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To: <Practiceimprovement1@yahoogroups.com>
From: "Dr. Annie Skaggs" <askaggs@fayettefamilymed.com>
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Thu, 24 Mar 2005 07:51:08 -0500
Subject: [Practiceimprovement1] RE: [Practiceimpt srovement1] eMDs & financing
Reply-To: Practiceimprovement1@yahoogroups.com

Hi Earnie,

I can't speak to eMDs, (I have Healthmatics from A4) but I did use ACI and wish now that I hadn't. I did not understand when I signed up with them on the advice of the consultant that there is no way out once you sign with them. If you go with a bank loan, or even just put the stuff on a regular credit card, and then you find that you have the means, you can pay them off early at considerable savings. No such thing with ACI. I used them to pay for about $60k worth of stuff in two different contracts. It turns out that what they do is buy your stuff from the vendor, then double the price that they turn around and sell it to you for, and spread the payments over time (66 months on my contracts). If you decide to "buy out", the buy out price is actually higher than the sum of all the remaining payments. I wanted to pay off the smaller of my two contracts. It was for stuff originally priced at about $8,600, and I have already been paying for 28 months. When I asked for a buyout quote it was $10K. When I asked the consultant why on earth she recommended this deal, she said that most startup practices can't get any other kind of financing for this type of purchase.

The sad thing is that, as a "nontraditional" (read "older") med student->resident->startup doc is that I could easily have just put the purchases on plastic. I have sky high limits, low balances, and there have been tons of zero interest offers to shuffle for the past 4 or 5 years. If I had used them, I could have all that stuff paid off by now, but instead I am locked into 38 more months of payments.

Of course, using plastic has inherent risks and you could get squeezed. The other confounding issue is that all the plastic is mine personally, and when I started up I did not have a credit card account for the business, so there would have surely been some accounting aggravations associated with sorting that out....but I still think if I had it to do again, I would avoid the lease situation.

Hope that helps,

Annie Skaggs MD

Lexington, KY

-----Original Message-----
From: Ernest Leland [mailto:ernie.leland@comcast.net]
Sent: Tuesday, March 22, 2005 12:39 PM
To: Practiceimprovement1@yahoogroups.com
Subject: [Practiceimprovement1] eMDs & financing

Hi all-

We are about to "write the check" for eMDs. I noticed in the information to join the group that there were probably ten people who are using it. Does anyone have any serious regrets about going with eMDs? Or advice about which clearinghouse to use? (I was leaning towards T.H.I.N. because it is free in our area.)

The minimum requirement for a server comes in at about $6,500. (It is a 2.8 Xeon processor, upgradeable to dual processor, with 2 GB RAM, SCSI 15K RPM RAID 5 Array, with a few other bells and whistles.) It seems to be overkill to me. What is your eMDs server and does it work well enough for a low volume office?

We are talking to ACI financing for it. Did anyone work with them? It seems easy. The rate is a little higher than the bank offer was, but the application resembled a credit card. (i.e. sign here, sign here, add your address, phone, and social security number.) Approval happened near instantly. They will cover up to $75,000 in software, hardware, furniture, phones, medical supplies, etc. They will defer the first payment for nine months. In contrast, the bank wanted a second mortgage on our house.

Thanks for your thoughts in advance,

Ernie Leland

360.903.2099

I don't have any ties to the above companies.