How to Start a Profitable Private Practice
How to Start a Profitable Private Practice CSM Boston, MA Feb 14, 2007 Pre-conference-Beginner Dr. Ed Ramsey, PT Business Consultant Diane McCutcheon, Business Consultant A Little about Dr. Ramsey n n n n n Almost 39, married 1 year 1st child born December 15 Graduated from SC 1990 BS, 1991 MSPT RMUofHP 2004 DPT Worked in every PT setting between 1990-1996 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 2 Nicholas Jay Ramsey (2 weeks old) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 3 Nicholas 5 weeks old Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 4 Opening of Ramsey Rehab n Opened Ramsey Rehab 1997 with 3 employees counting myself n n n n n n Turned down from 3 banks Finally approved for $68K business, $122K mortgage, $30K equipment lease 2,200 sq ft between 2 basement office condos Added 1st PTA in 2 months, PT in 4 months 100 visits/week in 3 months Story about Tufts, 100 visit mark Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 5 Continued Growth n Opened satellite in 2000 n n n n n Leased 400 sq ft, $1,000 capital outlay Dr. Jones moves out Increased space to 1,200 sq ft Added more employees 2004 Decided to build new 10,000 sq ft clinic n n $1.7 million ($1.2 million 7,000 sq ft bldg, $500k land) Bldg completed and opened 9/2005 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 6 9+ Years Later n n n n n n n Took 49 employees/family on Cruise Employ 34 employees Need 1 more PT s, 1 PTA Bill out $4.5 million 2006 Collect $1.9 million 2006 Profit per Visit of $6.2 Schedule 710 patient s/week Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 7 Consultant, Speaker & Author n National Speaker n n n n n PPS 2003, 2004, 2005, 2006 CSM 2004, 2005, 2006 Pre-conference PPS & CSM 2006 Co-writing a book with Diane McCutcheon 2006, ? Published 2007 National Consultant 2004-current Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 8 Why Do I Tell You This? n n n n n n Even today you can succeed in private practice if you develop and use a plan VS-NY clinic (manual, ortho) TM-NY clinic (general, wellness) HQ-UT clinic (inpt, LTC, AL, rehab, HC) KE-TX clinic (aquatics, ortho, women s) OpportunitiesDiane are there McCutcheon, BMC & Feb 14, 2007 Ed Ramsey DPT 9 What about You? Now that you know a little about me… n Show of Hands-How many people have been: n In business > 5 years n Between 2 and 5 years n Between 1 and 2 years n Less than 6 months n Still in the planning stage Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 10 Did you … n n n n Complete Business & Marketing Plan Hire a Consultant Network with peers Use resources from National and State PPS or APTA Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 11 Handout n Please refer to your handout titled n Questions to Ask and fill out as we go Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 12 Questions to Ask n Yourself n n n n n Do I want to do this? Am I committed? What am I willing to risk? Can I put my life/relationships/family on hold to do this? Your Family n Spouse n n n n Kids n n n n To do this you need to be 100% in synch with the family Missing family functions, birthdays, vacations Long nights, weekends, not enough money Missing family events Missing sporting and school events Being tired or not around as much Extended Family n n Feb 14, 2007 Support to help in your absence Potential financial support for your family or business Diane McCutcheon, BMC Ed Ramsey DPT & 13 Questions to Ask cont. n Experts n Legal n n n n Accounting n n n n Corporate status Ownership structures and Federal/State laws Leases and Contracts Method (cash vs. accrual) Out-source or not Projections Financial n n n n n Feb 14, 2007 Business Plan creation, development, modification Projections (patient volume, P&L, debt to equity ratio) Cash-flow Bank Relationship Mortgage Brokers Diane McCutcheon, BMC Ed Ramsey DPT & 14 Questions to Ask cont. n Best friend/personal confident/spiritual advisor n What do they think of your idea n n Are they supportive or not n n Why Why or Why not Are their comments valid n n Feb 14, 2007 If yes-Thank them for taking the time to listen and analyze, then answer them and put the answers in the business plan If not-was your explanation clear, concise, accurate? Diane McCutcheon, BMC Ed Ramsey DPT & 15 Additional Questions to Ask n n n Other Successful PT clinic owners (Retired and Current-same state and other states) Other Business Owners All Feedback is worth listening to-but may not be worth acting upon. If someone is willing to listengive them your spiel. It s good practice for you and repetition will help you focus and develop your plan. n Caution: Be accurate, honest and remember there are competitors out there somewhere. (HA Story) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 16 Handout n Please refer to your handout titled n Personal Skill Inventory Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 17 Personal Skill Inventory n n n n What are you good at? What are you horrible at? What would you need to hire HELP for? Personality n n n High strung, low key Energy Level Big Picture or Small Picture Person Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 18 Skill Inventory cont. n n n n n n n n Previously could you sleep at night Are you the type of person that can deal with ongoing long term problems Can you live with a bad decision Can you forgive yourself of your mistakes if you learned from them Can you learn from your mistakes/or others Can you take constructive criticism Are you a leader? Team player? Both? Can you make the hard decision/tough call Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 19 Best Teacher n n n Experience is the Best teacher Do you have experience in the exact business you plan to open? If not-can you get some before opening? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 20 Business Experience n Business Experience n n n n n n n n n Managing a business in any field In PT Supervisory experience Customer Service experience Creating and working within a budget Hiring/Firing/Interviewing/H.R. Reading P&L, making projections, looking for trends and making management decisions based on them Has your business judgment proved trustworthy Have you learned from your mistakes Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 21 Family/Friend Skill Inventory n What are their talents n n n n n n Legal Financial IT Maintenance Keep this list for an emergency Experience has taught many of us never to hire family or friends Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 22 Establish Relationships n Established Relationships with the Pro s n n n n n Legal Financial (Personal and Professional) IT Maintenance Construction Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 23 Personal Resources n Financial Do you need your salary to survive? n How many months total expenses do you have in the bank? n How is your credit score, line and credit worthiness? n What is your current debt to equity ratio? n Have you ever used a budget successfully? n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 24 Personal Resources Cont. n Time n What time commitments do you currently have other than this adventure? n n n n Feb 14, 2007 Child care Elder care Volunteer Associations/groups/religion/charities Diane McCutcheon, BMC