Clinical Business Framework

About Clinical Business Framework

Replays

Publisher

Uncluttered Mind, MD

Category

business

Language

en

Explicit

No

First episode

26 Jan 2026

Latest episode

29 Jul 2026

Latest episodes

22 episodes in the feed.

1. 

   29 Jul 2026

   Live Call July 28, 2026

   School Year Start and End Dates The group discussed the different start and end dates for the school year across different regions. Charu mentioned that school in Texas starts later, around August 19th, and ends before Memorial Day. Florence noted that schools in New York start and end much later, with public schools ending as late as June 26th. The conversation also touched on year-round schooling in places like Arizona, which Charu found appealing for travel opportunities. Florence's Six-Month Reflection Session Jennie led a reflection session marking Florence's six-month anniversary with the company, during which Florence shared how understanding the business's financial metrics and costs has transformed her approach to managing the practice. Florence explained that she now better allocates expenses and staff resources, having realized she doesn't need additional front desk staff but could benefit from expanding virtual assistant services for calls and document management. She described implementing a new system where VAs review and categorize referrals from the EHR, with the goal of capturing and addressing all incoming patient referrals more effectively. Patient Information Management in Athena The team discussed challenges with managing patient information in Athena, particularly around tracking referrals and patient encounters. Charu explained that information disappears unless saved as charts, and demonstrated how to use reports to identify active versus inactive patients, revealing a significant number of patients waiting for insurance approval. The group agreed to implement a process where they will call patients multiple times and document outreach attempts, while also informing referring doctors about unsuccessful contact attempts to maintain communication channels. Practice Operations and Growth Strategies The group discussed strategies for managing practice operations and growth over the past six months. Florence shared her approach to implementing bonus structures for staff and balancing patient volume with quality care, while Charu expressed concerns about reaching profitability and the need to hire additional staff. Jennie advised Charu on scheduling efficiency, recommending she establish dedicated administrative time and better organize patient slots to maximize productivity. Vineka reported progress in delegating tasks to staff and improving billing processes, including successful resolution of payer code issues that were causing payment delays. Schedule Management and Efficiency Concerns Vineka expressed concerns about filling her schedule due to legal requirements, evaluator needs, and administrative tasks that require her direct attention. She explained that maintaining some empty slots allows her to handle crucial tasks like prior authorizations, insurance denials, and patient selection, as she focuses on accepting patients who will provide better ROI. Jennie acknowledged Vineka's approach to operational efficiency and noted that clinic management is an ongoing process that continually evolves. Group Meeting Structure Proposal Jennie proposed a new structure for the group meetings, suggesting individual one-on-one strategic sessions followed by two group meetings per month from September to March, with August designated as a break. The group discussed continuing their business development discussions, with Florence expressing enthusiasm about moving forward and Vineka noting she needs to address current burdens before focusing fully on business development. Jennie requested that all members complete surveys to help assess progress against business pillars including financial clarity, service line profitability, and operational efficiency. Partnership Transition Stalling Issues Jennie discussed her struggle to transition to half-time clinical status in January, as her partnership has refused to vote on the proposal after seven weeks. She explained that after 20 years in full-time partnership, she wants to reduce her workload and pursue other impact opportunities, while maintaining her $20K monthly passive revenue from APCM (Advanced Primary Care Management). Jennie noted that she needs six out of eight partner votes to approve the transition, and she is considering legal action due to the partnership's stalling tactics and attempts to delay the decision until August. Chronic Care Management Billing Guidance Jennie led a discussion about billing for chronic care management (CCM) and advanced primary care management (APCM) programs, explaining that specialists can perform CCM while primary care providers can do APCM, with different qualifying conditions and billing requirements. The group discussed challenges with billing for phone calls with family members and patients, with Jennie recommending that providers track non-face-to-face time spent on complex patients and enroll eligible patients in CCM to capture billing for this work. Jennie advised the team to start using Athena's CCM module to document and bill for the time spent coordinating care for patients with multiple chronic conditions, noting that Medicare covers these codes while commercial insurance may not.

2. 

