Melissa Young, MD: I survived the first month

November 11, 2009

So I officially left my old practice eight weeks ago, and opened my doors four weeks ago. I have neither broken down sobbing nor screamed hysterically at my receptionist, patients, or husband.

So I officially left my old practice eight weeks ago, and opened my doors four weeks ago.  I have neither broken down sobbing nor screamed hysterically at my receptionist, patients, or husband. I have seen patients, paid bills, borrowed money (to pay said bills), and learned a lot of things that no book, seminar, or conference could ever teach me. There have been days that I’ve sworn under (and over) my breath, but for the most part, it has been a fulfilling month.

A word of advice to anyone who is planning to leave one practice to start another:

While I thought I had the timing planned perfectly, you really can’t expect to transition quickly as far as payers are concerned.

In general, the insurance companies (and particularly Medicare) won’t even entertain your change of address/change of tax ID number any sooner than 30 days before your effective date. Yet, it takes longer than 30 days for them to process the changes. So I had naively thought that I could start my new practice two weeks after leaving my old one, but no. And at week four, the new practice was only credentialed with a couple of payers, even though I had participated in nearly 20 at my old practice, and I had only moved a couple of towns away. I hadn’t even moved out of the county. I didn’t worry do much about Medicare (which took the longest, by the way) because I figured I could back bill as far as 90 days.

After seeing patients for two weeks, we finally were able to submit claims, and guess what? Checks came in yesterday! As an employed physician, I never saw the money come in. I got my salary and at the end of the quarter, got my share of collections (which was regularly a source of contention). For the last four months, as a new business owner, I had only seen the money go out. And now, happy day, remittance. Now, to figure out who’s paying me how much.

Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J. She is a regular contributor to Practice Notes.