Ed Ramsey DPT & 25 You decided Yes-Now What? n n After completing the skill inventories, looking at you and your support system-What is next? Identify the Holes and their fixes with a Business Plan Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 26 Develop a Business Plan n n n A great business plan will force you and your support staff to answer many difficult questions that are important to your businesses future. They can be 20 pages or over 400 pages It is a road map for your corporate success and will allow other professionals to see your potential in a multidimensional sense Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 27 Business & Marketing Plan n It will also include a detailed Marketing Plan with an in depth market analysis SWOT (strength, weakness, opportunity, threats) n HOW DO I DO IT? n You can pay a professional to write it n n n You can use free resources to assist you n n Accountant, Consultant SBA, Local business college, library book, PPS You can write it yourself, or any combo Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 28 Help is Available n n See Impact (April and May 2005) PPS has a great How to Class & book n n n n n n www.ppsapta.org www.SBA.gov www.RamseyRehab.com (sample) www.score.org www.cweboston.org Library, bookstore, community college Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 29 What is in a Business Plan n n n n n n n n n n n n n n n n n Executive Summary/Objectives Mission Keys to Success Start-up Summary Company Ownership Company Location and Facilities Services Competitive Comparison Sales Information (Sell) Sourcing (Info) Future Products (Services, Expansion) Market Analysis Summary (What, Who, Where) Market Segmentation (Services Provided) Industry Analysis (Who else is doing it? Their success) Distribution Patterns Competition and Buying Patterns Strategy and Implementation Summary (Computer Back-up) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 30 Continued… n n n n n n n n n n n n n n n n n n n Marketing Strategy (Payer Mix) Sales Strategy (Information Management) Sales Forecast Milestones Management Summary Organizational Structure Management Team Management Team Gaps Personnel Plan Other Management Considerations Financial Plan Important Assumptions Key Financial Indicators Breakeven Analysis Projected Profit and Loss Projected Cash Flow Projected Balance Sheet Business Ratios CV Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 31 Sample n This is a portion of the Business Plan I developed for a Start-up Wellness Clinic Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 32 Executive Summary n n WALK-IN WELLNESS CENTERS, INC. Name of Company n n n n n n n n n n n n n n n n Executive Summary Brief 1-2 page summary Recognize the funder interest (SWOT) Situation Weapons Objectives Tactics Do you know who your customers are? Do you know the economic and physical demands required to service the customers? Do I know what to offer to relieve those demands? (point of service, location, personnel, equipment) Pinpoint request and ROI expectations How do we mutually benefit from the risks Recognize challenges Review and link elements Demonstrate confidence in you and the plan (May decide not to include in Exec Summary- but a summary of it to get the people with resources to release them) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 33 Executive Summary-sample n n n n n 1.0 Executive Summary On September 1, 2002 Ed Ramsey opened Walk-In Wellness Centers, Inc (WIWC) to provide mobile health and wellness testing to the residents and businesses of Northern Central Massachusetts. In addition to wellness testing a main priority was to provide community education on disease prevention. WIWC started with permanent locations within Global Fitness Center of Leominster and Stow, MA and a mobile unit that was available to go to local businesses and health fairs. After 14 months it was determined to restructure WIWC and dissolve its corporate status then integrate it into Ramsey Rehabilitation, Inc. (Ramsey Rehab). Ramsey Rehab was established in May 1997 as an out-patient Physical Therapy clinic servicing the residents of Northern Worcester County. Ramsey Rehab has grown from 3 employees and 1 location to 12 employees and 2 locations. Ed Ramsey, owner of both companies felt integration of WIWC into Ramsey Rehab was a natural extension that complimented Ramsey Rehabs current services and strengthened its community outreach. The transition of Walk-In Wellness Centers Inc. from a privately owned independent company to a wholly-owned division within Ramsey Rehab Inc. was started on December 1, 2003. The integration of WIWC from its previous structure of providing wellness tests out of gym based settings and corporate events to a clinic based site and a mobile program to reach corporate clients at their workplaces has been laid out in the pages that follow. Failures of seamless integration into Global Fitness-Leominster and a lack of corporate contracts provided insufficient cash flow for continued independent operations but combining the companies allowed for the following: n Access to Ramsey Rehab qualified staff. n Access to Ramsey Rehab databases. n Validation of quality by affiliation with Ramsey Rehab, a known leader in Health. n Access to improved financial resources. n Ability for WIWC employee to work at Ramsey Rehab during downtime to off-set payroll and associated costs. To date the integration has progressed quickly and the combined marketing efforts have produced excellent early results. It is expected that WIWC financially will go from a loss of $150,000 in FY03 to a potential profit of $35,000 for FY04. Savings will be gained in all areas from marketing, employee benefits, overhead and especially management costs. It is expected that the addition of WIWC will cause a small reduction in Ramsey Rehab profits from Q103…………. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 34 Vision Statement Section n Vision Statement Section n n n n n n Objectives Mission Keys to Success To provide the public with a multiple of Health Screening Tests and immediate results with in-depth information concerning their actual results. This valuable health related information will be used to address health concerns, injurious behaviors and nutritional problems with the intent to modify behavior or attitudes that lead to these problems. It is then the employee s job to instruct the testee in ways that Walk-In Wellness Centers, Inc. s (WIWC) services can assist them in living a healthier lifestyle. To achieve these goals will require a knowledgeable, friendly well educated staff with an out-going, extroverted personality and a wiliness to engage the public while selling products. They must have the ability to see the big picture concerning each testee s health and factor that into their personalized educational discussions and the product WIWC offers. ……… Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 35 Start-up Summary n n n n n Start-up Summary All Materials (Equipment, Sales Literature, Marketing Literature, Training Manuals, Training, Free Standing Inserts, etc…) for opening and continued operation are being purchased through US Wellness. (www.USWellness.com) US Wellness is the leader in Public Health testing (onsite and through