Applying for a new job

[F0nzie]

Asking for advice because I have no idea what I am getting myself into here. The job seems fine but I am concerned about my compensation and whether it would be high enough to justifying leaving my CMHC. I think I am getting paid $93 an hour right now. W2. Part-time.

New Job: Seeing patients in nursing homes and supervising a NPs and PAs. Offer: 50% of what insurance pay(whatever that is) and $1500/month to sign off on NP and PA charts. Average is 14 patients per day. I would be paid as a W2 employee. This is all I know so far. What questions should I ask during the interview?


Sent from my iPhone using SDN mobile app

---

Members don't see this ad.

 

[zolof]

I had a similar type of job almost exactly in fact offer, but in another state that Im licensed in but I never took it. But the Director was telling me the averages made by some of the current docs and they were very high but they were doing it full time not part time. In this case the good was that the scheduling was very flexible, 3 or 4 day a week, or weekends if you needed, you essentially created the schedule. The thing is to find out how many pts are on straight medicare as opposed to supplemental or secondary or some other insurance.

 

[F0nzie]

50% seems like very high overhead... I know everything is negotiable but I feel a bit offended and I am considering backing off on the interview. Unless home visits pay a lot more?


Sent from my iPhone using SDN mobile app

 

[nexus73]

How many mid levels will you have to supervise? 3 mid levels x 5 days a week is a lot of liability.

I want to know the average dollar amount collected per encounter by the previous psychiatrist. If they are halfway organized providing that number should be simple. This will give you a better sense of what you will make. You could also estimate how much the mid levels are bringing in and negotiate your supervisor's fee. $1500/month may not be enough.

 

[F0nzie]

Maybe I am overthinking this but figuring how much I will get paid to sign off on charts and weigh the cost of liability is hurting my brain. Maybe I should just stay at my CMHC and get stabbed or quit and stay at home.


Sent from my iPhone using SDN mobile app

 

[nexus73]

If you get stabbed and develop PTSD, you can get paid and stay home.

 

[splik]

Maybe I am overthinking this but figuring how much I will get paid to sign off on charts and weigh the cost of liability is hurting my brain. Maybe I should just stay at my CMHC and get stabbed or quit and stay at home.

In terms of liability - remember if there is a malpractice suit involving midlevels the lawyers will come after you. why come after the monkeys when you can get the organ grinder? That said, the liability involved in nursing home work is exceedingly low. nobody gives a **** about these patients and these patients are probably too demented to cause any problems. the major lawsuit risk for nursing home psychiatry is inappropriate prescription of neuroleptics to subdue patients without consent from patient or the family. These are becoming more common. In general, the lawsuit is targeted at the nursing home (often part of some evil corporation or chain) rather than the individual psychiatrist but you could certainly find yourself named in the case.

 

[TexasPhysician]

50% seems like very high overhead... I know everything is negotiable but I feel a bit offended and I am considering backing off on the interview. Unless home visits pay a lot more?


Sent from my iPhone using SDN mobile app

For my own work and with insurance patients, I'd consider 65% as borderline low as my cut.

 

[Shikima]

If your work is going to be supervision and in NH, then the OH would not be more than 10%. Sounds like they're chumping you. It's a good deal overall, but you're giving up 40% of the income that you've earned. If they can come down to a reasonable rate, plus cover malpractice, then it's a good deal.

 

[trophyhusband]

Asking for advice because I have no idea what I am getting myself into here. The job seems fine but I am concerned about my compensation and whether it would be high enough to justifying leaving my CMHC. I think I am getting paid $93 an hour right now. W2. Part-time.

New Job: Seeing patients in nursing homes and supervising a NPs and PAs. Offer: 50% of what insurance pay(whatever that is) and $1500/month to sign off on NP and PA charts. Average is 14 patients per day. I would be paid as a W2 employee. This is all I know so far. What questions should I ask during the interview?


Sent from my iPhone using SDN mobile app

So the first thing I'd say to my wife if she were thinking about taking that job is... so if insurance pays $0 you get half of $0? So you'd basically be seeing that patient for free. In addition you have no idea how good or bad their billers are so you could be getting paid nothing just because their billers are inept. I'd tell her to try to negotiate a flat rate for new evals and one for followups. She shouldn't be punished because they have crappy billers and/or take crappy insurance plans. Might not work but I'd at least try.

 

[doctorpilgrim]

Rvu based salary is better than collections in my experience in fairness and amount of compensation, as you can find the median compensation per rvu easily and use that to negotiate. There are too many variables in collections. Overhead in nursing home is usually billing, scheduling and emr which is 10 percent. Supervising nurse practitioners in setting of geriatric population can be a liability risk.

 

[michaelrack]

Make them a counter offer- you bill for seeing the patient yourself and keep 100% + $1000 to $1500 per NP or PA supervised. If it's mostly medicare (rather than private medicare advantage) you should be able to make much more billing yourself