General Category > General Questions

Provider or Vendor

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Michele:
Do you have any resources to assist you in learning the billing?  If the patient load is small and you have resources to make sure you are doing things correctly, it could work.  The concerns would be that a lot of money could be lost, and also, if things are not billed properly there could be ramifications such as fraud (unintentional of course - but still fraud).  Is your wife familiar with how to code her own services?  If she is familiar with the coding that is a huge help.  If she isn't, it would be difficult.  Also, do you have a practice management system? 

I wouldn't think setting up as a vendor would be beneficial in the beginning.  I don't know about being an employee with receiving $0 pay, but I know that spouses "help out" their provider spouses all the time.  I just don't know the legal ins and outs. 

PMRNC:

--- Quote ---I wouldn't think it would violate any STARK regulations considering if she were doing it all herself she would have the same financial interests as I would.
--- End quote ---

That's exactly why an attorney should be consulted.

I would not go into this without legal consultation.

Niosh:
She is in close contact with two of her preceptors who both have started their own practices years ago. Otherwise we were looking at getting a few books or taking classes of some sort. Long term she doesn't want to see a large volume of patients, maybe 30 or so per week.

When you say practice management system do you mean some type of EMR software or a business plan?

I think for now I'm going to avoid setting up as a billing agent. I really appreciate your help on this, thank you.

Michele:
EMR is for records.  Practice Management system is for billing.  Some PM's contain EMR, and vice versa.  You really need some form of PM system not only to submit claims, but to track, record payments, and run reports.

PMRNC:
Not to sound harsh, but PLEASE get someone experienced to start your wife off and learn that way rather than the other way around. The beginning is a chance to start off on the right track and learning as you go and begin is not going to benefit her at all and in fact could do much more harm than good.

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