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A keystroke or two opens the door to hundreds of sites on many practice areas - a generous representation of what today's practitioners need to know. Regardless of the specialization, these sections offer in-depth industry info, news, technical support and business tools geared to keeping physicians professionals conversant and current in their disciplines.
By Wendy Dean, MD and Simon G. Talbot, MD
A recent article in Health Affairs draws an important distinction between patient-centered care and patients as consumers. We need to retire the concept of patient-as-consumer.
The authors, from the Hastings Center, cite the absence of a true market, the lack of sufficient knowledge and time to make informed choices, and the erosion of physicians’ professionalism as reasons to retire the idea. While these alone are sufficient reasons to do so, we would take it one step further. We believe that positioning the patient as a “consumer” and the physician as “provider” erodes the trusting relationship between physician and patient, which is the cornerstone of healthcare, and in so doing, contributes to the moral injury of healthcare.
When the patient is a consumer there is a shift in the implied power dynamic. Rather than presenting to the physician seeking his or her expert advice and counsel, the interaction becomes a transactional one in which the physician provides a service and the patient pays for it. In this type of dynamic, the patient-customer is “never wrong,” according to Cesar Ritz’s well-known edict, broadly adopted in the hospitality industry.
This has led to the bizarre situation where rooming staff in clinics now sometimes ask the patient what he or she expects from the visit before the patient has had the benefit of any expert guidance. An MRI? An injection? A prescription? Most of them, answering thoughtfully, would probably say, “I want to feel better, whatever that takes.” But often, web searches or marketing campaigns have already set patients’ expectations, and they want specific diagnostic or therapeutic interventions, before they even receive a differential diagnosis.
When physicians become customer service reps, whose reimbursements and incomes are tied to their patient satisfaction scores, the implications for care are subtle, but important. Physicians might no longer initiate difficult conversations, giving feedback patients do not want to hear about their weight, their smoking, or their substance use, because they fear patients will score them poorly. In addition, patients may come to their appointment with expectations of testing or medication, so physicians may over-test or overprescribe if there is any way to justify it, to avoid an angry reaction.
But physicians know this is not good care. They know it may lead to delayed prevention measures, and they know when patients don’t need the care they demand. But physicians are caught between doing what’s best for the patient—having the hard conversations, declining testing or a prescription—and protecting themselves.
Much of the business of medicine, curiously enough, seems to assume patient capabilities on par with fully functioning, knowledgeable, and healthy doctors. It assumes patients have the time, energy, focus, and mental acuity to consider all their treatment options dispassionately. It assumes they can shop around and have equal access to other options (i.e., that their insurance covers other entities equally). And it assumes they can walk away without purchasing care in the moment. That may all be true for well care, preventive care, and some elective services, but it is untrue in the context of illness. Anyone who has ever come down with the flu, been a caregiver for a cancer patient, an elderly parent, or an injured child knows none of those conditions apply.
When the patient is a consumer, the obligation of assessing the value (quality vs. cost) of their care shifts to them. And how many non-physician patients have sufficient knowledge to make deeply informed decisions about their medical care? How many can ask the second-, third-, or fourth-level questions about quality metrics or the risks of cardiac surgery?
This leaves patients evaluating the things they do have the expertise to compare: How good the food is, how nice the lobby is, how large the rooms are, whether staff members are friendly, and whether they were “delighted” by their encounter. None of these, of course, have anything to do with the quality of care they receive.
Medicine as a whole used to be overly paternalistic to patients. But we must be vigilant about overcorrecting in the other direction, requiring patients and families to assume responsibilities they are not equipped to manage. Sometimes, we just need to take care of patients when they are ill and ask for a partner when they are better.
Source: Medical Economics, July 16, 2019 (https://www.medicaleconomics.com/med-ec-blog/time-retire-patient-consumer)
By Laurie Morgan
Most physician practices will need help on occasion with tasks or questions that require expertise you don’t have in-house. Three types of advisers that can add tremendous, even essential, value to your practice business are CPAs, management consultants and attorneys. But before picking up the phone to engage one of these experts, it’s important to think through which type of assistance you need.
