For-profit multidisciplinary clinics

[deleted106747]

Curious if anyone has ever worked for one (as opposed to a major for-profit hospital)? Thoughts?

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[Sanman]

I have not, though I know a few people that have and looked at a job for one. Are we talking mental health only or primary care disciplines as well?

 

[Therapist4Chnge]

I’ve never worked for one, but i’ve gotten referrals and/or seen patients from some. Mixed reviews.

Chiro, PA, w medical director and neuropsych is one model i’ve seen. Another was a neurology practice w. vestibular/OT, neuropsych, etc. A third is occ med docs, PAs, PT/OT, neuropsych, chiro, and massage. All working primarily with workplace injury and personal injury cases.

They can be lucrative as the owner and/or provider, though some are more “best practices” than others.

 

[deleted106747]

Thanks. A friend is looking at a job in one - with a specialty focus - and it made me think about whether I'd be interested in working for such an endeavor. I wonder if they tend to pay low to keep profit margins high.

 

[ClinicalABA]

I work for a large for-profit agency/group practice with psychologists, speech therapists, and behavior analysts. Not sure if that’s what you’re talking about. Pay and benefits are pretty good, with good productivity bonuses (and fair minimum billable requirements). We have a very good owner/president who sincerely emphasizes mission focused service delivery. I’ve worked at non-profits where there was much more emphasis on the bottom line, with lower salary and benefits. I think you’ll find a lot of variance across programs, regardless of for- or non-profit status.

 

[deleted106747]

Thanks for the feedback. I know next to nothing about that model of care, since I've worked only in public or private hospitals. I'm glad to hear that there can be good compensation with it. (I've been thinking a lot about the next direction for my career.)

 

[ClinicalABA]

As an FYI- Non-profit status has to do with things like tax categories, percentage of revenue that can remain unspent each year, what money can be spent on, and board structure and oversight. Many non-profits bring in lot of revenue and have very high CEO salaries. I have not noticed any major or consistent differences in day-to-day operations (other than having to remember to have my sales-tax exempt form with me when buying stuff for the non-profit), salaries, etc.

 

[Sanman]

Thanks for the feedback. I know next to nothing about that model of care, since I've worked only in public or private hospitals. I'm glad to hear that there can be good compensation with it. (I've been thinking a lot about the next direction for my career.)

Depending how much work you are willing to do, it can be very profitable. At a health psych conference last year, I spoke to some psychologists setting up integrated care clinics in primary care and specialty clinics due to accountable care organization rules coming. Good percentage splits if you are willing to do the leg work.

 

[deleted106747]

Thanks again for all the feedback on this question. It's very helpful, especially since I've been inside the VA bubble for a long time.

 

[Sanman]

Thanks again for all the feedback on this question. It's very helpful, especially since I've been inside the VA bubble for a long time.

As ans aside, I wonder when that bubble is going to burst. Both sides seem to want to get rid of the VA.

 

[deleted106747]

As ans aside, I wonder when that bubble is going to burst. Both sides seem to want to get rid of the VA.

That's not, in my opinion, a bad thing to wonder about. It's been on the back of my mind for awhile and did have a role in me considering other types of jobs. I know the VA needs help to manage its caseload; however, I don't know if the community is really equipped to handle it. TriWest, however, might be the nail in the coffin.

 

[erg923]

That's not, in my opinion, a bad thing to wonder about. It's been on the back of my mind for awhile and did have a role in me considering other types of jobs. I know the VA needs help to manage its caseload; however, I don't know if the community is really equipped to handle it. TriWest, however, might be the nail in the coffin.

I'm over a year removed and out of the loop. What's the latest here?

 

[WisNeuro]

That's not, in my opinion, a bad thing to wonder about. It's been on the back of my mind for awhile and did have a role in me considering other types of jobs. I know the VA needs help to manage its caseload; however, I don't know if the community is really equipped to handle it. TriWest, however, might be the nail in the coffin.

Unless there has been a big change in the amount and how timely they pay outside providers, I don't see many specialists rushing to sign up. "You mean I can see PITA patients, for less money, and you will delay payments for 6+months! Where do I sign"

 

[deleted106747]

It's a big change. This is most decidedly NOT the Choice program. It's managed by Tricare and the rates are comparable to BCBS. Have a look at their site.

