Introduction
This comprehensive checklist is designed to help you maximize efficiency in Professional Corporation (PC) and Managed Services Organization (MSO) relationships by aligning with the exact financial and operational flows depicted in the CPOM model. This guide will ensure your healthcare practice operates smoothly, remains compliant, and optimizes economic performance. Let’s dive in!
Table of Contents
- Define the Relationship Between PC and MSO
- Establish a Managed Services Agreement (MSA)
- Set Up a PC/PLLC Bank Account
- Manage Revenue from Professional Services
- Direct Management Service Fees to MSO Bank Accoun
- Utilize MSO Bank Account for Non-Clinical Expenditures
- PC Provides Medical Services312
- Assign Medical Director Fees
- Pay Licensed Providers’ Salaries
- Structure PC Owner Draw
- Allocate Funds for Provider Training
- Maintain Malpractice Insurance
- Pay Non-Licensed/Admin Staff Salaries
- Ensure Business Insurance Coverage
- Handle Rent Payments
- Implement Business Marketing Strategies
- Engage Accounting Services
- Monitor Compliance with Management Services Agreement
- Conduct Regular Financial Audits
Define the Relationship Between PC and MSO
Understand the distinct roles: the PC provides medical services, while the MSO manages administrative and operational tasks.
Establish a Managed Services Agreement (MSA)
Draft an MSA that clearly outlines the responsibilities, management fees, and expectations between the PC and MSO, ensuring alignment as shown in the chart.
Set Up a PC/PLLC Bank Account
The PC must maintain a separate bank account to receive professional service revenues directly from patient care and treatments.
Manage Revenue from Professional Services
All income generated from medical care should be deposited into the PC’s bank account, as depicted in the flow chart.
Direct Management Service Fees to MSO Bank Account
As part of the MSA agreement, management service fees are transferred from the PC’s bank account to the MSO bank account.
Utilize MSO Bank Account for Non-Clinical Expenditure
The MSO bank account should be used to handle all management-related expenses, such as staff salaries, business insurance, and rent.
PC Provides Medical Services
The PC focuses solely on delivering medical services and maintaining the operational boundary defined in the chart.
Assign Medical Director Fees
Allocate funds from the PC’s account to pay medical director fees, ensuring the PC’s clinical governance.
Pay Licensed Providers’ Salaries
Ensure licensed providers are compensated directly from the PC’s bank account, reflecting the expenditure path in the flow chart.
Structure PC Owner Draw
Manage the PC owner’s draw from the PC’s bank account in a structured manner that supports personal compensation and tax planning.
Allocate Funds for Provider Training
Budget and disburse funds for provider training and education to maintain a high standard of care.
Maintain Malpractice Insurance
Dedicate resources from the PC’s account to secure comprehensive malpractice insurance coverage for providers.
Pay Non-Licensed/Admin Staff Salaries
The MSO should manage salaries for non-licensed and administrative staff, as depicted by the expense flow from the MSO bank account.
Ensure Business Insurance Coverage
The MSO should handle payments for business insurance from its bank account, safeguarding the practice’s assets.
Handle Rent Payments
Manage rent expenses through the MSO, ensuring operational costs do not burden the PC’s clinical focus.
Implement Business Marketing Strategies
Use MSO resources to manage business marketing, enhancing patient outreach and growth.
Engage Accounting Services
Utilize accounting services from the MSO to manage financial compliance and optimize tax strategies.
Monitor Compliance with Management Services Agreement
Regularly review compliance with the MSA to ensure both entities adhere to the agreed terms and maintain efficiency.
Conduct Regular Financial Audits
Perform regular audits of financial transactions between the PC and MSO to ensure accuracy, transparency, and adherence to agreements.
Breaking It Down
By following this 20-step checklist, your PC and MSO will maintain an efficient, compliant, and financially optimized relationship. Contact ProMed Preferred for expert assistance tailored to your specific needs, ensuring that your practice thrives under the CPOM model.
Frequently Asked Questions
What is the primary purpose of the PC-MSO relationship?
The primary purpose of the relationship between a Professional Corporation (PC) and a Managed Services Organization (MSO) is to separate clinical responsibilities from non-clinical management. This structure allows the PC to focus on providing medical care while the MSO handles administrative, financial, and operational tasks, ensuring compliance with Corporate Practice of Medicine (CPOM) regulations.