store-front locations) for the last 5 years. They have 10 corporate owned and operated locations expanding to 40 by 2004 and 350 locations throughout the United States and 2 Internationally. USWellness is currently adding 2-4 new sites per month. Company Ownership The company (WIWC) is a Sub Chapter S Corporation owned by Edward Ramsey MSPT, president and owner of Ramsey Rehab, Inc. (www.RamseyRehab.com) Ramsey Rehab is an out-patient Physical Therapy clinic specializing in Orthopaedics and Sports Medicine. Ramsey Rehab is THE recognized leader in Sports Rehabilitation having provided services to the Northern Worcester County Region for over 6 years. Ramsey Rehab s strong management team and proven track record as well as all company resources will support WIWC in all forms of HR and operations through consultation, including capitol outlay and establishing a line of credit. Charity is a large part of the owner s and management team s philosophy. It Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 36 Company Location & Facilities n n n n n n n n n n Company Location and Facilities Ramsey Rehab has two locations: Main Office 33 Electric Avenue Suite B-10 Fitchburg, MA 01420-7954 Walk-In Wellness Centers, Inc. (WIWC): Main Office 100 Erdman Way Leominster, MA 01450-1841 Primary service area for WIWC and one of it best assets will be its mobility. WIWC will have the ability to service a different location each day. (Health clubs, health stores, alternative medicine locations, YMCA or YWCA s, Pharmacies, Physician offices, Wal-Mart/K-Mart or Grocery stores like USWellness models). Management will contract with specific target locations to rent/lease space 1 day per week. Marketing literature will support each service location. As volume grows at that location it will be determined by management whether to add additional days at that location and eventually a permanent storefront there. Expansion into Health Fairs, Local and State Fairs, Agricultural or Art Fairs, Corporate or Business Conventions and Corporate on-site services. n Services High quality standardized, objective, reliable, reproducible and public friendly health tests and health related counseling available immediately and at a fair value. Tests will include: Bone density (assess actual risk of breaking a bone), Body Fat Analysis (Measures your percentage of muscle mass to fat mass and compares it to the healthy normal), Arterial Stiffness (reliable indicator for risk of heart attack), Skin Hydration and damage (Illustrates the damage already done to your skin by sun exposure and chance of cancerous cells), ………. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 37 Competitive Comparison n n n n Competitive Comparison Currently there is no Independent competition in the Northern MA, Central MA or Southern CT. There are 4 Urgent Care centers (within 30 miles) that provide a few of these tests but typically require physician authorization, insurance approval, long waiting period and clinic appointments. Occasionally justification to any of these check points could delay or prevent the testing to occur. A co-payment is usually also paid. Local hospitals also offer some of these tests but the above restrictions still apply. No similar weighty management program combined with objective testing, nutritional education and scientifically supported targeted biopharmaceuticals/supplements. None of these services are currently provided at local fairs, state fairs or conventions at present. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 38 Sales Information n n n n n Sales Information (Sell) Sourcing (Info) Future Products (Services, Expansion) Expansion into additional areas for permanent storefronts and addition of other tests can include drug testing, allergy testing, hormone testing, vaccination program for flu, pneumonia, etc. USWellness provides over 110 tests for a myriad of health issues and has the documentation for instruction of employee/tester and testee handouts. All tests and literature as well as the health monitoring programs are designed by renowned experts in the health field and the company is overseen by a medical oversight board Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 39 Market Analysis… n n n n Market Analysis Summary (What, Who, Where) Market Segmentation (Services Provided) Industry Analysis (Who else is doing it? Their success) Currently there is no Independent competition. There are 4 Urgent Care centers (within 30 miles) that provide a few of these tests but typically require physician authorization, insurance approval, long waiting period and clinic appointments. Occasionally justification to any of these check points Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 40 Competition n n Savvy consumers will continue to look towards their insurance to provide these ancillary testing but if insurance trends of managed care continuethese tests will not be covered in the future or a larger sharing of the cost will be passed on to the consumer. We will offer the same high quality, reliable services for less because the over head and paperwork will be much less. Convenience will also be a major selling point…….. Implementation now will allow us complete market dominance and the ability to educate the public for improved branding and market loyalty. n n n n n n n Distribution Patterns Competition and Buying Patterns Strategy and Implementation Summary (Computer Back-up) Marketing Strategy (Payer Mix) Sales Strategy (Information Management) All computer systems will have a daily removable back-up as well as a copy to a second hard-drive. As mentioned the Management of WIWC is experienced in the Health Field, Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 41 Milestones n Milestones Opening Day Breaking even Paying off start-up Debt Hiring third employee Establishing permanent storefront Purchasing additional equipment Each site sales surpassing $300,000.00 Sales of Biopharmaceuticals equal 25% site sales Recognized as the Leader in Public Health Testing n n n n n n n n n n n n n n n Management Summary Organizational Structure Management Team Management: Ed Ramsey MSPT. Owner of Ramsey Rehab Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 42 Management n Minimal experience in contract negotiation for facility leases in union and non-unionized companies. This deficit will be reduced by awareness of this, establishment of short-term contracts in unfavorable conditions and use of USWellness information on typical rates and contracts for its other 350 facilities. A partnership will also be cultivated with local business owners to elicit advice in this area to prevent egregious errors. n n Personnel Plan Hiring only highly qualified personnel with health care/promotions/marketing experience. Then an extensive training program initiated at USWellness then continued onsite by management staff. Training will be on-going through monthly phone conference calls by USWellness medical directors, newsletters, on-line courses and direct phone calls or e-mails to the medical directors as needed. n n n n Management Team Gaps Other Management Considerations One strategy to maintaining respect will be by surrounding our company with experienced leaders in the health and business world to act as mentors and advisors. Also establishment of a local Medical Board of Directors to assist with local decisions. