1. Be sure to charge the same amount for each procedure, regardless of what insurance the patient has.

2. Be sure you are charging your patients their co-payments. If you would like to waive their copay due to financial hardship, be sure the correct paperwork is completed.

3. Do not schedule unnecessary visits.

4. Do not accept kickbacks for referrals.

5. Have a compliance manual in place, and ensure your office staff is properly trained to utilize it.

At present, the law states that any person who commits any form of fraud will be fined or imprisoned for no less than 5 years, or both! You must pay attention to detail and be aware of what is going on in your office at all times. Even if the error is “your biller’s mistake”, guess who pays the price?You! These fines are not cheap…Typically they are equal to the amount of the claim, plus up to $250,000.00 for the felony. Definitely not pocket change!

For Unpaid College Loans, Feds Dock Social Security
http://www.smartmoney.com/borrow/student-loans/grandmas-new-financial-problem-college-debt-1344292084111/#article_tab_article
It’s no secret that falling behind on student loan payments can squash a borrower’s hopes of building savings, buying a home or even finding work. Now, thousands of retirees are learning that defaulting on student-debt can threaten something that used to be untouchable: their Social Security benefits.
The government’s withholding power also extends to Social Security disability benefits. Tammy Brown of Redding, Calif. says that the government has been taking $179 out of her Social Security disability check each month for the past five years. Brown, 52, became disabled in 1986 after being involved in a car accident. Unable to work, she fell behind on her student loan payments. She says the Social Security check is now too small to cover her food and medical bills, so she quit taking prescription pain pills. “It’s kind of hard to live on this amount of money,” she says.
FROM THE READER COMMENTS:
Posted by VINNYNY.
“BOO, HOO, HOO!…
As a mortgage banker after graduation, I had dozens of clients who did not qualify for mortgages because they had defaulted on student loans. The absolute worst offenders weredoctors and lawyers. In fact, I stopped taking applications from doctors because virtually all had bad education debts.”

Dave’s Comments;
Of course, the mature and responsible thing for everyone to do is to repay one’s debts, preferably on time and in full. Then again, sometimes “life happens” and adjustments have to be made… sometimes in the timing (and even the certainty of timing,) and sometimes ultimately in partial or complete default… sometimes leading to derogatory credit or bankruptcy. The most critical thing every person must do is manage their economics to remain self-sufficient and survive.

Its easily arguable in favor of the government (as lender) garnishing wages (social security) as the income payor… but there is a more critical point here.

When a person takes out a credit card loan, both the lender and borrower understand that the loan is unsecured, and that any delay or default is at the lender’s risks… and the loans are subsequently priced in rates & fee for those risks, plus the lenders cautiously measure how much credit they offer.

When a person takes out a real estate mortgage, both the lender and the borrower understand that the outstanding balance is collateralized by the value of the real estate itself… and in some instances *ONLY* the value of the real estate can be used to offset any delay or default costs to the lender (so if the value ends up less than the outstanding loan balance, in some cases that unsecured balance is again at the lender’s full risk.) This reduction of risks is priced into the rates & fees & terms as well. MORE IMPORTANTLY, this allows a smart and responsible borrower to SEGREGATE RISKS… like a large ship tanker with compartmentalization so that the ship can take a direct torpedo hit, and still proceed without sinking.

MANY federal student loan borrowers were probably unaware that although their student loans were unsecured, the lender (the government) still reserved garnishment rights against their future social security income and disability benefits. Being unaware is no excuse, and earns no sympathy…

However social security benefits are commonly expected to be “last resort safety net” benefits, not any kind of luxury lifestyle supplementation therefore easily tapped for repayment of student loans. There is something that seems viscerally sinister in the idea of a lender squeezing out repayments from someone’s ‘last resort’ sustenance income source.

ULTIMATE MORAL OF THE STORY: Risk Compartmentalization!
Better to never put yourself in the position of relying on *anything* from government benefits… but if you are given no choice (such as a career in a position where paying into the social security system is mandatory,) then be fully aware that the government can determine in the future, for whatever reason convenient at the time, that you owe them money. In this particular story case, the “balance owed” is obvious and “bright line” in student loans… but I think its safe to realize that politicians can be ruthless when the system is financially starving, and every asset they have access to is vulnerable, in order of their ease of access.

The most obviously and immediately vulnerable are accumulated payout benefits, as described above. The close second most vulnerable are the so-called “qualified plans” (401k/403b/TSP plans, IRAs, ROTHs, etc.)

