I think the CURES act actually explicitly says somewhere that it doesn't apply to paper records, meaning that it wouldn't mandate EHR use. Unless I'm misremembering.
I currently use a company, but may do it for myself at some point. I don't really think the fee tends to be worth it, unless your state has some strange reqs for the registered agent.
I also pay the lazy tax.
If that is all you are doing, go to a UPS store that offers PO Boxes with a physical address. $40/yr
I looked into that. Registered agent is not much more and I can be a bit lazier. Which is why I was weighing the options.
I hired one, and found that Northwest Registered Agent has been pretty good and reasonable.
This is what most private practices, and particularly smaller private practices, that I know do.
Even fully telehealth ones?
As was said, yep. The telehealth folks I know will often find a MH billing specialist (also usually remote) and pay them hourly to handle billing.
I couldn’t get around it. I used a RA for state registrations & my PO BOX (street address) for EIN. My county required the physical location of where services are being delivered. It’s on my business license which is searchable if someone knew what county I live in and was really determined. In searching for ways around this, I found something online that said shifted my perspective. There are so many ways someone can find our address online that unless we were going to take drastic measures to completely scrub it, one more source is not going to make a difference. Voter registration, property tax records, those random phone number lookup sites, etc. And if you bill insurance or if the client submits out of network claims, you need to provide your home address as the service location if you are telehealth from home. So eventually it will be seen. Most will not notice or care. NPI also requires home address for NPI-1 but not NPI-2 for fully remote practices. However, I’ve found that for billing purposes as a solo LLC, most third parties require use of NPI-1.
Thank you for this advice and information so much. I am hoping for a mix of assessment and therapy. I didn't know that rates change. What is CMS?
Yes - but honestly I have been in the VA bubble so haven't really understood it all. I wish I had the bandwidth to pay more attention, but it has been all-consuming to work there.
I hear you, but please understand I'm in a terrible place right now with work and could use a little grace coming here for help while I try to figure this all out. The depression of this VA situation is real and working there is incredibly hard right now to the point where I wake up at night panicking. I'm open to the criticism, just please not right now.
VA is having a rough go of it, as is most civil service, for sure. The good news is that private practice is generally much more tolerable and enjoyable. At least IMO. There are certainly downsides, but (again IMO) they're far outweighed by the positives. At least right now.
My spouse keeps bringing up the fact that there is no sick and vacation, which makes me anxious, but it seems like one could plan to accommodate that.
There's the national factors and then how they have rolled down to my particular site. It's been bad and there are a lot of people who have become extremely difficult at all levels. I can't say much more without giving away who/where I am, but there are a bunch of factors. It has been hard for a couple years now, and now things have gone in a direction that has made it unbearable. I do think it is site-specific as well specific to my particular job in the agency.
This is good to hear, thank you.
Yeah, I'd say at this point, from my perspective, the main benefit to employed positions is healthcare. But even that has tax breaks tied to it if you're paying for it yourself.
This is all very encouraging. It's scary to make this leap. But if that's the only benefit, I am already good there as I'm covered under my spouse.
I'd add that an employed position is potentially more stable, and it can be easier to leave work at work, whereas in PP you need to be better about actively setting whatever boundaries work best for you. Although personally, I prefer being able to work when I want to work much of the time (and being able to decide who and what I'm seeing for that work).
I have a little taste of this in the small practice. Patients have messaged me on the weekends and while I feel an initial pull to respond, I have set the boundary not to until the work day starts. I could see myself working on treatment plans and so on, however. But I want to keep patients well trained to NOT expect an answer from me outside of normal business hours. The flexibility you describe sounds amazing. It was always limited at the VA and now there is absolutely none. I wouldn't be surprised if they installed a punch clock. Not joking. Punch in with your PIV.
Watching private equity bankrupt healthcare companies and what is now happening at the VA, I question that piece of conventional wisdom. It is feeling more and more like "go to college so that you can have a good job".
? It is what is keeping me up at night. Not sure why you'd say that? I mean I am upset about the country as a whole, but the anxiety and panic have to do with what's going on at my job and the role that I'm expected to manage in it. Maybe it has deeper rooted stuff, but doesn't everything? And I am getting a new job, that's why I'm here posting, to learn best how to do it. It's more than disliking my job, also. It's a day to day dread for what's going to happen next as well as the job taking away everything that made it special (research, student education, etc).
ok fair-- for my current job, it's a done deal, I'm leaving so I don't think I need to say much more. The problem is the public forum. Maybe it's paranoia but I feel like I could be recognized. I will say I've been in the system a long time, so it's not like I don't know the setting. It's just changed beyond what I can tolerate anymore. I will say that I read the whole VA thread and other stuff on this site and the niche I am in within the VA gets a lot of people posting about how challenging it is.
