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  • #236 The Two-Year Plan That Took an Employed Doctor to Four Locations

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    In 2007, Dr. Amin Mery was an employed allergist in Houston, frustrated with partners who wanted a CT scan ordered on nearly every patient, kids included. A colleague gave him blunt advice: stop complaining or do something about it. So he gave himself two years. He hired a lawyer and a CPA, set up an LLC, learned the business side medical training never covered, and in 2009 opened his own practice in Austin. Today he runs a four-provider, four-location allergy and immunology practice, and he’s building something new on top of it.

    Dr. Heather Signorelli talks with Dr. Mery, double board-certified in allergy, asthma and immunology and in internal medicine, about what that plan looked like, what running multiple sites really takes, and how he found a way to enjoy medicine again.

    What we cover:

    • Inside the two-year plan. The legal and financial setup, the drives back and forth to Austin, a partnership with a growth-minded dermatologist who sent him patients, and the work ethic he learned busing tables at nine.
    • The hardest part of multiple locations. People, payers and competition. Small practices have little leverage with payers, while hospitals, private equity, ENTs and pediatricians all move into allergy.
    • Why he passed on the extra tests. Running a business while refusing to order tests just to order tests.
    • Life without an IPA. His rural locations made IPAs hard, so he joined a national consortium of independent immunology practices instead.
    • Integrative immunology. After COVID he saw a sharp rise in inflammatory conditions. That led him to build a data-driven model that looks for the root causes of inflammation instead of only managing symptoms.
    • Beating burnout. How building something new made medicine rewarding again, for doctor and patient.

    Episode breakdown
    00:00 Welcome and Dr. Mery’s background
    01:44 Going independent in 2009 and the two-year plan
    05:24 Four providers, four locations and what COVID changed
    05:55 The hardest part of running multiple sites
    07:54 Would he go independent again?
    09:02 IPAs, ACOs and joining a national immunology consortium
    10:45 Staffing chaos, private equity and new revenue ideas
    11:44 The rise in inflammatory conditions after COVID
    13:30 What integrative immunology looks like in practice
    18:25 How other physicians can learn the model
    20:33 Building something new after burnout
    22:35 How to reach Dr. Mery

    Connect with Dr. Amin Mery

    • Health Atlas MD: healthatlasmd.com
    • Request an Inflammation & Immunity Assessment: healthatlasmd.com/request-assessment
    • Articles from Dr. Mery: healthatlasmd.com/insights
    • Hill Country Allergy: hillcountryallergy.com
    • LinkedIn: linkedin.com/in/aminmerymd
    • YouTube: youtube.com/@HealthAtlasMD
    • Instagram: instagram.com/healthatlasmd

    Resources from NatRevMD

    • Billing Performance Scorecard: score your billing on six numbers and get a one-page 90-day plan. https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • Free Metrics Audit Review: https://eligibility.natrevmd.com/metrics-audit-natrevmd

    If you enjoyed this episode, subscribe, leave a review, and share it with a physician who’s thinking about going independent.

    20 min
  • #235 Who Really Decides What’s Medically Necessary?

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    When Dr. Heather Signorelli picked a 2026 health plan for her family, she could compare deductibles, copays and out-of-pocket maximums in minutes. What she couldn’t see was what happens when someone actually gets sick: what’s covered, what needs prior authorization, and what counts as medically necessary. Prices are public now. The rules that decide whether a claim gets paid are not. In this solo episode, Heather explains where that gap comes from, how it ends up in your practice as denials and delays, and what needs to change.

    The Form Shows the Basics, Not the Rules
    The standard Summary of Benefits and Coverage only shows costs for a few simple cases, like having a baby or a simple fracture. A breast cancer example was in the original 2011 proposal and was taken out. When Heather ran her own benefits summary through AI, “no benefits if not pre-approved” came up again and again, with nothing saying what approval actually takes.

