Anything new in the foot care business? Updates on your business?

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    I just happened to come across this speciality thread while reading the wound threads. My dream has always been to become an entrepreneur. My original thought was to branch out into independent wound consultuting; however, after reading more about foot care, I have decided to start with it. My plan is to go to Elon University in May, and then Washington state and train with Dr Overstreet in June. My business plan is already in the works. I can't find anyone (RN or LPN) in my state who does "nursing foot care". As a matter of fact, the BON doesn't even address it. So, of course, my plan is to reach out to them first and foremost. I do have a question......I worked in LTC for several years, and currently work in hospice. I know, from experience, our local podiatrist visits all the ALF/LTC facilities in the area to perform nail care. After carefully reviewing Medicare/Medicaid guidelines, I have determined he should not be cutting as many nails as he does. I remember as a nurse in LTC, we would write "Podiatry consult for thick, mycotic toenails". Well, I have since learned, a podiatrist cannot be compensated for debriding nails just because they are "thick, and mycotic", unless there are further issues r/t (which in these cases, there were not). IS this a common problem with everyone else too (Podiatrist seeing Pt's which he really shouldn't be seeing?) I guess I shouldn't be concerned, because my plan is to cater to those who are able to pay out of pocket, as in my state a RN cannot bill Medicaid/Medicare. And, I feel if I have no competition, I shouldn't have a problem getting those "cash" patients.

    I am sooooo excited to have come across this particular speciality. I have ALWAYS loved wounds (am currently a WCC). Hopefully, my foot care business can branch off into wound care. Any tips/suggestions from those of you who are currently in the field and practicing would be soooooooo appreciated!!

    Thanks!!
  2. 17 Comments so far...

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    The podiatrist I have experience with (almost 1.5 years) sometimes does this service without charging the medicare recipients out of the kindness of his heart. It has been explained to me that even if the pt is a double armed amputee or blind, he or she may not qualify for nail debridement b/c Medicare thinks someone else could do it...ie family or nail salon-SERIOUSLY!?!? YES!!!! Unbelievable but sadly true. ABNs are provided to pts who notoriously come back before 61 days, do not qualify, or haven't seen their PCP in more than 6 mos, all issues that will let medicare deny the nail debridement claim even if they have diabetes with nueropathy etc. This is such a frustrating issue because of so many stipulations and pts do not want to cooperate with medicare's rules, nor do they want to pay to have their nails debrided, so we have outstanding pt balances b/c no one thinks they should have to pay for it; if not medicare, nor the patient who is by the way specifically asking for the service, then who? Good luck with your "cash" patients! Sure would be nice to not have to deal with insurance!
    footqueen likes this.
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    What state are you in? That can make a huge difference in finding clients!
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    I visited our local SCORE office for some free business counseling. ....I bet my counselor said TAXES >50 times......very obvious she was a government employee.....she did say a few things I hadnt thought about, but for the most part I was well prepared thanks to Dr Overstreets information.

    I suppose my first step is hiring an accountant, though I really just wanted to use QuickBooks.

    Has anybody ever used LEGALZOOM to get LLC and such initiated? Looks like an awesome service, but wondering what you, the experts, thought.

    So, gotta get licenses, name, tax number.... My class at Emory University isnt until the end of May, so I have a little time....

    Any further words of wisdom appreciated. ...
    Twinkle Toes, Corp likes this.
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    Hi NC29mom,
    I used LEGALZOOM to set up my LLC. They take care if everything including the naming and licensing. It was fast and cheap. There is no reason to employ a lawyer because this is not a complicated business arrangement. I paid $270ish as opposed to my friend whose lawyer charged $1200 for the same service.
    My accountant charged me $100 fora "business consultation" in which I was told to use Quick Books. He also explained the differences between LLCs and other types of business licenses to help me decide which I should go with and why. The LLC was the least complicated.
    Feel free to PM for more info at footcarenurses@yahoo.com
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    I am a sole proprietor. I have a DBA, business checking account, no lawyer, no accountant (for the business...but my personal accountant helps with questions). I use quickbooks. My accountant said that Quicken is a nightmare so to use quickbooks. Be careful about your startup costs since some of us have found that it is really, really hard to get the word out and get business. You can always go LLC once you have established yourself. Also, in some states (like mine) you don't need a business license. My RN license acts as my business license! Best of luck to you and your new venture!!! ps... Hi yrmajesty!
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    Hi! This sounds like a very interesting idea. I am going to look into it in Tennessee. Thanks for sharing!
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    I have taken the course at Emory University in Atlanta GA and have been doing foot care in our PCP physician practice for about 14 months. I am really loving doing foot care and strongly considering my own business and trying to get info on how to get started. Any advice about getting business and/or malpractice insurance?
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    Google "Dr Julia overstreet" she's a podiatrist in Seattle who trains nurses to become CFCN. awesome awesome lady. I also took the class at Emory, which was exceptional. Trained with Dr overstreet as well. Dr overstreet has a website, raienermed.com (might be spelled wrong so Google her name) where she offers kits to get nurses started in opening a foot care business. I bought the kit and was pleasantly surprised. Everything, and I mean everything (form/contract) is included, as well as dvd's with instruction on foot care. You will not be disappointed. She is an awesome resource. Good luck
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    Hi NC29mom. have you pursued getting any type of malpractice/liability insurance? Not sure I need the Kit from Dr. Overstreet if I am already trained and have been seeing patients in this capacity through my current employer. Wanting to branch out on my own.


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