Concierge and Direct Pay Practice Setup
Our healthcare business law firm assists doctors who want to set up or transition to concierge medical practices (also known as “retainer practices,” “boutique practices” or “membership practices”). Although engaging in concierge medicine requires you to consider a different way of thinking about conducting your business, the driving force for most physicians to change to the concierge model is “quality of life.” (See three reasons to practice concierge medicine, below).
Atlanta Healthcare Attorneys
We ensure your concierge practice is set up properly by providing the following services:
- Preparing legally compliant documents and forms for the concierge model, including Patient Services Agreements, Patient Enrollment Forms and Membership Contracts, HIPAA Privacy Notices and Disclaimers, Consent for Use and Disclosure of PHI, Consent for Treatment
- Review or drafting legal RX policies to ensure compliance with applicable law and regulations regarding prescribing medication.
- Review and analysis of malpractice policies regarding coverage issues for your concierge practice
- Review and analysis of health plans and third party payer contract provisions that might be impacted by retainer based billing (improper “double billing” or “balance billing”)
- Review and analysis of telemedicine issues for compliance with applicable regulations
- Review and analysis of Medicare issues for compliance with federal law and CMS rules and pronouncements
- Preparation of physician and employee agreements for the staff in the concierge practice
- Review and negotiation of concierge franchise agreements for doctors who want to practice concierge medicine under the umbrella of a franchise
- Review and assessment of risk assumed by concierge model to avoid tripping over State insurance regulations
- Review of marketing strategy to ensure compliance with applicable laws
Our Atlanta healthcare law firm advises and represents healthcare providers in throughout Georgia, South Carolina and other parts of the Country. (See Communities We Serve). Our law firm has substantial experience and demonstrated an interest in helping healthcare businesses succeed.
“Kevin Little [of Hamil Little] represented the Medical Association of Georgia and individual physicians in a matter addressing the abuses of the health insurance industry. Kevin was a pleasure to work with and brought forth legal theories to hold the health insurance industry accountable to physicians and patients. We received outstanding representation from Kevin.” *
Donald Palmisano, CEO and General Counsel, Medical Association of Georgia.
Our attorneys have extensive experience as trial and business attorneys and hold Martindale Hubbell's AV rating, its highest rating. To schedule a consultation with our attorneys, email us at email@example.com or contact us at our office nearest you.
Three reasons why concierge medicine may be the happiest way for you to practice medicine
It is easy to see why concierge medicine is a rising trend. For the patient: same day appointments, 24/7 access, more face time with the doctor, extra preventive care and wellness, not dealing with insurers. For the doctor, more control, not practicing “hamster” medicine (cramming in dozens of six-minute patient meetings every day), actually knowing your patients and their families, not dealing with insurers. Although setting up a concierge practice takes effort, time and commitment, and some risks, the following are three of many reasons to consider it:
1. No more insurers (or less of them)
This reason alone is enough motivation for many physicians to consider alternatives to a traditional, insurance-driven medical practice model. Wouldn’t it be nice not to have to deal with insurers (or deal with them less)? Wouldn’t it be nice not to sign onerous, adhesion provider agreements, or speculate about why an insurer delayed or denied payment again on a group of claims, or try to get the insurer’s business person to understand why a physician’s medical judgment should determine whether a particular procedure or treatment was medically necessary? Most concierge practices do not accept insurance or, if they do, only on a limited basis.
2. Equal Pay but More Gratifying Work
While how much you make will, as with any practice, depend upon a variety of factors, a 2012 Medscape study concluded that the average salary for primary care doctors was in the range of$156,000 to $315,000, and Bloomberg BusinessWeek reported that the average salary for a concierge doctor ranged from $150,000 to $300,000. Other studies are consistent with those numbers and tend to demonstrate that concierge doctors make about the same amount of money as doctors in traditional practices, or slightly more. Therefore, money tends to be a neutral factor. The real incentive for concierge doctors is quality of life. Fewer patients mean more time with patients and a greater sense of truly practicing medicine and helping people, as opposed to dealing with administrative details.
3. The Affordable Care Act (“ACA”)
Government estimates indicate that over 30 million additional Americans will obtain health insurance by 2020 as a result of the ACA. The Association of American Medical Colleges estimates a shortage of 91,500 doctors by 2020. It will become very difficult for patients to see their doctor. Ironically, the ACA (which purports to increase access to healthcare) may make it much harder to see a doctor. Many experts predict a great increase in the patient popularity of concierge medical practices. Patients will be willing to pay for access to a doctor. This dynamic may create significant business opportunities for savvy doctors.
Georgia and South Carolina Business and Healthcare Law Firm
Our attorneys have extensive experience and are AV-rated. Our firm has offices in Atlanta and Augusta, Georgia. Our firm’s lawyers practice law in Georgia and South Carolina. Contact us at 404-685-1662 (Atlanta) or 706-722-7886 (Augusta and Aiken) to schedule a confidential consultation.
DISCLAIMER: Any result this law firm or any lawyer of this law firm may achieve on behalf of one client in one matter does not necessarily indicate similar results can be obtained for other clients.