Licensed Positions (licensed upon contract start)

(Tracy [& K.], remember not give this url away; it is confidential information that explains how we work our practice's pricing, options, etc. This is not a contract and is updated with or without notice.)

A. Percent with Full-Service Billing Included (% paid as you earn, but tenant may opt to pay based on what will be received):

1. Pay 35% and you get a furnished office usable amongst multiple days and the following options included if you wish to make use of them: the safety-net of referrals if a time comes along where business slows down, phone line (such as if you don't remember your cell or want to not use its minutes), voice mail with voice-to-email option (a feature I use often), faxing (incoming and outgoing), an optional listing in our practice website (note that we already had someone get a cash-client because of our high-exposure website), unlimited filtered water, computer access, high-speed internet, a separate bathroom just for us (many suites do not have a separate bathroom), building and grounds maintenance and repair, handicap accessibility, clean air (we use filters in our air system; good for allergy sufferers), utilities, special practice pricing of $10 off per month through our best advertising source, and a very diligent person to take care of your needs (Sam). (2-yr contract required).
2. 33%: Sign a 3-year contract and get the same furnished office, and any of the above options as needed.
3. 32%: Sign a 4-year contract and get the same furnished office, and any of the above options as needed, plus special training in how to gross ~$200 more per week in insurance panels, and special training in how to eventually and successfully become unpaneled via out-of-network benefits, grossing a 6-figure salary.
4. 29%: Sign a 5-year contract and get the same furnished office, and any of the above options as needed.

B. Percent with Basic Billing Included (tenant must pay based on what will be received) (services are similar to "A.", but more limited billing support):

1. 2-yr: 33%
2. 3-yr: 31%
3. 4-yr: 30%
4. 5-yr: 27%

C. Percent with no Billing Included (tenant must pay based on what will be received) (services are similar to "B.", but without billing support):

1. 2-yr: 29% (Effectively 25% for good tenants achieving and receiving bonus)
2. 3-yr: 27% (23%)
3. 4-yr: 26% (22%)
4. 5-yr: 23% (19%)

***Note: Seniority bonus: After Tenant has been with us for five years Tenant may begin to accrue a bonus of 5% of any amounts paid for months following this five-year anniversary.

D. Hourly-Rate: A dollar figure is agreed to that you keep for each client you see and collect the fee due. This option also allows for a loan for up to the 1st three months of the first and possibly of each subsequent year. These are the basic rates. Raises are available to those who bring in more money through taking on full-fee clients, out-of-network clients, etc. The maximum amount one can earn through these raises is 3.5X the below figures:

1. 45-minute sessions: You keep $40/session.
2. 75-minute sessions: You keep $60/session (some exclusions apply).
3. Assessments: You keep $75/session (some exclusions apply).

E. Fully Furnished Flat-Rate Per Day Per Week Per Month: Your contract will state how many days you are signed up for. You can upgrade, but can't downgrade (therefore if your business slows down and you go from 4 to 2 days per week, you will remain paying at the rate for 4 days per week, unlike the % option, which always fluctuates based on your office usage):

If an office is $165/day/month, an example would be if someone wanted to claim Mon. and Fri., they'd pay $330/month.

Bonuses:

1. Bring on a new Tennant: Doing so will net you a bonus, if available. Just ask if you're interested. One bonus currently running (2010) is 1/2 the 1st month's rent of the new tenant.
2. Bring on a new Prescriber (psychiatrist, APRN, or PA): You will be awarded a $500 bonus after that person signs on (ask for details). We can hire a psychiatrist, possibly even the one w/in our own building, to supervise an APRN or PA, plus we have additional support available for new prescribers. If you are considering switching to doing prescribing, the $500 bonus can be awarded to yourself.

Credit Cards:

Credit card terminal is available. Fees for flat-rate tenants are $5/month, and 5.9% + $.60 per transaction. For variable rate tenants & post-grads it is reduced to 5.9% plus a $.40 transaction fee. Any other fees, if applicable are covered by the practice, thus beyond what's shown here there is no charge for access to the terminal, no account maintenance fees, etc. Terminal is currently in the bathroom due to infrequent use and limited space, however we will move it to an easier location when it is used regularly.

Payment: Tenants will receive payment as a credit to their rent. So, when you give your rent check, just subtract the amount you charged from that month's rent, less the fees. For example, a flat-rate tenant who charged $1000 in a month in two transactions of $500 each would do the following (let's say they pay $1000 for their rent):

$500 - 5.9% (-$29.50) -.60 = $469.90

$5 (flat-rate tenant terminal contribution)

$1000 (base rent) - $939.80 (credit card $ obtained minus fees) = $60.20 (rent check for that month)

Terminal use (steps 1-5 may take a few minutes; we recommend including it w/your session time, as taking the credit card is a courtesy to those who don't have other ways to pay, and also include step 6 if it is the end of the day):

1. Plug into electrical outlet and a phone line and wait until finished loading.
2. Any time passwords are requested, use the date the terminal shows. If the terminal has the wrong date, prior to processing a card, use the menu button and scroll to date & time, then enter correct info. From then on during that day you'll use the new date you've inputted for password (1/1/11 password would be 01012011).
3. Swipe credit card.
4. Key in $ amount, then press enter or the equivalent.
5. Transaction will quickly process on an available phone line. Tear off receipt for pt to sign and one for your records.
6. VERY VERY IMPORTANT: At the end of the day, batch out (something to the effect of the menu button followed by "2" or whatever # batch is assigned to. This will print the day's translations, which you'd save w/your receipt.
7. ~Monthly I'll fwd. you credit card statements so you can ensure each of your transactions posted. If any do not, let Sam know so he can say how to remedy the situation.

