Legal Traps in Clinics (And How to Avoid Them)

We talk with healthcare attorney Matt Stevens about the real-world legal and operational fights clinics face with insurance reimbursement, audits, and payer clawbacks, plus the steps that keep small problems from turning into career-level crises. We also get practical about employment disputes and why strong systems, especially timekeeping, reduce wage and hour exposure even when people act unpredictably.

• what Provider Legal does for healthcare providers as outside general counsel and transaction support 
• why insurance reimbursement creates conflict and how payer incentives shape denials and delays 
• how to handle SIU inquiries and recoupment demands without overreacting 
• common triggers for payer scrutiny including incident-to billing documentation and unusual coding patterns 
• strategies to pursue underpayments without jumping into litigation, including escalation tactics 
• why employee billing concerns can escalate into qui tam risk and government investigations 
• early moves that lower exposure, including compliance plans and third-party billing reviews 
• where employment disputes show up most often and how plaintiff firms approach staff claims 
• wage and hour vulnerabilities driven by timekeeping records, breaks, and documentation 
• accepting that you cannot eliminate claims, only reduce frequency and cost

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Contact me directly at mike@seasoned-advice.com 

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Transcript

Welcome And Live Q And A

SPEAKER_01 0:01

Greetings and welcome to iCare Leadership Live. This is the podcast for iCare leaders who want to level up their leadership, create better cultures, and improve the financial results of their clinics. Now, let's join the show. Welcome, Matt, to the show.

SPEAKER_00 0:21

Thanks for having me. This is very exciting. Never done a live one like this before. Uh, it's a fun format. I like that. Uh, it gives you a chance for people to gibber jab if they want.

SPEAKER_01 0:30

Exactly. And and for anyone out there that is listening live, please gibber or jabber at us by commenting on LinkedIn. Just on that LinkedIn uh screen, you can just write a question or a comment from Matt. He loves giving legal advice directly off the hip. Uh, no pressure there, Matt.

SPEAKER_00 0:49

Um, I like it. No, I'm in-house counsel. I'm used to I'm used to people coming in with random questions for about anything at all. So, no, I love it.

SPEAKER_01 0:57

Okay, cool. Well, awesome. Well, yeah, would love to get a question or a comment. If you know Matt, say hi. If you know me and you want to say hi, would love to hear from you. But yeah, Matt Stevens, welcome to the show.

What Provider Legal Actually Does

SPEAKER_01 1:09

Matt's an attorney, he's got his own practice called Provider Legal, where he helps healthcare providers. So, yeah, Matt, I guess maybe just as a start, tell us about tell us about your business and what what do you guys do?

SPEAKER_00 1:25

Yeah, yeah, thank you for that. And thank you for having us on. I really appreciate it. It's just these are always fun to do, and and I hope it's of value uh to the people that are listening and and and hopefully we get to do some more of these down the road. Um you know, I uh I I picked who I like to service my client base, and and I like doctors. I like, I like, I like doctors, I like dentists, I like licensed healthcare professionals, and and so in general, that's who we serve, that's who we care about. I I think they are smart, they are caring and are interested in helping people out. And it it uh as an attorney, like you're in fights a lot, and it's nice to be like, hey, at least my guy, no matter what happened or whatever it is that we're fighting about, somebody came in, had a problem, my guy is trying to fix it, and and that's a really nice place to be. That's a really as a client, it just it just makes you feel good. And as an attorney, and look, man, we need all the good feelings we can get in the legal field. We're we're it's rough enough there.

SPEAKER_01 2:20

I love that. You know what? I as an HR practitioner, I feel exactly the same way. I I want to work for people that I like, and that's a you know, that's a big deal. You're representing them legally, and if they're a shyster or an a-hole or whatever, you know, that doesn't that's not a good feeling, right?

SPEAKER_00 2:38

No, especially those that are like unnecessarily aggressive. I'm like, everyone calm down. Like, we're gonna get a deal done by the end of the day.

SPEAKER_01 2:45

Yeah.