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 43 Marketing n n n n n n n n Every interaction (physical, verbal, non-verbal, by phone, letter…) is a Marketing Opportunity – seize it!!!!! Develop a logo, a tag line and branding All marketing literature, company literature and staff conversations must stay on the company message Have a 30 sec, 1 min and 3 min spiel Complete a SWOT, marketing plan Know your abilities (Corporate/Personal) and capitalize on strengths, downplay weaknesses Cultivate relationships, monitor quality Effectively deal with all problems now/cool head only Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 44 More on Marketing n n Attend as many community events as possible. Encourage your staff to attend as well n n n n This is part of my staff merit raise system Give staff company coats, etc to raise your company visibility and branding Try donating sports screens, and your services instead of the $10-$20 ad in books and events-do that too if possible Potentially assign staff to each area team or community program to act as a reference. They don t necessarily have to attend all functions but it s a point person Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 45 Heads or Tails n n n SWOT SWORT Does it Matter? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 46 Handout n Please refer to your handout titled n SWOT or SWORT Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 47 Marketing Plan-SWOT n Situation: Where are we now? n Weapons / Resources: What do we need? n Objectives: Where do we want to be? n Tactics/ Strategies: How do we get there? n Thomas E Little-University of Baltimore School of Business Certificate Class 2002 with PPS Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 48 SWORT Strengths n Weaknesses n Opportunities n Roadblocks n Threats n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 49 Practice/Setting Ideas n Now using the knowledge from the preceding slidesuse that information when considering the following specialty areas for expansion or opening a Niche clinic. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 50 Handout n Please refer to your handout titled n Practice Setting Ideas Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 51 AQUATICS Before buying a location or adding a pool to your site-consider the following: n What population do you want to serve/target? n Special needs population Post-operative Neurologic or radicular patient s Arthritis, joint disease n Athletes-injury recovery or sports enhancement n n n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 52 Aquatics n n n n Check out the local YMCA/YWCA, gym s or hotel s that have pools. Make sure that the location is accessible, clean, warm enough. There are many regulations to consider so check them out first. It is possible to work out an arrangement that would allow you to use their facilities while developing a steady caseload. Eventually it may be possible to transition to your own facility or expand into other areas and populations. Cautions-Pool cleanliness, PH, temperature, multiple vs. exclusive use, liability Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 53 Industrial Consulting n Areas to Consider n n n n Ergonomic assessments Pre-placement screenings (PPS) On-site PT Work hardening and work conditioning Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 54 Industrial Consulting Best way to start: n Get all current evidence based studies, training and work diligently on your presentation. n Remember-you are offering them something they MUST have. n n n n n n Through contracting with you-you will provide a decrease in days lost from work. Stress how much money they will save by demonstrating how you will prevent injuries through screenings, ergonomic assessments and then PT to return their employees back to work sooner. By establishing a historic days lost from work baseline, and putting a $ to that-you can show them how a little invested in prevention and PT can easily save them multiples by reducing the days lost from work. You do not need to provide all the services to be successful. Only offer what you can handle. Cautions-Contract negotiations, working with MD s, unions, employees, liability. They will have high expectations. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 55 Wellness n Wellness can cover many areas-some are: n n n n n n n n n n Weight Management Diabetic Management Body Composition/Body Fat analysis Lung volume testing Arterial Stiffness Index/Framingham Heart Study Profile Hypertension monitoring Skin integrity, cancer assessment Nutritional counseling Flexibility and strengthening consultation Postural assessment Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 56 Wellness n n First decide if any of these programs fit your company s philosophy and if so, establish if there is a need. Then decide if you want to provide this service in the clinic or be portable and provide it to corporations at their location to management, employees or both. Decide if you want to have the employer pay for it as an employee benefit, partially cover it or allow you to make a presentation only, then any participating employee pays for the services used. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 57 Sports Programs n Video analysis-Golf, running, swimming, pitching, cycling, etc Advanced sports enhancement-CORE strengthening, agility training Olympic Weight lifting n Sports screening n n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 58 Sports Programs n n n These programs can be added to your clinic or done as a portable service for very minimal start-up. These programs tend to be private cash based but that should not deter you. If you have a clinic, cross-promotionalize to your current and past patients, referral sources. If you do not have a clinic-then consider offering these services to local clinics, hospitals, executives as an on-site service. You would supplement their programs and make this a win-win situation. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 59 Other Areas to Consider n n We just reviewed a small sample of ideas to develop into a clinic or add-on Here are some others…. n n n n n n n Home Care Hands Foot/ankle Women s Health Contract Care Pediatrics, EI, SI You can apply the concept to more settings…. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 60 Sample Marketing Plan outline n n n n n n n n n n n n n n n n n n n n n Table of Contents 1.0 Executive Summary………………………………………………….……………............ 2.0 Market Audit…………………….………………………………………………………………. 2.1 Market Research……………………………………………………………………………..… 2.1.1 Customer Survey………………………….......... 2.1.2 Data Base Mining………………………………. 2.1.3 Competition Analysis…………………………... 2.1.4 Demographic Analysis…………………………. 2.2 Market Needs…………………………………………………………………………………..9 2.3 Environmental Data…………………………………….. …………………………………… 2.3.1 Strategic Plan/Goal………………………........... 2.3.2 Service Area……………………………………. 2.3.3 WIWC Facility Location/Hours/Access………... 2.3.4 Medical Staff/Provider Structure……………….. 2.3.5 Referral Sources/Volume………………………. 2.3.6 Historical Activity Levels………………………. 2.3.7 Payer Mix………………………………………. 2.3.8 Pricing Arrangements…………………………... 