Practice Management Q&As

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Dealing with worsening collections; when you're wronged by a lawyer; taxes and temp workers; should a salaried doctor pay overhead? is a postage meter worth the money?

Dealing with worsening collectionsQ My practice has seen a significant increase in accounts receivable over 60 days old. I'm assuming it's because patients are having trouble affording the higher out-of-pocket costs caused by higher coinsurance requirements. Are other doctors experiencing this problem, or am I doing something wrong?

A In general, primary care physicians' accounts receivable have been going down in recent years, according to the Society of Medical-Dental Management Consultants. This is probably due to electronic billing, posting, and remittance.

Should a salaried doctor pay overhead?Q A group I'd hoped to join decided to keep me on as an employee, rather than make me a partner. But I'll be required to pay overhead. Is this fair?

A It depends on the details of your salary agreement and how overhead is allocated. When it comes down to it, every provider who bills for services in a medical office contributes to overhead-from the most senior physician to the nurse providing "incident to" care. You've always been contributing to overhead, but, up to now, that contribution came out of the difference between your collections and the amount you received in salary and benefits.


So in negotiating with the partners, focus on how much of what you bring in you get to keep. Since you're a salaried employee, your group shouldn't subject you to the same financial risk as full partners.

When you're wronged by a lawyerQ I believe I have a legitimate claim for legal malpractice. How can I find an attorney willing to sue another? Would I have an easier time if I looked for a lawyer from another city?

A If you live in a metropolitan area, you shouldn't have to look beyond the local bar association for a reference. If you live in a small community, you may have better luck if you look elsewhere for a lawyer.

Taxes and temp workersQ Should I issue a 1099 or a W-2 to temporary workers who occasionally cover for vacationing or sick employees?

A Use a 1099, assuming you're treating the worker as an independent contractor-not an employee-and that you didn't withhold taxes.

Is a postage meter worth the money?

Q How much mail would my practice have to handle to make it worthwhile to invest in a postage meter? My office manager is tired of running to the post office every time our stamp supply dwindles.

A Get the meter, which will allow your office manager to replenish your postage account online. The staff time you'll save will be well worth any initial expense.

Do you have a practice management question that may be stumping other doctors, too? Write PMQA Editor, Medical Economics, 5 Paragon Drive, Montvale, NJ 07645-1742, or send an e-mail to (please include your regular postal address). Sorry, but we're not able to answer readers individually.