CPAs
Virtually any business can benefit from the ongoing help of a certified public accountant (CPA), especially for tax filings and related questions. Tax rules are quite complicated and change frequently, so when it comes to business taxes, doing them yourself can quickly become costlier than hiring an expert.
CPAs also create financial statements: balance sheets, income statements and statements of cash flows. Financial statements can be invaluable for understanding your business performance and progress over time. These reports are also essential if you’re looking for financing or considering selling your practice — lenders and prospective buyers will require them. If you’re just starting out, teaming up with a CPA who can advise you on setting up your accounting can help avoid costly mistakes and revisions down the road.
CPAs offer invaluable tax and financial reporting services you can’t easily get from any other source. But it’s important to have realistic expectations. For example, CPAs’ adeptness with financial information doesn’t imply they can look at it and diagnose at a glance why your profitability is declining. Nor can they prevent, or easily spot, embezzling — a common misconception. When buying or selling a practice, it’s also critical to understand the limits of your CPA’s advice. CPAs often get involved in buying and selling small businesses, but the standards for valuing practices are often quite different from other categories; relying only on a CPA for valuation help in a buy-sell situation can lead to mispricing, potentially causing you to overpay for a practice you’re buying or set the price of the one you’re selling suboptimally.
Management Consultants
Consultants of various stripes provide many services to practices. IT consultants, for example, can help you set up and maintain your technology infrastructure; marketing or reputation management consultants can help you promote your practice and manage your business image. But if you’re looking for help with profitability problems, streamlining workflow, solving personnel issues, strategic planning or other business advice that requires a more holistic viewpoint, consider engaging a practice management consultant.
Practice management consultants look at your business from the perspective of a general manager. Usually, they have deep experience running practices and other types of businesses. They often have academic training in business analysis, too. They combine their knowledge with a fresh perspective and a data-driven approach to get at the root of business problems (and spot opportunities, too).
In some ways, practice management consultants are like primary care doctors — even healthy practices can benefit from an occasional checkup. A practice management consultant can also be a good first call for help with a seemingly intractable business issue. But like primary care doctors, good consultants should also be prepared to refer you to specialists when they can serve specific needs better. For example, unless a consultant is also a CPA or attorney (uncommon), they should refrain from giving tax or legal advice.
Attorneys
When you need a lawyer, there is no substitute. It’s important to have reliable legal advice available for the common situations your practice business faces (personnel issues, employment and partnership contracts, leases) and not-so-common ones, too (lawsuits, liability claims and discovery of any potential criminal activity, to name just a few).
It’s no secret that attorneys can be expensive. Sometimes, practices are reluctant to involve an attorney in “boilerplate” agreements, or when pursuing a contract that is “just a formality” and seems unlikely to be revisited any time soon. But often, contractual relationships don’t go as planned, and the decision to forgo legal review before proceeding can end up costing more than it saves.
There are better ways to avoid costs than skipping legal advice and hoping for the best. One of the best ways to do so — and avoid other pitfalls as well — is to be sure you and your lawyer agree up front on the scope of work. Without clear boundaries on scope, legal discussions can expand unintentionally into business decision-making. This can be costly not just because it runs up your legal bill, but also because the legal lens is often not the best way to analyze business problems. Contain scope by making sure that all matters you discuss with your attorney are actually legal ones.
Defining the scope may also allow you to negotiate a flat-fee arrangement with your attorney, depending on the nature of the case. This can keep costs predictable — and discourage forays into unrelated discussions.
Attorneys, CPAs and consultants all offer potential benefits to your practice, depending on your current needs. A key to working well with any external adviser is to understand what services and advice you need before making the call — and to work with a professional you can trust to refer you to a different type of expert, if appropriate.