SPEAKER_00 2:46

Like we're we're we're gonna get through this, whatever it is, we're gonna figure it out. And and what are you gonna stop practicing medicine or or whatever your specialty is because you had a problem? No, you're gonna have to figure it out. So let's just figure it out. As far as like the services that we provide, we do really two things. We do outside general counsel work, and and I really like that part. I I like that part because it gives a lot of variety of issues. Uh, you know, it ends up being employment, regulatory work, um uh contracts, and then just off the just weird questions, you know, just hey, I was thinking about this and I got stressed. And what do I do with this? And I'm like, great, love it. Would love to talk with you about it. And then the other half of our businesses, we do a lot of transactions. So all on the provider side, we don't really mess with facilities, except for community health clinics, FQHCs, like those, those are more outpatient than facility. And uh yeah, so that that's that's where we're focus our practice on.

SPEAKER_01 3:39

Okay, awesome.

Why Insurance Reimbursement Gets Messy

SPEAKER_01 3:40

Well, you know, we were talking about some of the issues that are hot, you know, in the clinical healthcare world. And one of those topics has to do with billing. And, you know, I guess, I guess you could tell me, but there there are there are some disputes from a legal standpoint that can arise when it comes to billing. So can you kind of elaborate on that and where you might step in to help uh practice with that?

SPEAKER_00 4:07

Yeah, and and with billing, there's you you first kind of define like where it is that we're talking when you're talking about cash basis and and and how does that work versus insurance reimbursement. Let's just focus on the insurance reimbursement because that's that's where 80, 90 percent of us are always gonna end up living. The the tricky part with insurance reimbursement is is one, like imagine a business model where you essentially just get to take a bunch of money in, and your profit margin is directly related to just not paying money out. Like it doesn't take like a Harvard business school graduate to tell you, like, just don't pay any money out, obviously. Obviously, and then you can set your profit in advance, it's the easiest business on earth. And and and then they're the natural response is well, they can't do that because ethically, and they get regulated. And I'm like, okay, great. So then the next part is they make a bunch of games that make it difficult to get paid out that that uh makes them pay out just enough that they don't get thrown in jail. And everything up until that line is fair game. And and so that's the tricky that as an attorney, that's how I view insurance companies, that's how I view payers. And my experience hasn't shown me any different. I am 100% spot on. And so the the the tricky part that I find, or how I like to describe it, it's kind of like a hydra, you know, that Greek mythical thing where it can hit you with a bunch of different and you slice one off and you have another two. So it's it's one of those things where you first have to say from philosophically, like, hey, this is always gonna be a pain. This is always gonna be difficult. I'm gonna have to dedicate some part of my business to just handling this stuff because it's gonna happen. That that is the cost of being in healthcare and accepting reimbursement. And and and that's gonna be the bet the case no matter what. So, in terms of like major issues, it's like, oh man, I could name like

