Starting a practice

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caliking87

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I have read through many past posts on here about starting a practice. The most helpful of which was Feli’s detailed cost breakdown.
I got into podiatry for the private practice aspect, office visits and simple surgeries (1st ray, soft tissue) I’ve never liked the hospital setting. My main concerns with opening are closed insurance panels. The area I’d hope to open is very geriatric with roughly 30% of insured people insured through Medicare. Everyone always says private practice is dead, I hear about reimbursement cuts all the time. Is solo owner private practice doing routine podiatry still viable?
 
Yes. You won't be making a ton of money but if you build it up you can be on autopilot making 200-300 working 9-5. Thats a pretty good quality of life.

If thats something you can accept then yes its "viable". Join an IPA to get on insurances. Market a lot. Expect it to take 1-3 yrs for a full schedule depending on location/demand. Nothing however can make up for being a good doctor. If you suck..well good luck.
 
You could also be the guys down the street from me billing 11305 to circumvent non covered routine footcare and cutting on people who shouldn't be cut on.

That way they end up coming to me for 2nd opinions and FMLA paperwork and then disappear.

Business management.
 
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Unfortunately my employees continue to ask for cost of living increases and my supplies/rent continue to increase as well.
 
Hello everyone and happy holidays! I have a question: If you work at a podiatry practice for several months or a year and then leave to start your own practice, can you transfer the existing PPO/HMO contracts to your new practice, or would you need to apply and credential with each insurance from scratch?
Thank you so much!
 
podiatryresident said:
Hello everyone and happy holidays! I have a question: If you work at a podiatry practice for several months or a year and then leave to start your own practice, can you transfer the existing PPO/HMO contracts to your new practice, or would you need to apply and credential with each insurance from scratch?
Thank you so much!
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From the couple of people I know who did, its from scratch. Now you're doing it as you with your own practice, not as an auto part of your prior practice
 
podiatryresident said:
Hello everyone and happy holidays! I have a question: If you work at a podiatry practice for several months or a year and then leave to start your own practice, can you transfer the existing PPO/HMO contracts to your new practice, or would you need to apply and credential with each insurance from scratch?
Thank you so much!
Click to expand...
If they were using 3rd party credentialing, soon as that contract expires you are responsible for getting back on with those insurances yourself.
Certain insurances don't work with any credentialing companies and rely on the individual to get onboarded (looking at you UHC).

Its like pulling teeth just trying to get on their panel because all of their "Contact Us" lines are automated bots. Almost impossible to reach a real person unless its collections/reimbursements related.
 
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Weirdy said:
If they were using 3rd party credentialing, soon as that contract expires you are responsible for getting back on with those insurances yourself.
Certain insurances don't work with any credentialing companies and rely on the individual to get onboarded (looking at you UHC).

Its like pulling teeth just trying to get on their panel because all of their "Contact Us" lines are automated bots. Almost impossible tor each a real person unless its collections/reimbursements related.
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How do you even contact them. Do you look up the website for each individual insurance and find a credentialing contact number?
 
Homo sapien said:
How do you even contact them. Do you look up the website for each individual insurance and find a credentialing contact number?
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You can do that or go through a 3rd party credentialer like TIOPA, SPA, etc.
They basically charge you a fee to negotiate all the credentialling for you.

So you fill out the basic CAQH form, send them everything.
Have malpractice cert, hospital privileges, board cert, DEA, license ready

They'll be like hey here's the list of insurances we got you onboarded with, here's when the next re-up is due.
Some will also send you updates on changes within the insurances themselves like hey btw this guy is gonna cut your E&M by 3% next month etc.
 
Weirdy said:
You can do that or go through a 3rd party credentialer like TIOPA, SPA, etc.
They basically charge you a fee to negotiate all the credentialling for you.

So you fill out the basic CAQH form, send them everything.
Have malpractice cert, hospital privileges, board cert, DEA, license ready

They'll be like hey here's the list of insurances we got you onboarded with, here's when the next re-up is due.
Some will also send you updates on changes within the insurances themselves like hey btw this guy is gonna cut your E&M by 3% next month etc.
Click to expand...
Do these 3rd party IPA's ever have "closed panels"?
 
GreenHousePub said:
Yes.
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Geez.
So someone that's an awesome podiatrist can start a ground up practice and legitimately be screwed due to insurance panels themselves being closed, AND the 3rd party "backups" like the IPA's also being closed?

So if an established practice wants to hire someone, they have to call whoever their insurance panel company or group is and ask if there's room to add on an additional podiatrist? And if there's not any room, the office is just screwed and can't hire anyone (for insured patients)?

Is it a non-issue in-practice basically everywhere in the country? Because I've definitely seen and heard of private practices in extremely saturated markets hiring people on and they get on board to insurances just fine.
 
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Thanks everyone. The insurance/credentialing side is the only thing holding me back from opening my own practice, so any advice or experience you shared would really mean a lot. So basically, working for another podiatrist wouldn't help for credentialing ?
 
No, once you leave, you have to get recredentialed under your new entity. Joining a good IPA can help because you could possibly benefit from their payor rates as well as getting added to all their insurance panels. Joining an IPA is also a way to get around closed panels from certain insurance companies.
 
Boba Foot said:
No, once you leave, you have to get recredentialed under your new entity. Joining a good IPA can help because you could possibly benefit from their payor rates as well as getting added to all their insurance panels. Joining an IPA is also a way to get around closed panels from certain insurance companies.
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The person above said that IPA's could also be closed when I asked. So closed insurance panels, and no room on the IPA for us, so no in-network patients?
footpainhealer said:
Do these 3rd party IPA's ever have "closed panels"?
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"Yes."

Am I understanding that correctly?

Also, why aren't these IPA's the "go to" way to be able to get paid for seeing patients? Seems like its easier, quicker, more money reimbursed, and not having to worry about "closed panels" (whatever closed panels even means; I am just assuming it means the insurance companies deny to make you in-network, which would just cost the insurance company MORE money if the patients still come to see me as OON wouldn't it lol).
 
Weirdy said:
You can do that or go through a 3rd party credentialer like TIOPA, SPA, etc.
They basically charge you a fee to negotiate all the credentialling for you.

So you fill out the basic CAQH form, send them everything.
Have malpractice cert, hospital privileges, board cert, DEA, license ready

They'll be like hey here's the list of insurances we got you onboarded with, here's when the next re-up is due.
Some will also send you updates on changes within the insurances themselves like hey btw this guy is gonna cut your E&M by 3% next month etc.
Click to expand...
Are hospital privileges specifically a requirement?
 
This is particular to my situation, but I def have to remain on staff at my hospital in order to participate in insurance plans. I know of several doctors who moved their practice out of state specifically to avoid being on staff at hospitals they want nothing to do with.
 
Adam Smasher said:
This is particular to my situation, but I def have to remain on staff at my hospital in order to participate in insurance plans. I know of several doctors who moved their practice out of state specifically to avoid being on staff at hospitals they want nothing to do with.
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That sounds horrible
 
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