Facility fees/reimbursement

[au bon pain]

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I’ve been booked out one day forever. Scheduling flexibility for my practices success has been key.

By “booked out for one day,” do you mean you keep a few slots open for last minute add-ons? Or something else?

 

[SSdoc33]

Meaning you’re doing 10 hours of procedures
I’m going to get Flack on this but I do 90 procedures a week (3 whole days) and two days of consults, with APP help
I want to reduce procedure days down though (I do 4/hours)

something like that. maybe a little more b/c RFs take longer.

 

[nvrsumr]

I dont keep appt slots open. Dont have a max/day of patients. If someone calls and wants in they get in. If surgeon calls and wants a patient to get a shot they get in. If someone wants to pay cash today for a same day shot after eval we make it happen. We always make the offer. Most dont take you up on the same day appt but they appreciate that it was offered.

I also dont have an unlimited number of patients in my pain doc saturated city so not usually an issue.

 

[Ferrismonk]

My practice goes the other way. We are private but work most of our days at a hospital. We bill our own professional fee, but the hospital provides all staff, referrals, supplies, support, etc. Hospital doesn't control how much or what days we work. We limit ourselves to 4/hour, 24 max per day, with a dedicated lunch from 12-1 (often 11:30 to 1). Partners work 3-4 days per week. If our new patient waiting list gets more than a week, we pick up days to see them. If our procedure appointments get too far out, we add a day.

It's a good work/life balance and while we may not make the huge bills others are, we make plenty of money.

 

[BobBarker]

So you have no overhead at all?

 

[buddababa]

My practice goes the other way. We are private but work most of our days at a hospital. We bill our own professional fee, but the hospital provides all staff, referrals, supplies, support, etc. Hospital doesn't control how much or what days we work. We limit ourselves to 4/hour, 24 max per day, with a dedicated lunch from 12-1 (often 11:30 to 1). Partners work 3-4 days per week. If our new patient waiting list gets more than a week, we pick up days to see them. If our procedure appointments get too far out, we add a day.

It's a good work/life balance and while we may not make the huge bills others are, we make plenty of money.

i was this first few years, realized model didn't benefit me or partners, ended up breaking off and going into a hospital employee with rvu model. patients dont always pay the professional fee, when i switched, i had over 120K in collections

 

[doc1324]

Generally if the physician is compensated by a percentage of their collections, they would only take a percentage of the pro fee.

And yes you are correct about the pro fee at a surgery center usually being significantly less than if the same procedure was done in office.

Sorry for the late bump...just wondering if the "office" is actually a hospital outpatient department (clinic attached to the hospital) and so would reimburse at the facility rate, how is this financially sustainable/worth it for the doc? Would the docs practicing in an office on a hospital campus just make significantly less than a doc practicing in a freestanding office if they're both getting a % of collections? Like for Medicare it seems like there's a big difference (anywhere from 30-70% lower!); not sure about commercial payers. Thank you.

 

[clubdeac]

Sorry for the late bump...just wondering if the "office" is actually a hospital outpatient department (clinic attached to the hospital) and so would reimburse at the facility rate, how is this financially sustainable/worth it for the doc? Would the docs practicing in an office on a hospital campus just make significantly less than a doc practicing in a freestanding office if they're both getting a % of collections? Like for Medicare it seems like there's a big difference (anywhere from 30-70% lower!); not sure about commercial payers. Thank you.

Most docs practicing in a HOPD clinic are paid on wRVUs so it doesn’t matter to them. Everyone else gets screwed of course

 

[BobBarker]

Hospital employed docs are payer/fee schedule blind. They get paid the same per task no matter where it is done.

 

[drusso]

Hospital employed docs are payer/fee schedule blind. They get paid the same per task no matter where it is done.

Disgusting.