Advice on tail insurance if taking call as a 10[emoji2397][emoji2397]

[billBOB213]

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Hey all,

Hope everyone is having themselves a great and restful weekend.
I was approached by the hospital here to take call as a contractor, RVU based pay ($60 per wRVU) for lamb salvage only, so this would not be for ankle or calc fractures. Pretty much Ortho is not wanting to deal with wounds and limb salvage. Which is fine, as I like to do that kind of stuff and it pays well. I have never done this type of work as a 1099 contractor taking call though, and my question is what did y’all do with tail insurance? I only plan on doing this for one to two years, but I’m not excited to pay tail insurance and so I’m going to push back and ask that they pay for it. But I wanted to see what everyone else does or recommends. I’m pretty sure it’s claim based, not occurrence based tail insurance.
Thanks in advance.

 

[Sendin_Toes_2market]

Hey all,

Hope everyone is having themselves a great and restful weekend.
I was approached by the hospital here to take call as a contractor, RVU based pay ($60 per wRVU) for lamb salvage only, so this would not be for ankle or calc fractures. Pretty much Ortho is not wanting to deal with wounds and limb salvage. Which is fine, as I like to do that kind of stuff and it pays well. I have never done this type of work as a 1099 contractor taking call though, and my question is what did y’all do with tail insurance? I only plan on doing this for one to two years, but I’m not excited to pay tail insurance and so I’m going to push back and ask that they pay for it. But I wanted to see what everyone else does or recommends. I’m pretty sure it’s claim based, not occurrence based tail insurance.
Thanks in advance.

Occurrence based does not require tail, double check your policy if you are confused. Due to increased liability ask them to cover tail or don’t take call. They are getting a surgeon for $20-30k(probably 1/3 of the sign on for a surgeon)… they keep their orthos happy… also if not Occurence based and do 50+ cases a year, do occurence based. Just one less headache.

[edit] on average hospital docs non-salary benefits cost the the hospital $50-100k. I don’t think it’s greedy.

 

[DYK343]

This is NOT worth it unless you have tail coverage covered by hospital.

Decline the work unless they provide tail coverage.

Usually they require X amount of years of employment to cover tail insurance.

My current hospital job (not 1099, Im W2) required 2 years of work for 50% tail coverage. 3 years for 100% tail coverage.

 

[heybrother]

What is your current practice arrangement?
Where do you currently get your malpractice from and what type is it?
Have you spoken to your current malpractice carrier about how it would affect your policy to add this new responsibility?
Do you currently take call?
How often will they expect you to take call?
How far is your home from the hospital? How far is your office?
Does your current employment contract preclude taking call or require your collections from other work to be used to support your current office/arrangement?

I don't think malpractice is what sinks this. I think having irregular work, paid on productivity, in a world where everything takes hours / is not productive, while everyone else is paid by the hours just doesn't make sense. The anesthesia team is getting $300-500 an hour while you are waiting for the case to go.

Additionally, RVU people get paid $60 an RVU for heel pain in the clinic and $60 an RVU for higher risk cases. You aren't getting to pad your paycheck by running up 99204s claiming you independently interpreted other people's work and wrote meloxicam.

Some of these patients are likely uninsured and "paid call" is better than free call, but some of them are part of DRG payments where the hospital received a lump sum to resolve the issue.

I think you deserve a stipend - either something hourly or a set dollars value per day. I spent the day yesterday with my family, helping coach my kids team, watching my college football team etc. I looked up some of the values for toe amps, I&Ds, etc. I personally wouldn't give up my Saturday for $300.

 

[DYK343]

I was paid $500 a day to be on call (cover 2 sister hospitals close together) when I was a 1099 for hospital call at my last job.
Thats cheap for hospital in comparison to what they pay other specialties.

 

[heybrother]

I was paid $500 a day to be on call (cover 2 sister hospitals close together) when I was a 1099 for hospital call at my last job.
Thats cheap for hospital in comparison to what they pay other specialties.