    Who Really Decides What’s Medically Necessary
    You make the first medical necessity decision. The payer makes the second one, and theirs is the one that counts. Many plans use proprietary criteria from InterQual or MCG that are only shared on request. One example: a patient with years of worsening arthritis can be denied a shoulder replacement because their last round of PT was more than 12 months ago.

    What the Numbers Say
    In a 2025 AMA survey, physicians reported about 40 prior authorizations a week, taking roughly 13 hours of physician and staff time. 95% said prior auth delays necessary care, and 26% said it led to a serious adverse event for a patient. Prior auth data is now public for Medicare Advantage, Medicaid managed care and marketplace plans, and it shows something important: few denials get appealed, and many of the ones that are appealed get overturned.

    The Fix: Physicians Set the Minimum Standard
    Heather makes the case for a physician-defined minimum level of coverage set nationally or by state, not insurer by insurer. Then plans would have to compete on price, quality and outcomes.

    The 2027 HMO Shift
    Medicare Advantage is moving toward more HMOs and fewer PPOs. That means more referrals required before specialist visits, and more denials when they’re missing.

    Three actions before January:

    • Pull every Medicare Advantage patient booked for January and February and check their 2027 plan type in the payer portal.
    • For anyone moving to an HMO, get the PCP referral before the visit.
    • Make sure your team is appealing denials. The data shows it’s worth the work.

    Episode breakdown
    00:00 A physician picking a health plan for her family
    01:30 What the Summary of Benefits leaves out
    03:45 Running a benefits summary through AI
    04:50 The conference conversation on utilization management
    07:10 Why plans can’t be compared on what really matters
    08:45 The case for a minimum standard of coverage
    12:00 Who decides what’s medically necessary
    13:30 The AMA prior authorization survey
    14:15 Proprietary criteria and the shoulder replacement example
    16:00 Biomarker mandates and coverage standards in the lab world
    19:00 Prior auth data made public for the first time
    21:30 Medicare Advantage moves to HMOs in 2027
    23:00 Your January checklist

    Resources

    • Billing Performance Scorecard: score your billing operation and get an action plan built from your results. https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • Free Metrics Audit Review: a NatRevMD review of your key revenue metrics, best if your Scorecard shows 2+ red areas. eligibility.natrevmd.com/metrics-audit-natrevmd
    • NatRevMD: natrevmd.com

    If this episode helped, subscribe and share it with a practice owner or manager who’s fighting prior auths right now.

    23 min
  • #234 Your Medical Practice Doesn’t Need Fewer Meetings. It Needs These 5.

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    Why does your practice keep solving the same problems over and over?

    A claim issue snowballs, a provider gives notice, a patient complaint lands on the owner’s desk. Everyone scrambles, and six weeks later it happens again. Most independent practices don’t have too many meetings. They have the wrong ones, or none at all.

    In this episode, Dr. Heather Signorelli shares the five-layer meeting rhythm she has used to lead teams of up to 8,000 people. She scales it down for practices from a team of four to multi-location groups. It draws on Death by Meeting, Traction (EOS) and Scaling Up, and it’s built for healthcare.

    You’ll learn:

    • The 10-minute daily huddle that catches problems at 8 AM instead of 2 PM.
    • The weekly leadership agenda: five to seven scorecard numbers, wins, commitments and one or two real issues solved.
    • How a monthly review turns status updates into decisions.
    • How to set quarterly “Rocks.” For example, “improve patient experience” is not a Rock, but “cut check-in wait time from 14 to 8 minutes by December 31” is.
    • How to run an annual planning session so your whole team knows where the practice is going in 2027.
    • Why async video updates can replace the Monday round robin.

    If 2026 ended with goals you didn’t hit, your meeting structure may be the reason. Start with the huddle, the weekly meeting and one-on-ones, and build from there.