How does the MSO benefit a healthcare practice?
An MSO enhances a healthcare practice by streamlining administrative functions, optimizing billing and financial management, handling marketing efforts, and ensuring regulatory compliance. This allows healthcare providers to focus on patient care without the burden of managing non-clinical operations.
Why is it essential to have a Managed Services Agreement (MSA)?
The MSA outlines the terms, responsibilities, and fees between the PC and MSO, providing a clear framework for how the MSO will manage the PC’s non-clinical functions. This agreement ensures transparency, defines expectations and helps prevent conflicts, making it a critical component of a successful PC-MSO relationship.
What are the critical financial responsibilities of the MSO?
The MSO manages non-clinical financial responsibilities, such as paying salaries to non-licensed and administrative staff, business insurance, rent, and marketing expenses. These are paid from the MSO bank account, aligning with the financial structure depicted in the flow chart.
How do PCs ensure compliance with CPOM regulations?
Compliance is maintained through structured agreements, proper role allocation, and regular audits. The MSO is crucial in managing non-clinical functions according to CPOM laws, ensuring that the PC’s clinical operations remain independent and compliant.
What types of expenses are handled by the PC?
The PC handles expenses directly related to clinical operations, including provider salaries, medical director fees, malpractice insurance, and training costs. These expenditures ensure the clinical side of the practice operates smoothly and maintains high standards of care.
Can an MSO operate across multiple states?
Yes, MSOs can support multi-state practices, especially when working with PCs owned by multi-state licensed physicians. ProMed provides services tailored to multi-state practices, helping them navigate varying state regulations and ensuring consistent compliance.
How does the PC-MSO relationship impact revenue management?
Revenue generated from medical services is first deposited into the PC’s bank account. The PC then pays the MSO a management service fee as outlined in the MSA. This financial arrangement ensures that revenue is managed correctly and allocated according to the services provided.
How often should financial audits be conducted?
Regular financial audits are essential to maintaining transparency and ensuring adherence to the terms of the MSA. Audits help identify discrepancies, optimize financial management, and provide peace of mind that both the PC and MSO are fulfilling their obligations.
Why is it essential to keep collaborative agreements up to date?
Collaborative agreements between the PC and its medical providers need to be regularly updated to reflect any changes in roles, responsibilities, or state regulations. This helps ensure that the clinical operations remain compliant and aligned with current laws.
What role does accounting play in the PC-MSO relationship?
Accounting services are crucial for ensuring accurate financial records, compliance with tax laws, and effective management of both clinical and non-clinical expenses. The MSO typically handles these tasks, providing the PC with a clear financial picture and helping maintain regulatory compliance.
What happens if the terms of the MSA are not followed?
If the terms of the MSA are not followed, it can lead to financial discrepancies, compliance issues, and operational inefficiencies. Regular reviews and open communication between the PC and MSO are essential to ensure that both parties adhere to the agreement and maintain a productive working relationship.
Glossary
Professional Corporation (PC): A legal entity formed by licensed healthcare professionals to provide medical services. PCs are structured to comply with state regulations governing the Corporate Practice of Medicine, focusing on delivering patient care while maintaining professional autonomy.
Managed Services Organization (MSO): An organization that provides non-clinical administrative, operational, and business support services to Professional Corporations (PCs). MSOs handle tasks such as billing, staffing, marketing, and financial management, allowing PCs to focus solely on clinical responsibilities.
Corporate Practice of Medicine (CPOM): A legal doctrine that restricts corporations or non-physicians from practicing medicine or employing physicians to provide medical services. This rule is intended to ensure that medical decisions are made by licensed professionals rather than influenced by business interests.
Management Services Agreement (MSA): A contractual agreement between a PC and an MSO that outlines the scope of services, responsibilities, fees, and terms of the relationship. The MSA serves as the foundation for how the MSO will support the PC’s operations while maintaining compliance with CPOM regulations.
Medical Director Fees: Compensation paid to a licensed physician who oversees the clinical aspects of the PC’s operations. This role involves ensuring that clinical standards are met and that the PC remains compliant with medical regulations.
Licensed Providers: Healthcare professionals, such as physicians, nurse practitioners, and physician assistants, who are legally authorized to provide medical care. Their salaries are typically paid directly from the PC’s bank account as part of clinical operations.
