Archive for month: August, 2016

Practice Manager of the Month

Categories: Practice Manager of the Month

pmm_2016-0728-debra_ledbetterDebra Ledbetter, RN, CMPE
Practice Manager, Rivertown Pediatrics

Debra Ledbetter is the Practice Manager at Rivertown Pediatrics in Columbus, Georgia.  It is a large practice with ten providers and a staff of 40.  The practice is focused only on pediatrics with the vision to help the children of the community enjoy longer, healthier and more productive lives.  Debra enjoys the larger practice as it’s always a challenge and lots of moving pieces.  She finds the fun in taking care of children, and especially enjoys being able to utilize management and clinical skills at the same time.

Prior to working at Rivertown Pediatrics, Debra was a critical care nurse in Columbus, GA for eight years.  She followed the hands on nursing experience with management experience at a urology office for six years.  She took some time off to be home with her children, and then came to Rivertown Pediatrics.  She started as a clinical manager, worked her way to practice manager, and has enjoyed 19 years at Rivertown Pediatrics.  Debra has recently become a Certified Medical Practice Executive (CMPE) with MGMA and is working on Fellowship.  She must do a professional study and submit for approval

The piece of advice that has stuck with Debra the longest was from Neonatologist Dr. Louis Levy.  He told her on her second day at the practice “Touch it once.”  She says, “Not a week goes by that I don’t hear him say it in my mind.”  With a big busy practice, that is how Debra keeps the office successful.  She doesn’t let things pile up or stay behind.  If it comes her way, she makes the decision and moves on.  Everything has to be checked off, but she does it once and moves on to the next task.

One tip Debra has for her colleagues is to come in with an attitude that you can’t just maintain.  You must always be looking for ways to move forward in healthcare.  Maintaining is never good enough.  She suggests networking with other practice managers and practices to look for new opportunities to learn something different.  She tells others to look for opportunities in the industry at conferences, on the internet, in magazine and newspaper articles – ‘read anything about healthcare.’

With 19 years at Rivertown Pediatrics, there’s no question that she’s a valuable asset.  One of the doctors, Dr. Kathryn Cheek said this of Debra, “Debra is an innovative but totally practical leader in our office.  She researches a topic and then implements the necessary steps to achieve change. She is a person you can always depend on and she cares deeply for the success of our office. She has been a delight to work with over 15 years and our success would not have been accomplished without her input. We all admire her skills and feel blessed to have her as our office manager.”

Outside of work, Debra loves to spend time with family.  She enjoys traveling, especially if there’s a beach.  From Columbus, Georgia, she finds it easy to get to the Florida beach areas.  Her favorite is the Panhandle area, and she also loves Savannah and Tybee Island.  She recently went on an Alaskan cruise.

Debra Ledbetter was nominated by Bart Segal, Tri-Med Solutions.  She states, “Bart understands our practice. Not just with our EMR needs but also as a whole.” She feels that Bart understands that she has needs as a practice manager and is constantly looking for new ideas for the practice.  He knows this and sends information, articles, and links to new ideas and takes the time to go beyond his one area.

A Fresh Look at Your Office Space Provides Real Benefits

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Just as you review office procedures from time to time to determine their efficacy, likewise you should periodically evaluate your office space to determine whether it is really meeting your current needs. Occupancy cost represent a practice’s second largest expenditure next to personnel expense. Your office space’s ability or inability to meet your needs will significantly impact your bottom line and it deserves your attention. Such a review should involve five steps.

First – Do you have at least a basic understanding of the business terms relating to your office lease. In the case of leased space you should consider creating a lease abstract for each lease. A lease abstract is nothing more than a concise explanation of the important terms of a lease. In the case of a lease how many square feet do you occupy both rentable and usable? When does the lease come up for renewal? Do you have a renewal option and if so how much notice do you need to give for a renewal? What is your base rental rate? What does that rate cover?  Is there a mechanism for challenging operating expense increases if you feel they are out of line? How much does the base rental rate escalate each year?

Second – You should complete a needs assessment, a fresh look at how your office does function as opposed to how it ideally should function. Make a list of your current office space needs. Have these needs changed since your last review? Are you contemplating additional providers and if so will they be doctors or other types of providers? Particularly as you approach the final year of a lease you should objectively consider whether your current space satisfies your current needs in terms of flow and the adequacy of its component parts. Over time the needs of the practice change, sometimes in subtle ways. You adapt those changes to the space you have and make it work. The office review is a time to take a fresh ground up look at the component parts such as the number of exam rooms, the size and layout of the lab, the size and layout of the front office, the size of the waiting room and the number of staff working in the front office to see if you really have the components you need, arranged in a manner that creates the most efficient work flow.