    Free resources:

    • Billing Performance Scorecard. Score your billing on six numbers in about 20 minutes and see what’s green, yellow or red. A ready-made start for your weekly scorecard: https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • Free Metrics Audit Review. For practices with two or more reds, a physician-led second look at your numbers: https://eligibility.natrevmd.com/metrics-audit-natrevmd

    Want help setting up your practice’s meeting rhythm? Email us at [email protected]

    Books mentioned: Death by Meeting by Patrick Lencioni, Traction by Gino Wickman, Scaling Up by Verne Harnish

    Missed the last episode? It covers how to run one-on-ones and skip-level meetings that develop your team.

    If this episode helped, share it with a practice owner or office manager who needs it, and leave us a review. It helps more independent practices find the show.

    31 min
  • #233 From Zero Patients to Five Physicians: Building an Independent Practice That Lasts

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    You hung your shingle, or you’re thinking about it. Now what? How do you get patients through the door, keep good staff for a decade, and add physicians without the practice falling apart?

    Dr. Ram Surendran, M.D., MBA, opened Rochester Primary Care in Michigan in 2003 with three exam rooms, one employee and no patients. His first patient walked in two weeks later. To keep the doors open, he worked urgent cares, ER shifts and medical evals on the side. He practiced solo until 2021. Today the practice has five physicians.

    In this episode, Dr. Heather Signorelli talks with Ram about what it actually took, and what independent owners can borrow from his playbook.

    You’ll hear:

    • How he built patient volume from zero: being available, same-day access, and showing up at ERs and urgent cares until they sent patients
    • Why his staff stay 5, 10, even 15 years, and why paying for their education costs less than replacing them
    • How a medical assistant became his operations manager, and the three-person team that now runs the office
    • Why he markets each new physician as their own brand, so their patients follow them and they stay
    • The hardest part of ownership: narrow networks that exclude independent physicians, shifting rules on care management, and the fight to get paid for the work
    • Why he thinks we’re entering a new wave of physician independence, and what he hopes 2027 brings

    Free resources for practice owners

    • Free Metrics Audit: Get a physician-led review of your billing numbers with Dr. Signorelli, so you know where your practice stands before you add your next provider. https://eligibility.natrevmd.com/metrics-audit-natrevmd
    • 2027 Revenue Impact Brief: See where the 2027 reimbursement changes will hit your practice’s revenue. https://eligibility.natrevmd.com/know-where-2027-will-impact-your-practices-revenue-free-brief-natrevmd
    • Billing Performance Scorecard: Score your billing on six numbers and get a one-page 90-day plan. https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan

    Connect with Dr. Ram Surendran on LinkedIn: https://www.linkedin.com/in/ram-surendran-md/

    Questions about your billing or your team? Email [email protected] or visit natrevmd.com.

    If Ram’s story hit home, leave a review and share it with a physician thinking about going independent.

    25 min
  • #232 The Meeting Every Practice Owner Skips (and Pays For Later)

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    You own the practice. You see your team every day. So why are you always the last one to hear about the problem?

    Your front desk has been falling behind on eligibility for weeks. One of your providers runs 45 minutes late and patients are starting to complain. Your billing team is sitting on open charts and denials nobody has flagged. Everyone around you knows. You don't, because nobody has a set time and a safe place to tell you.

    By the time it reaches your desk, it's a resignation letter, a payer takeback, or a month of lost collections.

    In this episode, Dr. Heather Signorelli, co-founder of NatRevMD, walks you through the one meeting that fixes this: the one-on-one. She ran them across a team of roughly 8,000 in corporate healthcare, and she shows you how to make them work in a practice with one office manager or five locations.

    What you'll walk away with:

    • Why "I talk to my staff all day" is exactly why you're missing things
    • The four ways owners turn one-on-ones into meetings nobody wants (and how to avoid them)
    • A 30 to 45 minute format where your employee sets the agenda, not you
    • The one question that gets your team to tell you what they really need
    • How to use skip levels to hear from your front desk and billers without undermining your office manager
    • What happens to trust when you cancel, reschedule, or never follow through
    • Three things to put on your calendar this week

    If you're planning a second location, adding a provider, or just tired of finding out about fires after they've spread, start here.

