Consulting Small Business Entrepreneurs – Under Promise and Over Deliver

The other day, I was talking to a small business consultant who had an angry client, a customer who had expected more, but due to his actions made the consultant’s job even tougher. The client had misstated some key information, leading to an unfavorable result. The angry client went on a rampage and trashed the reputation of the consultant online on numerous websites. Okay so let’s talk about this.

You see, I was thinking about the small business coach consultant’s predicament, and the scenario reminds me of the anguish of many writers when trying to get their books published. You see I belong to a couple of writer’s groups and there are “literary agents” which assist authors in getting book deals and putting together book proposals, shopping publishers, and arranging meetings. Often I’ve heard stories that a literary agent has charged someone $1500 to $4000 to help get a publisher for a book deal to no avail.

The authors, remember a good many writers are pathetically broke by my observations, barely have any money, and more often than not manically depressed, over the years, I’ve reasoned that I guess many creative people tend to be, as I’ve also noted this while sifting through think tank applications, which is a little something I do in retirement. Anyway, so, what happens is the authors complain, bitch, and moan that the literary agent did nothing for them, and stole their money, and they tend to banter around the words; scam artist, fraudster, con-woman/man, etc.

Indeed, in watching and observing all this, I’ve noted that many times the authors get all full of themselves, ego sets in, and they become overly optimistic, convincing themselves that even though their chances are barely 1:15 with a literary agent and 1:65 without, even if they are a decent writer – they always want to blame someone for their own failures, this appears to be human nature, right?

What I’m saying is; as long as a small business consultant isn’t giving false expectations, and as long as they vet their clients a bit before they take their money, then they can probably prevent similar future incidents of angry clients. In this case study, with the coaching consultant, the gentleman “lied” on a form and thus, I suppose he actually he hurt the coach’s reputation with their vendors, so actually the consultant should be the one angry not client in this case.

Meanwhile, the client’s behavior afterwards working to slander and trash the coach’s reputation online is “totally unacceptable” – so the consultant can stand tall knowing they did the right thing. Finally, I’d like to advise all consultants that have such a thing happen to them to never quit or give up just because one psychopath has made you his new excuse for his own failures okay.

How to Market Your Consulting Business For Free

Let’s face it, if you’re like most consultants you are a one-man-band operating on a shoe string budget. You don’t have thousands of dollars to spend on marketing and advertisements. At the same time, the market looks a bit gloomy and you need to keep finding new clients.

This article will show you a step-by-step process to launch or grow your consulting business on a strict budget. In fact, the tips in this article will not cost you a thing!

Let’s face it, sometimes its good to have limited resources. Not having money to waste on marketing efforts that generate no return helps you focus on areas that will create results. To start, let’s get down to the basics of marketing your consulting business.

Step 1: Determine Your Target Market.

I know this sounds elementary, but you must understand the importance of choosing a target market. Many consultants don’t want to focus, for fear of missing out on prospects. Don’t fool yourself into thinking you have an unlimited number of prospects. Focusing on a specific market will show your prospects that you have expertise and concentration in their area. This will make you more valuable and in return, close more deals. Remember to choose this market based off of your previous experience and education.

Step 2: Create a Strong Message and Hook.

Once you have determined your target market, you need a strong message to reach your prospects. You can’t just market that you are the best consultant in their industry. They will not believe you. Instead, you need a solid message that will show your value. This message needs to include:

  • identify the problem they have
  • your solution
  • the benefits of your solution
  • why you are unique
  • proof (examples, testimonials, case studies)

Next, you need a short version of this message called a “hook”. Instead of saying “I’m a marketing consultant.” You could say: “I help local retailers market their stores using the latest technology to increase sales.”

With a strong message and hook, you will be able to attract more interest. Once you have them asking to learn more, you can move onto why you are unique and provide examples of your successful projects.

Step 3: Position Yourself as an Expert. Have you ever known a consultant who has projects come to them? Ever wonder why these consultants got these deals (which always seem to be at a high rate with a blue chip client)? It’s because they were perceived as experts in their field. How did they get there? They got there by doing a few simple tasks.

