Office Hour March 27, 2026

Summary Paris Trip and Work Updates Florence shared details about her recent trip to Paris, including visiting family and Disney, and discussed the logistics of the trip. The conversation then shifted to work-related matters, with Jennie asking Florence about reviewing a spreadsheet on provider compensation in neurology. Jennie mentioned sending the spreadsheet to Florence's email, though there was some confusion about whether Vineka had also received it. Medical Practice Financial Projections Jennie and Florence discussed financial projections for a medical practice, with Florence clarifying that the target salary for neurologists should be around $300K rather than $500K. Jennie presented a spreadsheet model assuming 18 patients per day at $190 per visit, with overhead costs of $20K monthly per FTE plus $60K for a medical assistant. They discussed how to allocate overhead costs across providers and reviewed the ramp-up period from 14 to 18 patients per day over the first year. Physician Practice Revenue Structure Discussion Jennie and Florence discussed revenue calculations and compensation structures for a physician practice. They reviewed a spreadsheet model showing net revenue per visit of $190 and explored different revenue scenarios, including a 60-40 split between physician and practice compensation. Jennie explained that the practice share of 40% should cover both the practice costs and MA overhead, with the practice keeping 60% of the revenue. They also discussed adjusting overhead percentages based on productivity levels and potentially implementing bonus incentives for higher revenue performance. Medical Practice Compensation Models The discussion focused on compensation structures and partnership models for a medical practice. Jennie and Florence explored various revenue-sharing arrangements, including a 60-40 split model where physicians would receive 40% of profits after covering overhead costs. They discussed implementing a partnership track requiring 3-year tenure and meeting productivity benchmarks. The conversation also covered how to structure compensation for new hires, suggesting a combination of guaranteed salary for the first year followed by productivity-based compensation. They examined how to account for additional revenue streams beyond patient visits, including incident-to-billing for mid-level providers and various testing procedures. The discussion concluded with recommendations to calculate specific overhead numbers and use existing practice metrics as benchmarks for determining appropriate compensation levels. Revenue Cycle Management Challenges Jennie and Vineka discussed challenges with billing processes and revenue cycle management. Vineka expressed frustration about a lack of progress in addressing billing issues, particularly regarding a patient with seven unpaid visits over 1.5 years. Jennie introduced a revenue cycle management tool to help identify fail points in the billing process and proposed using it to analyze current issues systematically. They agreed to review the tool further in an upcoming meeting to address Vineka's concerns about improving active billing processes. Billing Process Improvement Planning Jennie discussed plans to create a spreadsheet to identify and address common fail points in billing processes, with a focus on reconciling claims and ensuring timely filing. Vineka expressed concerns about relying on a VA for reporting and emphasized the need for the VA to independently identify issues rather than being directed. They agreed to review specific service lines, particularly office visits, from recent months to better understand where processes are falling through. Vineka also mentioned challenges with setting a company valuation date due to ongoing legal proceedings, which is impacting decisions about streamlining systems. Project Timeline and VA Management Vineka discussed the need to set a timeline for a project, emphasizing the importance of not allowing delays to continue indefinitely. Jennie and Florence had a conversation about using virtual assistants (VAs) and AI scribes in medical practices. Jennie advised Florence on managing a new VA, suggesting the use of Loom videos or screen recording for training purposes and emphasizing the importance of a business associates agreement (BAA) for handling patient information.