    Free resources for practice owners

    • Free Metrics Audit: Get a physician-led second opinion on your billing numbers, so you know what to ask your team in your next one-on-one. https://eligibility.natrevmd.com/metrics-audit-natrevmd
    • Multi-Site Revenue Cycle Scorecard: Opening another location? Find out where ownership and accountability will break before you grow. https://eligibility.natrevmd.com/natrevmd-multisite-scorecard
    • Practice Financial Health Dashboard: The numbers your team should be bringing to you every week, in one ready-to-use workbook. https://eligibility.natrevmd.com/free-practice-financial-health-dashboard-for-physicians-natrevmd

    Books mentioned:

    • High Output Management by Andy Grove
    • Radical Candor by Kim Scott

    Next episode: the other meeting rhythms that keep your practice aligned as you grow, without burying your team in meetings.

    Want Heather's eyes on your numbers or your team structure? Email [email protected] or visit natrevmd.com.

    If this one hit home, leave a review and send it to another practice owner who needs to hear it.

    28 min
  • Pitched an AI Billing Tool? Fix Your Process First

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    How many AI billing tools have you been pitched in the last few months? If you are like most practice owners, more than any other vendor in years. Some of these tools are very good, and we are piloting one ourselves. But if your billing process is not clean, adding AI on top of it will only break it faster.

    In this episode, Dr. Heather Signorelli shares how we are running our own AI pilot alongside our billing team. She also gives you a simple framework to decide where AI belongs in your revenue cycle and how to evaluate any vendor before you sign.

    Fix the process first. If eligibility breaks because the right information is not captured at the front desk, a tool will not fix it. Get workflows out of people’s heads and onto paper, with one set of policies, trainings and checklists across every location. Then decide what to automate.

    Automate the work, keep the judgment with your people. AI fits high-volume, rules-based, repetitive work where the right answer is known. Complex denials, judgment calls and quality assurance stay with humans.

    Run a controlled pilot. Start with one painful process in one or two practices. Check 100% of the AI’s work at the start and track how fast the review time comes down. If your team has to recheck everything forever, that is not automation.

    Define success before you start. Know your denial rate, clean claim rate, eligibility issues and claim speed today. Decide what accuracy the tool must hit and who on your team owns the evaluation.

    Ask the hard questions. Ask about accuracy on claims like yours, who catches the errors, what the contract says about performance, and what an exit looks like if the vendor is sold.

    Where AI fits in billing today:

    • Eligibility and benefits: work clearinghouse failures, check payer portals, escalate what it cannot fix
    • Claim scrubbing: check every claim against payer rules and coding edits
    • Payment posting: handle checks that fail auto posting and pull missing EOBs
    • A/R follow up: claim status review and the first layer of denial work
    • Payer contracts: prepare the data and test offers against the CPT codes you actually bill

    Your one action this week: if you are evaluating an AI vendor, ask them which of your billing metrics their tool will move, and by how much.

    RESOURCES

    • Free Metrics Audit Review (a physician-led second opinion on your numbers): https://eligibility.natrevmd.com/metrics-audit-natrevmd
    • Free Billing Performance Scorecard (six numbers, green, yellow or red, plus a one-page 90-day plan): https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • NatRevMD AI Kit (prompts and tools for using AI in your practice): https://eligibility.natrevmd.com/natrevmd-ai-kit-tool
    • Website: https://natrevmd.com

    IN THIS EPISODE

    • Why every practice is getting pitched AI right now
    • AI on a broken process just breaks it faster
    • Multi-site practices: getting the process out of people’s heads
    • How we are running our own AI pilot
    • Where AI fits, and where humans still win
    • How to evaluate an AI vendor and define success
    • Contracts, performance terms and your exit plan
    • Red flags that the tool is not working
    21 min
  • #230 Your Next Patient Called. Nobody Called Them Back. With Dr. Mona Sodhi

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    Most practices don't have a lead problem. They have a follow-up problem.

