (known as CCM) with the intent of improving the care of patients with chronic conditions. CCM offers physicians an opportunity to be compensated for the work that they were doing between office visits including but of course, not limited to calls, education, coordination, and pre-authorizations. In 2020, CMS rolled out Principal Care Management (PCM).

What is Chronic Care Management?
CMS defines CCM as care coordination services done outside of the regular office visit for patients with two or more chronic conditions that are expected to last at least 12 months or until the death of the patient. In addition, these conditions need to place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

You can bill for CCM when a physician or qualified health care professional directs your staff to spend at least 20 minutes of non-face-to-face clinical time treating the patient per calendar month.

CMS distinguishes between complex and non-complex care. The key differences between them are the:

• Amount of clinical staff service time provided
• The Involvement and work of the billing practitioner
• And The extent of care planning performed

Wondering how much you can increase your revenue by?

Currently CMS reimburses $42.00 for providing a minimum of 20 minutes of CCM per patient per month. Provide 60 minutes of CCM per patient per month and your practice will get $117.60. Let’s say you have a practice with100 CCM patients you could earn an additional $4,200-$11,760 per month for work you are likely doing anyway.

What is Principal Care Management (PCM)?

PCM is similar to CCM because both services are intended for patients requiring ongoing clinical monitoring and care coordination. One of the key differences, however, is that PCM only requires patients to have one complex chronic condition.

There are 6 criteria for PCM:

• The condition is expected to last at least three months.
• The condition places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death.
• The condition requires the development, monitoring, or revision of a diseas

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!

Owning a private medical practice is a journey. Initially, you're focused on how to get the practice up and running. The next phase is how to best run the practice. Over time, you transition to how to grow and leverage the practice. And, at some point, you will want to leave the practice that you started.

Having a roadmap definitely makes the journey easier. That's where having a business plan helps. One of the key considerations, from the start, needs to be "what does my exit look like." Now I totally understand that this may be difficult to envision but many of your decisions will depend on where you want to head.

You wouldn't get in the car without knowing where you are going.

In today's episode, I speak with Eric Miller of Econologic Financial Advisors about the five most common options for exiting a private practice.

• Die with your boots on
• Just close your doors and turn off the lights
• Bring on partner physicians and selling them shares of the practice
• Sell the practice to private equity or other corporate entity
• Sell the practice to a hospital system

It's exceedingly unlikely that you want to die while still owning/running your practice. If you simply turn off the lights then you don't get any sale price for having built this successful business. And, for most of us, it's unlikely that one or more of your children will join you.

Realistically, that leaves the last 3 options. Given that, how do you maximize your practice's EBITDA so that you get the biggest return on your investment? Because your practice is an investment.

There is no "right" answer for what your exit strategy should be. You need to educate yourself and understand the pros and cons of each option. Set yourself up from the start to have multiple options by having a well-defined operating agreement that spells out buy-in/buy-out, drag along rights, decision making, partnership and more. Understand what's need to sell your practice to others including partner physicians, physicians (not already in your practice) or corporate entity.

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!

Employees often ask about taking leave through the Family Medical Leave Act, otherwise known as FMLA. As the employer, like when you own your own practice, you need to understand FMLA and everything that goes along with it.

FMLA allows employees to take an unpaid leave of absence for up to 12 weeks for medical reasons or family reasons. The first thing I want to point out is that FMLA is only applicable to employers who have 50 or more employees working at least 20 hours per week to comply with FMLA. Employees who have worked at a company for at least 1,250 hours during a 12-month period are eligible for FMLA.

Realistically, many smaller medical practices aren’t legally required to provide their employees with FMLA. It'a very likely that your employees will think they’re entitled to FMLA regardless of the size of your practice. This is why you need to have clear cut policies about leave and what your practice offers if you are not obligated by law to offer FMLA.

1. Develop comprehensive policies

• Have a written policy that defines what type and amount of unpaid leave you will be offering
• The policy needs to apply to all employees
• Include the policy in your employee handbook

2. Define the 12-month period in which the employee can access it

3. Determine the parameters of your policy

• Will you require your employee to exhaust all of their paid-time-off benefits before accessing unpaid leave?
• Or can the employee choose whether to use PTO or unpaid leave? Now you may be thinking why would any employee want to take unpaid leave if they can get paid?

The whole reason is all of this is important is that you are trying to run a business. In order for your practice to run efficiently, you need to understand your staffing requirements. You need to think about how long you realistically can hold a job for someone who is out. And, of course, how you are going to staff their position during their absence. Having a well-defined policy will help prevent misunderstandings.

One of the most difficult situations though, is when, near the end of their leave, the employee requests that they need a different schedule. Under FMLA, the law states that you only have to guarantee that the employee has the same position to return to, or a similar position

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!

We send and receive email every day so it would seem natural to send emails to your patients. But what if the emails contain protected health information? How do you make email HIPAA compliant?

How you will use email with protected health information

The first questions to ask are, “Is my email network is behind a firewall?” Are you only emailing protected health information between you and your staff within the confines of the firewall? If you answer yes to both questions, then you don’t need to encrypt your emails. But, you do need access controls for email accounts so that only those individuals who are authorized have access to protected health information.

On the other hand, if you intend to use email to send protected health information externally, you are responsible for protecting the protected health information—in other words, making it HIPAA compliant. Encryption is the key to making your email HIPAA-compliant but it’s not that simple. Many email service providers that offer an encrypted email service are not HIPAA compliant because they do not incorporate all the necessary safeguards to meet the requirements of the HIPAA Privacy and Security Rules.

Here are some of the things you will want to consider to make your email is HIPAA compliant

• Ensure you have end-to-end encryption for email
• Enter into a HIPAA-compliant business associate agreement with your email provider
• The most important step—Develop policies on the use of email and train your staff
• Emails containing PHI need to be retained for 6 years
• Secure, encrypted email archiving saves storage space and is indexed making its easier to search
• Obtain consent from patients before communicating with them by email

HIPAA email compliance should be included in your compliance plan. You don’t want something we all do every day—send and receive emails to get you into HIPAA trouble. If you are unsure of the requirements of HIPAA compliant speak with a healthcare attorney that specializes in HIPAA to advise you of your responsibilities and the requirements of HIPAA with respect to email.

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!

In this episode, I had the pleasure of chatting with Wendy Margolin who owns Sparkr Marketing and is the founder of The Clinician’s Social Media Club. I asked Wendy to join me to discuss where social media fits into the private practice physician's business plan. Here are some of the topics we discussed:

• How to choose which social media channel(s) should you choose
• What content should you post
• How to get your posts seen
• Should you spend money on ads (and how much)
• Your personal FB profile vs. your practice's business page
• How to use your practice's FB page to engage with your community
• How to monitor whether your SM posts are working for you.

One of the key points we discussed was using your personal FB profile to share your business info. Unfortunately, your FB business page is much more likely to get folks that are already interested in hearing from you. So how do you connect with others? You can use your personal FB profile. But--how do you separate your posts about the info you want to share about your practice and your truly personal info? You can divide your FB contacts into FB audiences. Here’s a link to how to divide Facebook audiences.

My take-home message to you about social media: It's a top in your tool chest. Even if a new patient doesn't find you on social media, they probably checked out your website and FB page.

Click here if you'd like to know more about Wendy Margolin's The Clinician’s Social Media Club for monthly fill-in-the-blank social media captions and customizable Canva templates.

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!