Reasonable Net Collection Percentage

[Pain321123]

I have an employed job offer, 350K base for first year then switch to production with no base and 35% net collection. I would also get 10% of NP/PA net collections. This offer seems extremely low so my questions is what would be a reasonable percentage of net collections to ask for/negotiate. Also what percentage of NP/PA net collections would you recommend? This would be office based clinic/procedures. Medicaid < 5%. Opportunity to buy into ASC that will be built within the next year.

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[JelloIsJigglin]

Net collections reasonable is 40-50% probably.

 

[drusso]

I have an employed job offer, 350K base for first year then switch to production with no base and 35% net collection. I would also get 10% of NP/PA net collections. This offer seems extremely low so my questions is what would be a reasonable percentage of net collections to ask for/negotiate. Also what percentage of NP/PA net collections would you recommend? This would be office based clinic/procedures. Medicaid < 5%. Opportunity to buy into ASC that will be built within the next year.

It depends upon what the overhead is for the organization. As a W-2, there is no skin in the game to keep overhead low so any percentage that gets you out of bed and turning the crank gets the job done!

The best you could say is that the current incentive offer doesn't get your juices flowing. You'd rather just sit at home instead of coming in for such a pittance.

 

[Agast]

Collections will drop next year due to the CMS reimbursement cuts

 

[drusso]

Collections will drop next year due to the CMS reimbursement cuts

It's time for everyone to tighten their belts if sustainability is your concern.

 

[Pain321123]

The other offer I have is a 1099 position 450k/yr base for the first 2 years then 100% net collections minus 7% billing. Catch with this is hospital based practice with approx 20% to 40% Medicaid and all office visits and procedures done in hospital so I would be getting lower physician fee.

 

[BobBarker]

hospital employment only works well in the RVU set up.

 

[drusso]

hospital employment only works well in the RVU set up.

Can you explain it? I tried to buy some Starbucks with an RVU but they would only take Bitcoin...

 

[BobBarker]

Can you explain it? I tried to buy some Starbucks with an RVU but they would only take Bitcoin...

I will later. Still at a Gel One dinner. It is socially distant. We even turned off the screen with the canned zoom presentation. Can never be too safe. Excellent sea bass however.

 

[painfree23]

I have an employed job offer, 350K base for first year then switch to production with no base and 35% net collection. I would also get 10% of NP/PA net collections. This offer seems extremely low so my questions is what would be a reasonable percentage of net collections to ask for/negotiate. Also what percentage of NP/PA net collections would you recommend? This would be office based clinic/procedures. Medicaid < 5%. Opportunity to buy into ASC that will be built within the next year.

what part of the country? any other benefits (retirement/healthcare/malpractice covered)? These things add up

 

[TIVAndy]

speaking of reduction in cpt payment, there's actually increase in EM code reimbursement - i think the net effect of my practice would be net neutral due to this

 

[lobelsteve]

Can you explain it? I tried to buy some Starbucks with an RVU but they would only take Bitcoin...

You need to go into the Starbucks inside your local hospital....

 

[Agast]

Collections based is also Zero during a shutdown. Although even salaried docs were strong-armed into accepting lower pay last summer. I am wondering if the trend in contract offers is going to be collections based in order to avoid hemorrhaging cash.

 

[drusso]

Collections based is also Zero during a shutdown. Although even salaried docs were strong-armed into accepting lower pay last summer. I am wondering if the trend in contract offers is going to be collections based in order to avoid hemorrhaging cash.

I took a lot of heat earlier this year for pointing out this...people did not want to hear it.

Corona-Triggers in MD Employment Contracts

I'm hearing reports of Admin including various "corona-triggers"--ie "in the event of a national or state emergency RVU conversations shall be suspended or reduced **%." Is anyone else seeing this in their jurisdictions? What is a good counteroffer or symmetrical offset for these kinds of...

forums.studentdoctor.net

"They will never love you back."

 

[lobelsteve]

I took a lot of heat earlier this year for pointing out this...people did not want to hear it.