2.3.9 Market Share (see chart)………………………... 2.3.10 Competitive Profiles……………………………. 2.3.11 Sales System and Activity……………………… 2.3.12 Communication Activities and Budgets………... 2.4 Marketing Systems……………………………………… ………………………….. 2.4.1 Key Audiences…………………………………. 2.4.2 Access to Data Bases…………………………… 2.4.3 Consistency of Graphics/Name Usage…………. 2.4.4 Employer Mix………………………………….. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 3 5 5 5 6 8 8 9 9 9 10 10 11 11 11 12 12 12 13 13 14 14 14 14 15 61 Sample Marketing Plan outline n n n 2.5 2.6 2.7 n n n n n n n n n n n n n n n n n n 2.8 2.9 2.10 3.0 4.0A 4.1A 5.0A 4.0B 5.0B 4.0C 5.0C 4.0D 5.0D 6.0 Market Trends…………………………………………... 15 Market Growth………………………………………….. 15 SWOT Analysis…………………………………………. 15 2.7.1 Strengths………………………………………... 15 2.7.2 Weaknesses…………………………………….. 16 2.7.3 Opportunities…………………………………… 17 2.7.4 Threats………………………………………….. 18 Competitive Analysis…………………………………… 18 Keys to Success…………………………………………. 19 Critical Issues…………………………………………… 20 Marketing Position………………………………………………. 20 Marketing Strategies……………………………………………... 21 Marketing Mission Statement…………………………… 21 Marketing Objectives and Action Plans……………………. 21 Marketing Strategies……………………………………………... 32 Marketing Objectives and Action Plans……………………. 32 Marketing Strategies…………………………………………….. 37 Marketing Objectives and Action Plans…………………… 37 Marketing Strategies…………………………………………….. 43 Marketing Objectives and Action Plans………………….... 43 References………………………………………………….. 47 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 62 Competitive Analysis n n n n n n n n n n n n n n n n n n 2.1.3 Competition Analysis All prior marketing analysis from WIWC start-up in September 15, 2002 was reviewed by July 1, 2003 and a detailed update was undertaken between July 2, 2003 and November 1, 2003 to assess changes. The following was determined: WIWC is the only comprehensive mobile wellness center. Maxim is the main competitor to WIWC and only provides a narrow scope of mobile services. Local Urgent Care Centers and Occupational Health Centers provide most of the services but are not portable in most situations. WIWC will be the only local comprehensive wellness testing center inside a PT clinic within 25 miles of our primary location (100 Erdman Way, Leominster, MA 01453). 2.1.4 Demographic and Economic Analysis Utilizing the Ramsey Rehab database and information gained from WIWC and US Census 2000 for MA. Data was not available from the North Central MA Chamber of Commerce so they referred me to the US Census.(1) a) MA Median household income: $50,502 2-4 b) Worcester County Average family size: 3.03 5 c) Worcester County Population: Female: 327,059 Male 307,420 5 d) Northern Worcester County Unemployment Rate of 8,077 (6.4%) 6-7 e) North Central MA Population: 42,021 housing units (8) (1) http://www.ma.gov/portal/index.jsp?pageID=mg2homepage&L=1&L0=Home&sid=massgov2 US Census Bureau 2000 main page Retrieved 12/2/03 (8) http://quickfacts.census.gov/hunits/states/25cty.html Department of Employment and Training Career Center internal access website Retrieved 12/11/03 (Northern Central MA population by town and county) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 63 SWOT-Strengths n n n n 2.7 SWOT Analysis a) b) Highly trained staff. Partnership with Ramsey Rehab and Global Fitness which each have an excellent reputation, strong public and physician affinity and strong name brand recognition. Access to several databases. Ability to quickly integrate into all Ramsey Rehab marketing. Ability to cross market from Ramsey Rehab, Global Fitness and current referral sources. Immediate, convenient testing and results. Portability - ability to bring the test to the companies. Flexibility - ability to adjust to trends quickly. Closing of local Occupational Health Center (PrimeMed). Hiring staff (Jim Hamilton - J.H.) from local Occupational Health Center to market and provide flu shots. Having J.H. re-establish contact and contracts with companies that formerly contracted with PrimeMed. Use of a coupon system to market test of the month, entice delayed testing after large group seminars. Contracted to provide wellness screen (3 tests) to all new Global Fitness gym members which allow 1:1 captive audience for up sales. 2.7.1 Strengths n c) d) e) f) g) h) i) j) n k) n l) n m) n n n n n n n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 64 SWOT-Weakness n 2.7.2 Weaknesses n a) n b) n c) d) e) n f) n n Low volume of clients currently willing to pay cash for a service covered by their insurance company. Competition has a current lock on all health insurance covered tests. Overhead and costs larger than current revenue. Strong competition from Health Alliance (local hospital group). WIWC is a 1 family company (husband and wife). Not much coverage or flexibility if they (JM and CM) take a family vacation. Need to maximize coupon use by non-Ramsey Rehab referral sources. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 65 SWOT-Opportunities n 2.7.3 Opportunities n a) n b) n c) n d) n e) f) n g) n Increasing flu shot market share due to PrimeMed closing and state providing less free serum to PCP s. Using J.H. to exploit the closure of PrimeMed to establish annual contracts for monthly services beyond flu shots for other tests, wellness/prevention packages and work compensation patients for Ramsey Rehab. Start marketing to local churches and community groups to diminish opportunities for non-local national groups. Educate the public on wellness and physical therapy to strengthen both patient streams. Establish more profitable weight management clients. Produce additional community prevention seminars and functional training/exercise classes. As insurance co-pays continue to increase, the cost of Ramsey Rehabs cash based tests will equal or be less than an insurance based copayment. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 66 SWOT-Threats n 2.7.4 Threats n a) n b) c) n d) n Need to change public and physician mindset that it is better to have immediate health tests and the ability to work with a recognized professional in a prevention mode than to wait for a hospital based insurance covered test that may require many weeks delay and several physician office visits and a co-pay that may equal the cost of the cash based test. If LifeScreen starts more aggressively working the market. If Maxim decides to enter the small business market. Previously, they have found it not cost effective to market to companies fewer than 50 employees. 16 months of an economic recession in our region has decreased disposable cash which was already low. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 67 Marketing Objectives… n 5.0A Marketing Objectives and Action Plans n 5.1 n n Establish in 3 weeks what number of personal wellness tests would equal the goal of an increase from the current level of 25% to the 1 year level (12/1/04) of 60%. Action Steps: 5.1.0 Strategy Joe will establish the current base line for all personal/individual (non-corporate) wellness tests by 12/22/03. n 5.1.1 Action Description Tracy Despin (account biller) will compile all data necessary for Joe to establish the current base line for personal/individual wellness tests by 12/15/03. Implementation Steps n n n n 5.1.2.1 Ed (owner) will identify all reports necessary for Tracy to run and provide to Joe. Ed will have the list prepared and delivered to Tracy by 12/10/03. 