    Dr. Mona Sodhi, DO, co-founder of Super Doc Tech, built her own direct-pay obesity medicine practice from scratch and found herself running ten disconnected tools on top of seeing patients. In this episode, she and Dr. Heather Signorelli talk about why interested patients slip away, why your CEO time matters as much as your clinical time, and what it takes to build a system that turns interest into booked patients.

    What we cover:

    The Disjointed System
    Website in one place, newsletter in another, networking cards lost under a car seat. None of it talks to each other, so you never know what happens after you meet a potential patient. Most people need about seven touches before they decide to book, and one ask is rarely enough.

    The Perfectionist Trap
    Medical training teaches us we can't afford a mistake. Carry that into marketing and most physicians freeze and do nothing. Business is flexible. Lives are not on the line when you build a business.

    Make Time to Be the CEO
    Dr. Mona and her co-founder block four hours a week, just the two of them, to work on the business. If it isn't on the calendar, it doesn't happen.

    The Leaky Bucket
    Calls that never get returned, contact forms that go nowhere, Instagram automations with no follow-up. Heather shares her own experience trying to find a new physician and never hearing back. Speed to lead matters, and plugging the leak is easier than chasing new patients.

    A VA Executes. A Thought Partner Builds Revenue.
    Why outsourcing marketing tasks is not the same as having someone ask whether each newsletter, automation and CRM step is actually driving revenue.

    Three actions this week:
    - Put one recurring CEO block on your calendar and protect it like a patient visit.
    - Check how every new patient inquiry gets answered today, and how fast.
    - Map the follow-up a new patient receives after the first contact. If it ends after one touch, start there.

    Episode breakdown:
    00:00 Welcome Dr. Mona Sodhi
    00:53 From obesity medicine practice to tech company
    02:09 Disjointed systems that never talk to each other
    05:11 Why running a practice feels so hard for physicians
    07:17 How to find time to be the CEO
    11:02 Calendar blocking everything
    12:28 What practices struggle with most
    15:53 Why a VA is not a thought partner
    16:33 Heather's unanswered contact form
    19:06 A CRM built around revenue
    21:43 How to work with Super Doc Tech

    Free resources from NatRevMD:
    Billing Performance Scorecard: see where your billing stands in 20 minutes
    https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    Free Metrics Audit Review: for practices with 2+ red flags
    https://eligibility.natrevmd.com/metrics-audit-natrevmd

    Connect with Dr. Mona Sodhi and Super Doc Tech:
    Website: https://superdoctech.com
    Instagram: https://www.instagram.com/superdoctech/
    Facebook: https://www.facebook.com/superdoctech/
    LinkedIn: https://www.linkedin.com/in/superdoctech/
    YouTube: https://www.youtube.com/channel/UCGcVrEsMu7vjjRP5y-iAi9g
    Listen to her podcast: Super Doc Stories

    Connect with NatRevMD:
    https://natrevmd.com
    https://www.linkedin.com/company/79500978/

    24 min
  • #229 The Bill to Stop Corporate Takeovers of Medical Practices: What It Covers and What It Leaves Out

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    Last week a bill was introduced in Congress to stop corporate takeovers of physician practices. Some people are calling it reform. Dr. Heather Signorelli read the actual text, and in this episode she walks through what the bill says, what it leaves out, and why she thinks it misses the root cause of what’s squeezing independent practices.

    This is not a political episode. It’s a briefing for practice owners, physicians and healthcare executives who want to understand what’s moving before they’re asked for an opinion on it.

    What the bill actually does
    Practices would have to be majority owned and majority governed by licensed clinicians, including NPs and PAs. Private equity, insurers and for-profit corporations could not own or control a practice. MSOs could still handle billing, payroll and IT, but not hiring, schedules, pay, billing policy or payer contracts. Non-competes, NDAs and non-disparagement clauses would be void for clinicians, except those who own 25% or more of the practice.

