Maintain Solid Financial Policies

A Cornerstone to a Medical or Dental Practice Collections

Third-party payers are paying less and patients are paying a higher percentage of their medical costs.  Employers and patients are opting for higher deductibles to keep their out-of-pocket premium costs at a reasonable level.  To work effectively with your patients it is becoming more important that you have a written financial policy and use it.   The following are some thoughts regarding the importance of maintaining a solid financial policy.

Financial Policies
  • Why do you need a financial policy? Collecting money directly from your patients can be the hardest money to collect.  Emotionally, it is difficult for doctors and their staff to deal with patients and their financial matters.  A financial policy provides a set of procedures that will help you with your collections.  This written document provides you and your staff with the methods and best procedures needed  to service your patients when collecting from them directly.  Being most effective in this process is key – it will keep you in the business of caring for your patients.
  • What are some best practices for communicating our financial policy to patients? First and foremost, the policy should be in writing. Use simple, words.  Use Microsoft Word or similar program to assess the reading level of your document.  For best practices, your document should have a reading level no higher than the seventh grade.

All of your staff should be educated and have a complete understanding of the policies.  Everyone in the office should know how to collect money from a patient.  Having clear, consistent, and firm policies are crucial to having an effective policy that patients will understand and respect.

Best practices include communicating your financial policies and your expectations to the patients when they are scheduling an appointment.  Include a copy of the policy in their “new patient” packet that you mail to them or direct your patients to a copy on your website.  Be sure to have them sign a copy when they visit your office.  Retain the signed document at your office and provide a copy of the original to the patient for their records.

In addition to providing this to new patients, it is a good idea to remind returning patients of your policy.  If you find that it is necessary to update or change the policy, be sure to notify your patients of the policy change.   This can be done by way of a letter, notice in the office, or a notice on your website.  Use what will work best for your practice ensuring that the patient is well-informed.

  • What should the financial policy contain? Be sure to clearly indicate all the financial aspects associated with a patient’s care in your office.  For example, do you charge a no-show fee?  Are there penalties assigned if the patient doesn’t pay his co-pay at the time of service?Let the patient know, your office strives to provide the best possible care and will help the patient, using your best efforts, to obtain their maximum insurance benefit.  Remind  the patient the financial responsibility for payment is, ultimately, their responsibility.  Explain co-payments, high deductible amounts, and non-covered services must be paid at the time of service.  I recommend you have a financial arrangement agreement that will address these amounts and how they will be collected.  Also, it is important this financial arrangement is reviewed with the patient before they are scheduled for any procedure.

    Additionally, here are some other items your policy should include:

  1. The patient agrees to inform you of any address changes or updates to their insurance benefits (there should be no surprise if you ask them for a copy of their insurance card or driver’s license)
  2. The forms of payments your practice accepts (cash, debit or credit cards, checks, Care Credit)
  3. The fees charged for checks that are returned
  4. How delinquent accounts are handled
  5. Hardship application and documentation
  6. To whom the patient should direct their billing questions
  7. How patients without insurance be handled (this is especially important for dental practices)
  8. Charges for making copies of medical/dental charts
  • Office Procedures for your staff – In addition to having a financial policy and a financial arrangement agreement for your patients, I would also suggest that you have a written protocol for managing the accounts receivable.  In this document you should describe the procedures and systems that you use.  Everyone in the office should be trained on the procedures.  When someone joins your team, this written document should serve as a training system for your new hire.  This document would also become the source by which you hold your employees accountable to keeping the accounts receivable clean. This document may include items such as:
  1. How a patient credit balance is handled
  2. When a patient balance is sent to collection, what code is used to adjust the balance off the patients’ ledger
  3. What notes and alerts are put on the patients accounts when the account is in collection or when a “hardship” situation is granted
  4. The process for granting a hardship application
  5. How the aged accounts receivable balances are worked and who is responsible
  6. How the aged insurance balances are worked and reviewed and who is responsible
  7. How often billing statements are sent out
  8. What the criteria is for not sending a statement
  9. What dunning notices are used and when they should be applied
  10. The process for granting and approving patient payment adjustments
  11. How the practice management will be used to note communications and agreements with patients
  12. How to process credit cards

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Are You Ready for MACRA?

How do you define the success of your Practice?

What's the formula for defining Success in your practice?

Is it based upon the profits you earn?  Or, how about the difference you make in the lives of those for whom you care?  To truly care for your patients effectively, you need to be profitable.  And, to be profitable, you need to know your financial numbers and what strategies to employ to make a difference in your bottom line.  Knowing your numbers is like knowing the score of a game you are playing.  When you know the score, you know what strategies you need to employ to win the game.