PC Owner Draw: A financial distribution taken by the owner of a Professional Corporation from the practice’s profits. This draw is a form of compensation separate from a salary and must be managed carefully to avoid disrupting the PC’s financial stability.
Provider Training: Ongoing education and skill development programs for licensed healthcare providers within the PC. This training ensures that providers maintain up-to-date knowledge and deliver high-quality patient care.
Malpractice Insurance: Insurance coverage that protects healthcare providers and PCs from legal claims related to medical errors or negligence. Maintaining adequate malpractice insurance is a critical component of risk management in medical practice.
Non-Licensed/Admin Staff: Employees within the MSO who handle administrative and operational tasks but are not licensed to provide medical care. Their roles include billing, scheduling, and other non-clinical responsibilities essential to practice management.
Administrative Services Fee: The fee paid by the PC to the MSO for the management services provided. This fee covers the costs of administrative support, staffing, and other operational functions performed by the MSO.
Business Insurance: Insurance policies that protect the MSO and PC from business-related risks, such as property damage, liability claims, and other operational hazards. This coverage is essential for safeguarding the practice’s assets.
Rent: Payments made by the MSO for the physical space used by the PC, whether in a telemedicine setup or a brick-and-mortar office. Efficient rent management is crucial to maintaining the overall financial health of the practice.
Business Marketing: Strategies and activities conducted by the MSO to promote the PC’s services, attract new patients, and enhance the practice’s brand. Effective marketing supports business growth and helps maintain a competitive edge.
Accounting Services: Financial management services provided by the MSO to ensure accurate bookkeeping, tax compliance, and financial reporting. These services help maintain transparency and optimize the PC’s financial operations.
Multi-State Licensing: The process of obtaining medical licenses in multiple states, allowing PCs to operate across state lines. This is particularly relevant for telemedicine practices or healthcare providers looking to expand their services regionally or nationally.
Collaborative Agreements: Legal agreements between physicians and other healthcare providers, such as nurse practitioners or physician assistants, outlining their working relationship and scope of practice. These agreements ensure that all providers operate within their legal and professional boundaries.
Financial Audits: Regular reviews of financial transactions, agreements, and operations between the PC and MSO. Audits ensure compliance with MSAs, identify discrepancies, and provide an opportunity to optimize financial management.
Revenue Flow:: The movement of money earned from medical services provided by the PC, starting from the PC’s bank account and, in part, transferred as management service fees to the MSO’s account.
Compliance: Adherence to legal, regulatory, and professional standards governing medical practice and business operations. Both the PC and MSO must maintain compliance to avoid legal issues and ensure the integrity of the healthcare practice.
Additional Resources for You
American Medical Association (AMA)
The American Medical Association provides resources on compliance, medical ethics, and legal guidelines, which can help physicians and medical businesses navigate the complexities of professional practice, including CPOM regulations.
Healthcare Financial Management Association (HFMA)
HFMA offers valuable insights on financial management in healthcare, including revenue cycle management, compliance, and operational efficiencies relevant to both PCs and MSOs.
Medical Group Management Association (MGMA)
MGMA provides resources, best practices, and tools for medical practice management. It covers topics such as financial management, operational strategies, and the integration of MSOs in medical practices.
National Association of Medical Staff Services (NAMSS)
NAMSS focuses on credentialing, compliance, and quality standards for healthcare providers. It’s a great resource for understanding the legal aspects of collaborative agreements and provider management.
American Health Lawyers Association (AHLA)
AHLA offers resources and guidance on legal issues in healthcare, including structuring PC-MSO relationships, compliance with CPOM laws, and drafting management services agreements.
Centers for Medicare & Medicaid Services (CMS)
CMS provides essential information on billing, insurance credentialing, and compliance standards that are crucial for PCs and MSOs managing healthcare practices.
The Physicians Foundation
The Physicians Foundation supports physician leadership and helps address the challenges in medical practice management. Their resources can provide insights into optimizing the relationship between PCs and MSOs.
What Next?
Ready to take your medical practice to the next level? By registering with ProMed Preferred, you gain access to a network of experienced physicians and tailored PC-MSO solutions designed to maximize efficiency, ensure compliance, and streamline your operations.
Whether managing a single-state practice or expanding across multiple states, our expert team provides the guidance, agreements, and support needed to thrive under the CPOM model.
Don’t leave your practice management to chance—register here today and let us help you build a more efficient, compliant, and successful healthcare business.