The Best Medication Resource

Carlat Medication MFB_2016_Cover

From one of the most trusted resources for psychiatric medications, The Carlat Report, a new version of the Medication Fact Book is available for preorder.

Each medication sheet of this PDF document contains medication dosing, side effects, clinical pearls and a “fun fact” that keeps studying these medications entertaining.

Vyvanse Carlat Report Medication Fact Book 2014Charts to help compare medications are also helpful.

ADHD Chart Carlat Report Medication Fact Book 2014-2The 2016 Edition will provide the latest information on several new medications (Rexulti, Vraylar, Namzaric, Belsomra, Adyi, Xyrem), updated since the 2014 edition.  To Pre-Order, follow this link for the 2016 Carlat Medication Book.

Efficient Use of Adwords

If you haven’t yet begun using Google Adwords for your private practice marketing, you should consider starting. I have found that this is one of the most efficient ways to market a practice. Unfortunately, in a crowded market, this can become very expensive. Some keywords maybe $25, $50, or more per click.  

The key to efficient use of Adwords is using “longtail keywords.” These are more descriptive keywords than “shorttail” keywords, such as “mental health therapist in Los Angeles” as opposed to “therapy.” You read that right, a “keyword” might be more accurately called a “key phrase,” but in the field of digital marketing, these are all called “keywords” regardless of the number of individual words it contains. These longtail keywords are much cheaper and more targeted than the shorter ones. There are fewer searches for these keywords, which may seem to lead you to fewer visitors. That may be true, but when you are paying for each click, you want the most qualified “leads” possible (meaning patients searching for treatment, rather than people searching to learn more about what therapy is in general.
 

One free way to find good keywords is using Google’s Keyword Research Tool, a component of Google Analytics. A more powerful tool is Longtail Pro, which allows you to view the competition for each keyword. Competition is directly proportional to the cost of keywords. Longtail Pro also allows you to see the search volume for these keywords, which can help you decide whether or not to use a specific keyword.

For a limited time, you can get a 10-day trial of Longtail Platinum for just $1.  I like this program, because once you purchase it, there are no recurring fees.  

Best of luck to everyone as you forge ahead with digital marketing!

Understanding Billing Codes

CPT Codes

CPT Codes are used for individual providers, such as those in private practice. CPT Codes are billed on the CMS-1500 Form, also called the “HCFA.” Even if you do not accept insurance, if a client has a PPO insurance plan, they may receive some reimbursement for services. For clients with PPO insurance, you may print a “superbill” which has the CPT code on the form. You may also provide a patient with a pre-printed CMS-1500 form, which are available on Amazon.

Here are some examples of CPT Codes, with sample rates:

CPT CODE DESCRIPTION BILLING AMOUNT
0 none $0
90792 Psychiatric Diagnostic Evaluation (with Medical Services) $300
90833 ADD ON-30 Min Psychotherapy $50
90837 Psychotherapy 60 min (53+ min) $180
90838 ADD ON-60 Min Psychotherapy $100
90839 Psychotherapy (Crisis) $340
97813 Acupuncture with Electrical Stimulation – 15 Minutes $50
97814 Acupuncture with Electrical Stimulation – Additional 15 Minutes $50
99205 Psychiatry 60 min Follow-Up E&M $300
99215 Psychiatry 30 min Follow-Up E&M $150
G0434 Drug Testing, EtG/EtS Urine Alcohol $85
G0434 Drug Testing, Urine Drug Screen (DSC6309) $25

HCPCS Codes

Facility codes, also known as HCPCS Codes, are used by hospitals, intensive outpatient treatment centers, and other facilities. These codes are billed on the UB-04 form. UB-04 Forms are also available on Amazon. Most private practitioners will not need to use the UB-04 or do any facility billing.

Another Gadget – Credit Card to Hold all Business Credit Cards, Personal Cards, etc.

I am a big fan of keeping business and personal credit cards and bank accounts separate. It helps you keep track of revenue and expenses, and is a critical part of private practice.

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Coin is a new device that allows you to keep all those cards from different accounts electronically.  By swiping this card, you can use credit cards, debit cards, and gift cards, without having a huge wallet to carry the separate items.

What does this have to do with Private Practice?  You must, must, must have a separate account for all your business revenue and purchases.  Do not try to do this in your personal bank account.  With a separate debit and credit card for business and personal use, the number of cards you are carrying starts to add up.  I joined the Kickstarter campaign for Coin, and am looking forward to the new device shipping next month.  You can pre-order your Coin by clicking on this Coin Website Link.  Enjoy!