 

[WisNeuro]

It's a big change. This is most decidedly NOT the Choice program. It's managed by Tricare and the rates are comparable to BCBS. Have a look at their site.

Fee schedule lookup tool keeps returning nothing for testing codes

 

[deleted106747]

Fee schedule lookup tool keeps returning nothing for testing codes

I forget how I did it, I did the codes for initial assessment & psychotherapy and saw the rates were like BCBS. I had to pick a VA so I picked Phoenix. Where I am, private practice psychologists are getting letters asking them to opt in and they are building the rates.

 

[WisNeuro]

I forget how I did it, I did the codes for initial assessment & psychotherapy and saw the rates were like BCBS. I had to pick a VA so I picked Phoenix. Where I am, private practice psychologists are getting letters asking them to opt in and they are building the rates.

Hmm, I may wait until some colleagues try this out before thinking about experimenting.

 

[deleted106747]

Hmm, I may wait until some colleagues try this out before thinking about experimenting.

you can look without biting on them - it just shows the rates.

 

[WisNeuro]

you can look without biting on them - it just shows the rates.

TriWest Healthcare Alliance - VA Fee Schedule

If this is the one you are using, it's not working for me

 

[deleted106747]

TriWest Healthcare Alliance - VA Fee Schedule

If this is the one you are using, it's not working for me

I did Phoenix VA 90791 and got this:

PHOENIX VAMC 90791 234.00

 

[Sanman]

Therapy and initial CPT codes work. Testing specific codes dont cond up.

I got this for my region:

90791 - $200
90832 - $120
90834 - $120
90837 - $170

Interesting that 90832 and 90834 are the same reimbursement. Explains why I limit my 90834s.

 

[WisNeuro]

Looks like just the neuro codes are not coming up.90791 in my area is $328. 90834 is $172

 

[Sanman]

Okay this site is crazy. I picked a different VA an hour from mine and 90791 reimbursement was $926. Either that is wrong or I am quitting my job and opening a practice doing initials there.

 

[WisNeuro]

Okay this site is crazy. I picked a different VA an hour from mine and 90791 reimbursement was $926. Either that is wrong or I am quitting my job and opening a practice doing initials there.

No ****, I'm down for scheduling intakes straight through, all day every day at that rate.

 

[deleted106747]

Okay this site is crazy. I picked a different VA an hour from mine and 90791 reimbursement was $926. Either that is wrong or I am quitting my job and opening a practice doing initials there.

ha ha well, it IS still the VA after all, this sort of thing should be par for the course...
still, from what I understand, the reimbursement rates are based on what BCBS reimburses in the geographic area.

 

[Sanman]

ha ha well, it IS still the VA after all, this sort of thing should be par for the course...
still, from what I understand, the reimbursement rates are based on what BCBS reimburses in the geographic area.

BCBS ain't reimbursing that much.

 

[WisNeuro]

ha ha well, it IS still the VA after all, this sort of thing should be par for the course...
still, from what I understand, the reimbursement rates are based on what BCBS reimburses in the geographic area.

There is no way BCBC is paying that much for an intake. That's forensic type money there.

 

[deleted106747]

No, I meant that the obvious glitch is par for the course for the VA and technology. Of course they would never reimburse that much, but if they did, every psychologist on the board would probably move to that area!

 

[WisNeuro]

No, I meant that the obvious glitch is par for the course for the VA and technology. Of course they would never reimburse that much, but if they did, every psychologist on the board would probably move to that area!

Maybe not move there. But definitely license up, rent an office for a week or two here and there, and just fly over and do a butt ton of evals, and then take a few months in between doing it again.

 

[deleted106747]

Maybe not move there. But definitely license up, rent an office for a week or two here and there, and just fly over and do a butt ton of evals, and then take a few months in between doing it again.

I'm in!

 

[Sanman]

I'm in!

I'm already licensed there and live in the area. Want to rent office space?

 

[WisNeuro]

I'm already licensed there and live in the area. Want to rent office space?

If I can clear $900 per intake? Sure thing, I'll sign the lease today.