Third – Once you know what you have and what you need, you can determine your options for getting there. Does the area in which your office is located still fit your needs? If you are a hospital based practice are most of your patients still admitted to the hospital nearest your office? Have your patient demographics changed since your last review? Even if you have significant time left on your lease you may be able to make changes that would have a significant impact on operating efficiency which could justify their cost. If your lease is coming up for renewal and you have made a determination of your needs you are ready to assemble a list of available alternatives that encompass those needs. Practices often don’t take the time to look at all their options. They often just look at a few possibilities, generally the most obvious. Your time is a precious commodity and it is always in short supply but don’t short change the process. For an item which affects your bottom line so significantly it just makes sense to take the time to do your homework to make sure at the end of the process that you have picked the best option. Otherwise you will live with your mistake for a considerable period of time. Consider hiring a professional if you don’t have the time or the market knowledge to work through the process of assembling and analyzing your alternatives. Once you have a comprehensive list you need to whittle that list down to a workable number of alternatives, usually 2 or 3. Negotiate between those alternatives to find the alternative which offers the best combination of lease terms, location and efficient layout.

Fourth – Following selection of the best alternative the next step is the negotiation of a lease document with that alternative. As a part of choosing the best alternative you will have finalized the business terms, now you need to make sure that you negotiate a lease document that will be survivable. The majority of lease terms will never be used but it is nevertheless important that you negotiate all of the lease provisions as if they would be invoked so that if an unforeseen event does occur it will not devastate your practice.

Among the issues which should be negotiated in your lease agreement:

Assignment and Subletting

Make sure that you will be allowed to sublease your space if a change in the practice should arise as the result of growth, contraction or the need to close the location.


Make sure that throughout the lease the Landlord cannot unreasonably withhold, condition or delay it’s consent.

Full or Partial Destruction.

In the case of full or partial destruction of your space make sure that the Landlord gives you notice of their intent as soon as possible and that the period allowed for rebuilding your space is as short as practical. No one benefits from damage to the building and it is important that the landlord work with you to help you survive an event which would be devastating for everyone concerned.

Fifth – The final step in the process is follow through. You have a space and you have a lease, now you need to follow through the construction process to make sure that you get what you negotiated. Tour the space periodically checking the construction against the space plan you agreed upon in the lease. It is particularly important to walk through the space with the contractor prior to the cover up inspection. This gives you a chance to look at the construction far enough along to see if there are construction errors but early enough to minimize the cost of any revisions which the tour dictates. In that tour you will be looking for two things, elements which have not been constructed according to the plan and elements which are constructed according to the plan but when viewed in three dimensions don’t work the way you intended and therefore need to be changed. Once the space is finished you will walk through the space with the contractor and do a punch list of items that need the contractors additional attention.

A fresh look at your office space provide real benefits. Time spend on the search and negotiation process is time well spent with benefits that extend to your practice’s bottom line.

Provided by Stan Sharp, Founder of HealthOne Realty Advisors (770-578-4996 or

9 Great Ways To Prep For A Meeting With A Financial Adviser

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2015_03_02By Alden Wicker

If you have an appointment to meet with a Certified Financial Planner™, you may be feeling a mix of emotions ranging from excited, hopeful or even anxious about what could happen on that first big date to discuss your finances.

One way to ease your mind: Do everything that you can to be fully prepared. And we’re not just talking about organizing all of your tax returns, bank statements and investment account info.

There are actually several experts and smart strategies that can help smooth the path—and boost your confidence—for a successful money talk with a financial adviser. From consulting a credit counselor to familiarizing yourself with your financial weak spots, these nine to-dos can prime you for a productive sit-down with your planner.

Step #1: Talk to HR About Your Benefits

One thing that you can be sure your financial planner will talk about? Retirement. “Surprisingly, I’ve found that there are a lot of people who have no idea what their retirement match even is,” says Katie Brewer, a CFP® with LearnVest Planning Services. “So it’s a good idea to spend some time figuring out what you already have in place when it comes to your benefits.” That includes retirement matching, of course, but also life insurance, health-care benefits and HSAs, to name a few. And it’s easy to do: Just place a call to your HR department contact.

Step #2: Get a Grasp on Your Money Weak Spots

Brewer also appreciates when clients already know what some of their financial weaknesses are in advance of that first financial planning session. This way, she can spend less time playing detective and more time strategizing with someone to help mitigate the damage.

So what’s one of the best—and easiest—ways to go about this? Brewer recommends reviewing a few months’ worth of bank account statements to pinpoint any troublesome trends. “It allows people to help identify a weak spot, like emotional shopping or habitually sending money to a relative,” she says.