   22 Jul 2026

   Office Hour July 20, 2026

   Key Highlights Follow the money. We discussed the importance of tracking claims through the entire revenue cycle—from claim generation to payment—to identify where revenue may be leaking. Delegate, don't disappear. CEO-level leadership means empowering your team to investigate operational issues while you maintain accountability through timelines and measurable updates. Revenue transparency matters. If collections decline while patient volume increases, it's important to determine whether claims are being held, denied, partially paid, or down-coded. Institutional knowledge has value. We saw firsthand how experienced team members can become invaluable problem-solvers during system transitions. Plan ahead for physician coverage. We explored practical strategies for securing locum coverage, understanding malpractice implications, and protecting both patient care and physician well-being. Action Items Map one claim from submission through payment to identify where visibility is lacking. Review recent revenue trends by payer and compare them against visit volume. Verify that payments received match the services billed, particularly for higher-level visits. Set clear timelines for your billing team to provide updates on identified issues. If planning time away from your practice, begin researching locum coverage early—including malpractice requirements and potential recruitment sources.

3. 

   15 Jul 2026

   Office Hour July 13, 2026

   Personal Updates and Technical Issues Jennie shared details about her recent week-long trip to Hawaii for their anniversary, including a visit to Lanai island. Florence discussed attending her youngest daughter's national dance competition in Jersey, which was the third competition of the year for her daughter who started dancing this year. Florence also mentioned technical issues with EEG and EMG machines that required laptop replacement and vendor troubleshooting. Hospital Lease Space Discussion Florence discussed a potential lease opportunity with a hospital that wants to rent space for a year while building a new office for cardiologists joining their system. The hospital would occupy about three-quarters of Florence's upstairs space, potentially including four exam rooms and one larger unfurnished room for providers' offices. The hospital proposed paying per utilization rather than per square footage, and Florence is considering whether to rent the entire space or just the portion currently needed. Healthcare Tenant Pricing Strategies Jennie advised Florence on pricing strategies for leasing space to healthcare tenants, emphasizing the importance of ensuring charges are commensurate with market rates to avoid Stark violations. They discussed considerations around Wi-Fi networks, IT management, and the potential impact on Florence's personal real estate expenses. Jennie recommended preparing multiple pricing scenarios and understanding current costs to make informed decisions about tenant rates and personal charges. Rental Management and Insurance Guidance Jennie advised Florence on managing rental numbers and insurance considerations for potentially subleasing space to a medical tenant. They discussed the benefits of running financial projections ahead of time and the importance of understanding insurance requirements for subletting versus separate leasing arrangements. Vineka shared updates about her legal deposition regarding property transfer complications and discussed implementing better revenue tracking and collections processes in her practice, with Jennie providing guidance on managing accounts receivable and collection strategies. Billing Process and Challenges Jennie and Vineka discussed billing processes and challenges with their current biller. Vineka expressed concerns about the reliability of AR reports due to system glitches and shared an incident where their biller missed a scheduled meeting without proper communication. Jennie advised Vineka to implement more structure and boundaries with the biller, suggesting a collaborative approach to introduce industry-standard processes and KPIs. Vineka also mentioned issues with onboarding a new biller onto the Optum system, highlighting the need for better coordination and access management. Team Performance and Billing Discussion Vineka expressed frustration with a team member's performance and professionalism, particularly regarding billing processes and data presentation. Jennie suggested having a transparent conversation about the expected sophistication level of billing processes and inviting the team member to decide if they see themselves as part of the team moving forward. They discussed potentially reframing the focus to include AR (accounts receivable) metrics, which might be more suitable for the team member's skills, and considered whether weekly reviews might be too frequent. Biller Challenges and Solutions Vineka discussed challenges with her current biller, who is a friend, including issues with professionalism, communication, and accountability. The group explored having a backup plan, with Vineka considering having her current consultant's biller take over some responsibilities. They agreed on the need to implement standardized processes and regular reviews of key performance indicators like days in AR and clean claims rates. Jennie emphasized the importance of having clear expectations and ownership of work, noting that while these conversations might impact their friendship, they are necessary for the business's growth. Revenue Cycle Framework Implementation Vineka plans to meet with her consultant to discuss implementing a more detailed revenue cycle framework in their weekly meetings, moving beyond just reviewing tracker numbers to address specific data points and process improvements. The consultant has made significant progress over six months, including simplifying insurance payers from 140 to 26, implementing front desk improvements like insurance card organization and ID verification, and reducing denial rates from hundreds to a more manageable number. Jennie suggested celebrating these wins more visibly in meetings, as they represent permanent process improvements that will have lasting benefits.