Kind of funny. Comes out to be a bit more than $20/hour. Probably a good meme right there.

Your tolerance for an arrangement like that is going to be a measure of
1. How often you are called in and when. The "stress" of being on call vs just pocketing the money.
2. The efficiency of your hospital / OR / hospitalist. We're still waiting on cardiology, clearance, anesthesia, the OR etc.
3. Overall independent stuff related to you rlife. Distance getting there / traffic. Where you can park on call. Your personal life / family / kids. If they dump on you at shift change every day and shift day is dinner with your family it will get real old.

 

[SoleSucking]

Yeah get paid by the day to be on call. Ortho hates feet bro. You have huge negotiating power

 

[Sendin_Toes_2market]

This is NOT worth it unless you have tail coverage covered by hospital.

Decline the work unless they provide tail coverage.

Usually they require X amount of years of employment to cover tail insurance.

My current hospital job (not 1099, Im W2) required 2 years of work for 50% tail coverage. 3 years for 100% tail coverage.

Or just buy tail now if you are a new grad and switch to occurrence based… if you are planning to leave in 2 years… doesn’t make sense.

 

[DYK343]

Kind of funny. Comes out to be a bit more than $20/hour. Probably a good meme right there.

Your tolerance for an arrangement like that is going to be a measure of
1. How often you are called in and when. The "stress" of being on call vs just pocketing the money.
2. The efficiency of your hospital / OR / hospitalist. We're still waiting on cardiology, clearance, anesthesia, the OR etc.
3. Overall independent stuff related to you rlife. Distance getting there / traffic. Where you can park on call. Your personal life / family / kids. If they dump on you at shift change every day and shift day is dinner with your family it will get real old.

On a 24hr basis yes not much. But on call for a week $500 a day plus what ever I collected was typically decent (Medicare rates for uninsured patients).

I did get called every day at least once.

Usually 5-8 diabetic inpatients.

I also took trauma call and got called for that fairly frequently.

Usually added ~7k a week or more when I was on call to the salary which I was happy with.

But yes. ortho/gen surg/anesthesia doctors would turn this down every time. I didnt have their negotiating power.

 

[billBOB213]

Occurrence based does not require tail, double check your policy if you are confused. Due to increased liability ask them to cover tail or don’t take call. They are getting a surgeon for $[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]-[emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]k(probably [emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]/[emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]] of the sign on for a surgeon)… they keep their orthos happy… also if not Occurence based and do [emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]+ cases a year, do occurence based. Just one less headache.

[edit] on average hospital docs non-salary benefits cost the the hospital $[emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]-[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]k. I don’t think it’s greedy.

It is claims based that is in the contract.

I wanted to see what anyone had done and if they had fought to get claims paid for, or had had the hospital switch it to occurrence (which I agree with you, is better for my situation and easier).

 

[billBOB213]

This is NOT worth it unless you have tail coverage covered by hospital.

Decline the work unless they provide tail coverage.

Usually they require X amount of years of employment to cover tail insurance.

My current hospital job (not 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Im W[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]]) required [emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]] years of work for [emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]% tail coverage. [emoji[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]]] years for [emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]% tail coverage.

Good advice
And yes I have seen that type of tail coverage model with W[emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji638][emoji639][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]]]] hospital work, but I hadn’t found anyone talking about this type of paid call.
I have a gig, I like it and it’s FQHC work and I’ll not have to pay tail insurance if I ever leave it (federal tort claims act), but now with this coming up I’ll need to counter that they are paying for it. If they decline I can always just not take it and I’ll be just fine

 

[billBOB213]

Crap, every response I have it’s putting all the characters weird
Well, hopefully yall can understand my replies, sorry I can’t get to them all

Thanks again for everyone’s help

 

[Weirdy]

Crap, every response I have it’s putting all the characters weird
Well, hopefully yall can understand my replies, sorry I can’t get to them all

Thanks again for everyone’s help

If you're replying through the app or something similar- update it

 

[billBOB213]

I tried that and it says I’m up to date

Will delete and reinstall, thanks