SIU Letters And Recoupment Demands

SPEAKER_00 5:56

half a dozen. It can range from let's say a special investigations unit comes in and says, Oh, we don't like the way you're billing. We're like, okay, so we're billing correctly, we're we're fulfilling, you know, and then it's just we're fulfilling your requirements, there's nothing wrong with what we're doing, and you're not asking for money, and then it's like, well, what do you do with that? In that situation, I still like to reply, even though, even if especially if it comes from SIU. So it depends on like where you get the request from. If it's from special investigations, that means that something has happened. Somebody has said you have an issue, the algorithm has tricked it off. They are doing an internal focus on your practice area for whatever reason. They have an internal focus to that algorithm. Maybe you're a high biller, something's happening that they said, Oh, we're gonna take a look at this. And and for those, I like responding, even if there's not a practical, they're not asking for money, because it's like, no, no, no, I want it to be a hundred percent clear that we were billing correctly the entire time. You just didn't like the documentation in this field, and then you had to go in that field. But there was nothing fraudulent, there was nothing wrong with it. So that's sort of at one end, right? It's like uh it's like getting a traffic ticket where you just got to spend some time, but you're not really paying that much money in in that time. And then you have all the way over to uh let's just keep it in private payer land, a recruitment quest where you say, Hey, we're give us, you know, we're we're not paying you because you owe us $250,000. And and that can range from like, oh, okay, so let's let's find out why that is, what data are you using to support that, what claims specifically are you withholding and why? And and there could be like a half a dozen issues that come up. It could be like, hey, did they did they properly notify you according to their provided contract? Did they follow their own rules with how they're supposed to notify you as as to the recruitment? Uh, did they follow your state guidelines as to whether or not they did that uh correctly or not? And and then that's before you even get into like, hey, what did what are the actual claims? Like, what are you saying that we're missing or haven't done? And and for those, it is why meaning, meaning that like I have had a recruitment once for 1.6 million bucks. I wrote one letter, I looked at it, and it was so like disorganized. And and once you actually like went through the spreadsheet on a per claim, per topic basis, it was it was just just it was almost just like, how are you in this business? How? Like, how is this? You know what I mean? Like, yeah, it was just almost negligent in the way that they I wrote one letter, heard nothing for three months, and then they settled for 40 grand. And so, like, and I don't that's not because I'm good or bad as an attorney, it's just like, oh, that's how disorganized these can be. So, I would probably say, like, the first step is around billing. If you're getting one of these requests, is that like, hey, let's not jump to being scared just yet. It's gonna take a little bit to figure out what the heck this is, because it could be or you know, on the other end, yeah, you're completely right. And man, you have been building wrong for a long time, and we have got to have some very serious discussions about what the next four months of your life are gonna look like.

SPEAKER_01 9:04

And are these are these um um so as special investigation unit is a term that's unfamiliar to me, maybe it's more familiar to the uh to practice administrators out there. So can you is that a is that a federal regulatory uh business unit, basically? Yeah, no, no, no, no.

SPEAKER_00 9:22

We're still in private payer land. We haven't gotten away. Oh, struggle, we're still in private payer. Okay, just what I'm saying, you know, and I forget what people don't know. I assume everyone knows too everything that at least that's okay.

SPEAKER_01 9:33

So and so, and so if so, so these these requests are coming in from private payers. Um what are and and I think I would be very nervous. So I appreciate your first tip here, which just sounds like stay calm. Yeah, because we don't know, they could be shooting from left field over here. What is it that um typically like if if a practice maybe did something that that brought this on, you know, it's not just a random thing. What are some of the things that maybe they did that might have you know tipped off these private payers that, hey, maybe we need to look into this a little bit?

Why Payers Flag Your Billing

SPEAKER_00 10:16

You know, it's it's one of three things. One is that there's probably a specific issue. Like, for instance, if you're doing like incident two billing, for instance, incident two billing is required by Medicare, so plans have to do it, but they have their own procedure for how you can do incident two billing. And and and for context, Mike, incident two billing is when you say, Hey, I've got a mid-level who's performing the medical services, but I'm billing as the MD or DO that's actually as the one who's provided the services. So a lot of times they'll have rules uh in the provider manual that say, look, the the doctor, the MD DO, they've got to do the initial visit and they've got to check in every six months. But apart from that, yep, you can have the mid-level do this according to the plan of care and botch your oak, you're done. Or something like that. They might be more specific or less specific depending on the particular plan. And so they'll say, ah, well, hey, uh, your notes don't include any doctor review that meet our requirements for incident two. So you can't bill out of the doctor rates, you got to go in 80%, which is a big haircut. That's a big, big haircut to take because you didn't follow these compliance rules or whatever it happens to be. So that's that's it. So I would say it's some issue like that. It's very specific. Uh, number two is you're just a high building provider, or there's something weird about your practice. I talked with a guy who had a so you have like nine nine two one fours, three, three, fours, fives, and you know, for complexity of cases. Honest to goodness, Lord is my witness, all fives, like 95% of his practice. And I was like, look, there's just buddy, what's going on? This is weird. This is weird. And then I talked to him, he's like, Oh, yeah, I'm the central repository for everybody's cases that nobody knows what to do with. All of my cases actually are like this. I went to his documentation, and yeah, he was right. It was just it was verified, it was weird, very weird. But he's just he was in a small state, and he'd been doing it for 40 years, and just everybody knew that, like, hey, if you can't solve a problem, this is and he was right, and so that one wasn't hard to do. Um, the third reason you tend to get them, no one knows. It's just something you didn't scratch behind your left ear like you were supposed to. Uh, you did not throw salt over your shoulder, and that's just a randomness that's just sort of unfair about what's so hard about these provider relations.