Step #3: Sync With Family Members

Your loved ones can have a big impact on your financial goals and potholes. For example, have you discussed with a spouse how much of your child’s education you plan to fund? Does Alzheimer’s run in your family? Have your parents saved enough for retirement or will they need your financial support? All of these things will determine how much you need to save—and how. “If you can think of these issues beforehand, your adviser can then better plan around them,” Brewer says.

Step #4: Work Out Money Issues With a Partner

Fighting with a significant other over finances? To a degree, a financial planner can help you sort through your sticking points, such as disagreements over joint budgeting and saving. “Couples who have conflict may need a financial planner to get an interpretation of what their numbers mean,” says Susan Zimmerman, a chartered financial consultant, licensed marriage and family therapist, and author of “Mindful Money for Wealth and Well-Being.”

But do your CFP a favor and have a one-one-one conversation with your partner before you get on the phone. “Talk about what works well in your financial life, as well as in your communication about your money,” Zimmerman says. “Think about not just the problems that you’re bringing, and the challenges that you have faced, but also what your strengths are—as individuals and as a couple.”

However, if you’re getting into extreme fights over money, finances may just be a proxy for deeper issues. So it might be helpful to see a couples counselor before treating your CFP to a screaming match. “I’ve been part of the unfortunate experience of couples arguing while I’m on the phone with them,” Brewer says.

Step #5: Digitize Your Documents

This is by no means necessary, but it could definitely help to streamline your first session with a planner. “If somebody wants to get organized, and they don’t have a system in place, it helps them feel in control,” Brewer says. “And the more in control they feel, the better they will feel about working with a financial planner.”

Digitizing isn’t just a method for clearing out space on your desk, either—it can also make your financial planning sessions go faster. Case in point: When your CFP asks what your renter’s insurance covers, you can quickly pull up the paperwork and tell her. As an added bonus, you can back up important documents in a cloud service, so if your computer dies, you’ll still have access to them.

Step #6: Seek Out a Financial Therapist

A Certified Financial Planner™ is a great resource for running the numbers for you—and can even give you pep talks and strategies for how to help get a handle on financial faux pas, like overspending. But some issues that cause chronic under-earning, marital money conflicts and emotional- or stress-induced spending run deeper.

So if you know that you need to save $1,000 a month, but you keep throwing it away on late-night Internet shopping sprees, that’s when a financial therapist—a licensed professional tasked with helping people understand the emotional and psychological reasons that lead them to make bad money decisions—can get to the root of your overspending.

Step #7: Talk to a Credit Counselor

If you’re swimming in debt, a great move for your money may be to consult a credit counselor—who can create a plan to help pay down your debt for free—before you meet with a financial planner. It’s important to note that a credit counselor doesn’t replace the services of a CFP, but simply supplements them by devising a debt repayment plan that will free up more money to put toward retirement, savings and other future goals when you do meet with a financial planner. To find a reputable credit counselor, check out

Step #8: Meditate

“When I get on the phone, I tell people that this is just a benchmark, with no judgment,” Brewer says. She also encourages clients to forgive themselves for past mistakes, opening them up to work on what they have today.

The same can be said of meditation, which can also help you purge bad feelings, leaving space for positive progress. “Meditation clears the mind,” says Catherine Tingey, a meditation instructor based in Santa Monica, Calif., who often works with high-profile money managers. “Any kind of deep breathing and mindfulness technique is helpful before going into a stressful situation, like a job interview or a meeting with a financial planner,” she says.

Ready to breathe? Tingey recommends this simple, 10-step meditation.

Step #9: Have Fun

Managing your money is important, but you should allow yourself to have a laugh too! So if your heart still races when you think about your finances, try a light, fun activity to help put things in perspective—like taking a friend to a tarot card reading, with an emphasis on “large sums of money heading your way.” (Don’t they always seem to say that?) Or try tapping, which looks silly, but it can clear away anxiety, so you can work with a financial planner without having a stress-induced panic attack. Intrigued? Read our interview with a financially-focused tapping expert.

LearnVest Planning Services is a registered investment adviser and subsidiary of LearnVest, Inc. that provides financial plans for its clients. Information shown is for illustrative purposes only and is not intended as investment advice. Please consult a financial adviser for advice specific to your financial situation. LearnVest Planning Services and any third parties listed in this message are separate and unaffiliated and are not responsible for each other’s products, services or policies.

Provided by Joshua C. Harper, CFP®, CLU®, of WealthMD (877-Our-MDPlan or

Lost and Stolen Computers are $2 Million Worth of Reasons to be HIPAA Compliant This Month

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Two settlements between Concentra, QCA Health Plan, The Department of Health and Human Services for HIPAA violations have brought new enforcement expectations into focus.

