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is a question-and-answer forum featuring leading practice management experts who may or may not be employed by Physicians Practice. Physicians Practice receives questions from physicians, office managers, office administrators and others. Have a question about the operation of your practice? Visit www.PhysiciansPractice.com. Your question will be answered within three business days.

Q I am planning to set up a movable ultrasound service for doctors’ offices. We will do billing as well. Since I already have my own practice and tax ID set up, can I use the same one, or do I need to apply for another?

A Here is a response from Owen Dahl, an experienced practice administrator and consultant:

As I understand the question,

• The practice currently has all the appropriate tax ID and provider numbers.
• The practice is currently offering the ultrasound service to its patients and has done the billing for it under its tax ID and provider numbers.
• The practice, for some valid reason, is changing its approach to providing the same service. I assume there has been a cost-benefit analysis applied to this matter and the best decision for the practice is to contract these services.

There is no need to seek another tax ID or additional provider numbers, and there is no major problem related to billing procedures, barring a carrier-specific need to disclose that these services will be contracted rather than provided directly. I suggest contacting the local carrier Web site or provider representative to obtain any specific information.

There is, however, a definite need to have a valid contract in place with the ultrasound equipment vendor, with fees based upon fair market value, etc. Medicare or other payers may request to see this contract.

This is a service that was provided by the practice and will be continuing, so it should not be a difficult switch.

Q I’m thinking about accepting a new job as manager of an ambulatory surgical center (ASC), but I’m not sure my experience is sufficient. Where can I obtain knowledge quickly?

A It’s hard to learn everything overnight, especially about a specific type of practice, but if you’ve simply noted a few issues that make you uneasy, consider calling the managers of ASCs in your state to ask whether they’ll meet you for lunch or spend 20 minutes on the phone to talk to you about their key challenges, give you advice or provide insight into the issues that concern you. Your future competitors might even be willing to lend you a hand to some extent. People love to be considered experts and are usually willing to help a peer.

Or you can pay a consultant you respect for the time it takes to give you a crash course.

Specific books and articles also are easy to locate in these days of Internet access and Amazon overnight delivery.

Keep in mind that assuming you didn’t exaggerate anything, your future employers think your experience is sufficient. You can always extend your education in a more thorough and careful manner once you start.

Q I work as an administrator for a two-physician practice. The physicians take a management salary for managing the practice. Do you have any information on similar practices that also pay their physicians a management salary and approximately the average dollar figure of that salary?

A In my experience, it’s somewhat unusual to see management salaries in a two-physician practice in which both physicians handle management tasks and there is an administrator to boot. I find it more common in practices with a compensation structure built on productivity in which a physician’s clinical productivity is hampered because of the time that physician devotes to management tasks and to serving as the only real go-to physician contact in this regard. In such a case, that physician needs to catch up and be paid reasonably.

Management salaries can be paid based on actual time spent at an hourly fee, a set fee or a percentage of the practice’s profits per year.

Your decision should take into account the value the physician brings to the group in the management role. That is, how is this position affecting your group’s profitability? Do you get more revenue from your managed care contracts? Does the position involve managing operations only? Your answers to questions like these can help you determine the value of the position and, subsequently, its fair compensation.

Some groups feel that a physician administrator basically saves them from having to hire another administrator. In that case, compensation is based on an administrator’s going salary — in other words, the group pays the physician the amount the group is saving by not having to hire another staff person.

There’s really no industry standard for this, so your small group should principally look at its overall budget and work out with its physicians fair compensation for their contributions. It’s a matter of negotiation.