  1. Speak – Find associations and conferences associated with your target market. These groups are always looking for good, informative speakers. Take time every few months and speak at one of these engagements. You will be perceived as an expert and make a ton of contacts.
  2. Write Articles – Many trade publications accept articles from consultants. Write a few helpful articles (not sales pitches) that address some of the rising concerns in your target market. Yes, you will be providing free information. But that’s ok! This is proving your expertise in the industry. At the end of the article provide your contact information. You’d be surprised at the prospects that will contact you.
  3. Create a Blog or eNewsletter – Another way to build your network is to create a following. With technology you can start doing this in a matter of minutes. To start, post a blog or send an eNewsletter every week or two that has helpful information. These can usually be shorter than your articles and help provide ideas for future publications. If the information you provide is helpful people will begin forwarding your tips on to their colleagues and your network will begin to grow.

Using these steps you will begin to generate a following. Because of this your client list will grow and so will your hourly rate! If you start your marketing plan by focusing on the basics, you will become more successful than you ever imagined!

Your Ultimate Guide to the Different Types of Tea

Nothing energizes you like a warm cup of tea early in the morning. Tea has been enjoyed for centuries, and this delicious drink is also packed with a lot of goodness. That’s not all. Did you know there are different types of tea, each with its own use and benefits? Knowing them would certainly help you get the most out of them. Here are the different types of tea:

Black Tea

Black tea is one of the most popular tea types. They are generally produced in China and India,Guest Posting and other popular producers include Kenya, Vietnam, Nepal, and Sri Lanka. Indian black teas are usually more robust and offer an exquisite taste. Black teas are also known for their high caffeine content, but it’s still lower than the caffeine in coffee. When brewed, black tea offers a coppery dark color, and they usually possess a stronger flavor than other tea types. Black teas are rich in anti-oxidants and may boost heart health.

Green Tea
Green tea is derived from the plant Camellia Sinensis. Japan and China are major producers of green tea, and when brewed, green tea offers an emerald green color. They contain lower caffeine than black teas and generally have a bitter taste. Green teas have become a major part of a healthier lifestyle and offer drinkers a myriad of benefits such as improving brain function encourage weight loss and even help fight cardiovascular diseases.

Oolong Tea
Oolong teas are partially oxidized. In terms of oxidization, they’re between green and black teas. Taiwan and China are primary producers of oolong tea. When brewed, they can range anywhere from rich amber to a pale-yellow cup of tea. What makes oolong tea so interesting is that it can be re-infused several times with subtle changes in flavor. They are also potent in anti-oxidantsand can be a great addition to a healthy lifestyle.

Herbal Infusions
Even though herbal teas are termed as ‘tea,’ they’re not made from the camellia Sinensis plant that true teas are derived from. Instead, herbal teas are a rich combination of various spices and herbs. Herbal teas have been used in India for centuries to treat a myriad of illnesses. Generally, herbal tea contains no caffeine, and they’re packed with anti-oxidants. Depending on the ingredients, herbal teas can offer various benefits. Some popular herbal teas include chamomile and peppermint.

White Tea
White tea is a minimally processed and delicate type of tea and is enjoyed by many people. Countries like Nepal, Sri Lanka, Taiwan, and China produce specialty white teas. They have very low caffeine content and offer a mild flavor. They are also potent with anti-oxidants and may help lose weight as well.

Tea is an exquisite and healthy drink, and understanding the various types and benefits can help you achieve your health goals. If you haven’t already, you should incorporate a daily cup of tea into your daily routine.

Primary advantages of Self Publishing

This article will tell you about the pros of self-publishing a book.

Soon after writing a book,Guest Posting an author will need to determine whether she would publish it traditionally or self-publish it. A lot of creators would just share their publication with friends and family or publish it online and also have their book downloaded, at no cost!

But, isn’t it far better if the book becomes published plus a larger number of readers get access to the book and be able to take pleasure in your hard work? The simplest, most convenient method of doing it can be through Self Publishing. The number of creators self-publishing their guides is definitely increasing nowadays. Below are some factors why individuals opt for the self-publishing course:

You can forget about refusal letters

Exactly why is it necessary to pressure yourself with writing proposals to many publishers and get rejected? It will only make you feel your book is not worthwhile to become circulated. By using self-publishing, there is absolutely no holding out, no publishing of synopsis of the story, no looking at the wall surface. You can just head out directly by publishing your personal book!

