Realistic billing/collections #’s

[auditgraft97602]

Current resident a few offers. A couple of them are PP with a guaranteed base or xx% of collections, whichever is higher. Full benefits with both, new office, XR, grafts and dme included. Hard to compare to other offers without knowing what the expectation for collections would be. If you wouldn’t mind sharing, curious to hear what you all would expect to or did collect your first few years out.

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[Scrantonicity]

Current resident a few offers. A couple of them are PP with a guaranteed base or xx% of collections, whichever is higher. Full benefits with both, new office, XR, grafts and dme included. Hard to compare to other offers without knowing what the expectation for collections would be. If you wouldn’t mind sharing, curious to hear what you all would expect to or did collect your first few years out.

Keeping in mind that A) takes FOREVER to get credentialed under all the insurances, so sometimes it's very hard to keep good track of your own collections until then since you're most likely billing under the practice/owner, and B) can take even longer to have a steady flow of patients where your are constantly busy, I'd say collecting anywhere from $250K the first year to mayyybe $400K (if they have great advertising or were already overflowing with patients and you are busy right away). Worst case scenario you don't even pay for your base salary, which can happen too...

I was collecting $750K-$800K a year after about year 5, and that stayed pretty consistent (sometimes closer to $900K) the 5 years after that (except for a 100K dip during the peak Covid year)--never had a good contract in PP (hint: I never made over $200K), so I was always making my boss rich...same old classic podiatry associate story...glad I'm out!

Also should be noted that I was always a fairly conservative biller. I was always super careful about the codes I used, and even with the E/M change I rarely coded level 4's--sooo these numbers could have easily gone up, but I didn't want to make my boss THAT rich. I also never pushed for laser, creams, OTC inserts, or anything extra. I knew it was all going to my employer, not me, so I sent them to the stores haha.

 

[Scrantonicity]

BTW, they mentioned dme and GRAFTS included? I personally wouldn't mess with grafts in PP, especially these days now that they are getting the crackdown. I see your username is "auditgraft97602"...planning on doing a lot of grafts, and getting a lot of audits are ya?

 

[auditgraft97602]

BTW, they mentioned dme and GRAFTS included? I personally wouldn't mess with grafts in PP, especially these days now that they are getting the crackdown. I see your username is "auditgraft97602"...planning on doing a lot of grafts, and getting a lot of audits are ya?

Lol play on auto, probably should’ve been au(di)tograft. Not planning on doing a ton for that reason.

 

[Scrantonicity]

Lol play on auto, probably should’ve been au(di)tograft. Not planning on doing a ton for that reason.

Ha! Gotcha--yeah, I have a feeling skin substitutes and grafts are gonna go the way of compounding pain creams---people made bank off of them, but the ship is sailing away, as insurance is sick of paying out the nose for it. Soon there will be a wave of news: kickbacks, arrests, audits until the next big thing comes around!

 

[Feli]

Grafts are done... those kind of PPs need to find the next scam.

As to collections, a lot depends on payers and if the employer is going to be honest. Part of it also depends on what services and DME the office has.

Assuming you see roughly 20pt/day and 20d/mo (holidays, vaca, etc) and $100 per visit, that's about $450k/yr. That is a bit optimistic for new PP associate (due to being slow and needing to learn billing and little/no collections in first month or two). That same figure is a bit low for exp podiatry PP associate; they should be more efficient, seeing more pts, and understand PP and coding more.

I probably collected around $300k-400k my first associate year (10yrs ago, but pay for CPTs was about same as now) and maybe $400k-800k in subsequent associate years (these were various PPs... some busier than others, variable payer mix but usually giving me most of the lower/MCA pts, Saturdays, hospital work, etc when I was new). I just do the basic visits, injects, DME, surgery, procedures, OTC, XR or u/s if the office had it, etc... I don't do the scammy stuff like grafts or "custom" DME or laser or etc, never did.

I don't collect a ton more than my associate amounts now in owner PP, but I keep much higher % of my collections and see far fewer pts/hours. You can basically see half as many pts or net twice as much $ as owner... or some hybrid of that. I could easily hit much higher numbers if I wanted to work longer days or more days; it's dealer's choice. From starting my own, I can tell you 100% that all of my past employers had minimized my collections used for bonus calc, hid and/or refused to pay stuff to associate (OTC, DME, copays, secondary payments, etc) to various degrees. There is no way I now collect that much more overall (and $/pt) seeing fewer pt visits. Just not possible.

...Either way, there are 101 ways for the employer to hide or minimize or lie about collections, so just be aware of that. You sometimes want to consider who you work for/with and the teach/learn value and the non-compete area as much as simply your % or your volume...

Is this a good Offer?

With all this in mind - I have a question. What happens when the owner of a PP mill dies (in general/typically)? I’m guessing the office manager (wife) takes over. But how long could that possibly last? What self respecting pod (low bar I know) would keep working for their former pp boss's wife...

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