If you are a physician or healthcare provider that cares for Medicare beneficiaries, you should have a full understanding of the MACRA payment program.  It’s likely that you have heard of the program, but you may still have questions about how it will affect you.  Do you know what you can do to increase your MACRA goals to have an impact on your profits?

The National Committee for Quality Assurance (NCQA) has developed a Toolkit to assist you.  This toolkit details the MACRA requirements, explains how the payment structure will impact your scoring potential, and suggests strategies that you can incorporate the patient-centered medical home model to improve your MACRA Score.  You can use the virtual toolkit at anytime by simply registering to use it.


Learn to Be a Winner!  Use this toolkit to explore case studies and improve your scores- it’s a formula and strategy worth knowing.

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Benefits of a Cash Balance Plan – FREE Webinar

Save Taxes by Contributing to a Cash Balance Qualified Retirement Plan



Cash Balance Plan

Join me as I host this informational FREE Webinar on the Benefits of a Cash Balance Plan



This Webinar is for you if:

  • You are paying 33% or more income tax on your income
  • You desire to save taxes
  • You have extra cash flow that you wish to save on a pre-tax basis

If you want to…

  • Fund more than what your 401(k) plan will allow
  • Provide for a disparity in retirement funding between business owners
  • Create more flexibility in your funding

This Webinar on the Benefits of a Cash Balance Plan will help you gain an understanding of this type of Qualified Retirement Plan and achieve the above objectives.




The Department of Health and Human Services Office of Internal General (OIG) recently published this video on their website after entering into a Corporate Integrity Agreement with eClinicalWorks for $155 million dollars.  The OIG is showcasing this settlement as an example to other Electronic Health Record (EHR) vendors.  eClinicalWorks, on the other hand, is moving forward as dominant player in the EHR space and admitting no wrong.

What is the take away for physicians? Be certain that you have business procedures and compliance training in place to protect your business.

  • The matter of healthcare fraud is being taken seriously.  In addition to fulfilling their duty to protect the public, the work of the OIG offers a large source of revenue for the government.  Take time to Review the OIG’s workplan each year.  Here is the OIG’s 2017 Workplan.
  • Be sure that all your employees (including you) are up to date on the required annual compliance training and mandate that employees notify you of any known activities that may be considered out of compliance.
  • Your EHR or other Practice Management Software vendors are at risk of Fraud and Abuse audits.  Even if they aren’t found guilty of actual fraudulent activities, the cost to defend such a case can be financially harmful and impact the ability to support your business.  So, know your healthcare software partners well.  Look to the purchase agreement to protect your business on the front-end of a purchase by making certain that you are able to get your data if you need to make a switch in vendors.

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Recruiting a New Doctor? Offer a Student Loan Repayment Program

New Doctor Associate

Student debt has become a major financial factor for new medical and dental graduates.  Your new associate doctor is likely to have student debt in the range of $260,000 or more. Rather than looking for a position that offers the benefits of ownership with an independent practice, younger doctors are seeking positions with a secure paycheck.  Adding a student loan repayment assistance program to your compensation offering will put you one step ahead of your competitors seeking to hire the same candidate.

New recruits offered this benefit are more likely to accept a position.  They are also less likely to leave, if it means leaving their student loan repayment assistance program behind.  Hospitals and larger corporate employers, in the dental profession, have been offering these benefits for years. Independent practices that address their potential associates’ concerns about student debt when making an initial offer of employment, stand a better chance to successfully hire their desired candidate.

To make your offer even more attractive, get creative with your benefits.  Consider offering a salary amount along with an upfront low-interest loan that can be used to jump-start the reduction of the student debt.  You can structure increased contributions to be made based upon determined factors that align with your business goals.  Your goals might include a vesting schedule based upon length of employment, taking on new business, or becoming a business partner.

The tuition assistance payment that is made on behalf of your employee is a taxable benefit. However, the company contribution, or the “jump-start” loan, will provide a favorable interest savings to your new doctor employee.

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Guidance on Ransom-ware Attacks

Top 10 List to Protecting Yourself from Ransomware

In July, 2016 the Department of Health and Human Services Office of Civil Rights issued guidance intended to help healthcare entities understand and respond to ransom-ware attacks.

ransom ware touchscreen is operated by businessman.

Ransom-ware is a type of malware that denies a user’s access to its electronic data by encrypting the data with a “key” known only to the perpetrating hacker.  After the malware is deployed, the hacker demands that the user pay a ransom (often the request is made in cryptocurrency, such as Bitcoin, to preserve the hacker’s anonymity) to obtain the key and decrypt the data.  However, there are no guarantees that once the ransom is paid will the hacker provide the necessary key.