One tactic to take into consideration is actually to self-publish, be sure that the book sells properly, and then in the event, you still want to get a conventional publisher to publish your book, they would think about you much more seriously given your background.

Acutrack provides powerful book printing and fulfillment services. that helps businesses deliver their books directly to consumers (B2C) or to retail and other marketplaces like Amazon (B2B) etc. Hardcover Book Printing

You are in control

Regular publishers modify your publication to make it “far better”. You are the actual creator of your task. You are the actual writer. Why would you actually allow another person to revise your current book for their personal convenience? That is your storyline; thought; creative thinking and perseverance. If you Self Publish your own book, you actually have complete command over your story. You can publish what you want to publish.

Most importantly, you actually own the copyright of your own publication. Allowing you to market, giveaway or bundle your book in any manner you want to, without needing to receive consent from your publisher!

You may make far more profits

Self-publishing your publication may give you a lot more revenue compared to a traditional publisher. You should earn all the cash after paying off marketing and book publishing. A regular publisher will pay you 10-15% of the sales value of your personal publication. Remember you also control the worth of your own publication, therefore you determine how much income you make for every publication you sell-off.

Sell off your current book on the web

You may get to a more substantial crowd with self-publishing. You can offer your own guides on, Barnes & Noble as the regular publishers carry out. With the invention of the Kindle and iPad, viewers have the ability to bring in several thousand publications everywhere they go. When you Self Publish your own book, you are presenting yourself a chance to be found like you never dreamed of. Typical publishers will suspect your book but once it’s out on the internet, you actually could become surprised about the number of readers who get pleasure from your hard work. A lot of successful writers also have offered their books via their websites and earned a great deal of money in the backend after offering their books.

Acutrack is a technology-driven eCommerce fulfillment company with a specialization in publishing any product needed for your business. Acutrack offers a solution that no other publisher does, i.e, the ability to help customers by connecting with their eCommerce and ship books, DVDs or USB thumb drive directly to their end-users! So, if you have an established customer base and wish to have full control over your sales and simply need a book fulfillment partner, we are the perfect fit for you. We integrate seamlessly with ClickFunnels, shopify and over 100+ online marketplaces. We Print. We Ship. Spiral Bound Printing.

Your personal publication is your own work

You are in charge of your book. Regardless of what you want to do with it, do it! No one will hold you back. Write down whatever you want. Design the cover the way you want it. It’s all you. You make all the decisions in your guide from start to finish. A good self-publishing organization will be there only to provide you with creating services, that’s it.

There are many self-publishing horror tales out there, read through them and learn from their errors. Concurrently, there are thousands of success stories with self-publisher out there; be encouraged and model their achievement.

How Dining Table Set can bring your family together?

Saraf Furniture the best office furniture store has ergonomic designs for your back and they are creating a buzz in the market.

A dining table isn’t just a place for eating food,Guest Posting it is a place where life happens. Saraf furniture know that your favourite place to catch up, to make plans, talk about your dreams around the dining table with my loved ones.

To find the perfect dining table for you and your family is to hit the internet and find wooden dining table and chairs online. Online shopping is fast and you can easily find different products and prices. Saraf furniture provides its furniture pieces at very reasonable prices.

Most people take eating as granted but this act of sharing is a greater step towards building a healthy relationship. Food is our fundamental part of health, culture and well-being. Eating together has several benefits physically and mentally both.

Eating all together is more significant today than in the past on the grounds that there are additional contending interruptions, more selections of exercises outside the home, and a steady siege of data from present day innovation.

There are several benefits of eating together.

Eating together is a tradition
Families have eaten together for long. In many social orders, families celebrate significant occasions by sharing food. Eating times have customarily been those occasions when entire networks or towns meet up. Eating together is an image of shared life.

