PhD/PsyD Group Practice Billing

[HarkWhoGoesThere]

---

Members don't see this ad.

Long-time lurker on this forum, first as a student, now as a practicing professional. I don't know if anyone has any help for me but I have to try. I'm going to be general so as not to arouse suspicion by folks I know.

I have been practicing in a very small group practice for quite some time as a 1099 contractor. The owner of the practice had a falling out with the person who did our billing and then took over the billing, during which time approximately 20-25 sessions of therapy and some testing that I performed were not billed correctly. In fact, in all cases, the errors are due to insurance issues that were not verified until long after services ended. The owner (now biller) has refused to take any action to collect and, frankly, bill these sessions correctly because it is seen as my responsibility, even though I have no power to bill or collect beyond simple asking (and that isn't working) for payment from clients who have either self-terminated or have been terminated for non-payment when the issues were brought to light. For some, if not most, it has been too long to bill in a timely manner.

PM me if you want more details and are willing to help me with my options, I just don't want to post them publicly.

What can I do? My pay has been commission-based and I am not getting paid for work that I performed because the group has not been paid, but through no fault of my own. Can I file a wage claim or lawsuit? It's a lot of money, obviously.

Edit: Please also PM me with suggestions on where to get help with this issue, if you know of any.

TIA.

 

[deleted343839]

The owner (now biller) has refused to take any action to collect and, frankly, bill these sessions correctly because it is seen as my responsibility, even though I have no power to bill or collect beyond simple asking (and that isn't working) for payment from clients who have either self-terminated or have been terminated for non-payment when the issues were brought to light.

How are these responsibilities spelled out in your work agreement? It doesn't make sense to me that you are responsible for billing, yet are paid as a 1099 contractor. If the situation changed after the outside billing person was fired then your contract should have been re-written.

Without knowing the full details, it's concerning that patients are being asked for payment because of the owner's billing error and then terminated when they (rightly) refuse to pay the practice directly.

Perhaps as a start you could contact your state psych association to find out if they offer any free professional consultation.

 

[HarkWhoGoesThere]

I am not responsible for billing. There is no written agreement, but I never did any billing. I somewhat agree that the issue for the patients is confusing--I say somewhat because I don't exactly know what the situation is since the billing got messed up. Does that mean I don't get paid at all for those services and take the hit, even though it wasn't my responsibility?

I will try to contact the state's psych association, thanks.

 

[deleted343839]

There is no written agreement, but I never did any billing. I somewhat agree that the issue for the patients is confusing--I say somewhat because I don't exactly know what the situation is since the billing got messed up. Does that mean I don't get paid at all for those services and take the hit, even though it wasn't my responsibility?

Getting paid for those hours will probably be an uphill battle. You were never paid on an hourly basis, so you can't suddenly claim wages as though you were an employee. There might be the makings of an ethics complaint in this somehow (eg, if the practice really is going after patients for fees after agreeing to accept their insurance), but if your pay has always been tied to actual revenues then I'd say you're in a tight spot.

The amount of money you're talking about (20-25 hours * payer reimbursement rate / the owner's cut) probably isn't enough to justify hiring legal counsel. State and local bar associations and law schools have volunteer services and legal advice clinics. You might be able to get some free or low-cost advice through those services.

Bottom line: working without a formal contract is extremely risky and gives you little recourse if something goes wrong. Don't do it.