For the last few months, Medicus Solutions’ blog has been in the forefront of the discussion about HIPAA and health care security. While we’ve been discussing the more technical side of security such as crypto ransomware, most of our focus in 2016 has been talking about how the Department of Health and Human Services and its Office of Civil Rights has been stepping up enforcement of HIPAA laws with new waves of audits across the industry and discussing related matters with our favorite partners who are also leaders in the field.

Now, news of recent events have surfaced showing that HHS means business: HIPAA violation settlements totaling nearly $2 million dollars have taken place involving two health care entities — Concentra Health Services and QCA Health Plan Inc. — that reported stolen, unencrypted laptops. With theft or loss of unencrypted devices representing one of the biggest threats to the health care sector with some 2.8 million breaches in California alone since 2012, the need for proper security and encryption in health care has never been more critical.

Back in March, we discussed the most common breakdowns and breaches in security at many health care entities referencing a report released by the California Attorney General, Kamala D. Harris and her team. In that report and our subsequent article, it was determined that physical loss of hardware (lost or laptops, hard drives, thumb drives, phones and physical files) comprised more than 50% of health care’s industry breaches. More alarming, 55% of compromised medical records on these devices are utterly unencrypted.

Costs of Data Breaches For Individuals

The significance and impact of these data breaches for individuals cannot be understated. For the individual, research from Javelin Strategy & Research notes that 67% of victims of data breaches eventually become victims of fraud. On May 5, 2015, UCLA Health concluded that a hacker accessed parts of their network that contained the addresses, DOB’s, social security numbers and medical records of 4.5 million individuals. The data was not encrypted. If the percentages hold, more than 3 million of those people are likely to become victims of fraud at some point in the future.

Costs to Data Breaches for Businesses

For businesses, the cost is different but no less impactful: data breaches not only impose financial, reputational, and business opportunity penalties and costs, they also threaten critical infrastructure. Violations have to be made public and the current list of reported breaches can be seen here, creating a very embarrassing situation for many health care providers. It is becoming increasingly clear that HHS is looking to continue to set its own very clear standards as it relates to failure to observe proper HIPAA rules and regulations. The $2 million settlement that happened a little over a week ago should be best considered as an opening salvo, and one that businesses that wish to stay in business need to sit up and take note of. Concentra will be paying OCR $1.72 million and filling their 2016 calendar with corrective actions. QCA Health Plan has agreed to a $250,000 monetary settlement and to correct a multitude of observed failures within its own HIPAA compliance program, according to OCR.

In the past, loss of unencrypted laptops or other computer hardware with patient information would have been considered a concerning but ultimately a relatively small infraction. In 2016, such failures will cost your health care entity hundreds of thousands or even millions of dollars.

Roughly 50% of health care breaches came secondary to lost or stolen computer equipment, typically laptops. 55% of compromised patient records were the result of a failure to encrypt data.


How Your Entity Can Address Its Health Care IT Security Issues

We continue discussing these issues here because all health care entities need to take note: HIPAA enforcement is here. The run of more than a decade of accepted non-compliance is at its end and your health care entity must be prepared for the inevitable audits and enforcement for any uncovered violations. As such, it is essential that your health care organization implement strong encryption systems to keep your sensitive data safe. For devices that represent a natural threat for physical loss like laptops, implementing encryption of work-related folders, developing and implementing a security plan, and educating staff in the proper use of said systems are essential to bullet-proof security.

Whether you work with Medicus Solutions or another medical IT security company, we encourage you to not wait for an OCR audit to start your review and act on your security deficiencies. Get an independent party to review your security and compliance with HIPAA regulations and do everything you can to be above and beyond reproach. In doing so, your entity can ensure that its patients are as protected as reasonably possible and avoid any consequence or penalty from HHS even in the unexpected event of a breach. Fail to do so and your entity may be the next one we write about being hit with harsh penalties from HHS.

The good news: Medicus Solutions can help! Our team specializes in medical IT solutions including implementation, ongoing support, and related services. We can quickly evaluate the quality of your current security solutions, test your backups and networks, scan for vulnerabilities, implement new secure systems and services as needed, and much more. If your organization would like an evaluation from a team with more than 20 years of experience in IT security services, we encourage you to contact us today.

About Medicus Solutions:

Medicus Solutions, LLC ( is an Alpharetta, GA based company that specializes in providing IT management solutions to improve the efficiency, security and stability of your company’s operations. Medicus offers a range of IT services that work both independently and in unison to ensure your company operates securely, seamlessly and efficiently. Featuring secure email and backup services, virtual hosting services, HIPAA-approved file encryption systems, and much more. For more information about Medicus Solutions, please call our main office in Alpharetta at 678-495-5900 or visit our website.

Medicus Solutions writes about news, technologies, and educational topics that are defining the future of health care IT solutions and security issues at its blog:

Provided by Chris Jann, President & CEO, Medicus Solutions (678.495.5902 or

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