More efficient and healthier
People who eat together, eat healthy than who eat alone. Research also suggests that people who eat alone have the higher risk of developing chronic diseases such as high blood pressure and diabetes.

On our health and happiness there is a positive effect of eating together. We have better relationships with people when we eat together. People feel more engaged, if food is consumed together. An environment with no distractions will encourage you to eat mindfully and helps to practice gratitude.

Enhances bonding and communication
Dinner table set is a place for sharing, laughing and talking. It is an important opportunity for families to catch up, to truly connect and distract themselves from technology and have some fun together. Couples are greatly benefitted by eating together. Couples are 100% focused and really communicate when they eat together. They are better at sharing, more comfortable and tend to know more about each other.

Model healthy eating behaviour
Eating together is a perfect opportunity to teach your children healthy eating habits. It will teach your children table manners, intuitive eating, social skills and much more. Its also a great time to debate, discussion, reflection, and to build confidence and communication skills.

Moment of reality
In this age of high-tech world, most of our lives are glued to their screens all the time. One should definitely enforce themselves to free from digitalisation and eat and talk as a family together, at least once a day.

If you have a smaller family then small solid wood dining table will be a great choice for you. It is especially made for four to six people. If you ever want to expand your family or you expect some guests, Saraf furniture has dining table sets with extendable feature as well.

Round tables have for a long time’s been an incredible method of advancing unity. The way that there are no edges on round tables implies that each one eating at the table will get a similar encounter. There will be no top of the table, so nobody will have a superior view over any other person.

Saraf furniture has wide variety of online furniture products that offer both items and information about easy furnishing and how should you decorate your space. They have tips for every corner of your home. There wooden study table online is available in different beautiful designs for your children. These tips will make your home more functional and beautiful.

Which is Better Physical Gold or Digital Gold

Gold has been a popular go-to asset for Indians for several decades now.

And why not? It is perhaps one of the few assets that does not lose its value over time.

However,Guest Posting this asset is mostly held in physical form – jewellery, bars, and coins – which gives rise to several challenges regarding storage and security.

Accordingly, many investors have been looking for a better alternative and have managed to find an ideal match in digital gold.

Which is Better Physical Gold or Digital Gold
There is a lot of speculation among investors concerning whether digital gold can emerge as a better alternative. Of course, the answer to this question is subjective. Then again, it’s suggested to take a close look at the difference in concept and approach towards physical and digital gold investment to gain a better idea.
Digital Gold Investment
Digital gold is a new age investment instrument that allows you to invest in 24 Karat purest gold, which is then stored in MMTC-PAMP’s secure vaults under your ownership. If you wish to take possession of the same, you can redeem digital gold for 24 Karat/ 999.9 purest gold coins and ingots from MMTC-PAMP. MMTC-PAMP is India’s leader in digital gold and you can buy digital gold online through our trusted partners like Paytm, PhonePe, and GPay. You can also reach out to your relationship manager in firms like Aditya Birla Capital, HDFC Securities, Motilal Oswal among others to manage your digital gold investments.
Gold coins and bars have been India’s most trusted investment instrument across generations, and for good reason. Reliable and convenient, the value of gold has increased enormously over the past few years, which makes it an increasingly lucrative option to store and compound. Gold prices have gone up more than 50% just in the last 3 years!

Plasma Cutting Consumables- Types, Uses, and Tips for Maintenance

Plasma cutter consumables are crucial in the operations of the machine. Also, the quality of the consumables plays an essential role in the machine’s output and the life span of consumables. Suitable quality consumables like Hypertherm powermax 45 consumables can give you incredible accuracy and possess a longer life.

Plasma cutting consumables are different parts of a plasma cutting machine. These consumables include:

How long a plasma cutter consumable will last depends on the quality and their extent of usage. If there is any fault in a single plasma cutting component,Guest Posting then the whole system can suffer from malfunctioning.

And you do not want that, right? So, it is better to replace the consumables on a regular time interval. This will optimize the system’s performance. Also, Hypertherm powermax 45xp parts serve as an excellent option for installing or replacing. They give you better outcomes and have a longer life.

