Split fee?

[futuredo32]

~$2500/year for part time clinical hours, less than 20hrs. This is for the preferential occurrence based coverage.

mine is claims made I have no idea what the difference is. I finished residency and rented an office from a former attending in his suite, he told me what kind of insurance to buy, what company to use, the name of a biller. I have to keep this company until I retire to get tail coverage, but they give you like 1500 for staying five years and a little bit. I don't know if its my carrier that is so expensive or it's Michigan. But my practice is about an hour from my home because it was way more expensive in the counties closer to home. It was less expensive the first three years and went up a little each year and now it's 6400 a year for 20 hours a week. I have been waiting for a quote for a week.

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[hallowmann]

At the clinic where I work you need to fill out forms for prior authorizations or call. The clinic where I am a locums, the receptionists do everything for refills and all I have to do is click. At this other private clinic, your patients email you and you use therapy notes to write that you filled it and some other system to prescribe. For my micro practice I use paper charts and rx pads. I usually do 99213, my biller said 99214 will trigger audits. I'm waiting for a quote. I only asked for it last Monday............ I pay 6400 a year for part time malpractice in a county that is cheaper. I know it's outrageous in other counties.

Wait, so just so we're clear, you're barely billing 99214s? How long are your appointments? As long as you are documenting appropriately and spending the time, it doesn't matter if you get audited. If you are billing almost all 99213s for 30+ min appointments, I understand why you've struggled to make much money in your private practice.

 

[futuredo32]

Wait, so just so we're clear, you're barely billing 99214s? How long are your appointments? As long as you are documenting appropriately and spending the time, it doesn't matter if you get audited. If you are billing almost all 99213s for 30+ min appointments, I understand why you've struggled to make much money in your private practice.

I do 99213 90833 if it's a half hour. Most of my patients are therapy patients, so for them it's 90834 or 90836 and 99213. My biller put the fear of God into me about 99214 when I sent her that code initially, a psychiatrist she bills for got audited for using 99214, had to pay back a ton of money and had to go through a physician retraining program. My psychiatrist sees me 5x a week for therapy and doesn't use an add on code for the rare visit when he prescribes a medication and said it was because he's worried about an audit.

 

[TexasPhysician]

I do 99213 90833 if it's a half hour. Most of my patients are therapy patients, so for them it's 90834 or 90836 and 99213. My biller put the fear of God into me about 99214 when I sent her that code initially, a psychiatrist she bills for got audited for using 99214, had to pay back a ton of money and had to go through a physician retraining program. My psychiatrist sees me 5x a week for therapy and doesn't use an add on code for the rare visit when he prescribes a medication and said it was because he's worried about an audit.

Worrying about an audit makes no sense if you are meeting MDM. Even if you get audited and lose part of it, you are paying back money that you wouldn’t have received anyway. Obviously don’t defraud them and be completely off to be penalized. Billing 100% 99215’s every 10 min will land you in trouble.

Technically under-coding knowingly is also inappropriate.

 

[calvnandhobbs68]

Worrying about an audit makes no sense if you are meeting MDM. Even if you get audited and lose part of it, you are paying back money that you wouldn’t have received anyway. Obviously don’t defraud them and be completely off to be penalized. Billing 100% 99215’s every 10 min will land you in trouble.

Technically under-coding knowingly is also inappropriate.

right because then it contributes to the bull**** letters we get saying “hey look you’re “overcoding” cause other psychiatrists in your area are billing 75% 99213s”

The response to crap like that isn’t to just bill all 99213s it’s to appropriately document to bill appropriately.

 

[robellis]

Psychiatrist under the new rules should be 90%+ 99214, otherwise those patients should be sent back to PCP

 

[Mass Effect]

mine is claims made I have no idea what the difference is. I finished residency and rented an office from a former attending in his suite, he told me what kind of insurance to buy, what company to use, the name of a biller. I have to keep this company until I retire to get tail coverage, but they give you like 1500 for staying five years and a little bit. I don't know if its my carrier that is so expensive or it's Michigan. But my practice is about an hour from my home because it was way more expensive in the counties closer to home. It was less expensive the first three years and went up a little each year and now it's 6400 a year for 20 hours a week. I have been waiting for a quote for a week

What??? I've never seen that stipulation.

I'm afraid to tell you that you've been getting some pretty crummy advice about billing, audits, malpractice, and all of the above. Please don't take advice from the people who've been advising you ever again. Ever. They've led you astray.

 

[Sushirolls]

I believe that company is 'The Doctors Company' its a liability firm that will pay you back some of the 'dividends' when you retire, but the catch is you need to continue enrollment for the duration of the carrier and at retirement they flip over from claims made to occurence based (i.e. tail coverage).