SPEAKER_01 12:33

Gotcha.

When Clinics Cannot Get Paid

SPEAKER_01 12:36

What is um, you know, I'm curious. You know, we're talking about payers coming after clinics to say, hey, you know, we overpaid you basically. Is there ever a time when when you get involved? Because I I keep hearing more of providers who feel like they can't get paid, like, hey, we're trying to get paid and we're doing work that or we did work that was justified. Is it does it ever come to where you get involved with a payer to say, hey, you know, why aren't you paying us under contract terms?

SPEAKER_00 13:12

Yeah, yeah. And and normally, so here's how why the phenomenon like that exists. The uh and I want to talk a little bit about SAU so we get to some background on it. But imagine an octopus with eight arms but no central nervous system. The parts that collect the money, those parts of the insurance company, beautiful. They work quite a really well. I imagine every one of them has a marble desk, and and the ones that pay out money, they're in downtown, God knows where, in some unconditioned warehouse. Sweaty. And so my point in saying that is that they don't talk to each other, and and that's what makes it difficult. And so the short answer is a lot of times when you don't aren't getting paid, it's usually because there's they're just so administratively unorganized and they have no incentive to fix it, that it usually just means that you have to get up enough the chain to actually get a response from somebody. And so, yeah, we have helped them and and and we specifically I'm trying to avoid litigation because litigation usually isn't worth it. So you there's a few strategies that you can use, just having an attorney raises the temperature because all of a sudden it gets kicked to their counsel's office and something that's not even technically a legal issue. Now they've got to deal with, and I'm like, well, I'm I'm gonna keep harassing you until something happens. Um, in extreme cases, um, I've emailed just everyone I can get a hold of. So sometimes I've actually emailed the entire board of an insurance company, and it worked, it worked, and so a lot of times it's not even about the litigation, it's about raising the temperature for them so that they have to respond. And that's usually how we handle those issues. Uh, and yes, we do we do get into that a fair bit.

SPEAKER_01 15:00

This show

Sponsor Break And HR Services

SPEAKER_01 15:01

is sponsored by Seasoned Advice HR Services, where I help eye care businesses to make more money and save more money by hiring better, retaining better, and reducing your HR risk. If you would like an HR assessment or ongoing HR support, please reach out to me at seasoned-advice.com.

Employee Compliance Concerns And Qui Tam

SPEAKER_01 15:26

I understand that maybe there are times when are there times when someone within the practice says, you know, going back to more like the the payer, and maybe this is more on the regulatory side on the federal, someone says, hey, I don't think that their billing is happening correctly here, kind of a thing. Is that is that a common situation? And and I don't know, how do you how do you navigate that?