5.1.2.2 Tracy will use the list provided by Ed to produce all the reports in an organized, printed folder for Joe by 12/15/03. 5.1.2.3 Joe will utilize the information provided in the reports by Tracy to establish a current base line for all personal health tests which will be used to set the target goal. Joe will present this finished report to Ed by 12/22/03. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 68 Marketing Objectives.. n n n n 5.0B Marketing Objectives and Action Plans 5.1B Establish 2 annual corporate contracts for monthly on-site educational seminars or wellness testing by 12/1/04. Action Steps: 5.1.0 Strategy Joe has established the current baseline of corporate contracts 0 for 2003 and will now work toward a minimum of 2 through reviewing existing contacts and that of Ramsey Rehab. Action Description Joe will use all available contacts to establish communication with local corporations and works towards establishing a minimum of 2 annual corporate contracts for monthly on-site educational seminars or wellness testing by 12/1/04. Implementation Steps n 5.1.2.1 n 5.1.2.2 n Format based on-IntroSports Physical Therapy Marketing Plan Paul Gerrits DPT July 2002 1/14/04. Feb 14, 2007 Tracy will print a list of all referral sources and contact names and numbers for Ramsey Rehab and WIWC by 1/2/04. Joe will review the list provided by Tracy and provide a prioritized list of who to contact first, second, third etc. by Diane McCutcheon, BMC Ed Ramsey DPT & 69 Why Plans Fail n n n n n n n n Not there (no plan) Not mine (no commitment) Not possible (no feasibility grounding) Not grounded in customer base Not enough resources (cash/expertise technology poor) Not flexible (no rolling with the punches) Not according to cue (Schedule did not match reality and no come back) Thomas E. Little-University of Baltimore class notes 2002 (Used with permission) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 70 Back to Basics n Clinic Design and other practical information Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 71 Deciding the type of Clinic n n n What are your interests? What did your market study tell you about the area you are considering? Competition: n n n n n Any, how many, proximity Same patient population Similar patient populations or treatments Do your strengths work well in this area, pt population Patient population-demographics (age, education, income, disposable income, community support) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 72 Clinic Type cont. n Reimbursement for your services n n n n n n n n Cash vs. Insurance or mix Will the mix work with the projections you ran Is it higher or lower than projected Are all insurance plans in the area taking new providers Enrollment delays? Do they pay for PTA s? No one pays for aides! Can you survive if you DO NOT get into some of the plans Do you need to join a PT network? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 73 Consider all options Think outside of the box! n n n n Can you buy someone else out Can you open a clinic within a clinic Can you add services to other local clinics without being their competitor Can you run your clinic without a bldg-a virtual office Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 74 Financing your Dream n n n Upon completion and refinement of the business plan-DECIDE how to finance: Business bank loan Personally fund through: n n n n n 2nd mortgage Home equity loan Cash in your retirement plan Borrow money from friends/family Take on a partner Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 75 Working 2 Job s or more… n n n n n n I recommend that you work on your dream, develop your business plan, sales pitch, marketing plan, scouting a location all while still working at least 1 job. Never cheat your current employer-but in your off hours, weekends get this out of the way while banking as much as possible. Some employers will assist you; others may see if you want to open up another location for them, others may be hostile. Be honest in any direction you choose to go. Plan to work per diem initially even when you open your own place to allow some cash flow to pay bills. Banks historically will not finance close to what is needed and will not bankroll your payroll. Consider opening part-time while continuing to work for someone else (your previous job, or per diem, self-contracting, etc). Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 76 Picking a Location n As in all real estate deals- CONSIDER: n n n n n n n n n Location, location, location Drive-by traffic count (weekday, weekend, hourly, holiday) Accessibility (car, bus, taxi, metro, shuttle, on foot…) Future area of growth or decline and effects Proximity to current/future referral sources, ? Too close? More than adequate parking-or else Drive-by visibility, day or night, safety of area Run the numbers- do they fit the budget? Does it fit into the business and marketing plan? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 77 Buying/Building versus Leasing n Things to consider: Which option are you comfortable with n What do you think the area will be like in the next 10, 20, 30 years n What are your plans for retirement n Will the cash flow support a mortgage n n Pro s and Con s of each n My numbers and why I build when I did Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 78 Clinic design/flow n Typical or Unique n n n n n n Rectangle- RX rooms, offices on outside Gym space in the center Design only one path for pt s in/out flow Single vs. Multiple use space Think patient and staff flow Plan for future expansion n n n Patients Programs Physical Plant Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 79 Insurance-Fire, Liability,… n n n Too Much is almost as Bad as TOO little! Make sure you have a good representative Make sure you get the correct type Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 80 Insurance cont. n Make sure your venture is insurable Business location, patient population, etc n Example-Wellness Center, Rock climbing wall n n n Speak to your agent prior to funding State and National APTA, PPS can help Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 81 Incentive Policies n n Depends on your Corporate Philosophy I find it beneficial but it took some convincing for me to buy into it. n n n n n n n Determine which stat most reflects what that persons jobs is or what you want to focus on (most use % arrival, productivity) Be objective and consistent in enforcement Retroactively apply prior to roll-out to test impact Adjust every 6 months Don t GIVE away the Farm, or under-incentivize Incentives must be motivating to work Excellent presentation at last years PPS conf Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 82 www.ppsapta.org Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 83 www.ppsapta.org Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 84 PPS 20 step Plan-Opening Up a Private Practice Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 85 PPS Member Mentor Program Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 86 Previous Web casts n Consider purchasing previous web casts for your reference library: n n n n n n n HIPAA Billing Employment policies Contacting/Joining your state PPS Becoming active on a National/State level Attending State and National PPS meetings/ conferences Join PT-PAC (Political Action Committee) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 87 www.SBA.gov Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 88 www.score.org Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 89 Center for Women and Enterprise Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 90 www.RamseyRehab.com Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 91 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 92 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 93 Additional References 1. 