Office Appointment “Reservation Fees”

Posted on June 2, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Minimizing the Patient “No-Show” Problem

Staff Writers

In what is perhaps the next evolution of office-based medical practice – at least according to American Medical News reports – some physicians are now making their patient’s reserve office appointment slots with a cash deposit in case of “no-show.”

Much like their plastic surgery, new-wave anti-aging esthetics, cash-only, cosmetic-dental or concierge practice colleagues, these doctors are serving up their healthcare offerings much like a fine restaurant serves its cuisine.

Causation

According to anecdotal research, the average no-show rate for medical practices is about 5 to 10 percent, while the rate can be higher if the office has a larger percentage of new, Medicare. Medicaid, indigent or self-pay patients

Deposits

Physicians who charge de-minimis deposits – ranging from $10 to half an office visit cost – emphasize the primary goal is to cut down missed appointments and increase office efficiency; not generate revenue.  

“This is not like a Blockbuster™ store late-fee, or about making money through cancellation-fees”, according to Executive-Post managing-editor Hope Rachel Hetico, RN, MHA, CMP™ of Atlanta

Results

Of course, cancellation-fees are not new, but are retroactive and may bespeak a “certain perception of avarice” according to Hetico; and are a “pain to collect.” 

But, “appointment reservation-fees” are pro-active, and give the perception of “gravitas and physician-patient collaboration”. 

And, the practice may yield patients who are more faithful about showing up, or at least giving notice if they can’t; while fewer empty slots mean more cash-flow and practice revenue.

Conclusion

What are your thoughts and opinions on this emerging business management practice; legitimate business strategy or bad public relations move? Please comment.

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Filed under: Managed Care, Op-Editorials, Practice Management | Tagged: , | Leave a comment »

Determinants of Medical Practice Value

Posted on June 2, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Goals and Objectives

By Dr. David Edward Marcinko; MBA, CMP™

By Hope Rachel Hetico; RN, CPHQ, MHA/MBA, CMP™biz-book1

Much has been written, and much has been said about the goals, objectives, reasons, techniques and methodology of professional medical practice appraisals online at the Medical Executive-Post.

And, even more actionable information is presented in our institutional 1,200 pages, 2-volume print guide Healthcare Organizations [Financial Management Strategies] http://www.stpub.com/pubs/ho.htm

In fact, this quarterly subscription journal, modestly priced at $535/year, contains more than 200 pages devoted to many sub-topics of this fluctuating and important practice management and financial endeavor. And, increasingly such detailed material is needed in the changing healthcare economic milieu http://www.stpub.com/pdfs/toc_ho.pdf

But, as a quick overview of valuation determinants, goals and objectives, this checklist is an indispensable tool when pro-actively contemplating – or retro-actively reviewing – any medical practice appraisal engagement or practice worth analysis https://healthcarefinancials.wordpress.com/category/practice-worth

 

How to Determine the Kind of Medical Practice Valuation Required

 

Determine the purpose for which the medical practice valuation is required.

 

Yes

 

No

 

Estate or Financial Planning

 

 

 

 

 

 

Is the doctor looking for a full or abbreviated report?

 

 

 

 

 

 

Is timing critical to the completion of the valuation?

 

 

 

 

 

 

Is value required for buy/sell agreement?

 

 

 

 

 

 

Does the buy/sell valuation meet the provisions of IRC §2703?

 

 

 

 

 

 

Is insurance being purchased based on business valuation?

 

 

 

 

 

Estate or Gift Taxes

 

 

What is the date of death or date of gift (and alternate valuation date)?

 

 

 

 

Be sure valuation uses the “fair market value” standard of value (for estate or gift valuations).

 

 

 

Sale of the Practice Business

 

 

Are valuation experts knowledgeable of industry transactions?

 

 

 

 

 

 

 

Is entire practice for sale or only a portion?

 

 

 

 

 

 

Is the doctor taking advantage of the annual $12,000 gift exclusions and lifetime exemption to get shares of stock into the hands of his or her family?

 

 

 

 

 

 

Be sure the appraisal of the practice is done with reasonable care to avoid penalties under §6662 of the IRC.

 

 

 

Recapitalization

 

 

Is recapitalization using a combination of preferred and common stock in the conventional preferred stock freeze scenario?

 

 

 

 

 

 

Does the recapitalization meet the provisions of §2701 of the IRC?

 

 

 

 

 

 

Be sure that the shares received in the recapitalization are equal in value to the shares being given up.

 

 

 

 

Divorce

 

 

Is adequate information available to the appraiser to complete the valuation?

 

 

 

 

 

 

Be sure the appraiser is knowledgeable of the court cases governing medical practice and related business valuations in divorce matters in the state in which the action is being heard.

 

 

 

If client or spouse is a partner in a professional practice, is the appraiser familiar with the valuation of professional and practice goodwill and how they apply in this particular case?

 

 

 

 

 

Shareholder Dispute

 

 

Be sure the doctor understands the rights of shareholders under the business corporation laws of the state of incorporation of the business.

 

 

 

 

Be sure appraiser is familiar with the court decisions involving dissenting shareholder actions in the state in which action is being heard.

 

 

ESOP

 

 

Has doctor engaged an advisor who is thoroughly familiar with the intricacies of ERISA and how they impact the establishment of an ESOP?

 

 

 

 

 

 

Is the medical practice appraiser experienced in the valuation of shares for ESOP purposes?

 

 

 

 

 

 

Is the doctor taking advantage of the tax deferment and other tax benefits available in a sale of his or her shares to an ESOP?

 

 

 

 

 

Incentive Stock Options and Phantom Stock Plans

 

 

Is the doctor taking advantage of the benefits of stock incentive or phantom stock bonus plans available to key employees of closely held businesses?

 

 

 

 

 

Charitable Contribution

 

 

If the doctor interested in donating company stock to charity, will the value be more than $12,000?

 

 

 

 

 

 

If donation of stock is worth more than $12,000, be sure the doctor obtains an appraisal from a qualified appraiser and signs IRS Form 8283.

 

 
             

 

Conclusion

Remember, this is only the minimum data for analysis. And, although there are many reasons to have your medical practice appraised, the end result matters little if it is not understood within the context of its’ enterprise-wide applications. Therefore, your thoughts, opinions and experiences are appreciated?   

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: http://www.stpub.com/pubs/authors/MARCINKO.htm

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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Filed under: Practice Management, Practice Worth | 1 Comment »