Don’t be afraid to seek help from CPAs, lawyers, or consultants when appropriate. The money you spend on them can help you avoid greater expenses, give you peace of mind and even set your practice up for increased profitability.
Source: Physicians Practice, July 16, 2019 (https://www.physicianspractice.com/practice-management/who-physician-practices-can-turn-expert-help)
By Linda Girgis, MD
Interoperability was touted as the promise of electronic health records (EHRs). The vision was to create systems that could communicate with each other, making patient records available wherever and whenever they may are treated. While some systems talk with each other, the truth is that we do not yet have wide-scale interoperability in the healthcare system.
Integration is needed in order for disparate systems to share data. Different vendors need to work together to make interoperability a reality. And, for the most part, EHR vendors are not willing to do this. They have little incentive to build a bridge to another company’s software. After all, they’re a business, and they’d rather sell their own products than share with their competitors.
As a result, providers are stuck in the middle, and that puts patient care at a halt — and a disadvantage. Here are five ways the failed promise of interoperability interferes with daily practice.
More work to get records
In the past, labs and radiology facilities would fax or mail results to physicians’ offices. Today, some have the capability to integrate with certain systems to directly upload data into the EHR. Unfortunately, many do not.
The results still get faxed and mailed to us. Then we need to scan, download, and upload them into the patients’ charts. This clearly involves extra steps and extra time, none of which we’re paid for but need to do for proper documentation and the best patient care.
Sharing is more difficult
Interoperability makes it harder to get information that isn’t shared but should be. One of our local hospitals is supposed to be integrated with our system. But sometimes, the results don’t appear in our EHR. We then have to call and request the results. The clerk then argues we already have access to it.
When we finally convince him/her that we don’t have it, the clerk will fax it over, maybe within 15 minutes, maybe within 15 hours. Patients get upset waiting that long for the fax to come, and we’re left waiting until it does.
No one person is held accountable
When systems stop communicating with each other, no one is to blame. One of our local labs is integrated with our EHR but for two weeks, none of the lab results appeared in our EHR. We called the lab and after a 30-minute hold, we were told it was the fault of our EHR software. After another 30-minute hold and an hour and a half phone conversation with our EHR vendor, we were told the fault was with the lab software.
We were going back and forth between both companies for several days. In the meantime, we had to have all the results faxed over, scanned in, downloaded and then uploaded. Once the integration suddenly started working again, we then had double lab entries in all those charts from the previous two weeks, meaning we had to spend even more time reviewing and removing those duplicate results.
Multiple, poorly timed updates
Software vendors don’t all do their updates at the same time. When the system is down for one system to update, the others are still going. Then those are down at other times, creating a never-ending cycle of updates.
When a system is down, it doesn’t integrate with the others. In other words, we need to repeat the familiar yet frustrating process of faxing, scanning, downloading and uploading the data.
Mismatched records and search delays
Keystoke errors in data input can lead to prolonged searches. For example, if my practice doesn’t enter the patient’s middle initial but the pharmacy does, that creates a data mismatch, meaning the prescription will not be recorded in the patient’s chart. Sometimes a simple search will resolve the issue, but it is often more complicated.
When the patient comes for the follow-up appointment and the results are not in the EHR, we end up calling to request the results (maybe after a 15 to 20 minute hold) and they are then faxed over. Those records then they have to — you guessed it — be scanned, downloaded and uploaded into our EHR system.
Multiple portals
Where no bridge exists, a website may offer a connection. Many third-party companies now allow providers to access online portals to view results or records. This can be a great workaround if you are dealing with only one or two sites, but it becomes a very complex process when there are six or seven sites to look up, access, download and upload results.
Interoperability is a great idea, but we are still far from achieving it. And, in my opinion, I doubt we ever will. In the meantime, the lack of interoperability place burdens and waste time from a physician’s daily practice.