20 Questions To Ask Yourself When Starting a Business

business doctors

Ask yourself these 20 questions to make sure you’re thinking about the right key business decisions:

1. Why am I starting a business?
2. What kind of business do I want?
3. Who is my ideal customer?
4. What products or services will my business provide?
5. Am I prepared to spend the time and money needed to get my business started?
6. What differentiates my business idea and the products or services I will provide from others in the market?
7. Where will my business be located?
8. How many employees will I need?
9. What types of suppliers do I need?
10. How much money do I need to get started?
11. Will I need to get a loan?
12. How soon will it take before my products or services are available?
13. How long do I have until I start making a profit?
14. Who is my competition?
15. How will I price my product compared to my competition?
16. How will I set up the legal structure of my business?
17. What taxes do I need to pay?
18. What kind of insurance do I need?
19. How will I manage my business?
20. How will I advertise my business?

Having a game plan that answers these questions will put you ahead of the pack.  This exercise may also bring up questions about whether private practice is the right choice for you.  Not everyone is cut out to work for themselves.

Private practice requires you to tolerate a certain amount of risk.  If this risk/reward equation is not exciting to you, a more stable form of employment may be a consideration.

A Tool for Concentration and ADHD

As a psychiatrist, I often treat ADHD with medication. However, increases in productivity must be accomplished by behavioral changes. One helpful gadget to do this is the GymBoss.



This device is designed for interval training workouts, but can be an effective tool for persons with ADHD, who have limited attention span. The interval can be set to the maximum amount of time the person can concentrate, say 10 minutes. An alarm will go off after that time, either by vibration, sound, or both.  The reminder alarms will continue in the intervals selected.

Many people with ADHD become bored with their activities that they need to accomplish.  Having the pressure of a time limit is often helpful. Intervals can be set with the GymBoss for work-rest periods.  The GymBoss can also be set for intervals of task-switching, going from one task to a different task can use the ADHD individual’s ability to “hyperfocus” on shifting concentration tasks.  Some people with ADHD have the amazing ability to shift concentration  from one task to another, and be better at multitasking that other people.

There are other timers on the market for ADHD persons, but the GymBoss is one of the best interval timers. It can even be used for people while at work, using a silent vibration to remind the person to switch tasks, or to remind the person to rest… or get back to work.

The First 3 Steps in Starting a Private Practice

I cannot count the number of times I heard: “just hang a shingle” when I was starting my practice.  There are other parts of your practice to set-up before getting office space.

After making some accounting mistakes, I realized the best way to get started is with these steps:

1. Get a Tax ID Number

You do not need to be corporation to get started in your practice.  Insurance companies and other entities will ask for your Tax ID number.  Luckily, getting a Tax ID is very easy.

As a sole proprietor, you are basically just “you,” but you don’t have to give out your social security number when asked for identifying information on insurance forms.  Even if you decide not to take insurance, various entities will request your Tax ID number.  Patients who wish to get reimbursed will require SuperBills that need either your SSN or Tax ID.  No one wants to give you their SSN, so get a Tax ID.  Here is a link to get more info on the Tax ID. (and, as always, check with your attorney)

The other benefit of a Tax ID (or “EIN”) is that you can use it to start a business bank account, which leads us to Step 2…

2. Open a Bank Account for your Practice

Having a separate bank account for your business will make accounting much easier.  When you are just getting started, you may think that putting money into your personal account will be easier.  DO NOT do this, it is guaranteed that this will cause confusion down the road.  Plan to run your practice like a business, and having a separate account will allow you to track the profits and losses of your practice.

All bills paid (office rent, phone lines, internet, business cards, etc.) should come out of this business bank account.  Some banks will charge a fee if you don’t keep a high minimum account balance (e.g. $5000 average daily balance, or more).  Your business account does not necessarily have to be a “Business Bank Account” with the bank.  Any separate account will do (although they may not let you use your EIN if it is a personal account).  The point is, keep your business money separate from your personal money.

3. Get a Business Phone Line

Cell Phone

You need a phone where potential clients can call you.  When you are just getting started, you can have calls to a Business Phone Number forwarded to your cell phone.  This also helps you separate personal and business life.  You can do this for free with Google Voice or for a toll-free number where you can also receive faxes, take a look at Grasshopper.  (check with your attorney re: HIPAA compliance with these services).

You can set up these services to register your business phone number as the number that will be displayed on your caller ID.

Following these first steps will help you set up a business life that is separate from your personal life, financially, and time-wise.

Kill The Bouncing Icons!!

One of the most annoying features on the Mac is the bouncing icon.

Image

I find these bouncing alerts to be a serious productivity-killer.

To permanently eliminate these, go into the Terminal (Applications -> Utilities -> Terminal) and enter the following commands (without typing a “$”):

 

$ defaults write com.apple.dock no-bouncing -bool TRUE

then…

$ killall Dock

 

This will permanently remove these bouncing distractions from your life.  

I also like to keep a dated log of all the system changes that I make on the computer in a text file, in case I screw up something when using the command line.

Go on now, and enjoy the serenity of life without this jumping, bouncing, distraction!