2. 3. 4. 5. PPS-How To Open a Private Practice Manual (for sale on the PPS website- www.ppsapta.org) PPS "How To" 1.5 day classes, next one is scheduled for Philadelphia in April 2007. It covers what is in the book as well as additional information. The PPS website has a list of mentors. There are excellent classes at PPS National Conference as well as CSM each year Your state may have a local PPS chapter that could help you, also. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 94 If you want more information… n n n n n n n n n n n n n Barrera R. Over Promise and Over Deliver. The secret of unshakable customer loyalty. New York, NY. Penguin 10014; 2005 ISBN 1-59184-061-9. Nosse L J, Friberg D G, and Kovacek P R. Managerial and supervisory principles for physical therapists. Philadelphia: Lippincott Williams & Wilkins; 1999. ISBN 0-7817-4264-1. McCormack G L, Jaffe E G, Goodman-Lavey M. The Occupational Therapy Manager. Bethesda: American Occupational Therapy Association; 2003. ISBN 1569001782. Schaefer, K. Marketing techniques for physical therapists. Gaithersburg MD: Aspen Publications; 1991. ISBN 0834202085. Glinn J E and Crankhorn A. Marketing techniques for physical therapists: Independent study course 14.3.2. La Crosse WI: Orthopedic Section, American Physical Therapy Association; 2004. [Can be ordered from the Ortho Section website at https://www.orthopt.org/143.php.] Richmond T, Powers D. Business Fundamentals for the Rehabilitation Professional. Slack Inc. 2004. ISBN 13-978-1-55642-593-6. Articles and Web sites Roth MS, Amoroso WP. Linking core competencies to customer needs: strategic marketing of health care services. J Healthcare Marketing. 1993; 49-54. Weiss R. Don t forget about the office staff. Marketing Health Services. 2003; 10-11. Jacobs K. Innovation to action: marketing occupational therapy. Am J Occup Ther 1998 Sep; 52(8):618-20 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9739393&dopt=Abstract http://www.knowthis.com/tutorials/marketing/marketingplan1.htm http://sbinfocanada.about.com/cs/businessplans/a/bizplanmarkplan Palacio M. 25 secrets of profitability of private practice. Online Advance for Occupational Therapy Practitioners [serial online]. 2000. Available at: http://www.advanceforot.com/common/editorial/editorial.aspx?SEC=CC&CC=14. Accessed October 9, 2000. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 95 After you return from lunch n n Welcome Diane McCutcheon The Business of Running Your Business Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 96 Getting Started n Processing Patients n Treating Patients Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 97 Getting Paid Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 98 Credentialing n You and your Business Must Obtain A National Provider Identification – NPI https://nppes.cms.hhs.gov/NPPES National Plan & Provider Enumeration System All providers must get a NPI Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 99 More on Credentialing n Obtain provider numbers from HMO s, PPO s, including BCBS and other insurance plans prevalent in your area Get a group number for the facility n Get an individual number for each therapist Note: You will not be able to bill or get paid by most insurance companies if you are not a provider n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 100 Staffing How Many People Do I Need? n n n n n Who will be processing patients? Who will be processing claims? Who will do referral management? Who will do the collections? Who will be in charge of overall management of the accounts receivable? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 101 ANSWER In the beginning – it could be 1 person! As you grow, you will add staff and eventually your organization will look like…………….. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 102 Your Organizational Team! Owner Front Desk Feb 14, 2007 Therapist Biller Diane McCutcheon, BMC Ed Ramsey DPT & Collector 103 Hiring The Right Person n Questions to ask and answer BEFORE hiring n n n What Position Am I Hiring For? What Are My Goals? What Can I Offer Them? n n n Benefits Wages What Do I Want Them To Do? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 104 ……More Questions???????? What Hours Do I Need Them For? n Do They Need Special Skills? n What Education or Experience Do They Need? n Where Should I Advertise? n Who Will Interview – What Questions Should Be Asked? n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 105 Front Desk Specialist n What does a FDS do? n n n n n n n Answers Phone Processes New Patients Checks Benefits Obtains Referrals and Authorizations Schedules Files, Copies, Processes Mail Process Discharged Patients Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 106 Biller and Collector n What do Biller s & Collector s Do? n n n n n n n Enter Charges Bill for services - Paper & Electronic Billing Process Deposits Enter Payments Process Denials Call on Unpaid Claims Manage the A/R Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 107 Where To Advertise? n Where Will You Get The Best Advertising For Your Money? n n n n n n Newspaper Professional Magazines High Schools, Colleges, Trade Schools Word Of Mouth Job Fairs People You Know Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 108 The Interview Process n Some things to notice…… Appearance n Diction n Resume n Time it took to complete employment application n What kind of questions did they ask? n Overall presentation n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 109 Make Your Choice After You… n n n n n n Conduct A Second Interview Clearly Outline Your Expectations Agree On Start Date and Time Agree On Wages and Payday Agree and Understand Benefits Outline Orientation and Training MAKE YOUR CHOICE!!! Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 110 Office Space n Things To Think About n n n n How Many People Will Be Using The Area? Is It HIPAA Compliant Is There Room For Expansion Is It Secure Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 111 Office Equipment & Supplies Desk or Countertops - Chairs n File Cabinets w/Locks n Storage Space n Printer/Copier/Fax n Adding Machine n Phones – 1,2,or 3 lines n Misc Office Supplies – Charts, pens, files, Billing Forms, Copy Paper, etc. n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 112 Patient Forms & Information n Things You Will Need To Get Started n n n n n n Patient Intake Forms Patient Registration Forms Patient Welcome Letter & Information HIPAA Release & Patient Information Insurance Benefit Information Your Fee Schedule Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 113 Clinic Forms & Information n n n n n n Charge Sheets Evaluation Forms Re-evaluation Forms Progress Notes Flow Sheets Patient Exercises Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 114 Billing & Collection Information n n CPT Coding Information ICD-9 Coding Information n n n n n http://ingenix.com/ Ins Reimbursement Schedules Ins Referral & Authorization Information HCFA Forms Electronic Billing Information Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 115 Billing Software n Choosing Your System Can Software Integrate With Other Programs n Extent of Patient Data Files n Billing/Collection Capabilities n Management Reports n Documentation Module n Scheduling Module n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 116 Management Tools n What You Need To Manage Your Business n n n n n n Systems of Accountability Front Desk, Billing & Collection Handbooks HIPAA Handbook OSHA Handbook Staff Meetings Outside Services Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 117 Reports You Need To Manage Your Business n Daily, Monthly, and Yearly Reports n n n n n n n n n Feb 14, 2007 Charges, Payments, Adjustments Co-pay Collection Referral Management Average charge per visit Average payment per visit Visits & treatments per month Referrals and Authorization Expirations No Activity Accounts Receivable Reports Diane McCutcheon, BMC Ed Ramsey DPT & 118 Human Resources (HR) HR functions are necessary to insure: n n n Legal Compliance Operational efficiency Staff Retention Good HR Processes Minimizes Your Exposure To Liabilities Society for Human Resource Management http://shrm.org/ Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 119 HR In A Small Practice n What you need to know: n Posting Requirements – State & Federal http://home.govdocs.com/ n n n n n n Fair Labor Standards Act Equal Employment Employer Worker s Comp Insurance Payroll–FICA (Federal Ins. Contribution Act) Jury System Improvement Act Personnel Files Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 120 Personnel Handbook n Overview n n n n n Mission Statement Performance Management At-Will Employer Compensation and Benefits n n Feb 14, 2007 n n Safety and Health Termination Sexual Harassment Medical Time Off Diane McCutcheon, BMC Ed Ramsey DPT & 121 Where To GET Help! n Business Management Consultant n Purchasing a Billing System & Setting Up Software Directories n Establishing a Fee Schedule n Establishing Front Desk Procedures n Establishing Billing and Collections Procedures n Developing Forms n Establishing Daily, Weekly & Monthly Routines n Hiring & Training n Human Resources Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 122 Your Leadership Role Create And Share Your Vision n Develop Positive Relationships n Learn The Administrative Functions n Create A Winning Team n Keep Lines of Communication Open n Prepare For Growth If You A The Leader – Others Will Follow n Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 123 Final Notes n n n n n Preparation Is Key Check Your List Before The Doors Open Make Sure You Will Be Paid For Your Services Be A Great Team Leader Share Your Success! Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 124 Begin Climbing Your Ladder To Success Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 125 Legal n This information is the property of Diane McCutcheon and Dr. Ed Ramsey and should not be copied or otherwise used without the express written permission of the authors. Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 126 Contact Information n Diane McCutcheon, BMC n n n Business Management Consulting Services, Inc Phone: 508-876-9241 Fax: 508-876-9513 Ed Ramsey DPT n n n n Ramsey Rehab Inc. Phone: 978-466-6677 Fax: 978-466-1133 [email protected] www.RamseyRehab.com Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 127 References n n n n n n n n n n n n References for Ramsey/McCutcheon pre-conference class 2/14/07 Boston MA 1http://www.ma.gov/portal/index.jsp?pageID=mg2homepage&L=1&L0=Home&sid=massgov2 US Census Bureau 2000 main page Retrieved 12/2/03 2 http://quickfacts.census.gov/qfd/states/25000.html US Census Bureau 2000 sub page Retrieved 12/2/03 (census facts) 3 2003 Answer Book Sentinel & Enterprise, Nashoba Publishing, Summer 2003 (census facts) 4 2003 Greater Worcester County Community Profiles, Worcester Telegram & Gazette, 2003 (census facts) 5 http://fastfacts.census.gov/servlet/CWSFacts?geo_id=50000US2501&_sse=on US Census Bureau 2000 census statistics page Retrieved 12/2/03 6 http://lmi2.detma.org/lmi/lmi_lur_a.asp Department of Employment and Training Career Center internal access website Retrieved 12/11/03 (Northern Central MA unemployment rate) 7http://factfinder.census.gov/servlet/BasicFactsTable?_lang=en&_vt_name=DEC_2000_SF US Census Bureau 2000 Retrieved 12/2/03 (census facts) 8 http://quickfacts.census.gov/hunits/states/25cty.html Department of Employment and Training Career Center internal access website Retrieved 12/11/03 (Northern Central MA population by town and county) 9 Marketing And Managing A Physical Therapy Practice T-DPT 562 Class 4 (Jun. 03) Mark E. Brooks, MS, PT, ECS 10 IntroSports Physical Therapy Marketing Plan Paul Gerrits DPT July 2002 WEBSITES: All accessed between May and October 2006 Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 128 References..cont. n n www.ppsapta.org, www.SBA.gov, www.RamseyRehab.com www.score.org, www.cweboston.org n n n n Barrera R. Over Promise and Over Deliver. The secret of unshakable customer loyalty. New York, NY. Penguin 10014; 2005 ISBN 1-59184-061-9. Nosse L J, Friberg D G, and Kovacek P R. Managerial and supervisory principles for physical therapists. Philadelphia: Lippincott Williams & Wilkins; 1999. ISBN 0-7817-4264-1. Schaefer, K. Marketing techniques for physical therapists. Gaithersburg MD: Aspen Publications; 1991. ISBN 0834202085. n n n n Glinn J E and Crankhorn A. Marketing techniques for physical therapists: Independent study course 14.3.2. La Crosse WI: Orthopedic Section, American Physical Therapy Association; 2004. [Can be ordered from the Ortho Section website at https://www.orthopt.org/143.php.] Richmond T, Powers D. Business Fundamentals for the Rehabilitation Professional. Slack Inc. 2004. ISBN 13-978-1-55642-593-6. PPS-How To Open a Private Practice Manual (for sale on the PPS website) Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 129 References..cont 2 n n n n n n n n n n n n n n n n n n n Reference List: All web sites were accessed between May and October 2006 unless otherwise noted. Society of Human Resource Management – SHRM http://SHRM.org/ Medicare NHIC – Medicare Part B [email protected] Medicare NHIC – Medicare Part B http://www.medicarenhic.com Information on new Insurance Claim Form – 1500 http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5060.pdf National Provider Identification Information www.cms.hhs.gov/NationalProvIdentStand 800-465-3203 National Provider Identification Application Information https://nppes.cms.hhs.gov 800-465-3203 US Department of Labor http://www.dol.gov/compliance/ Ingenix (CPT/ICD-9 Code Books) 2007 http://www.ingenixonline.com Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 130 Questions???????????? n What Can We Do For You? Feb 14, 2007 Diane McCutcheon, BMC Ed Ramsey DPT & 131
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