Source: Physicians Practice, May 30, 2019 (https://www.physicianspractice.com/ehr/5-ways-interoperability-fails-physicians)
By Sarah Bennight
Today’s tech-savvy patients are using digital channels to seek health information and services, but human interaction still remains an essential element of the customer experience. The challenge for healthcare organizations is striking the right balance between technology and the human touch.
While traditional telephone services will remain a preferred contact method for some individuals, they often hinder an organization’s ability to provide high-quality service. Unpredictable spikes in patient call volumes make staffing and scaling call centers financially inefficient much of the time. And patients are quickly confused and agitated when they must navigate layers of menus and choices, only to reach a human who doesn’t have access to the information they need. To further complicate matters, America’s increasing diversity requires more multilingual expertise in call centers.
In the end, what patients want is a single and rewarding patient experience across all touchpoints, which can be best achieved with effective hybrid communication. To achieve maximum revenue growth and reduce patient churn, consider these best practices:
Send strategic communications
While patients want to be communicated with on their terms, they also want meaningful and customized communication. Research from Salesforce found that 52 percent of consumers said they are more likely to switch brands if a company doesn’t make an effort to personalize communications to them.
This is where the human component comes into play, even if the delivered communication is in digital form. Each appointment type should have its own messaging that is specific to preparation, including what to bring and when to arrive. Providing confirmation or rescheduling options within a customized appointment reminder makes the communication interactive, more valuable to the patient, and can reduce no-show rates by up to 80 percent.
Connecting with patients through multiple channels of communication (email, voice, text, etc.) will result in measurable, positive change in patient behavior, improving appointment reliability, patient loyalty, and more revenue growth. Providing choices is a key virtue in consumerism, allowing the patient to interact in the channel that is easier for them will result in more interactions, and greater long-term loyalty. Allowing them to switch between channels on demand when the situation changes enhances the experience even further. For example, if a patient trying to schedule an appointment online can’t find a date early enough, giving her an option to instantly talk with a human agent to meet her needs keeps her happy and loyal.
Today’s patients want more involvement and knowledge about their health. One in six use wearables and health apps to track everyday health, for instance. While this is a positive trend, wearables and apps are missing a key component—they don’t encourage patients to schedule appointments and visit their doctor.
Going beyond standard automated appointment reminders not only improves patient behavior and satisfaction, it can help grow revenue significantly. Patients crave a personal healthcare experience. Using a patient engagement solution can help achieve this with a diversity of communications, such as:
Engage through multiple channels
The best way to reach people is where they spend most of their time, which for most patients today are on their phones, tablets and computers. We have found that sending a text message-based appointment reminder reduces no-show rates to less than 10 percent. A recent survey from Doctors.com found that 45 percent of patients prefer using online tools to book their appointments and 71 percent of patients said they prefer digital appointment reminders via text message or email, as opposed to receiving a phone call reminder.
Patients expect to be communicated with where they are at any given moment, which often means their smart phone. Digital advances have led patients to seek more convenience in the forms of receiving text messages, email reminders, appointment reminders, physician referrals, and other self-services through digital devices.
For example, if you’re engaging with a millennial patient, research reveals that millennials overwhelmingly prefer text messages above emails and phone calls.
The most efficient way to get patients into the office is to engage with them often and empower them with information on when to come in. It’s why appointment reminders are necessary. But what about communicating to patients about other actions, like when to schedule a preventative care appointment?
An effective patient engagement solution eliminates costly manual efforts by integrating with EHR and Practice Management Systems. It enables providers to communicate with patients at the opportune times, ensuring they know when they are due for preventative care appointments. Integration also ensures that the information presented to the patient is directly from the source of truth, and therefore as accurate as possible. This proactivity reduces readmissions and increases a provider’s daily number of appointments.
Blending digital tools with the human touch is the best way to implement a patient engagement strategy that creates loyalty and generates revenue growth. The hybrid approach connects with patients where it’s convenient for them, while customization empowers them with the all the information they need to stay continually and positively engaged with their provider.