By having two columns in our fee-schedule, your credit card fees are very minimal. The regular price and the cash/check paid on the date of service discounted price (if dealing with in-network clients, please see Sam about how that would work). Whenever someone uses a credit card, even on a reduced fee scale, they should pay $5 (more or less depending on service) more for credit card or cash/check paid after the date of service, even if on a sliding-fee-scale (technically a conditional waiver in our practice). Please remind your clients of this policy as also applicable to discounted rates. When taking a credit card, even once, please have them fill out the attached credit card form. The main purpose of it is actually as a protection for you to be able to bill their card if they end up owing you $ and not paying after all reasonable attempts have been made (of course, in that process you'd not remind them that you have their card on file w/their permission). Card info. would have to be kept secure, as you do with your clinical notes.

Qs&As (how to reply to people with any of these concerns, should they have come up already or will come up):

1. Can I change my contract part-way through? You can upgrade (such as rent more days per week under option "E", or increase the % you pay to obtain more services such as to add on billing to a % contract that previously lacked billing) but not downgrade. However, exceptions sometimes exist if you have billing but decide to cease it if all strategies to have the billing fit your needs fail).
2. If I sign a multi-year agreement, but decide to either change it or leave part-way through, what happens? We can't have someone switching back and forth (see "1."). But, we understand that there are circumstances in which someone would seek to change things for major reasons. That's why each written agreement has a "contract buy-out fee". It varies depending on the length of contract you choose. To change, you would need to pay the contract buy-out fee, however a small (perhaps 5-10%) discounted buy-out fee may be negotiated provided you remain in the practice and you attain full support of the Director.
3. How much more is it to terminate a multi-year contract? Rather than 3X your highest rent paid w/in the last three months, it would be 3.25X for a 2-yr., 3.5X for a 3-yr., 3.75X for a 4-yr, and 4.0X for a 5-yr.
4. I want a full-service office manager, like at practice X in Groton who charges 40%; can I? We have tried this to some extent in the past, with only varying degrees of success. However, a new billing person with practice management experience may be available. Please discuss this w/the Director if interested.
5. I want to get a discount on a % plan that exceeds all parameters listed here; can I? We do not seek to have negotiations outside the parameters stated here, however for those who have demonstrated exceptional fit w/out practice, and/or a 3+ year long contract, special training will be available on how to increase your income far beyond what a couple percent more off the existing parameters would net you. You can see results almost immediately as implementation increases your income.
6. What if I sign a long-term contract, but am unhappy later on? Besides the contract buy-out option, and even more importantly, even if your needs change, we are an adaptable practice, allowing us to adapt to your changing needs. Feel free to ask anyone who has been with us for a while just how accommodating, listening, an attuned we are to your changing needs.
7. What if I am on a percent, but get ill, unable to work for the remainder of the contract, will I have to pay the buy-out fee? On a percent contract, you are paying based on what you bring in, therefore you would likely not need to pay any buy-out fee, because you never left us, you just became indefinitely unable to work. For more details, please talk to Sam.

Practice Philosophies:

Practice Philosophy (% & Hourly Rate):

1. We seek to have a partnership in which each tenant or independent contractor benefits from our brand name while establishing/maintaining their own. We seek to be there to help with referrals under times of need or provide other supports (supervision, practice building/enhancement, etc. as needed). This functions as a safety net in that way. The other aspect of the safety net is that people know if business slows down for a time, they are not then paying out a flat-rate rent. Hence, we do not have arrangements that are anything less than one year, assuring that people also will not swithc out of this plan when doing well, while they'll know we'll not ask them to switch when they are not doing well. The %/$ amount is intended to be highly competitive to retain people for the long-term, but not be so low as to disallow people the security we offer should tough times arise. We also do not have a high percent, such as the Groton practice at 40%, or the Norwich practice at 50% because we feel such %s decrease retention and those that are retained are statistically not always the best clinicians. We focus on quality over quantity here.

2. Practice Philosophy (flat rate rental options):

We seek to be in the middle or upper part of the middle third in pricing, with occasions in which we will go higher. Offering middle to lower pricing has thus far not attracted the kinds of therapists we have sought to have. But, we feel that even our highest pricing is of worthy value when looking at our atmosphere, who works here and those interactions, options for clinical consultations amongst highly proficient therapists, a location so close to the highway that it can literally be seen from the window, 5 minutes from 395, in a very well-known building with the most therapists in this part of the state, by and large the best renovated best kept offices in the building (explain further if someone asks for details), the value of being on our web site, etc.

(do not give this link [url] away)