Clinic?

[NDESTRUKT]

My attendings have clinic all the time...my understanding was that they don't get reimbursed for doing clinic, but is that true? Sometimes we have patients come in for a surgical consult - since that's not follow up, is it reimbursable?

I know some surg specialties have clinic as a huge component (ortho, ophtho, uro, ENT) but it seems to me that gen surg doesn't have the ability to generate income from doing office work...so my question is - am I right or are there gen surg subspecialties (super specialties) that have both a paid clinic and operative experience?

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[footcramp]

My attendings have clinic all the time...my understanding was that they don't get reimbursed for doing clinic, but is that true? Sometimes we have patients come in for a surgical consult - since that's not follow up, is it reimbursable?

I know some surg specialties have clinic as a huge component (ortho, ophtho, uro, ENT) but it seems to me that gen surg doesn't have the ability to generate income from doing office work...so my question is - am I right or are there gen surg subspecialties (super specialties) that have both a paid clinic and operative experience?

post op visits up to a certain amount of time (e.g. 90 days) are included in the reimbursement for operative cases, therefore do not pay separately. however post op visits for procedures (of which endovascular are included) do pay separately. in addition, initial visits and such are paid separately.

taking vascular as an example, clinic visits are a big part. vascular surgeons handle preventive care and screening. aspirin, plavix, beta blockers, etc. carotid ultrasound, US for venous disease, scintigraphy for lymphatics, etc. having your own vascular imaging lab can be a substantial source of revenue.

 

[Winged Scapula]

As footcramp notes, post-operative visits are bundled with the surgical fee. So it doesn't make sense to have a lot of them (ie, I knew one surgeon who put in external skin sutures and had the patients come back to the office for removal...since it wasn't paid, seemed to be a waste of his time to me) unless they are needed. Consider having your NP or PA see the patient while you are seeing new consults and other patients for which you can bill for.

New patients/consults are billable as are return visits which aren't post-operative or which are outside of the post-operative bundled period. Post-procedural visits can be billed for as well. General surgeons in academic practice don't worry so much about the billing issues, so perhaps aren't as savvy as those in private practice who have figured out a system to maximize reimbursement (or at least billings). If all of your patients are post-op or you don't do a full system review, you aren't going to maximize things for yourself...office procedures are often reimbursed at higher rate than operative ones. For example, I can make 4 x as much doing an in-office stereotactic core biopsy than I can by going to the OR for a excisional biopsy or partial mastectomy. In many cases, you lose money going to the OR.

"Procedures my boy, its the wave of the future"