Source: Physicians Practice, May 30, 2019 (https://www.physicianspractice.com/ehr/5-ways-interoperability-fails-physicians)
By Debra Shute
Even though high-deductible health plans (HDHPs) are now ubiquitous, many physician practices still struggle to collect patient balances.
In fact, 83 percent of physician practices with fewer than five practitioners cited slow payment of HDHP patients as their top collection challenge, according to the Black Book 2017 Revenue Cycle Management Survey. Their second biggest challenge, according to 81 percent of respondents: communicating patient payment accountability.
That’s a problem, considering that patient financial responsibility now accounts for one-third of healthcare organizations’ revenue, according to various estimates. Therefore, patient collections should be an area of continuous improvement.
Key areas of focus include financial policies and procedures, employee training, and patient engagement and communication, says Reed Tinsley, CPA, a consultant specializing in healthcare accounting. “Nine out of 10 patients couldn’t tell you what their copay or deductible is,” he says. “It’s incumbent upon the practice to educate the patient.”
Here are five expert-recommended steps that can help practices rise to these challenges.
Draft financial policies
A clear and reasonable financial policy is the first step in setting expectations with patients about their payment responsibilities. At Coastal Medical of Rhode Island, for example, new patients receive a copy of the practice’s financial policy as part of a welcome packet, says Marilyn Boichat, the group’s director of practice management. “When the patient checks into the office for the first time, we have them sign that they read and understand it,” she says. Patients who indicate they need further clarification are invited to come into the office and discuss the policy with the practice manager privately, she adds.
In general, the policy explains what patients are expected to bring to every visit, such as their insurance card and identification; their responsibility to contact their health plan about specific coverage questions; and that payment is due at the time of service unless alternate arrangements, such as a payment plan, have been made.
Coastal also offers a prompt payment discount for patients who choose not to use health insurance, she says. The discounted fee cannot go below the Medicare allowable and is due at the time of service. “For patients who have a hardship [out of their control], such as losing their job and their health insurance, we will discount the visit [further], and the patient is offered a payment plan to pay when they can afford to,” Boichat says.
In addition to having patients sign off on financial policies and posting them on the practice website, practices should consider placing hard copies of the policy in their reception area, says Ken Hertz, FACMPE, a principal consultant with the Medical Group Management Association (MGMA). “Particularly at the beginning of the year, when deductibles reset, it’s a good idea to make this information available for patients to review while they’re waiting to see the doctor,” he says.
Offer ongoing staff training
Inevitably, practice employees will encounter patients who are unclear about various insurance terminology, such as the distinctions among deductibles, coinsurance, and copayments, and how that translates to their out-of-pocket expense.
“If you want to collect the money that’s owed to you, you have to be willing to invest some time in making sure staff are trained to help, as a way of showing patients you care about them,” Hertz says.
It may not be feasible for employees to keep track of the nuances of all the various health plans patients carry, but they can and should advise patients on what questions to ask when they call insurers themselves.
“In other words, employees aren’t going to interpret patients’ policies, but they can explain terminology and provide guidance for reaching out to the payer,” he says. For example, employees could instruct patients to ask what their deductible is, how much of it they’ve paid for the current year, and to what services it applies.
At the very least, billers should be well-versed in understanding the ins and outs of insurance policies in general and common issues that can arise with payers, so that they can serve as a source of expertise for staff at the front desk, Hertz says. Ideally, front desk staff are trained to field these frequent questions or common scenarios.
For example, most health plans will cover one physical per calendar year. “If patients want to have it early, perhaps due to travel or another reason, our staff know to have them call their insurance company and ask whether the visit will be covered,” Boichat says. “What we don’t want to do is book it [prematurely] and have the patient get a bill.”
For staff to attain this competency, solid training is essential, experts agree. “It drives me crazy when practices hire new people and throw them into the fire without anyone sitting with them for the first few days,” Tinsley says.
