a sonographer's guide to entrepreneurship

Talking tech

Episode 2: Setting up your mobile ultrasound business to make $1000/day

Having our own mobile ultrasound business and helping techs across the country to start and grow theirs, we’ve identified the best way to start your business with the least amount of overhead. We’ve also identified over the years 4 Pillars of success that you’ll need in place to see the most success. Once you’ve know the best way to set up and the pillars required, we are diving into how to determine your revenue opportunity. The industry average is $1000/day gross revenue back to the mobile company, and I’m chatting about how to get ya there!


Jen (00:01):
Hello and welcome to the Talking Tech Podcast, the sonographer’s guide to entrepreneurship. I’m your host, Jennifer Lindsey, and this is episode two. Today we are talking about a business overview. We are going to touch on the four pillars of success in the mobile ultrasound industry, and we’ll also talk about the type of business structure we highly suggest. And this is the one we teach our students in our Ultrasound Business Academy. It’s the best way, in our opinion, to start up your business with the least cost overhead, and we’d love to go over that with you today, and we’re excited to get started. So let’s first chat about the four pillars of success over the years, and with all of the students we’ve worked with across the country and our own mobile ultrasound business, we have identified four specific pillars of success. These are much like the four legs of a table.

All of them are required to keep that table standing. So if one is a little shorter than the other, not quite as strong, it becomes a wobbly table. Just like in business, there are certain things that we have to have strong suits in. And these four pillars are just that. So they are clinical applications, business development, legal compliance, and sales and marketing. So let’s go through each of these in a little bit more detail. Now, in clinical applications, we’re talking about ultrasound protocols, patient care, bedside manner, and physician interactions. So referring doctors if you have to chat with them, we’re talking about radiologists, cardiologists, those doctors that you’re working with on the backend infrastructure, you know, sending images from point A to point B. As a tech, you are generally set with this pillar, but this pillar alone is not enough for a successful business. And I would imagine if you have done any research at all and looked into this business, you understand that there are a lot of other things that come into play.


So let’s talk about pillar number two, one of the other sections here that is so important, and that’s legal compliance. So this can be very confusing. It’s hard to find anything online about setting this up. And so I want to give you guys a little bit of a basic overview on some of the things you need to be looking at, some of the laws and regulations that come into play. And our biggest suggestion for making sure that you stay in compliance. So regulations we’re talking about here, the main ones are Stark Law, Medicare, fraud and abuse, anti-kickback regulations, and anti-markup regulations. What happens if we don’t comply with these? Well, there are some major consequences.

So doctors can be stripped of their Medicare number, not just for seeing patients for ultrasounds. This is their Medicare number being taken away from them, and they are no longer allowed to see Medicare patients. In some cases, they can even be criminally prosecuted. So these are huge deals. It’s definitely not something to take lightly at all. And so because of this, specific contracts are needed; you guys, I can’t tell you how many times I’ve had people call and say, Hey, I started my business, I’ve written my contract. What else do I need to do? You know, to make sure that I am in compliance? And it gives me chills when I hear that because there are so many rules, regulations, and laws. To give you an example, the contract that we utilize and have in our Ultrasound Business Academy that our students have access to is, I believe, 17 or 18 pages long because it carves out all of the exceptions, rules, and regulations.

Verbiage has to be in there to make sure that we’re compliant with all of those rules and regulations. And so just coming up with something on your own, or even having a business attorney or some other type of attorney other than a healthcare attorney craft, is not the best way to go. It needs to be created by a healthcare attorney. And I liken this to when you went to ultrasound school and got your education. Let’s say you touched on echo in school, but your focus was general and vascular. Let’s say, for example, you’ve been doing general and vascular for ten years, and someone asks you to do an echo just because you learned about it in school. You have a good background, but you haven’t performed it, and that’s not your area of expertise; you would likely feel like a fish out of water.

And so, although a business attorney could likely put that together, one of two things is likely going to happen. Either A, they are going to have to end up charging you more hours than a healthcare attorney would because that’s not their area of expertise. It’s going to take them longer to do the research they need to do to put those contracts together. Or they may not know all of the things they need to look into, and certain things could be left out of the contract. And so, because of those reasons, it is best to have a healthcare attorney put all of that information together, craft that contract, and do the research for you. Now, healthcare attorneys are expensive. I think the last contract we put together by our healthcare attorney was $12,000. Okay? So it is not cheap. Now I’m going to give a shout-out to our Ultrasound Business Academy students here because we include the contracts they need, and having them done on their own would cost them probably three times as much as our entire Ultrasound Business Academy costs.

So our whole goal with that is to make this as inexpensive as possible. So keep that in mind. If this is something you’re looking at, look at that Ultrasound Business Academy next time the enrollment comes around because it will save a ton of money. Let’s move along to pillar three here. So we’re talking about business development in this pillar and, what we need here are specific processes to scale, build, grow your business—so partnering with physicians, those physician clients, as well as interpreting doctors, because you’ll likely need physicians. You want to make this a turnkey and seamless process. So having an interpreting physician and referrals that you can provide to your physician clients is going to be key. You also want to have a good process for managing contracts over the long term because you want to partner with physicians and have them partnered with you for years to come.

