April 15^th, the deadline to file your personal income tax, will be here before you know it. As a small business owner however, you will have filed tax reports and paid all sorts of taxes already.

Most small businesses operate on a calendar year. And even though tax events happen throughout the year, they are reported at the end of the business year and quarter, when they get submitted to different taxing authorities.

Paying attention to those timelines is critical. Countless business owners have lost their business by ignoring the IRS and other taxing authorities.

Remember that you, as the owner of the business, are responsible that taxes are filed, paid on time and reported accurately. It does not matter who will do the work for you, the ultimate responsibility rests with you.

This is the reason you MUST have some basic knowledge about your tax obligations as a business and as the business owner.Below is a brief list of the most common taxes and tax reports and when to file and pay them. Please note that this is not a complete list of all the possible taxes.

Quarterly Taxes and Reports

Estimated Taxes: 

You’re required to pay self employment taxes on the income you earn throughout the year.

Most non corporate business structures file estimated taxes on or around April 15^th for Quarter 1, June 15^th for Quarter 2, September 15^th for Quarter 3 and January 15^th for Quarter 4 (exact due dates vary slightly from year to year).

SE taxes are reported as part of IRS Form 1040; quarterly estimated tax payments are submitted via IRS Form 1040-ES.

FICA, FUTA, Labor & Industries and Employment Security:

If you had employees during the tax year, you are required to file an Employer Federal Tax Return, reporting FICA (Social Security tax) and income tax withheld for your employees during the quarter; tax payments are submitted with report 941.

Next is Federal Unemployment Tax. These tax deposits are made on a quarterly basis if the unemployment tax collected is greater than $500. Otherwise, FUTA will be reported and paid at one time, due at the end of the year.

Both Labor & Industries and Employment Security are state dependent. Tax rates and reporting frequency vary so check with your state for the details.

Annual Taxes and Reports

1099-Misc:  You are required to issue a 1099-Misc for any contract work over the amount of $600. 1099s must be issued no later than January 31^st for the prior tax year.

W2 and W3:  Again, if you had employees, W-2s and W-3s are due at the end of the year. You must issue a W-2 to your employees no later than January 31^st for the prior year. Submit the W-2 and W-3 to the Social Security Administration no later than the last day of February.

FUTA:  File the federal unemployment tax return (Form 940) with the IRS, no later than January 31^st.

Business taxes can be confusing. The IRS publishes a number of different tools for small business. One of those tools is a tax calendar that lists all the important tax dates for small business.

Go to: http://www.irs.gov/businesses/small/article/0,,id=176080,00.html  to get your copy or to subscribe to the online version.

I hope the information helps you to better understand your Taxes.

Happy Tax Season…

Johanna Hofmann, MBA, LAc

Medscape  recently posted the results of a survey where physicians rated insurance companies in terms of best and worse to work with and the factors that lead into those ratings.

This got me to thinking about us. Insurance reimbursement for NPs and other Advanced Practice Nurses is all over the board. Some companies recognize Nurse Practitioners and reimburse them for the work they do, other companies seem to be ignorant of the work we do. Then it also varies by state and region.

For example, here in Washington State, for the most part, I don’t have difficulty with insurance reimbursement. I am credentialed with the two “Blues” in our state, yet I hear from NPs in another state where the “Blues” refuse to credential NPs. Does not make sense does it.

If you have having difficulty, contact the American Academy of Nurse Practitioners and get in touch with the Multi-State Reimbursement Alliance people for your region.
OK. Let’s hear from you. What state are you in? Who is credentialing and who is not? What have you found that works and what doesn’t. Advice for others in your area?

Most health care providers who have a clinical practice, or any type of business where they rely on clients, will need to market in order to sustain and grow that practice and business.  While knowing how to market is essential, it’s also just as valuable to know what you should not be doing when you are marketing. It goes without saying that that most common problem is just not marketing, but today let’s focus on the 5 of the most common marketing blunders I see health care providers make.