SPEAKER_00 15:52

I wouldn't say common, but it's one that needs to be handled. That is that is a a much bigger issue than people tend to think. It's it's it's huge. And here's the reason why. It's because, first off, whoever says this compliant concern, it's never your star employee. It's never somebody and and crazily enough, it's always somebody from billing. It's like, well, I hired you to fix it, so you know, I mean what they're doing, we'll fix it. And and if I don't believe your advice, show me and verify. Yeah. But the the real risk that you run up with is that if those that if those issues are not addressed and and and not handle, the temptation for that employee is then to file a key TAM case, which allows the employee to stand in the shoes of the US government, enforce a law with an attorney that does it, and and then they get to collect somewhere between, I think it's 10 to 18 percent of the total amount recovered. And and the attorneys that tend to take these cases, unfortunately, are not morons. They're usually pretty sharp and they know this area well. This is all they tend to do. So if they attract the attention of one of these attorneys and one of these employees talks to them, yeah, they because what happens, the key TAM is just the civil stuff. The government then has this period of time that says whether or not they're going to intervene, and then all of a sudden you have just gotten the attention of the Department of Justice, which are not exactly slouches either. Like they unfortunately are quite good at their job. Real pain, but they are they're they're smart attorneys, they know what they're doing. And and even if they decline the case, now it's public knowledge that you have this problem, or you at least are alleged to have this problem. And and then and then what happens next is what every state has their own Medicare, Medicaid, fraud enforcement unit that you might attract attention to, or if you can get somebody who's like an attorney general, and the attorney general gets really dangerous because they have no idea what they're doing a lot of times, like the DOJ and and and at the state, they work in healthcare, they know healthcare, they get reimbursement, they know they know it, they got all the issues. The attorney general, maybe, maybe it's someone who's excellent, or it could be somebody from the murder unit that like was just prosecuting gangbangers. And while they are an excellent attorney, this is a very different area of law. So I've seen people get prosecuted for stuff that is that are nothing, not nothing, but they are administrative errors, and they're being treated like they're murderers or or like real criminals. I'm like, nope, they're just they're 23 years old, and this is their second adult job. That's all that's happening. They just filled out the paperwork wrong, or joyfully will pay you back. And and that's that's the part that's real scary. And so when an employee has compliance concerns, it's one of those things where it's like, hey, if it's around Billy, man, you gotta you gotta talk with them and make sure you're seeing eye to eye with them because that when it goes bad, it's that's your whole life. That that's the next five years of your life. That's what you're doing.

SPEAKER_01 18:49

Yeah, I mean, I I can, you know, I cannot imagine getting contacted by the attorney general for any reason at all. Um, not interested.

SPEAKER_00 18:59

No, it's not a fun, it's not a fun. No one's marriage has gotten better with the DOJ investigation hanging over there. No one's skin looks younger and firmer and better with that kind of stress hanging over your life. Not one.

SPEAKER_01 19:13

Okay, with that. So let's say that I'm a I'm a conservative-minded uh physician, meaning I want to do everything by the book, I want to stay out of the crosshairs of the uh whatever the politically minded attorney general, ex-murder prosecutor who wants out to get me. Like, what are things that I should be doing to you

Staying Safer With Compliance Plans

SPEAKER_01 19:34

know, just do things correctly?

SPEAKER_00 19:37

There's two things I would say. First is is when you get the investigation, talk to a lawyer super, super early, even before the other side has an attorney, because most of the investigation is decided as far as the severity and the scope of it, is the investigator, not the attorney, the investigator that's assigned to it. Because remember, that investigator and that attorney have to work together like a lot. So if you get something from the government that's like, hey, you know what? Just call, spend the 500 bucks, talk to whoever you got to talk to to figure out what this issue is. So that would be sort of point one. Point two is you're supposed to have some kind of a compliance plan. It does allowed the more sophisticated an organization, the more robust it has to be. But at a minimum, let's check our billing to make sure that we are documenting correctly and aren't doing anything funky. Um, and I like every so often, if you can afford it, I like having a third-party review billing just to see. I don't mind in-house billing. I get why people do it. It's nice to control costs. The the problem I have with in-house billing, or the concern I have rather with in-house billing, is that they only know how to do it for that organization. And so when someone says, like, oh, I have 10 years experience, I'm like, Well, how many organizations have you worked at? How many different types of billing have you done? They say, Well, this one since I was 25 and now I'm 35. I have 10 years of experience. I'm like, Well, I think it's more accurate to say that you have one year of experience repeated 10 times. And the nice part about having a third party uh that you like a lot, and and that is fairly strict, even if they're a little like too strict or too complained, they see a lot of problems. They see a lot of stuff, and and they have a variety of billing, and they

In House Billing Versus Third Party

SPEAKER_00 21:19

can tell you like, well, this is what I've seen with this payer. This is this is what this payer is enforcing on. So, like it or not, those are the rules we're messing with.

SPEAKER_01 21:26

That's a f you know what, that's a really fascinating takeaway there because yeah, because that's a key decision for a clinic is should I have in-house billing or should I, you know, outsource that? And it sounds like there's a real value and I'd never thought about that. There's a real value to the expertise of an external billing company, even if you maybe are just using them for auditing or review, but maybe even that day to day, because they really know hey man, United Healthcare, you gotta like, you know, hold your earlobe and Scratch your head when you submit the claim or whatever, you know.