We also want to look at core business strategies. So we’re looking here at making sure we purchase the appropriate type of insurance. You will want to have multiple insurance policies in place for your business to ensure you’re covered. And you also want to have a good understanding of billing and coding surrounding the ultrasound environment. So what’s likely going to happen, if you think about it from this point of view, when you go in and bring the ultrasound equipment and yourself into a physician practice that doesn’t already have an ultrasound, likely they’re going to have some questions about how to bill that because they’ve not been doing that in their office. And so, although you will not need to be an expert in building, billing, and coding, you’ll want to have a good background in that and be able to answer their questions so that you can create a process that’s as seamless as possible for them because, in the end, we want to make sure they get paid for the ultrasounds they’re doing in their office.

And I’ll go over a little bit here on how the business structure is set up so you understand that a little bit better as well. You also want to partner with interpreting physicians, as I talked about a moment ago, because you’ll likely be working with a lot of general practitioners, internal medicine, and maybe even some specialists that can’t read their own studies. And so you’ll want to make sure that you’ve got a system and partnership in place with interpreting doctors for them to be able to purchase those reads. Pillar four is sales and marketing. And this is so important because even if you have all the other pillars put in place if you can’t sell a contract <laugh>, you’re not going to have a business. And so we want you to be thinking about best practices for gaining new contracts, so marketing to physicians. And then, once you get in front of the doctor, you need a sales strategy to move them through so that you end up with closed contracts.

On the other side, you’ll need to talk with plenty of physicians to go through your service, and you’ll have some nos and some yeses. And so, along the way, you’ll need a great way to keep track of all of the notes walking those prospects through that sales process. You’ll also want to have some great market branding. And suppose you think about it from this perspective. In that case, you are marketing to physician offices, and the other types of companies that market to physician offices are billion-dollar companies, pharmaceutical companies, medical device companies, and medical sales companies. Those groups have market branding that is on point. And so, so does your market branding. It does not need to be something that’s been printed out from your home printer and created by you. So even though we all start out as a mom-and-pop shop, you don’t want to look at it look like that.

You want your market branding to be on point. So those four pillars are what we have found over the years to be the most important four things for you to look at to make sure that you have in place in your company. So clinical applications, business development, legal compliance, and sales and marketing. Let’s switch gears here for just a moment and talk about revenue potential and the business setup itself. So we suggest our students set their business up on a service fee basis with a contract. Because in this scenario, you do not have to be credentialed with insurance. So your physician offices are the ones that are going to bill insurance directly because they’re already credentialed with insurance, they’re already in-network, they are going to bill insurance directly. You then charge a fee for your service and have a contract in place that has all of the exceptions laid out to make sure it’s in compliance with all of the rules and regulations.

We already spoke about the industry average is about $125 an hour that you can charge. And we suggest booking half-day or full-day slots at your physician’s offices. This way, you’re not driving from, you know, Dr. Smith’s office in the morning for one patient to Dr. Jones’ office in the afternoon. For two patients, you want to have it set up based on their patient load so that you’re providing services. And it’s a lot easier for them to book because Dr. Smith’s office knows, for example, you come in every Tuesday from 8 to 12, they can put all their patients in that time slot, and that’s when you’re available. So at $125 as the industry average going in for a half-day, four-hour time slot, the gross revenue back to your company is $500 for that half-day at a full-day, eight-hour time slot at $125. As the industry average, you’re looking at a thousand dollars a day. So the full capacity, so one machine, one tech, working five days a week for eight hours a day, is $20,000 a month or $240,000 a year. We have some students that this is perfect for them. Others only want to work a couple of days a week and replace what they were making at the hospital. And we have others who want to build their business to multiple machines and techs. And the great thing is you can do any of the above.

I want to talk a bit about service benefits because it ties into the best way to set this business up. In this scenario, the physician is keeping all of the revenue generated above and beyond what they’re paying you. So it creates a revenue stream for their practice. It’s cheaper for patients than going to the hospital. It increases patient satisfaction. Patients want everything at their physician’s office that they can have done there. Think about it. They want labs; they’d love x-rays, ultrasounds, anything to keep them from driving to an unfamiliar place, finding parking, and filling out a bunch of new registration paperwork. It’s wonderful marketing for the doctor’s office to have all of these things in their practice. And you are creating an ultrasound department for them without all the work. A lot of times, it increases patient compliance as well.

So because they don’t have to drive to another location, the doctor’s not just handing them an order and hoping that they get it done; they’re actually booking it right there in the office. So it increases patient compliance. And as I mentioned before, it’s also increased revenue for the physician practice. So in any business, looking at the revenue potential is important. And so that’s why I wanted to include this in this podcast today. So if we really look at even just a few case studies, if we’re thinking about a small first client, first account at just two full days a month, that’s $2,000 back to your mobile business as a gross and working out of your house, this is something you can put together that’s very inexpensive and doesn’t have a ton of overhead. Your real main expense is going to be the ultrasound equipment, and we don’t suggest purchasing until you’re ready to start that first account.

So that gross revenue is helping to pay for that ultrasound equipment. And so this gives you an idea of some of the main pillars that we know you have to look at to see a successful business. We talked a little bit about the service benefits and an overview of how the business is set up. If you guys have questions, I encourage you to comment and subscribe to our podcast. We’re going to have so much more information. This is only episode two here. I hope you all enjoyed it, and we will see you next time.

your strategy-obsessed ultrasound business coach.

I'm Jennifer -

Welcome to the Talking Tech podcast, where we answer your questions about legal, marketing, admin, sales, and so much more. After nearly 20 years in the industry running our own mobile ultrasound business and helping techs across the country do the same, I'm so excited to bring you industry insight, mindset, productivity, business tips, and inspiration to help you design the business of your dreams.

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