Practice Management

Article excerpt

Transient patients: boon or bane?

Q My partner and I practice in a tourist area where many of our patients may be out of their HMO service area. The paperwork hassles and reimbursement delays have become intolerable. We'd like to ask for payment at the time of service from all vacationers, but worry that the policy might discourage them from choosing our practice. Our bottom line depends on the seasonal influx of patients. What can we do to make dealing with out-of-state HMOs easier?

A Most HMO patients know they must pay a full charge up front when they see physicians who aren't affiliated with their health plans, so go ahead and ask for it. But make it easy for these patients to pay you by accepting credit cards. And make things easy for yourself by giving vacationers copies of their paperwork so they can deal directly with their HMOs instead of the HMOs' dealing with you.

Since out-of-town patients are unlikely to be seeking routine care from you, they'll be more interested in your location, availability, and local reputation than in your charges. Even so, when a vacationer calls for an appointment, make sure your receptionist explains your payment and paperwork policies.

How to handle goodwill in a multipractice merger

Q Should the value of goodwill be count ed in a practice merger? My partner and I are negotiating with another twodoctor practice and two solo physicians. Most of us are willing to value only our hard assets and ignore goodwill, but one of the soloists argues that without goodwill, his practice is worth much less than any of the others and his buy-in price will be that much higher. Who's right?

A The majority should rule. If you included goodwill to placate your colleague, that would reduce the buy-in price for the rest of you, too. With too little working capital supplied by the partners, the merged practice might have to borrow to stay afloat.

Recognize that you won't all bring the same dollar value to the new practice. You'll have to structure each doctor's buy-in price or ownership share to reflect this. Use the same valuation method for each practice. Exclude accounts receivable and payable, since those were incurred before the merger.

Redistributing expenses when senior members slow down Q We're a group of six OBGs. The two oldest have dropped OB and call. The

other four share OB income equally; all six of us divide Gyn revenue on the basis of productivity. We split all expenses in six equal parts. …