i am not the "head of the department." i spoke to him about it and he said i would need group consensus. i am the only one who is fellowship trained and the only one who is boarded in pain though. i am going to bring it up again at our next meeting which is next month
Yes, the surgeons and their PAs order about half. I probably don't do quite that many a month. the 2 mondays at the HOPD are maybe 12 procedures total. another 1-2 days a month i have a side hustle for some 1099 income so i can do a solo 401K so take those days away. today i only did 24 procedures, for example, as i left at 230 to get my nails done lol. some procedures at this point are pt's calling for repeats. a lot are also MBB/RFAs that are a series so filling multiple slots.
I used to do 25-30/day so it’s not out of the realm of possibility
Hawkeye was doing 500 per month regularly.
those "office based SOS" procedures possibly are being charged as HOPD procedures.
It's probably their way of taking a portion of his pro fee. Probably given him him 40-60% and they're taking the other 40-60%.
No, they are billing them as office based and "teasing out" the professional portion.
You prob do not have much leverage in this situation. I would still try to do office trials.
They are not savvy. The 2 interventional guys that have been at the practice for 10+ years do their stuff at the surgery center so the professional fee is very obvious because that is the only fee. They only started doing procedures in office about 2 years ago with 2 new docs as these offices were remote from the surgery center and the reason one of the doctors before me left was that she did not know they were going to tease out the facility fee as it was not spelled out very clearly in the contract. In my opinion, they are not being malignant, they just do not really know how to handle in office procedures. When I talked with administration about it their statement was that they only reimburse physicians for personally performed work so that is why they were doing that. It is obviously not what the majority of other practices do so that is why I wanted to get feedback from the group about whether or not anyone else had this issue and what I can do in my negotiations to trying get more of my collections back into my pocket. Our ASC is currently full in terms of pain procedure suites with the 2 guys that are already there so there really is not availability to do anything else there. ASC also over an hour from my office so there's that.
F the ASC. You’re cranking out volume and when you start doing office trials the game is over. You’re being denied those trials by incompetent doctors.
But if you’re double dipping, it’s always more lucrative.
Depends on the ASC.
the office payment is "one" payment, that is correct. however, it is a bundled payment that has 3 components: physician work, malpractice costs, and practice expenses. my practice takes this one payment and breaks it down and bonuses me on only the physician component. yes, i am keeping 51% overall when you run the numbers. i am wondering if everyone thinks that is fair or not. Most other people are bonused on the full in office payment, not just the physician component. just wanting to get the groups thoughts.
How is this breakdown calculated? Is it spelled out in your contract?
51% overall is very fair, and I want to add you’re doing a good number of trials that if done in the clinic would increase your collections significantly. Once you’ve done 15-20 your partners would follow suit.
You’ll see. Switch to office and your numbers will clearly improve.