SPEAKER_00 22:03

Yeah, yeah, and it feels like that. And yeah, and and and like the downside of outside building is like, well, will they chase after the money with the same passion that I will? Because it's my dollars, and I can I can directly control the employee. And fair comment. And I hear that. But like there is something to be said for having that third party experience. Okay, sure.

SPEAKER_01 22:20

Okay, you know, and I I could see that offsetting, right? Like maybe a little bit more cost, but then more expertise comes in and it kind of

MIPS Confusion And Fast Responses

SPEAKER_01 22:27

kind of balances out. You know, one topic that um I hear a lot in the in the ophthalmology community has to do with MIPS. Um, is you ever get issues with MIPS or MIP audits or or that kind of thing? Because apparently I'm as a as a I'm a green person in this area, you know, this is a significant issue for clinics, is is doing the MIPS right.

SPEAKER_00 22:51

It's it's the same rules as anything else where it's like you have to figure out what the heck it is. We got to figure out what it is, why is the issue coming up, what is it about our activity that has caused this issue, if anything, or is it on them? So it doesn't for from a reimbursement perspective, it doesn't get handled in some, there's not any new technique, it just requires attention as quickly as possible. Yeah, gotcha.

Employment Law Support For Clinics

SPEAKER_01 23:12

Well, another area I know that you deal with in your practice has to do with the employment side of things. And that's one area where I know a little bit more, uh a little bit more in my comfort zone. But what are some of the things that you that you help your clients out with and and maybe some of the issues that come up repetitively where maybe they make boo-boos that you have to clean up, or the areas where you wish they would utilize your your services more?

SPEAKER_00 23:42

Well, I think so so we do in-house counsel, right? So we're gonna do everything essentially short of litigation around an employment issue. So the stuff we typically get asked for is to really standardize their documents, which I like doing. It makes it really clear, uh, it allows me to update the whole organization all at once. We'll do some handbook reviews with it, though. Frankly, I I think that that's probably better in the hands of HR professionals because there are some cultural questions that you need to answer. And that's not my purview. And that's the thing where I think lawyers kind of need to stay in their lane, where it's just like, hey, my job is to and to realize that like HR folks and and attorneys have two different jobs. Like yours is a lot of things. What's the culture of the org? How are we doing? We have recruitment. How do I build the organization? The only thing that my my one guiding principle for employment matters is how do I get out for the least amount of money? And and that's the only thing. And and and and it's not my concern, or or I it's less of a concern unless the client tells me what the issue is. So the stuff we'll do is we'll do a lot of standardization of documents that we do a lot of tricky terminations. Uh, it's hey, I want to fire this person, tell me how much risk am I for doing that sort of thing. And it's uh it's a little bit like predicting when it's gonna rain. It's like, I don't know, I I can give you some sort of idea, uh, but what I can do a lot of is help get you an umbrella. So let's get our documentation together, uh, you know, and let me be incredibly responsive to that attorney. Because the reason and and the reason why we get responsive to attorneys is because of two things. One is the faster you respond to that attorney request, the less money that firm has invested in the case because all these guys are taking it on contingency. So if you handle it, it's if you if you the faster you respond and the faster you get down to brass tax of what the issue is, the less amount of money they've put in, which means the less settlement you're gonna end up paying. Because you're not necessarily negotiating with the plaintiff at that point, you're negotiating with the attorney, and the attorney always has their cut in mind for what they're doing. Um, the second reason that you want to respond and have attorney look at it is because you'll know what kind of firm it is. Like plaintiff employment attorneys can range from like extraordinarily disorganized to where like they lose clients just their contact information, the ability to reach their client, like you know, that level of disorganization, all the way to some pretty sharp attorneys that only take cases that they know they've got you dead to rights, and this is their model, and they've got it figured out. So knowing like what kind of a firm you're messing with and and you're interacting with will really delineate the strategy or really drive a lot of what that strategy is going to end up being.