Plasma consumables are useful for cutting thin and thick metals at a consistent speed. Some consumables may wear out quickly, while some may remain sturdy for a longer period.

Let us put some more light on the different consumables:

Swirl Ring
It is a minor component inside the torch that swirls the gas surrounding the plasma arc. The outer layer of gas helps to focus and direct the arc for providing a greater cutting precision. The swirling process keeps it cool. And the protective layer of gas surrounding the arc contacts the nozzle. The lower temperatures of the nozzle prevent the nozzle from burning up, slowing down the degradation process.


It is a narrow piece of copper-containing hafnium. Its job includes:

Receiving an electrical current from a cathode block placed inside the torch to which it is connected
Focusing the charge through its tip
This causes it to arc onto the workpiece.


It focuses on the plasma arc and the gas surrounding it to provide a clean and precise cut. A nozzle with a larger opening is useful for gouging. And a nozzle with a smaller opening is useful for providing delicate and detailed work.

Retaining Cap
It essentially holds all of the consumable parts of the torch together. The temperatures at this end of the machine are incredibly high, and thus, not only the parts that create and focus the arc worn down but the component holding them together also degrades over time.

Shield Cap

It protects the torch and its other components from sparks and molten metal. It takes the brunt of the fallout. Due to this, the wear to other components minimalizes as much as possible.

Replacing Electrodes and Nozzle

When the electrode produces the arc, the hafnium inside melts, and over time, fragments spurt through the torch in the cutting process. This results in the development of a pit at the end of the electrode. Do not worry; this is perfectly normal, but whenever the pit grows deeper than around 1-1.6 mm, you will need to replace the electrode. This is because there will not be much hafnium left then, and it will soon start burning through the electrode itself. After this, it will become challenging to cut and it can even damage the rest of your torch components. Hypertherm powermax 45xp parts are one of the best choices you can opt for while looking for consumable replacement parts.

It is hard to specify when exactly you will need to replace your nozzle and electrode. This will depend on many factors like:

The speed you cut with
The thickness of the workpiece
The amount of amperage you use
Replacing your consumables with Hypertherm powermax 45 consumables will put you back to optimum cutting performance. Your other components would not need replacement since they are prone to thermal dynamics, slag from the cutting process, and heating and cooling cycles. But do not forget to check your swirl ring and retaining cap for cracks, and if you see any, then you know what to do next, right? Replace them. Plasma cutting is a process that cuts through electrically conductive materials by means of an accelerated jet of hot plasma.

Tips for the Maintenance of the Consumables
Abnormal work practices might affect the machine badly, so it is advisable to work moderately
Place the materials at an appropriate distance from the plasma cutter
Install the system correctly as any disturbance in the network may affect the consumables of the machine adversely
Monitor the system regularly to check the condition of a consumable
Consider replacing the faulty consumables as soon as possible
Keep the system completely dry and free from any moisture as the moisture may cause rust
Keep the system free from dust as it might damage the consumable’s efficiency
Final Words
Plasma cutter consumables are crucial in the operations of the machine. Also, the quality of the consumables plays an essential role in the machine’s output and the life span of consumables. Suitable quality consumables like Hypertherm powermax 45 consumables can give you incredible accuracy and possess a longer life.

IT Consulting Is An Important Part Of The Successful Business

In today’s world of technology, it is almost impossible to extricate business and IT. For any forward thinking organization, IT becomes an essential component of its infrastructural needs. And if a company really wants to focus on its core competences, then it may need to consider outsourcing its IT needs. And many companies are doing that these days, that’s why IT consulting has become such an important and lucrative venture.

In an essence, the IT consultant works in partnership with you, helping you to utilize information technology in a way that inures considerable benefit to your business.

When you contract an IT consulting firm, you are advised as to how to scale up the structure and efficiency of the IT systems in your business. And this cab dramatically transform the structure of your business, allowing you to be more competitive.

It can hardly be over emphasized that IT consulting can bring a major boost to the growth and sustenance of your business. For example, IT consultants can be used to provide the strategic direction to businesses in the area of IT infrastructure and technology such that the business processes of of the company is enhanced.

