The business of healthcare is a serious one as it can make or break even the best physicians. In the course of my work with clients helping them through these steps, I encourage them to not only be involved, but also to work and gain a thorough understanding of each piece so that they can build internal solutions over time.
The following checklist will help ensure you don’t skip an integral step in setting up your practice. The online version of this article includes greater detail as well as some tips, tricks and outsourcing solutions that I love.
• Make It Real: File a Certificate of Formation with the Secretary of State’s office and apply for an Employer Identification Number (EIN) with the IRS.
• Plan It: Business plans aren’t just for MBA thesis projects. If you fail to design your company—including its mission, strategy, research, timeline and pro forma financial statements—it will design you.
• Fund It: When planning how much your business launch will cost you, make sure you assess the pro forma cash flow statement and not the profit and loss statement.
• License It: If you don’t already have your Texas medical license, start here. Pre-licensure in Texas is taking an average of 134 days at the time of this writing, and licensing takes an additional 36 days. Once you receive your license, file for your Controlled Substance Registration through the Department of Public Safety (DPS) and your Drug Enforcement Administration (DEA) Registration. Planning on selling product? You will also need a Sales & Use Tax license.
• Credential It: Credentialing with insurance companies and local hospitals is key, and one that you need to plan ample time for. A reasonable estimate for full credentialing after you have your medical license is seven to 10 months.
• Get digi-with it. Secure a phone number: Gone are the days of needing to call a phone company and wait for them to come out and “hook up” your lines. Voice-over IP (VoIP) phone systems make securing local, toll-free and fax numbers a breeze.
• Make it electronic. Choose your EHR solution: Choose an EHR with integrated systems for managing patient records, practice management (coding, billing and reporting), and the patient portal.
• Secure Your Space: Every physician needs a space in which to practice, but outside of traditional medical office space leases or purchases, consider streamlining costs when you start out by sub-letting a day or half-day a week in one or more physicians offices. This can help you create relationships, generate referrals and cut back on expenses.
• Be a patient, or at least think about it. Create patient materials: What patient intake processes and informational materials would you want to see if you were a patient with limited time, possible nervousness and questions over your diagnosis? Don’t just copy materials from the practice next door; create patient materials that make sense and that make a difference.
• Collateralize it. Design marketing materials: How are you going to generate patients? Is your practice driven more by patient-driven demand or referrals from other physicians? Design an eye-catching, informative logo and marketing collateral specific to your audience. This step also includes designing your website and securing a HIPAA-compliant email solution.
“Pre-licensure in Texas is taking an average of 134 days at the time of this writing, and licensing takes an additional 36 days”
• Bookkeep it. Get a bookkeeping solution early: Too many practices overlook this essential and easy step, thinking that their year-end accounting can do it. Bookkeeping and accounting are both different and necessary.
• Account For It: Meet with an accountant before you launch your practice so that you can design solutions in advance of your business needs, and ensure you are fully prepared for your year-end tax obligation.
• Bill it. Ensure you have a comprehensive billing solution in place: Billing solutions encompass more than just the company or employee you choose to provide the service. Billing starts with ensuring the patient is correctly scheduled within the EHR, checked in and out, documented appropriately, and sent over to billing in a timely manner. Many practices spend a ton of time in perpetual search of the perfect billing company, only to realize all too late that the bulk of their problem occurred before the billers were ever involved.
• Humanize it. Plan your human resources: Ensure you have an idea of whom you need to hire when, as well as job descriptions, an employee handbook, org chart, insurance, time-keeping program, and payroll solutions in place before you open your doors.
• Contract It: If you will be covering call at a hospital or hiring physicians or executive-level staff sometime in the near future, meet with an attorney now to draw up these important contracts.
• Operationalize It: Make sure you have posted required office signage, safety and eyewash stations, as well as policies and procedures for everything from chemical spills to emergency situations.
• Furnish It: Create lists, budgets, and timelines for everything that goes into your office including furniture, equipment, medical and office supplies, and utility accounts.
• Develop it. Beat the pavement: Plan your business development strategy. Get out early and introduce yourself to potential referring physicians. Plan your development through consideration of direct marketing, mailers, quarterly newsletters and blog entries.
Consulting companies are a great adjunct to utilize when needed, but the more you know about running your business, the more successful it will ultimately become. Become a student in the business of running your business, and you are sure to find success!
For more information visit www.cynEXconsulting.com or call 210.910.6266. Cynex Consulting is located at 311 Bowie Street, Suite 1806 in Austin, TX 78703.