Why Staff Claims Are More Common

SPEAKER_01 26:30

Are you seeing uh do you tend to see more disputes related to physician employment or staff employment, or is it kind of both?

SPEAKER_00 26:41

I see, no, I see more definitely on staff. Okay. Physicians don't make uh a big thing of it unless because they're they're too high of an income earner. So it's it's really decided by who's the high income earner versus not. The higher the income earner, the more serious the issue tends to be. And they're only gonna sue if it's like really sort of matters. You're gonna, and you also, because they're salaried, you don't deal with a lot of wage and hour claims and a lot of like technical rules that you can violate and create a lot of penalties real fast. Um, and on the lower end of the spectrum, that that does they're a whole law firms. Their model is just hey man, we just do wage and hour technical violations, we settle between five and eight thousand dollars per case, we take home 2,500, and uh just do a million of them. That's the model. Um and so you see more technical issues, plus, like as the economy not necessarily weakens or gets worse, or I don't I don't know where the economy, but whenever there are trouble signs for the economy, you get those types of cases a lot more because those individuals are getting squeezed. Uh if prices are rising for them and their wages are not, and they're about to lose their job, they don't know when they're gonna get another one. And so, yeah, that's what motivates them. That's that's what that's what drives these cases. Very little of what you actually do as the employer.

SPEAKER_01 27:54

Yeah, I've I've seen the same thing, right? So you see more disputes, you see more complaints about pay rates or complaints about discrimination or unfair treatment when when the economy gets gets tighter. Yeah, and so that's interesting. I guess I was thinking the reason for asking, do you see more on the physician side versus the employee side is because my initial thought was, you know, more money, um, you know, contract disputes and stuff. But actually, what you said makes a lot of sense. I mean, if I'm a provider, I've got a contract in place, everything's kind of spelled out. Whereas if I'm an employee, I might have a crappy handbook in place and a lot more emotion, and uh obviously a lot more staff, right? You probably have, I don't know, five to ten staff for every doctor, right? So just a numbers game, you're probably gonna see more of those claims come through than than for physicians. So so with that being said, you kind of invoked wage an hour there just on that particular

Wage And Hour Risk Starts With Timekeeping

SPEAKER_01 28:56

topic. What I don't know, what are some issues where you think clinics sometimes miss the boat on wage an hour where they where they get it wrong and they have to settle?

SPEAKER_00 29:06

Timekeeping, timekeeping, timekeeping, timekeeping, timekeeping, timekeeping. And it's just are they taking the lodge when they're supposed to? If your state has something for paid breaks, are they do you have something that signifies that they've done it? What kind of records do you have? Do you have the ability to pull the records when you're asked? It's that sort of thing that you've got. My most well-organized clients will have. I I had somebody who had a wage an hour claim and and and a wrongful termination suit, and they had a camera, which was among my more organized clients, and it was great. I literally had a camera on his computer screen. I was like, there he is. He's working on his t-shirt business, man. Like, I don't, I don't know what to tell you. This is as good an evidence as I could possibly get. That is clearly not the practice software. Um, and so people who have the ability and the and and take the interest in putting in systems to just recognize and put all of that in, they they are saving themselves, they're making clear relationships with the employees, but also they're saving themselves a headache, depending on the size of practice. Let's say you're five to 15 employees, you're gonna get one of these every year. You're gonna display it on it. Just but if you can avoid and if you can not have one for two to four years at a stretch, you're in great shape and doing really, really well. You must have good relationships with your employees, good systems in place. And um, and the relationship helps, it makes a huge difference, but it doesn't make up for systems because at some point someone's gonna get upset because humans are unpredictable.

SPEAKER_01 30:37

Okay, well, it sounds like a strong endorsement for having robust time tracking and payroll. Because yeah, no one nothing makes people more upset than feeling like they're not getting paid for their time.

SPEAKER_00 30:51

Of course, yeah, of course. Of course, like you can have the nicest place to work on earth. Someone can't make their rent, or like it's of they know for someone who maybe and for an employee who's not very good at their job, let's say they're terrible at their job, they know exactly how much they're getting paid. They know that part of their life really well. Yeah, yeah, they've got they've got that down to the millisecond.