Hertz agrees: “You can’t assume anything. You have to train, train, train. Remember, it’s about building good relationships with our patients. The result is that they’re going to feel much more positive toward us, and it’s going to improve our cash flow.”
Consider keeping credit cards on file
As HDHPs and other forms of consumer directed healthcare have grown in prevalence, so too have programs in which practices keep patients’ credit card information on file in a secure payment gateway that is PCI-DSS certified. This allows practices to charge and be paid for patient balances as they are incurred.
In 2009, when HDHPs were ramping up and the economy was sliding into a recession, Brandon Betancourt, MBA, implemented a credit card on file (CCOF) program at the pediatric practice where he was administrator — and has recommended it strongly ever since.
“The credit card policy states that all private paying patients must leave a credit card on file if they wish to be patients of our practice,” he wrote in a commentary for FierceHealthcare. “The practice would continue to send out claims to patients' insurance company and bill patients for their portion of the balance, per the insurance carrier's explanation of benefits. However, if we are unable to collect in full for our services after several attempts to collect, we reserve the right to process the patient's credit card.”
As an independent consultant, Betancourt now helps practices implement CCOF policies. Whenever transitioning to any new policy, practices should be prepared with an explanation, he says. “You have to anticipate that some changes might be a bit contentious, and train staff accordingly to make sure they can handle the issue.”
Beyond that, you must ensure that your practice is equipped with adequate cybersecurity to protect patients’ financial information, and that your policy complies with state laws and regulations, Hertz says. “Make sure that access to credit card information is very limited internally, and totally impossible externally. And notify the patient in advance of every draft being taken out or payment being made.”
Coastal Medical adopted a CCOF program last year after Boichat learned about it at a conference. She says that not only has it helped reduce bad debt, but also that patients have welcomed the convenience of not having to pay their bills manually.
Because insurance plans frequently change and credit cards expire, Boichat recommends making sure both are updated or verified as current at least annually as part of the check-in process.
Adopt helpful tools and technology
A few years prior, Coastal made a number of other changes intended to improve patient satisfaction, which ended up improving collections as well. For example, the practice added a kiosk to the waiting area so that people could check in on their own if there was a line at the front desk. “We really did it to improve the patient experience and our work flow process,” Boichat says. “What we didn’t realize was that the kiosk was collecting a lot of old balances.”
When patients checked in using the kiosk, the computer would remind them of their balances and give them the option to make a partial payment, she says. Most patients ended up paying off those old balances in full, a pleasant surprise to Boichat. Using tablets for patients to input their own demographic and insurance information can achieve a similar result, Betancourt notes.
Other useful times to remind patients of their balances are when patients call to make appointments and in appointment reminder messages, whether they be via voice, text, or email, she says. But perhaps the most powerful improvements have come with giving patients the ability to pay their bills online. This saves patients time from having to write a check and drop it in the mail. Plus, they can pay their bills from anywhere. “I’ve used the service myself and loved it,” Boichat says.
Don’t tiptoe around the money conversations
Finally, the cornerstone to making all financial policies and procedures effective is clear, up-front communication with patients.
“There’s always been the soft approach, which is the sign in the doctor’s office that says that copays are due at the time of service,” Tinsley says. In the age of increasing patient responsibility, he recommends upfront verbal communication. “Patients should know their financial responsibility before they even get in the car [to go to the practice],” he says. “With reimbursement continually going downhill, practices have to treat their office like a business, which it is.”
Practices shouldn’t feel the need to apologize for collecting patient balances, Betancourt says.
“No margin, no mission.”
Goodbye, simple copay collection
Patients’ annual financial liability continues to rise. According to the 2018 Kaiser Family Foundation Health Benefits Survey, family premiums for employer-sponsored health insurance plans rose 5 percent from 2017 to 2018, with employees contributing an average of $5,547 toward a $19,616 premium. Meanwhile, annual premiums for individual coverage increased 3 percent, with workers paying an average of $1,186 toward a $6,896 premium.