Corona-Triggers in MD Employment Contracts

I'm hearing reports of Admin including various "corona-triggers"--ie "in the event of a national or state emergency RVU conversations shall be suspended or reduced **%." Is anyone else seeing this in their jurisdictions? What is a good counteroffer or symmetrical offset for these kinds of...

forums.studentdoctor.net

"They will never love you back."

My hospital system decided to give everyone a free month of avg wrvu to offset any potential income losses due to March/April Covid slowdown. So that was kind of a trigger.

 

[drusso]

My hospital system decided to give everyone a free month of avg wrvu to offset any potential income losses due to March/April Covid slowdown. So that was kind of a trigger.

How do I get paid for not working?

 

[paindoc007]

My hospital system decided to give everyone a free month of avg wrvu to offset any potential income losses due to March/April Covid slowdown. So that was kind of a trigger.

Wait a sec. So if you’re averaging 1000 wrvu monthly typically. But March and April you hit only 300 each due to Covid. They GAVE you 1400 free wrvu ?

 

[lobelsteve]

Wait a sec. So if you’re averaging 1000 wrvu monthly typically. But March and April you hit only 300 each due to Covid. They GAVE you 1400 free wrvu ?

Let's say a PCP averages 500 per month. They are at 6000 per year over the last 2 years. The system would drop your single lowest month and give you the average of the other months instead. So for the March that was 200 rvu, they got 500 instead.

 

[paindoc007]

Let's say a PCP averages 500 per month. They are at 6000 per year over the last 2 years. The system would drop your single lowest month and give you the average of the other months instead. So for the March that was 200 rvu, they got 500 instead.

That’s amazing. My hospital didn’t do jack **** compared to that.

 

[mazinger]

The other offer I have is a 1099 position 450k/yr base for the first 2 years then 100% net collections minus 7% billing. Catch with this is hospital based practice with approx 20% to 40% Medicaid and all office visits and procedures done in hospital so I would be getting lower physician fee.

You are never collecting 450k while doing injections in the hospital it is a trap and don’t fall for it

 

[painfree23]

You are never collecting 450k while doing injections in the hospital it is a trap and don’t fall for it

What if it’s “clinic” based tho?

 

[mazinger]

What if it’s “clinic” based tho?

Clinic meaning what? In office and the professional fees go into your productivity? Then yes it is a no brainer..
If it is in the hospital and lure you with lies then wRVUs is the way to go..
Hospital CEOs love luring physicians with too good to be true promises.
I would never work for a hospital again, I would never take hospital calls for pain or in patient consults nobody can pay me enough to do that crap..

 

[bv123]

If it is a 1099 job with no salary guarantee, they pay for overhead - what is a reasonable % of collections to keep for yourself? Procedures are done in ASC and you dont collect facility fee until they let you buy shares 2 years in. No other benefits included

 

[likeaboss]

If it is a 1099 job with no salary guarantee, they pay for overhead - what is a reasonable % of collections to keep for yourself? Procedures are done in ASC and you dont collect facility fee until they let you buy shares 2 years in. No other benefits included

ask them for a work RVU based comp. If you are seeing 40% Medicaid you won't bill much...

 

[bv123]

ask them for a work RVU based comp. If you are seeing 40% Medicaid you won't bill much...

They do not see any medicaid patients. Was that your main concern with the offer or the fact that you dont keep any facility fees in the collections?

 

[Disciple]

I have an employed job offer, 350K base for first year then switch to production with no base and 35% net collection. I would also get 10% of NP/PA net collections. This offer seems extremely low so my questions is what would be a reasonable percentage of net collections to ask for/negotiate. Also what percentage of NP/PA net collections would you recommend? This would be office based clinic/procedures. Medicaid < 5%. Opportunity to buy into ASC that will be built within the next year.

Generally speaking, 40% is ok assuming good/full benefits, and typical high volume/ high overhead model.

If no benefits, I would ask for 50%, and to be treated as an independent contractor, not an employee.

 

[Ferrismonk]

If it is a 1099 job with no salary guarantee, they pay for overhead - what is a reasonable % of collections to keep for yourself? Procedures are done in ASC and you dont collect facility fee until they let you buy shares 2 years in. No other benefits included

No guarantee, no benefits, and they get the ASC facility fee for every procedure you do? You should keep 100% of your professional fee and they'll still make a killing off you.