IT consulting is also beneficial in the area of procuring technical equipment and even offering highly technical assistance. All of these can boost the performance of your business. In modern technological world, having the latest tech equipment is essential, because it will save your and your employees valuable time. This also helps to provide better customer services as businesses are able to provide immediate assistance to their clients. The increase of speed leads to high quality work.

But what should one look out for when engaging the services of an IT consulting firm? While there are many considerations, the following must always be on the top of your list:

- You need to be very specific about what are your requirements.
- The capacity of the consultant to deliver (experience counts).
- Are you hiring them for short or long term?
- Is your business ready to implement the changes that are likely to occur?
- Will the consultant be available to help in the future should you need him? Or this is something any IT consultant can do later?
- And of course, how much you are willing to spend on the project.

Needless to say, IT consulting has the potential of transforming your business once you know what you are about.

Management Consulting – Worst Interview Mistakes

The worst thing you can do is give bland, generic answers to the interview questions.

If you do not give unique answers that impart a bit of your personality, the interviewer will simply think you are the kind of person who is not willing to put forth an effort.

First of all, let’s discuss anecdotes. If you are not much of a consulting interviewee, you will fail to provide anecdotes. Here is an example.

What interests you about management consulting?

I like the intellectual challenge of the job. I also like to be able to work with ambitious, clever people solving difficult business problems.

That is a generic response. There is nothing personal about it – no story, no anecdote.

Do you understand the problem with this answer?

If you tell a little story or an anecdote about why you want to be a management consultant, it will stick out in the interviewer’s mind. If you just give a run of the mill, plain answer, it will just blend in with all the other run of the mill plain answers. You won’t get a job offer, and neither will anyone else who answered that way.

Once the consultants are done with interviews, they usually have a group discussion about the applicants. Applicants who leave a strong impression get discussed. Applicants that the interviewer can’t remember don’t. If the interviewer doesn’t remember you, he won’t have anything to say about you.

Here’s how you can add an anecdote or a takeaway.

A takeaway is a conclusion. It is a lesson learned or a 20/20 hindsight. Call it what you may.

In the answer that was given, there was no takeaway. No conclusion was given.

So let’s put in a takeaway, and you will see that just one sentence will make a big difference in the strength of the final response.

What is it about management consulting that interests you the most?

Ever since I did my internship in asset management, I have realized that it is important to me to work with a top-of-the-line team facing difficult business challenges. The people I worked with then really knew what they were doing, and I admired that. The work I did every day was a little dull, but I liked watching them. Now I know that if I want to get ahead in the business world, I will need to have work that challenges me and become a key member of a top-notch team like that.

Click here to learn more about business consulting interviews!

Don’t Hire a Rural Health Consultant Until You’ve Read This Article

As a rural health consultant myself with over twenty years in this profession and twelve years as a Fiscal Intermediary (MAC), I have seen what bad advice can do to a rural health clinic. Many times, I’ve been called in to pick up the pieces and help the practice get back on its feet. Let me give you some examples of the types of mistakes I have encountered and how an experienced rural health consultant would mitigate them.

Example 1

A Rural Health Clinic in central Florida had a contentious recertification by the State Agency. The surveyor was giving the business office manager a difficult time over their CLIA status and lack of Patient Care Policies. The physician intervened and the surveyor and physician got into a heated debate. The surveyor said that based on his findings, the clinic was out of compliance and he was going to recommend termination. The clinic called me and I spoke to the surveyor. He cited the discrepancies and I asked how he could recommend termination without giving the clinic the opportunity to take corrective action? When the surveyor returned 30 days later, the CLIA certificate still had not been issued and in spite of documentation that the business manager had, it was regarded as defiance. Additionally, the surveyor would not accept the adoption of the Nurse Practitioner Protocols as the clinic’s patient care policy. The surveyor again was going to recommend termination. I contacted the State Agency regional office and explained the situation but it fell on deaf ears. I contacted the CMS Ombudsman in Atlanta and furnished her with all the documentation showing that the surveyor and Regional Office were not following the State Survey Guidelines, but were, in fact, disregarding them. I assured her that the clinic was in compliance and had just received the CLIA approval. The clinic then received a visit from another surveyor and he was completely satisfied and the clinic was recertified.

