My uncle used to be a missionary to the distant tribes in Brazil. He often carried a machete to cut through the brush of the rain forest. In the near future, I fear we will be hearing the slashing ringing through the medical practice world. With trillions in cuts coming in the medical budget, if your practice accepts state or federal reimbursement dollars you will be affected.
Is your practice running as lean and mean as it can? Have you used auto-attendants, auto-call appointment reminders, online forms, and the every other possible efficiency gaining technology to keep costs down? Even simple changes like dual monitors on your billers’ computers will help improve their speed. If you have not, make changes nowas the machetes are ringing and the sound is growing closer.
“Missed business opportunity” That’s what Medicare calls it when you charge their recipients for missing their appointment. Are missed appointments a covered Medicare benefit? Not at all according to http://www.cms.gov/MLNMattersArticles/downloads/MM5613.pdf a Medlearns Matters Article. What this means is that if someone misses their appointment, you can charge them. Why do that? Well I bet most in-demand hair dressers and barbers do the same.
Why not? If you have loyal and punctual patients and they sometimes miss an appointment, perhaps you should cut them a break and call it a cost of business. Perhaps, but it is your life and you will never get those 15 -30 minutes back and that time, if you are normally efficient is wasted. If you were able to sneak some other work in and get home a little earlier, then that is up to you whether it cost you money or not.
How much to charge? Why not charge them for the amount that you would have charged for an office visit. If you truly consider it a lost business opportunity, that is exactly what it cost you.
I was just talking with an adviser with one of the large regional banks in our area. They are offering a pension plan with a fee. “But wait” you say, “Why pay a fee? I get my mutual funds for free.” Do you? It turns out that everyone has their grubby little fingers in your pension pie. Yes, didn’t you notice how your accountant is now working with a pension adviser? They all work together. You know what else? They all get a tiny little piece. What is a tiny piece? The pieces are measured in basis points. 100 basis points is a percentage. So sometimes they get 25 basis points, sometimes more.
You want to know something else? Pepsi and Acme brand soda have different markups. If you are selling soft drinks, which one do you want, Profit or Sales. I would say that you would push the product that gives you the most profit. Did you know your pension advisers sometimes do the same? Yes, depending on the basis points they get, there is a temptation to push those that have the highest profit for them. Unlike Doctors, there is no wall street creed to “do no harm”.
So, what do they do? Some I fear choose out of their best interest not yours. Even when they advise the employees on the self directed plans, they might be tempted to push them to the higher margin product. . . . sad but true.
So what do you do? Relief is on the way. Regulations in process will require the brokers, advisers, etc to disclose where and who is paying them. . . .might make sense to ask them now for a disclosure to find out what they are getting paid and from whom. Never hurts to know, and if they shy away might be time to look for a new adviser.