Every question, by the stage you're in. 56 recurring questions, blended from the operator rooms so no one's own post is
here, grouped into the four stages, and each one anchored to the business concept that turns
it from an argument into arithmetic.
All stages Deciding 8 Building 21 Practicing 9 Operating 18 Stage 1
Deciding 8 questions Employed, running the numbers at night. Should I leave, and for what?
I have two offers: 70/30 at one place and a flat hourly at the other. Which is actually better? constant thin Is 70/30 normal for my experience and my state? constant thin They offered the same split as W2 or as 1099 and said to pick whichever I prefer. Is there a catch? common false Is joining the platform worth it, or should I get credentialed directly? constant thin What does the platform actually pay per visit in my state? very common thin I want to go private full time. How many months of savings should I have first? constant thin I keep being told they want someone with more experience. How do I interview better for these roles? very common pileOn I've never worked in private practice before. What should I be asking them? common thin Stage 2
Building 21 questions Launching. Entity, credentialing, contracts, the gates between here and the first paid claim.
My NPI came through and the LLC is registered. Can I start seeing insurance patients? constant thin What order should I do all of this in? Everyone gives me a different list. constant thin How long until I actually get paid for the first visit? very common silence I practice by telehealth only. What address do I use for enrollment? very common silence What's a reasonable monthly fee for a collaborating physician? constant thin I already pay a collaborator and I think it's too much. Can I renegotiate? common thin Who do I even ask? I don't know a single physician who does this. very common thin Should I hire a credentialing service or do it myself? I started an application and it was fifteen pages. very common thin Everyone recommends a different tool, service or membership. How do I know what's worth paying for? common pileOn What does it really cost to start? Did you count malpractice, the EHR, e-prescribing, all of it? very common thin I take insurance now but I want to go cash-pay only. What changes? common thin Which EHR should I use? Everyone names a different one and I can't tell what actually matters. constant thin Does anyone have a contact at this vendor, or a rep who can help me? very common thin LLC or PLLC, and when do I actually need an accountant? very common thin What's a realistic monthly cost to run this once I'm open? common thin Everyone says an S-corp beats an LLC and I already filed my LLC. Should I dissolve it and start over? very common false When should I set up the bookkeeping? I'm already spending money and I don't know what to track. common thin Does anyone have an address in another state I could use for my DEA application? Happy to swap for mine, or pay for it. constant silence Do I need a separate LLC in every state I practise in? And does a new state mean a new tax ID? very common thin If I'm credentialed in my home state, can I bill for patients in the other states I'm licensed in? very common thin Does anyone have a lawyer they recommend, and what does it cost to have consents and policies reviewed? common thin Stage 3
Practicing 9 questions Open. Coding, documentation, the first patients, the first denials.
Can I add the therapy add-on to every medication follow-up? Someone in a group said it's free money. constant false The claim paid. Doesn't that mean it was billed correctly? common false An audit letter arrived asking for records. What do I actually need? common pileOn Should I level this visit by time or by complexity when therapy is involved? very common thin My EHR keeps suggesting a higher level than I think I earned. Should I trust it? common thin I have years of experience in an independent state, and my employer still requires ongoing chart review. Is that negotiable? common silence Can someone share their scribe template? And do patients need to sign a consent for it? very common thin I ordered routine labs and my patient got a bill for hundreds of dollars. Now they're upset and I'm on the phone with the insurer. How do I stop this? common pileOn Is it worth adding cognitive or lab-based testing to the practice? The kit and the subscription aren't cheap. common thin Stage 4
Operating 18 questions Running it. Cash, utilization, the funnel, a second provider, a second state.
I'm booked out weeks ahead and the bank account doesn't reflect it. What's wrong? constant pileOn A denial and a recoupment request both arrived this month. Where do I even start? common pileOn My schedule is nearly full and revenue hasn't moved in two quarters. Do I add hours? common thin Attendance is running well below what I expected. Should I overbook or charge a fee? common thin What should I charge per hour? very common pileOn Most of my platform patients are repeat visits now. Am I still paying for acquisition? common silence I'm bringing on my first NP. W2 or 1099, and what split do I offer? common thin If I bring someone on as a 1099, can I ask them to work only for me? common thin Should I enroll under my individual NPI or set up a group NPI if I plan to hire later? common silence Has anyone left the platform and gone direct? What actually happens to the patients? common thin They changed my directory profile and I get no referrals from them. What am I actually paying for? common thin How do I actually pay myself? Do I just move money to my personal account and call it a distribution? very common thin My tax bill this year was brutal and I didn't see it coming. How do people plan for this? very common thin Self-employed now. What do I do about retirement? None of the usual accounts apply and I don't know where to start. common silence The federal flexibility was extended but my state just ended theirs. Which one applies to my patients there? common pileOn Should I wait to expand until the rules settle? common thin Should I add a new service line? The equipment and training are significant. Is it worth it? common thin Everyone at conferences is doing this. Should I be worried I'm missing out? common pileOn These are the questions. The lessons are the method for answering them yourself, one a week, free.