    The exemption nobody is talking about
    The ownership ban exempts hospitals, all of them. By the sponsors’ own numbers, over 80% of physicians are corporately employed, and roughly 60% of them work for hospitals. That means the ownership rule reaches only about 20% of physicians. The non-compete ban and clinical autonomy protections do apply to everyone, which could be a big change for hospital-employed physicians.

    Autonomy without a payment rule
    The bill says no one can pressure a doctor on time with patients, orders or coding. But a payer still reimburses an office visit built for 15 minutes. The bill protects the 40-minute visit. It doesn’t pay for it.

    Where Heather thinks the real problem sits
    Low reimbursement, denials, prior auth fights and same-day bundling cuts are what push practices toward volume over patient needs. Ownership structure doesn’t change any of that. She also covers the Texas Attorney General’s action against UnitedHealthcare and how IPAs give independent physicians negotiating leverage, a thread from EP227 with Ben Phillips.

    Three takeaways for practice owners

    • Know what the bill does and doesn’t touch: ownership and contracts, not payment, denials or admin burden.
    • If you employ clinicians under non-competes, watch this space. That provision applies broadly.
    • Your negotiating position with payers matters more than who owns you. Pooling with other independents is one way to strengthen it.

    Episode breakdown
    00:00 What the bill is and why it caught our attention
    01:54 What the bill actually says
    04:05 Enforcement, divestiture and the odds it passes
    05:30 The Texas AG vs UnitedHealthcare and the pushback on payers
    07:28 What the bill doesn’t touch: payment, denials and admin burden
    09:48 IPAs and negotiating as a group (EP227 with Ben Phillips)
    10:30 The hospital exemption
    13:44 Clinical autonomy vs the 15-minute visit
    17:21 Fixing payment at the root: coverage tied to standard of care
    19:40 Final thoughts

    Resources

    • Billing Performance Scorecard: see where your billing stands in minutes. https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • Free Metrics Audit Review: if your scorecard shows 2 or more reds, we review your numbers with you. https://eligibility.natrevmd.com/metrics-audit-natrevmd
    • Listen to EP227 with Ben Phillips on IPAs, ACOs and payer leverage: [EP227 link]
    • Learn more about NatRevMD: https://natrevmd.com
    18 min
  • #228 Your Best Staff Aren’t Leaving for Money

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    Over the last two weeks I have been interviewing candidates, and I asked every one of them the same question: why are you leaving? The top answer was not money, PTO or benefits. It was career growth. In this episode I share what that means for your practice and how we run our own hiring process.

    Build a career ladder for every role. Growth does not have to mean management. Front Desk Coordinator I, II and Lead Front Desk give people a next step. The same works for MAs, NPs moving toward partnership, and physicians on a partner track.

    Map year one, two and three. Start people where they are, then add skills like eligibility, prior auths and patient workflow so year three still feels challenging. Often those tasks come off your plate or your office manager’s.

    Tie raises to responsibility. Instead of an automatic 2% raise every year, attach a small raise to mastering the next level. Culture matters too: trust, autonomy and input keep people.

    Give tech-savvy staff a real project. Evaluating AI vendors or automation, or running HIPAA-compliant social media and website updates. Carve out the time so it is real.

    Hire in two interviews. We use an Indeed automation, a short VideoAsk screen with four or five questions to see presence and communication style, then the top three meet me and our leadership panel.