  1. Religion and Politics: It’s often been said that religion and politics don’t mix with anything. I tend to agree.  While we can all acknowledge that a persons faith does play a part in health, in most cases you are better off leaving these topics out of our marketing.  When is it appropriate? If your business is specific to a certain group based on religion/faith, and these are the specific folks you are offering your services to, then feel free. Just be aware, that you’ll potentially lose patients that have other feelings.

 2. Omitting Contact Information: Believe it or not, health care providers have created brochures – beautiful brochures –  for their practice and omitted contact information. Always check and double check all of your marketing materials to ensure you have the proper contact information clearly displayed.

3. About you!  Health care consumers want to know about you, their health care provider. Anymore they don’t want to come into your office without knowing something about you first. Make sure you have a page on your website that tells something about you the health care provider as well as something about the practice itself (ie, health beliefs, mission, value statement, etc).

4. Drowning in brochures. When you call on another office or business to leave some of your marketing materials, be mindful of how much you are leaving behind. The office may not need/want that many and may be too shy to ask. Their patient population may not be ideal patients for your own practice. There can be any number of reasons. Be sensitive to their needs as well as your own.

5. Automation. Many practices utilize an auto attendant to answer their phone. While I understand the benefits of this for the practice (I love automation), it is also a very cold way to greet your patients at best, and at worse, can be seen as uncaring and downright hostile. The same goes with patients being place on terminal hold as if their time is not important. So while automation is important and often necessary for some practices, take care to minimize its use.

The one thing that is not listed here, but permeates this short list is poor customer service. For any practice, this is one of the most important concepts to keep in mind. Poor customer service will defiantly get people talking about your practice, but not in a good light. So if you do nothing else for the year, remember that excellent customer service, along with excellent clinical care will get people talking about you, raving about you and your practice. And when it comes down to it, that’s the most powerful marketing of all.

Do you have marketing blunders to share? Feel free to share with us.

© 2012 Barbara C. Phillips, NP

Like many health care providers, after years of schooling and continuing education, I have a fairly extensive reference library. So much so that I have been running out of space.

My question to all of you is this…what do you do with your outdated reference books? I’m almost embarrassed to say how far back some of this goes (though not as far as the Tabers I posted about earlier).

Do you just put the books in the recycle bin? Do you donate them (and to whom)? Do you past them off to your children who are following in your footsteps (though I venture to guess they need NEW reference material)? Maybe you turned your 1993 drug reference book into vintage art?

Share with all of us…what are you doing with your old reference books?

By: Johanna Hofmann, MBA, LAc

Nurse Practitioners and other health care providers are no different than other individuals who want to succeed in business and in life. True success in life comes in many flavors and certainly is not limited to money alone. However, money is used to measure business success and by default money is used to measure the success of the business owner.

With that in mind, what is it that sets truly successful business owners apart from the not so successful?

Is it that the successful were born with talents and gifts that others lack? There are scores of talented and truly gifted people, yet that alone does not translate into success of any kind.

Or perhaps it was good luck that got them to their success? Many people are blessed with all sorts of good luck. Good health, being born into a well to do family or growing up in a country, such as the USA, where education is available to all who want to get educated.

Yet not everybody takes advantage of the opportunities available to them. Nor do those that do necessarily become successful.

Or is it simply that hard work and the consistent execution of goals and plans led to their super success in business (and life)? Time and again it’s been shown that the super successful approach things different, they think different.

While there are many traits common to super successful people here are a few I think are of particular importance.

1. Successful people love what they do; they have passion for what they do!
   That makes sense. It is much easier to get good and improve on something that you enjoy doing as compared to doing something that just “leaves you cold”.
2. They effectively manage their time and money.  Successful people have become masters at managing their time effectively. They also know the value of each and every single dollar. They track where their money is going and they know the reason why.
3. They have learned to deal with failure and rejection and bounce back quickly. Failure is the shortest route to success (well, it can be). While many of us equate failure with having failed as individuals, the super successful know that failure is simply part of the game. Expect to fail, don’t take it personally and get back in the game!
4. They plan, have written goals and take action on those goals. “If you don’t know where you’re going any road will take you there”. While this may be true for many, it is not for the truly successful.  They know what they want and they know how to get there. They don’t get in and just start driving – they know where they are going.  They have defined clear, written goals and they know the steps to take to reach their goals.