Could be good for some if you know what you are signing up for.

 

[calvnandhobbs68]

What??? I've never seen that stipulation.

I'm afraid to tell you that you've been getting some pretty crummy advice about billing, audits, malpractice, and all of the above. Please don't take advice from the people who've been advising you ever again. Ever. They've led you astray.

@Sushirolls is right, it's that you get the tail coverage for free if you keep them until you retire. I don't think it's that you can't pay for tail coverage at all when you leave them, you just have to pay for it.

 

[TexasPhysician]

I believe that company is 'The Doctors Company' its a liability firm that will pay you back some of the 'dividends' when you retire, but the catch is you need to continue enrollment for the duration of the carrier and at retirement they flip over from claims made to occurence based (i.e. tail coverage).

Could be good for some if you know what you are signing up for.

The same company has reasonably priced occurrence policies in which tail is included. Mine is around $9k/year.

 

[Mass Effect]

Am I the only one having problems with the quote function?

 

[futuredo32]

The same company has reasonably priced occurrence policies in which tail is included. Mine is around $9k/year.

That is the company and it's variable regionally, quite so in the area of Michigan where I live.

 

[futuredo32]

What??? I've never seen that stipulation.

I'm afraid to tell you that you've been getting some pretty crummy advice about billing, audits, malpractice, and all of the above. Please don't take advice from the people who've been advising you ever again. Ever. They've led you astray.

It was my former attending. I am no longer in contact with him but he's doing quite well for himself. They didn't teach this in residency.

 

[splik]

mine is claims made I have no idea what the difference is. I finished residency and rented an office from a former attending in his suite, he told me what kind of insurance to buy, what company to use, the name of a biller. I have to keep this company until I retire to get tail coverage, but they give you like 1500 for staying five years and a little bit. I don't know if its my carrier that is so expensive or it's Michigan. But my practice is about an hour from my home because it was way more expensive in the counties closer to home. It was less expensive the first three years and went up a little each year and now it's 6400 a year for 20 hours a week. I have been waiting for a quote for a week.

Out of interest, I looked this up and apparently Macomb, Oakland and Wayne counties have the highest psych malpractice premiums in the entire country. However an occurrence place plan should be about $25k a yr (which is way more than most anywhere in the country) and possibly less. If you have a claims made plan (which it sounds like you do) it should be way less than that. Anyway, it would be a good idea to shop around and see if you can get a good quote if your current carrier does charge too much.

 

[Merovinge]

Out of interest, I looked this up and apparently Macomb, Oakland and Wayne counties have the highest psych malpractice premiums in the entire country. However an occurrence place plan should be about $25k a yr (which is way more than most anywhere in the country) and possibly less. If you have a claims made plan (which it sounds like you do) it should be way less than that. Anyway, it would be a good idea to shop around and see if you can get a good quote if your current carrier does charge too much.

I am working to get quotes for tail insurance presently, having never done this before, any suggestions?

 

[calvnandhobbs68]

I am working to get quotes for tail insurance presently, having never done this before, any suggestions?

Usually cheapest is to just see what your current claims made policy company charges for tail.

I actually recently reached out to an insurance agent about this for tail for my moonlighting and he said that tail only companies won’t even look at anything <10K. If your current company offer is over that, then might be worth looking at stand alone tail coverage vs prior occurrence (aka “nose” coverage) with whatever new company you’re going with.

 

[Merovinge]

Usually cheapest is to just see what your current claims made policy company charges for tail.

I actually recently reached out to an insurance agent about this for tail for my moonlighting and he said that tail only companies won’t even look at anything <10K. If your current company offer is over that, then might be worth looking at stand alone tail coverage vs prior occurrence (aka “nose” coverage) with whatever new company you’re going with.

Yup this was my experience today with the folks. Called up cunninghamgroups and the said anything under 10k they don't touch. Mine seems very high at 20k so they are going to work with me. It's very odd to me that my spouse who works in the same area as a surgeon has a nearly identical quote to mine, feels like hers is shockingly low and mine is shockingly high, given that she sees at least 2x as many overall patients and has all the risks associated with surgery.

 

[futuredo32]

Out of interest, I looked this up and apparently Macomb, Oakland and Wayne counties have the highest psych malpractice premiums in the entire country. However an occurrence place plan should be about $25k a yr (which is way more than most anywhere in the country) and possibly less. If you have a claims made plan (which it sounds like you do) it should be way less than that. Anyway, it would be a good idea to shop around and see if you can get a good quote if your current carrier does charge too much.

I told you it was expensive. Didn't it was know the highest in the country