Looking to make extra money in spare time, and a friend who is an MD was telling me about case review, or utilization review he does, basically reviewing medical records for 3rd party as a consultant. The money is quite good. Anybody here have experience with straightforward things like that to make extra money in spare time? Not looking to reinvent the wheel or start private practice, mostly a way to make money when I can't sleep!
Case review/utilization review/online consulting work
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deleted343839
I have dipped a toe in this and so far have not gotten more than low-paying, bottom-of-the-barrel jobs. Others on this forum have fared better and might be able to give you some pointers on accessing the better referral sources.
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I do this for my state worker's comp health management company and for handful of large commercial life insurance companies. I have also seen bottom of the barrel comp offered, mostly with the smaller IROs. I have simply refused these when offered, and then not recredential with these companies when my credentialing lapsed.
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The stuff that I've done that paid well was due to having connections. I've seen jobs and been offered some crap stuff that I quickly rejected (don't do VA disability work as a contractor). You can do well in this world, but you need the reputation to get good work. If you're neuro, you're gonna want to go through with ABPP boarding.
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deleted343839
I got approached by a company to do SSA evals part-time and I laughed out loud when they told me the compensation. Somebody is taking this work, though, and that makes me sad. I've done a few file reviews on the cheap to get a taste for the work, but sitting in a room with another person and providing a formal assessment is another matter completely.
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Do you think that this just comes down to ignorance? As in, people not knowing what they SHOULD be expecting for compensation for these assessments.
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SSS It's a high and reliable volume. You could built a practice around it. Then hire associates.
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I think it comes down to some people not having better options. For those of us who are paid into six figures, we know to an extent what our hourly time is worth. Why would we accept a side job that pays half as much, or less, than we make in our main job?
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deleted343839
No, I think it's easy enough to look up the CMS Physician Fee Schedule, at a minimum, and go from there.
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What are the ranges in pay that you have seen?
Sanman
O.G.
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In general, the way these offers work, someone negotiates a contract with an insurance company, military, SSA, etc to complete evals. They then put out these ads to hire others and take a cut for themselves. It is not always a bad deal. If you have a private practice and need fill some dead hours (say 2pm on a wednesday), it is better than no money. If you are making decent money already it may not be worth the time.
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Consider it but know what you are getting into. I did utilization review during my first 2 years out of my PhD. I actually learned a great deal about business, passing audits, and dealing with intense confrontation in a professional manner (MDs screaming at me and being told NO by me repeatedly and I had the final say) with all parties not being very happy. I was good at it. I was actually being groomed to buy out/take over/and own a very successful managed care company from a retiring solo owner when I was 31. Kind of a transition/mentor/10 year finance model. It came down to the "you can use your powers for good or evil" thing for me. Profits are sometimes made by denying patient care, packaged appropriately and legally as not being a covered benefit which essentially denies access and makes self pay prohibitive. Often times the benefits that are not covered are dictated by a corporate client in fine print on page 27. The profits were huge. Imagine having 1 contract that covers $2 per covered member on a company that has 30,000 covered members (60 k a month). Now imagine having 15 corporate clients. Instead I decided to to pursue why I got into the field, patient care. The owner thought for me to actually see patients was a bit beneath my potential/skill set and he was a bit confused why I would want to do that. Well, today was a typical Thursday at my clinic, and I absolutely loved it! Like, it's 8 pm, time to call it a day. It is hard to explain, maybe like a runners high. A flow state.
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I have only done "utilization review" per see for the workers comp health management company in my state-"relatedness" and appropriateness/medical necessity of treatment, etc.
There have been alot of "advancements" in education and the understanding of mental health sequela that is relatively new in the workers comp world over the past decade. I'm glad to have been a part of it and get this experience. I have never actually found this/them to be greedy or unethical. In fact, they are relatively lenient with mental health, and I think that's why my state started contracting peer reviewers such as myself (although we have contracts in other states too). There is alot of bogus practice out there, and very much practitioners who are perverting "relatedness" for their own cash cow.
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Providers can do questionable things. I know. 10 years ago while on the Utilization Review end I saw providers who see someone with an adjustment disorder document a change in GAF score from 68 to 68 with 40 psychotherapy sessions. Not sure any benefit was obtained with 4 k worth of treatment according to the documentation. On going supportive psychotherapy with no treatment goals was not a coveted benefit. Let's not even talk about med checks/with psychotherapy and absolutely no indication of psychotherapy according to the charting. Prozac 20 to Prozac 30 is not an indication of psychotherapy. Sounds like fraud to me or just bad documentation.
On the provider end, last week I requested a pre authorization from a BCBS covered member. Psych testing was requested for a kid with potential autism and intellectual functioning challenges. The pre authorization was denied indicating testing was not a covered benefit and not medically necessary. The middle class parents who paid their hard earned after tax money for insurance were denied access to an assessment for their impaired child. The family ended up paying cash for the non covered benefit. I don't think insurance companies always have the best interest of their covered members in mind and that's what I'm getting at. I understand cost containment and over utilization. I get it but this was a kid in need of services. We don't have to call the insurance company greedy or unethical, it's simply "not a covered benefit," all along while the CEO of the insurance company with a MBA makes 1 million a year is thinking that psychologists are making too much at $85 for a 96101.
On the provider end, last week I requested a pre authorization from a BCBS covered member. Psych testing was requested for a kid with potential autism and intellectual functioning challenges. The pre authorization was denied indicating testing was not a covered benefit and not medically necessary. The middle class parents who paid their hard earned after tax money for insurance were denied access to an assessment for their impaired child. The family ended up paying cash for the non covered benefit. I don't think insurance companies always have the best interest of their covered members in mind and that's what I'm getting at. I understand cost containment and over utilization. I get it but this was a kid in need of services. We don't have to call the insurance company greedy or unethical, it's simply "not a covered benefit," all along while the CEO of the insurance company with a MBA makes 1 million a year is thinking that psychologists are making too much at $85 for a 96101.
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