Do you have a plan, a written plan? Are you clear on what you want to accomplish in your personal life and your business? And … do you know how to get there?

Here is where “Smart Business Planning for Clinicians” can help. The first section of our course discusses in detail how you determine your wants and needs and then how to translate them into goals.

We designed and created our course to:

• Help you determine what it is that you want
• Assist you with formulating clear goals and strategies for your business
• Guide you in translating your goals and strategies into financials you can take to your banker

Click here to order your copy of “Smart Business Planning for Clinicians” and kick start your business today.  http://npbo.biz/BusinessPlanning.html

© 2012-Johanna Hofmann, MBA, LAc

Every clinician, indeed every person (well almost), wishes to make a difference in the lives of others. As a Nurse  and later as a Nurse Practitioner, I’ve always wanted to make a difference in the lives of my patients and their families. In the past 6 years or so, I’ve expanded my goal to include making a difference in the lives of fellow clinicians.

I feel blessed to do the work that I do. And to be honored for it…well, it’s a fantastic feeling.  In my mind, this is recognition for all of us that are business owners or aspiring business owners.

For those of you who are interested and cannot read the small jpeg, this is what it says:

Congratulations on receiving the 2012 AANP Nurse Practitioner Advocate State Award for Excellence! This prestigious award is given annually to a dedicated nurse practitioner advocate in each state who has made a significant contribution to the status of health care delivery and the practice of NPs.

I believe it’s safe to say, that you are someone who wants to achieve success.

Your definition of success is personal, but it will likely include goals for professional, financial and personal success. In order to do so, creating SMART goals are essential (we’ve touched on this before).  Consider theme words as an add-on bonus to your goals. They help move you forward more quickly.  

So what do I mean by that?

Think about setting an intention in the form of a theme word for the year. As you know, intentions can have far reaching effects. Think about it…you had an intention to win a tournament, play high school/college basketball, become a health care professional. There have been times in your life when you may have reached a goal and thought, well that was easy, as you had not consciously worked toward it.

This is the idea of setting an intention. It’s thought when we set an intention, all sorts of unseen and unconscious energy is put forth to meet that intention. This is no different when we write out our goals – our goals are more likely to come to fruition.

Many self-development gurus advocate for goals and intentions. And many feel that it’s a powerful statement to declare a theme word for the year. Thus I invite you to set an intention for 2012 and see what comes forth in the coming year.

My word for 2012?  It was a touch call. My initial thought was Focus.  However, in the end, I decided on Balance. In my mind, in order to achieve the balance I’m after in all aspects of my life and my business, I’ll also need to master focus.  I can’t wait to see how this plays out for 2012.   What’s your word? Please feel free to share below.

Ever wonder who are Nurse Practitioners, what we do and where to find us? Here’s a small samples of NPs and our practices from around the country. Feel free to share the video with your friends, your colleagues, your patients, your networks. Post it on your websites and your blogs. Spread the word about NPs.

It’s just about that time … many of us start to think about goals for the New Year. Does this sound like you: exercise more often; lose weight; eat healthier; better self care; take a vacation; start my own practice, etc. The list just goes on and on.

The sad thing is that for most people goals remain just that… an ambition or a dream that stands little chance of becoming reality.

But why is that? Why do so many people set goals but then don’t stick with them? Research has shown that the #1 goal (exercising!) is forgotten by the middle of February, when most fall right back into their old habits.

You see, there are 3 main reasons contributing to this phenomenon:  goals are too unrealistic, there is no measurability attached to them and they are not written down.

The goal is too unrealistic

It’s easy to see how some goals might be too unrealistic. Just look at an example:  Jack is significantly out of shape, he does not exercise on a regular basis and his goal is to FINISH the Tour de France within the year. While some might be able to pull this off, for most of us (and for Jack!) it would be VERY difficult, if not next to impossible.