SPEAKER_01 31:14

Yeah. Any any any examples of uh of a I don't know, an employment dispute that that stand out in your mind from recent memory that could be illustrative.

Even Perfect Systems Still Get Claims

SPEAKER_00 31:26

Oh, you know what it is? Uh they the wage and hour stuff gets so common. Yeah, I'll I'll tell you one. The the craziest thing about it is that sometimes even when you do everything right, you can still get a clay. And those ones, those ones drive me crazy because you've done the timekeeping systems, and yet somebody was mad, and then they still came in and did it. So my my point in bringing that out as an illustrative example isn't to say that it's useless or hopeless, it does reduce it, but it's not going to eliminate this human factor that you're gonna have. And that's the thing that people I think look for from attorneys and look for in businesses and consultants. It's like, how can I have no problems? I'm like, if you find that out, you tell me, because you're about to be a trillionaire, an actual trillionaire. You can't do it. But what you can do is you can reduce the number and you can reduce the severity of it. And an honest to goodness, like in that example where where I had a client who set up everything correct, uh, and somebody had a pocket claim that they wanted to put. We got on with the attorney and we're like, first off, we've got your dead rights on the evidence. And look, this is a tiny little case. This isn't worth your time and money. And they're like, Yeah, you're right. This isn't really worth our time and money because they were a pretty sharp law firm. They knew what they were doing and and they knew where to spend their money and where not to. Um, and also their claims were ridiculous a little bit. So I think it's it's it's to accept that things are gonna happen. And if we can just reduce it a little bit, and if we can make it a little bit cost, a little less costly, that's the goal. We're never gonna get to nothing. We're gonna get to smoother and better so you can focus your time on aging and treating patients and getting your business running.

SPEAKER_01 33:06

Well, you know, Matt, I think we lived up to our billing here in terms of talking about boring but potentially expensive problems

How To Reach Matt And Final CTAs

SPEAKER_01 33:16

here. Uh so I appreciate you being on the show. What are, you know, just in wrapping up here, what are some of the other issues that that you deal with at provider legal? And, you know, why would someone want to reach out to you to work with you?

SPEAKER_00 33:30

We we know healthcare is the only thing we know anything about. We specialize in healthcare, we specialize on the provider side. We know if you're somewhere between one to 1.5 and and and $50 million in the healthcare space, chances are we've got a client who's really, really similar to you. We have a pretty deep bench in terms of the ability or the experience that we've got to handle that particular issue. So whether it's an employment issue, a contract dispute, or just contract review. Um, or if you just want to talk about your business, like we are thrilled. We we love, I love having those conversations. They're really fun. We go to say, well, look, I don't know how to run your business, but this is what other clients have done. Um, that's really, really a fun place for us to act. And and in some sense, it's like, hey, come ask us. Chances are either we know it or look, we can at least point you in the right direction.

unknown 34:20

Cool.

SPEAKER_01 34:21

Well, yeah, Matt, you've you know, I've known you for a while. You're super easy guy to chat with. And I think anyone would uh enjoy a conversation with you as I've enjoyed this conversation here today. So if someone does want to uh chat you up, uh what's the best way for them to get in touch with you?

SPEAKER_00 34:38

Shoot us a call, 714-7280-7097. Our website's providerlegal.com. I can set up a consult. The first consult's always free. Just get a hold of us on the phone or shoot us an email, mstevens at provider legal, and uh we're happy to help you out.

SPEAKER_01 34:54

Okay, awesome. Well, Matt, thanks so much for being on the show today.

SPEAKER_00 34:58

Thank you so much for having me, Mike. I really appreciate it.

SPEAKER_01 35:01

Well, that brings this episode of iCare Leadership Live to a conclusion. If you enjoyed this episode, please subscribe to the show on your podcast app and share it with someone who would value the content. I promise to bring you more guests and content to help make you a better eye care clinical leader. I also invite you to subscribe to my HR newsletter for iCare leaders. You can find information about that at seasoned advice.com. Now go out there and lead with confidence.