According to the same survey, 85 percent of covered employees have a deductible in their plan, which averaged $1,573 for single plans, while 26 percent of all covered workers carry a deductible of $2,000 or more.
Source: Physicians Practice, May 6, 2019 (https://www.physicianspractice.com/medical-billing-collections/5-keys-collecting-patient-responsibility-upfront/page/0/2)
By Jessie Marolis
Caring for patients may come naturally, but you may find that navigating the lending process isn’t as straightforward as diagnosing a sinus infection.
Whether starting a new practice, expanding an existing one, or relocating to a new permanent space, there may come a time when you need external funding to elevate your career to the next step.
Deciding which loan you will apply for is only half of the battle. Lenders are going to examine you personally and professionally to determine your credit worthiness. You need to make a strong case for why a lender should issue you a loan.
Before you head to the bank, it may be beneficial to complete a personal audit so you can improve any shortcomings and maximize your chances of receiving the needed funding. To begin, review the three C’s to financing: cash, credit, and character.
Cash
To determine your credit worthiness and ability to repay your loan, your lender will first take a look at your complete financial profile. This may include your personal assets, expenses, and financial history.
Most lenders prefer that you have at least a 10 percent down payment, but you should also have an additional 5 to 10 percent available to cover project costs and overages. These expenses are often underestimated and overlooked, but failure to have additional cash on hand could lead to trouble. Whatever the amount, it is important that you do not completely drain your bank account to meet your down payment requirements.
In addition to maintaining your current lifestyle, you need a cash reserve in case of emergencies. Take inventory of all your assets — property, stocks, investments, and anything else you could liquidate quickly. If you aren’t confident that you have enough capital to keep you out of financial trouble, it may be wisest to postpone your purchase.
Credit
Your personal credit rating will have a large influence on your loan. Lenders like to see a FICO score of at least 650, and your credit history will also be thoroughly examined. An excessive number of late payments and multiple charge-offs are bad signs. Delinquent accounts, foreclosures, and outstanding debt are also red flags. Unfavorable information on your credit report does not automatically mean your loan will be denied, but it will affect the interest rate and amount of funds you receive.
To avoid a higher annual percentage rate and stricter loan terms, get a copy of your credit report before approaching a lender and verify that all of the information is accurate. Credit report errors are common. However, failure to resolve an error before applying for a loan could have a negative impact.
Character
While a lender’s primary job is to examine your financial status, most will also take a look at who you are as a person. If possible, establish a relationship with the lender beforehand or reconnect with a lender. If the two of you have worked together in the past, she may be more inclined to do business with you and assist in ways that best suit your needs.
Your reputation can take you very far, and an established relationship of trust could potentially overshadow faults in your financial history. A lender who sees that you have taken action to aggressively pay down your debt may disregard the fact that you do not have $50,000 in assets. Similarly, evidence that you constantly pay your taxes late may overshadow your near perfect credit score.
Your practice’s reputation and history can also affect a lender’s decision. If you’re a profitable practice with good community standing, you’re an attractive loan candidate. However, frequent employee turnover, poor ratings, and lack of community support may cause a lender to shy away from your practice.
You should remain professional and courteous during communications with your lender at all times to reassure her that you are worthy of funding. The loan process could be lengthy, so make sure you are available and willing to provide the additional information your lender requests. Go the extra mile for her, and she will go the extra mile for you.
Expanding or transitioning into a new property to support your business goals is a huge investment. Understanding the three C’s of financing puts you one step ahead of the game. With the right mix of cash, credit, and character, you can deftly navigate the lending process, negotiate a loan with favorable terms, and own the practice of your dreams in no time.
Source: Physicians Practice, May 20, 2019 (https://www.physicianspractice.com/finance/conquer-3-cs-secure-financing/page/0/1)