Suffice it to say, it is important to set goals that we can accomplish; otherwise we just set ourselves up for failure. Let me be clear though, this does not mean that you should not stretch and push yourself to test your own limits and reach new heights.

The goal has no measurability attached to it

When setting a goal we need to build in some measure to let us know that we are on the right track to accomplish it. If the goal lacks a way of measuring progress, it most likely will fall to the wayside.

A prime example here is “I will start to exercise”. Well, how many days per week are you going to exercise? How long will each workout last? Will you work out in the morning or in the evening? And what type of exercise will you do? … All of this is very easy to measure: either you worked or you didn’t!

Defining what it is that you will do to meet your new goal allows you to measure your success and build in some degree of accountability. That way you stay on track from the start (or you get back on track) so that you can reach your goal (starting to exercise) and stick with it (exercise from now on).

Goal is not written down

Remember the saying: “If it’s not written down it doesn’t exist”? Well, this certainly seems to be true for goal setting. It’s likely we will forget a goal unless we wrote it down. And it’s likely that we get off track with a goal unless it got written down. More often than not a goal unwritten becomes vague and often morphs into something different altogether.

Think about your charting. For most providers it’s difficult to follow up and remember everything discussed with a patient, even though the visit may have happened just a few days ago. You may have discussed and agreed on a certain treatment goal, but unless you wrote it down (charted it) it’s hard to follow up because you may not remember all the details.

Additionally, setting goals allows you to get clarity on what it is that you want and what you may expect from others. Having clear goals makes it easier to evaluate opportunities and choose the best course of action at the time.

Goals allow you to define milestones to measure your progress and make corrections should you have gotten of course. On the other hand, if you don’t know where you’re going it really doesn’t matter how, when or if you get there!

So take the time to plan for the months ahead, it just might be well worth your time!

©2011, Johanna Hofmann, MBA, MAc, LAc.  All Rights Reserved.

Nurse Practitioners and other  Clinicians can no longer continue business as usual.

Our patients (clients, customers) deserve and expect much more. Gone are the days when a white coat gives one cart blanche to treat patients and staff indifferently behind the ruse of being busy. There is no doubt that you are busy. But just as you want respect from your patients, they are now expecting it from you as well.  Addressing one of the most common concerns patients make about provider offices will go a long way.

You are no doubt familiar with this complaint: “Every time I go to that office, I have to wait for hours!” I trust patients waiting in your office, wait for a much shorter time. There is much we can do to reduce wait times, but waiting is a reality for both patients and providers. It’s a fact of life that emergencies and other situations can and do happen.

So what can we do to minimize the impact of waiting? Well, it turns out there is much that can be done.

1. First – stop calling it a “Waiting Room” and rename it a reception area or something similar. Waiting Room implies that I will be waiting, no matter what. Changing the name can help reduce that perception and soften the idea that there will be a short delay before seeing the provider.
2. Make your patients comfortable. Patients have been invited into your office to see you. Think of this as your work “living room”. Make sure the reception area is comfortable for your guest. Take a seat…are the chairs comfortable? What about the room temperature? Too warm? Too cool?
3. When we are waiting (and idle) time can seem to drag on and on. However, when we are distracted or better yet engaged, time flies. Do you have a variety of reading material that is up to date? And while you are at it, is the lighting appropriate for reading? I’m not a fan of TV’s in reception areas, but perhaps you may want to consider a TV or video screen that is playing something engaging and appropriate (maybe even educational)?
4. Comfort Station. If possible, it’s nice to have a restroom available to those who are waiting as well as water or other appropriate beverages depending on your office situation.
5. Children. It can be quite irritating to a non-parent (or parent!) to listen to a child who is bored and tired. If you see children, or the family members of young children, consider having appropriate items that may keep their hands and minds engaged.

Most important, if you have patients waiting to see you, make sure they are keep up to date on any delays. Consider offering them the option to reschedule. Respect your patients and their time. It will go a long way in making them happy, satisfied patients.

What changes can you make in your reception area today?