According to the report issued, there have been 4,000 daily ransom-ware attacks since early 2016 (a 300% increase over the 1,000 daily ransom-ware attacks reported in 2015).  Doesn’t that seem incredible? Why would these people target businesses such as yours?  Here are some thoughts:

  • They know it’s where the money is
  • They know that they can cause some major business disruption, which will put you in a very vulnerable position
  • Because through the business their dirty deeds reach a more extensive system – networks of computers, and cloud-based systems may be impacted
  • Because small business, especially healthcare providers, are often not well prepared to deal with these types of cyber attacks

After reading the HHS report, I set out to build a checklist that would help prevent this from happening to me and you, my client.  Here is my “Top 10 List to Protecting Yourself from Ransom-ware”:

  1. Back-up your data and make sure it works!  Having a couple of backups may even be a good idea – using an external drive that is removed from your office and using a cloud-based back-up system.  Side-note: Whatever backup system you may use for Protected Patient Information be sure it is HIPAA compliant and that it follows security management process described in your policies.
  2. Keep your computer operating system up to date.  New updates are issued often that contain fixes to security issues.  The same is true for the software you use – check for updates often.
  3. Use extreme caution when you are on-line and using the Internet.  Know your sites and stay away from any pop-up ad campaigns.
  4. Never open spam mail or mail from unknown senders.  If the subject line of the e-mail I receive is empty, or, if the e-mail looks even somewhat suspicious, it gets the “shift-delete” treatment.  It doesn’t even get a chance to reside in my trash bin.
  5. Use caution when downloading files, opening files, or clicking on hyperlinks – know your sources!  If you ever do open a suspicious file by mistake, shut off your Internet connection.
  6. Have security software installed and keep your subscription up to date.  One the best ways to protect against a virus is to have defenses in place to ensure you never receive any in the first place.
  7. Keep your system locked down when you are not using it and never share your password with another user.  And, I hate to say it – don’t keep your password on a sticky note placed on your computer (yes, I see this frequently).
  8. Keep your employees privileges locked down on your network.  Make it difficult for them to do their on-line shopping, visiting unknown websites, or social media sites on your business computer.
  9. Don’t let your children or grandchildren on your computer – I’m serious! Over the years I have tried to fix more computer problems as a result of kids games and files they download.  Give them their own gaming or computer system and keep them off your computer.
  10. Don’t pay the ransom. Even if we follow the above checklist, it’s possible we could find ourselves subject to a cyber-criminal.  Paying the criminal only puts you in a position of being a repeat customer.

Computers have become an integral part of the way in which we do business today.  I find myself being in a love, hate relationship.  I love the efficiencies and conveniences they provide.   I hate the damage they can cause to relationships, work / family time, and our pocket-book.  I’m probably not going to eliminate technology from my life any time soon.  In fact, my use will likely only increase with time – so, I guess it just makes sense to be smart in the way in which we use them.  Hopefully, this checklist will help us both in making life with them just a little better and little safer.

If you are interested in receiving a copy of the HHS report,  go to for a pdf copy.

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

A Budget – Personal Financial Management

Financial Planning Steps that Put you in Control

Today we are living in an uncertain economy.  There is talk of changing and increasing taxes, of a failing Social Security system and of skyrocketing educational costs.  Given the various financial uncertainties, it is more important than ever for you to apply financial planning principles to your personal life.  Budgeting is one of these key principles.

Budget Financial Planning

The majority of American households are in significant debt.  According to a study in Time Magazine – May, 2016, the average American household has total debt of $90,000, which includes households that live debt free.  The average households with debt owes more than $130,000.  This debt burden is costing the average household more than $6,600 in interest per year – about 9% of the average income.

Many do not have a budget and as a result most households have no idea where they spent their money last year.  A personal budget can provide this information and can help you take control of your financial life.

Bake My Day – A Recipe for Patient Satisfaction

The Secrete Sauce for Marketing a Doctor's Services

He called on Mother’s Day.  “May I speak to her?”, he asked.  My jaw dropped as I listened to my fifteen-year-old daughter, who was recovering from ACL knee surgery, talk with her Orthopedic Surgeon.  He was calling just to see how she was feeling. Even though my wife provided our daughter’s current status and answered all his questions, he wanted to take a minute to talk with the patient for whom he cared. It was awesome that Dr. Steward called to check in with his patient. One might even expect such a call.  But, when he ended the conversation with my wife asking – “May I speak to her?” – he just created an awesome experience – patient satisfaction for both the patient and her parents.  It was as if he put extra sprinkles on a baked cake…marketing at its finest.

Top of Easter cake covered with white icing and sprinkled with color pops. Candy background.

Build an Exceptional Team – Start with Position Descriptions

Free Position Description Templates

Having clearly defined Position Descriptions is the first step in the process building the right team for your office.  I often receive questions from clients related to staffing issues in their office. And, I often answer their question with a question – What does your position descriptions say?

Position Description