Query: Cyber Security Insurance
It has often been said, "you can’t have too much insurance," but what is considered reasonable coverage amounts for cyber security insurance? Some professional liability companies are including $50,000 to $100,000 coverage for their professional liabilities clients, but is that enough?
Joe Boylan, DPM, Ridgefield, NJ
Query: Instrument Sharpening Service
Where do podiatry practices send scissors, nippers, chisels for sharpening? Good quality and quick turnover wanted.
Billie A. Bondar, DPM, Rochester, NH
Query: Collection Agency for Medicare Deductibles
I am looking for a reputable collection agency for a very small number of patients. The common denominator in my practice is the very few who refuse to pay their Medicare deductible. Why isn't there any recourse doctors have that would allow them to report these patients to Medicare. I scratch my head every year wondering why our government doesn’t just take the yearly deductible out of every beneficiary's Social Security check at the beginning of the year. It would save a ton of aggravation, time, and money from our already financially squeezed practices, not to mention saving the government a large sum of money. It is very frustrating to think there is a very simple fix to a yearly problem many Medicare participating practitioners have.
Jack Ressler DPM, Delray Beach, FL.
Query: MBT Shoes
Does anyone have experience with MBT shoes? I have a patient asking about them and I'm totally unfamiliar with them.
Larry Aronberg, DPM, Lake Worth, FL
Query: Technical Support for an Alara CR T220 Digital X-ray Reader
Does anyone know who can give me technical support for an Alara CR T220 digital x-ray reader and more specifically the CRystalview software that it uses? It seems Alara is no longer in business nor is the imaging company that sold the system to me.
Sean Connolly, DPM, Everett, MA
Query: How are DPMs Dealing with Increasing Overhead Expenses?
My accountant read me the "riot act" when he was at my office last week. He does not understand why my overhead expenses are rising so astronomically. I am not just talking about rent, insurances, and payroll. The biggest rise seems to be the cost of supplies. I haven't changed vendors and yet my accountant was able to show to me my expense increases from year to year. Everything I buy is essential to day-to-day practice. How have some of you dealt with this insidious rise in the cost of day to day supplies. Are any of these "group buying" companies a viable answer?
Elliot Udell, DPM, Hicksville, NY
Query: Repair of Micromat 3000
My Micromat hand piece needs repair and Med-Pro Corporation is no longer in business. It is a Nouvag Swiss spray drill hand piece with a sprayer attachment for grinding nails. I would like to get it serviced but am not sure where to get it repaired.
Catherine Yack, DPM, Huntsville, AL
QUERIES (NON-CLINICAL) -PART 1
RE: CA Podiatrist Publishes 600th Issue of Practice Perfect
From: Alan Sherman, DPM
This week, Jarrod Shapiro, DPM has reached the milestone of completing his 600th issue of Practice Perfect. Over the past 12 years, Dr. Shapiro has delivered 600 consecutive weeks of professional insight and mentorship to a generation of podiatrists and those working in the podiatry profession. From the importance of checklists in clinical practice to communication issues to what it means to think like a surgeon to truly enjoying your professional life, Dr. Shapiro has taken us on an introspective examination of our podiatric lives and challenged us to live and practice in a more examined, deliberate, and fulfilling way. Along the way, we have all grown with him. Thanks Jarrod for sharing your prodigious and active mind with us.
Alan Sherman, DPM, CEO, PRESENT e-Learning Systems
Query: Time Clock, Attendance, and Scheduling Software
Our practice now employs 27 team members and our current facial recognition program is really poor. We tried a fingerprint system before that with similar results. Does anyone utilize a program that imports the data direct to Quickbooks and has features to change employee schedules, monitor tardiness, keep track of PTO (paid time off), and is reliable to use? I would like employees to be able to log in and out with their computers and/or phones but also make sure they are within a reasonable distance of the office. I have looked at Ximble and Humanity and it looks like Humanity might even remind me of employees' birthdays and work anniversaries.
Jane Graebner, DPM, Delaware, OH
Query: Recommendations for Billing Companies
Can anyone provide me with any contacts and names of billing companies with whom you have had a good relationship, and with whom you are satisfied with both the quality of their work and the fees that are charged for their services?
Dave Williams, DPM, El Paso, TX
Query: Recommendations for 4-Line Phone System
Can anyone recommend a 4-line phone system? All the systems I’ve researched have too many cons, i.e., no caller ID, etc. I’d prefer a corded system.
Jay Kerner, DPM, Rockville Centre, NY
Query: Bringing an PA/NP into Practice
My practice is expanding and I'm considering bringing on a part-time midlevel provider (PA/NP) to aid in patient care. I recognize that state laws ultimately dictate legality of employment, but I would love to hear the opinions of my colleagues out there who employ or have employed PAs/NPs in their practices.