Everything has its own measures of risks… and a previously under-recognized risk is now making itself known; Government economic desperation strong enough to break the sanctity of last-resort social safety nets.

Build your safety nets beyond the risks of liens & garnishments, whenever possible.

Dave Donhoff

The 30 FRM mortgage is currently available at par (no discount points) at 3.0% on the nose.

This is unlikely to remain in place very long… maybe a few months…..

BUT STILL… important to be aware of.

The intelligent and applied use of technology through Social Media can give a Customer the experience of very Personalized Care.  This includes things like Emails that remind people of things to do between visits.  Or Text’s that confirm a prescription has been sent or is ready at their pharmacy.

Tools that communicate and help people get what they need or want are very useful and changing constantly.

Your Staff Members can write Blogs on agreed topics, they can talk to Customers about topics that Customers might find helpful or useful.  Your staff can recognize bad reviews and ask Customers to post Reviews with Google or Yelp when they are happy.

You probably can’t avoid negative reviews, but when you have 10 – 15 positive Reviews for each negative one – it keeps things in perspective for most people.

Your Staff can talk to your Customers while they are waiting and find out if they have visited your website or seen the latest Blog on a particular area of interest.

Most Staff members use some form of Social Media already.  They might currently have a presence on FaceBook or may use Twitter to give and receive sound bites associated with their lives. They might share photos on Flickr.com or listen to music through Pandora.

Social Media is more prevalent than people realize and the best possible use of it for the Practice is to move the older “tell people what they need to know” and trade it in for a Dialogue of back and forth conversation.

People do business with people they like and trust.  Social Media and Social Marketing can dramatically increase your geographic reach as well as your demographic reach.  Your Staff is part of this and with good guidance, can be a major force in helping you grow (or slow) the Practice.

Relationships, Customer Conversations, Business Intelligence are constantly evolving topics that have a material effect on the overall health, performance potential and well-being of the Practice.

Above all, expressing your appreciation to your Staff and to your Customers for helping is something that everyone enjoys.

Sometimes in a conference, I will ask the question “Who here is feeling over appreciated in their lives or their work?”

The next sound I most often hear is laughter at the absurdity of that.

And then I ask people what it feels like to be genuinely appreciated and arm them to take that to others in their Practices and their lives.

More Later

A number of factors including Obama-Care, the 2014 changes, the economy and the current forecast are bringing major changes to the model.

The primary job of the Physician is to make sure that the Practice/Business performs to its full potential and produces sufficient results to justify staying open.

With all the changes, this has simply gotten harder.  So the idea of changing the relationship dynamics  to a Dialogue where information and performance expectations are explored, developed and shared becomes a way to proactively “own” your market.  What this really means is that if you look at what Matters to the people who can come see you, then you have a basis of offering things that are meaningful and compelling to them.

You can be proactive here and focus on the process of Setting and Managing Expectations as well as destroying unrealistic expectations and demands.

Here is an example: As a Patient I have experienced endless waiting to see a Physician at times and I have the feeling that I am just herded based on the convenience of the Practice. It is annoying, frustrating and the world I live in, I am penalized for not being on time or keeping my appointments.  Very often, this is missed or ignored at the Practice.  Of course I hear people complain, but Staff usually shrugs it off, apologizes and then stays mad at the Practitioners for being made to hear it all the time.

As a Customer, I have had to wait for all sorts of reasons – but usually, the provider makes my waiting matter by helping me set, manage and update my expectations.  They offer something to “make it right”, like a reschedule option or a discount or an extra bonus or some obvious consideration.

One office started with this solution.  It sends a text to every person coming to see them.  The text says this:  We try our best to be on time, but many times people need unexpected attention.  We don’t let anyone leave without doing the best we can to meet their needs and this includes you.  We will be as prompt as we can and are happy to update you at your request.

Complaints dropped by 60% the first 2 weeks and people were willing to wait because they knew they would get the attention they needed and it would be thorough.

This is a great example of treating People like Customers you value versus Patients you just deal with.  Customers naturally include attention to the Relationship, Patients generally feel like they are at effect Medicine.

Very often, Patients don’t “own” their well-being, they try to make the Doctor, PA or Practice be responsible for them.

As a Customer, the same people make it a point to know what they want and will converse as well as participate in getting the results they seek.

More later