    Three actions this week:

    • List every role in your practice and write the next level for each one
    • Pick one tech-savvy team member and give them one defined project with protected time
    • Add a short video screening step before your first live interview

    Episode breakdown:

    • 0:00 Why we are talking about hiring
    • 0:32 The number one reason candidates leave
    • 1:25 What career growth really means
    • 1:54 Building a career ladder for front desk and MAs
    • 2:51 Mapping year one, two and three
    • 3:21 Tie raises to mastery, not the calendar
    • 3:47 Culture: trust, autonomy and input
    • 4:46 Give tech-savvy staff an AI project
    • 5:40 Leveraging social media skills (HIPAA-safe)
    • 6:06 Our hiring process: Indeed automation
    • 6:34 Screening with VideoAsk
    • 7:31 Two interviews and a panel
    • 8:00 Wrap up

    Free resources:

    • Billing Performance Scorecard: https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan
    • Two or more reds? Free Metrics Audit Review: https://eligibility.natrevmd.com/metrics-audit-natrevmd
    • NatRevMD AI Kit: https://eligibility.natrevmd.com/natrevmd-ai-kit-tool
    • Website: https://natrevmd.com
    9 min
  • #227 Your Payer Rates Are Low Because You Negotiate Alone

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    Most independent practices sign the payer contract they are handed. One or two doctors alone are not on a health plan's radar, so the rate stays low and the practice works harder to make up the difference.

    This week Dr. Heather Signorelli sits down with Ben Phillips, CEO of Nivano Physicians, an independent physician association in Northern California, and host of Healthcare Uncut. Together they break down how small practices build the leverage the big systems already have.

    ACOs vs IPAs. ACOs are built to lower the total cost of care, and physicians share in the savings, usually paid the following year. IPAs bring independent doctors together to negotiate managed care contracts as one group, often on a capitated, delegated model.

    No IPA in your area? Throw a pizza party. Ben's advice is literal: invite the independent doctors in your community, across specialties, to dinner and ask whether everyone is struggling with the same rates. That conversation is how an IPA starts.

    How to judge an IPA. Look at it like any business you would join: its contracts, its stars rating, whether physicians have a real voice, and whether you are a shareholder or just a member.

    Brand is leverage. The bigger institution gets better rates because of the patients it brings. A practice that grows its patient base and shows a health plan where it saves money earns a stronger seat at the table.

    THE IPA INTERVIEW: QUESTIONS TO ASK BEFORE YOU JOIN
    - Contracts: Which payers do you hold, long-standing plans or startups? What are the rates?
    - Quality: How many stars do you have? How do you track HEDIS?
    - Patients: Can patients get in on time, get follow-up care and a call on lab results?
    - Voice: Is my voice as a physician expected, encouraged or dismissed?
    - Ownership: Am I a shareholder or just a member?
    - Network: Which hospitals and surgery centers do you partner with?
    - Community: Are local doctors of every specialty represented?

    THREE ACTIONS THIS WEEK

    - Pull your current commercial rates and compare them to Medicare for your top codes
    - Ask the independent doctors near you whether they belong to an IPA, and which one
    - Score your billing on six numbers before your next payer conversation

    FREE RESOURCES
    Billing Performance Scorecard: six numbers in, green, yellow or red on each, the dollar value of every red, and a one-page 90-day plan.
    https://eligibility.natrevmd.com/natrevmd-billing-performance-scorecard-actionable-plan

    Two or more reds? Get a free physician-led Metrics Audit Review:
    https://eligibility.natrevmd.com/metrics-audit-natrevmd

    2027 Revenue Impact Brief: where 2027 changes will hit your revenue.
    https://eligibility.natrevmd.com/know-where-2027-will-impact-your-practices-revenue-free-brief-natrevmd

    2027 CONFERENCE
    Heather and Ben are planning a 2027 conference for independent practices. Send topic ideas to [email protected]

    CONNECT WITH BEN
    LinkedIn: https://www.linkedin.com/in/bpsf
    Healthcare Uncut on YouTube, LinkedIn and Facebook

    CONNECT WITH NATREVMD

    Website: https://natrevmd.com
    LinkedIn: https://www.linkedin.com/company/79500978/
    YouTube: https://www.youtube.com/@NatRevMD

    32 min

About NatRevMD

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Medical billing tips for healthcare professionals — by healthcare professionals.
 

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