P David Applegate, DPM, Katy, TX
Query: Lidocaine Shortage
Does anyone have a reliable U.S. distributor with a solution to the current local anesthetic shortage?
Paul Kesselman, DPM, Woodside, NY
Query: Source for Bupivacaine w/Epi
Does anyone know the availability status of bupivacaine 0.5 % with epinephrine? I'm told that it is back ordered from the company.
Paul A. Galluzzo, DPM, Rockford, IL
Query: Holding Credit Cards on File
If your office is holding credit card numbers (safely offsite, in a cloud, etc.), do you charge off the balance of the account after 30 days or 60 days, or do you create a payment plan at the time of service?
Nicole Freels, DPM, Lexington, KY
Query: Repair of Midmark Equipment
After years of reliable service, we recently experienced a power surge that knocked out two Midmark 417 podiatry chairs and our R9 UltraClave. I need a recommendation for a reliable service company for these products in the Philadelphia area.
Greg Caringi, DPM, Lansdale, PA
Query: How Often to Change Benz-All Instrument Disinfectant Solution
Can anyone tell me how often we should be changing the Benz-All instrument disinfectant solution in the Bard-Parker trays. Is there literature to cite?
Ed Dos Remedios, DPM, Providence, RI
Query: Template for Credit Card Collections of Deductibles
Our practice is looking for a method to collect on high deductible patients via pre-authorized credit cards once the insurance company has concluded the claim. Does anyone have a template of a form they use in this regard?
Amy Sepehri, Practice Manager, Chicago, IL
Query: Formula for Value of a Practice
I am in the process of entertaining a bid for the purchase of my now second generation practice. What formula have others who recently sold their practice used to calculate a sale price? There are several rather complicated accounting methods floating around, but I was hoping for a more simple starting point, say X% of gross or X% of net. I recognize that there are a lot of variables in the negotiating process, but was hoping for a simple place to start and perhaps circle back to after the accountants and lawyers churn the pot.
Editor's comment: PM News does not provide legal advice. In a rapidly changing healthcare environment, there is no magic formula that works for all practices. One thing though is certain. Any formula you start out with MUST be based on a percentage of net. Gross income is a useless figure because three practices with the same gross, e.g., $300,000 can have three radically different net incomes. Net income is the only true measure of how long a prospective buyer will take to repay the loans necessary to purchase a practice.
Query: Online Bills to Patients
Does anyone know whom I can deal with to set up online bills to send to patients' emails?
Jill Hagen, DPM, Englewood, NJ
Query: Keeping Track of Employee Hours
How are offices keeping track of employee hours? A time clock machine? Each person filling out a weekly time sheet? Or something else?
Olga Luepschen, DPM, Sebring, FL
Query: Rationale for Penalizing CR X-Ray Technology
What is the reason for penalizing someone with CR x-ray technology? What makes DR technology deserving of a higher reimbursement?
Jeffrey Kass, DPM, Forest Hills, NY
Query: Storing Charts and HIPAA Compliance
I am a semi-retired podiatrist. My practice consists of a satellite office and a few independent senior facilities. There is a central medical wellness office where I see my patients at the facilities I go to. Because I only work part-time at all of my locations, I store all of my patient charts (still using paper) at home. To be HIPAA-compliant, what precautions do I need to follow when storing patient charts at home? They are kept in a locked closet.
Editor's Comment: PM News does not provide legal advice. Under the HIPAA security rules, covered entities must "Identify and protect against reasonably anticipated threats to the security or integrity of the information." The keyword is "reasonability" and a locked closet meets this requirement. Note: HIPAA is a national minimal standard which can be superceded by state law.
Query: Difficulty Getting Local Anesthetics
Does anyone know why I am having trouble getting Marcaine, Carbocaine, and Xylocaine (proprietary or generic)? I am being told there is a back order and it will be several months. No one seems to know why.
Sam Bell, DPM, Schenectady, NY
Query: Plug-in for Credit Cards
We have been using Spark Pay for several years, which is a plug-in for your phone or tablet to process credit cards with no terminal needed. I just received notification that Capital One is discontinuing Spark Pay on January 31, 2018. Square is a popular alternative, but it has the worst reviews. I ordered PayPal's device but upgraded (for $79) to a unit that will accept the chip, swipe, Apple Pay, and Android payments. It is also wireless to our phone, computer, or tablet. They charge 2.7%. Does anyone have a good or bad experience with Paypal, Square, or other plug-ins?
George Jacobson, DPM, Hollywood, FL