Example 2

A Rural Health Clinic in west central Florida had a desk review of the prior year’s cost report and it was determined that a field audit would be warranted due to the lack of response for documentation. Apparently the office staff did not get the requests for additional information in a timely fashion. The physician contacted me and asked if I could assist the practice during the on-site field audit. A review of the case revealed that the MAC determined that the physician was well over the MD salary limits according to the MAC. The MAC used a Federal salary study by region for the basis of their determination of the reasonableness of the salary. The field audit lasted for four days and the exit conference indicated that there would be a substantial adjustment of more the half of the physician’s salary and fringe benefits. The adjustment would result in the cost-per-visit rate being sharply reduced which would impact the current year. I asked the auditor for the study which was used as the basis for the adverse determination and noticed that the study was more than 5 years old. The study was further flawed in it did not take into consideration the specialty, (this MD was an Internist) with advanced training (Board certification) and length of practice experience. I was able to secure a more current version of the study which had been updated and found that the physician was very close to the salary range when the other qualifications were taken into consideration. The result was that the adjustment was only 10% of the original determination and had no material effect on the clinic’s rate.

Example 3

A Rural Health Clinic in middle Alabama had a desk review of their prior year cost report bad debts. The MAC requested a statistically valid sample of bad debts that were in need of the EOMB (Explanation of Medicare Benefits) to justify the balances that were written off. Some of the bad debts were more than several years old and the documentation had been shredded by the clinic’s billing service. The MAC decided that without the EOMB the bad debts would be disallowed. The clinic was ordered to pay back a substantial amount resulting from the disallowances. Since the statistical sample was randomly selected, it was considered to be representative of the entire population. Unfortunately, the cases that had no EOMB were the very old ones which made up a small percentage of the entire bad debts but all were to be denied which skewed the sample. I argued that the sample was skewed and the percentage to be applied to the whole was not valid. The MAC did not agree and suggested that an appeal should be filed. The clinic would have to file a formal appeal through the PRRB. This could take up to several years and I knew this was not true so I suggested that the clinic contact Sen. Jeff Sessions, a friend of the clinic’s medical director and bring him into the case. Within three weeks the clinic was contacted by the MAC and told that most of the EOMBs had been found. The clinic was refunded most of their payback.

As you can see, hiring a rural health consultant with limited or no experienced can be just as risky as not hiring a consultant at all. In today’s market, most rural health clinics deeply depend on receiving the maximum Medicare reimbursement rate possible. One mistake by an inexperienced rural health consultant may result in an audit, and one failed audit could bring a clinic to its knees in short order. So what should you look for when hiring a rural health consultant? There are some obvious and not so obvious qualifications to consider.

First, the rural health consultant must have a detailed knowledge of all aspects of the Medicare Rural Health Program (Public Law 95-210). Technical, as well as practical knowledge of the conditions of participation, application submission, coverage issues, billing issues and most important Medicare cost reimbursement are critical to a Rural Health Consultant.

Second, an experienced rural health consultant should have a detailed knowledge of cost reporting and the factors which prompt red flags and potential desk audits. Additionally, if an audit is scheduled by the MAC, the rural health consultant should be available to the clinic to provide advice and technical assistance on a priority basis either by phone or on site.

Third, the rural health consultant must be able to engage not only the MAC staff and the State Agency staff on matters of findings and correct them when they are wrong or expressing their personal preferences even though those preferences may not be permitted in the regulations or operating instruction. The rural health consultant must be prepared to go to the CMS Regional or Home Offices to get a resolution to the problem. The rural health consultant must have contacts in higher places to present credibility of his knowledge and expertise in the areas of the issues.

By no means is this the entire list, but hopefully it will get you off to a good start. There are a number of rural health consultants in the market who have practice management experience, but zero experience when it comes to the Rural Health program. If you are having difficulty finding a tried, tested, and experienced consultant, contact me at (800) 592 – 3051.

Don’t turn your practice over to an inexperienced rural health consultant; you cannot afford the consequences!