RE: Report wring time
I have my initial record review (before pt is interviewed), then I usually get more outside records once I know all of the docs involved, as my typical patient has been to a few other specialists (neurologist, neuro surg, physiatrist, etc) before getting to me. It'd be nice if they were all in our system, but I get cases from all over the place, so there are more records out there. As a result, a second review is done while writing.
As for report length, 6-8 pages...which includes a letter w. executive summary and 1.5-2.0 pages of detailed recommendations. I also include a summary chart of data (for the providers who prefer one). I have built a great referral base of providers because I am thorough in my assessments and provide the information that they want and in the format they want.
I do mostly Worker's Comp cases, take a handful of private insurances, see a few Medicare cases, and have a growing cash pay base. I negotiate my hours up front, and if the payor doesn't like them, I decline to take the case. I've seen 30-40% differences in rates for private insurances (and 50-60%+ less for budget/medicaid-like plans), so I dropped/declined to join any panel who tried to squeeze me. I'm about to drop off another panel bc of intrusive pre-auth requirements. I rarely have patients from them, so it is an easy decision.
There is far more demand out there, so I can be selective in who I see. I'd rather get paid a fair fee and do pro-Bono work on my terms, as opposed to trying to do volume that includes cases w 30-40% less in payment and not be able to afford taking pro-Bono cases.