Surgical assistants get paid too much?

[scoopdaboop]

Just found out these people get like a 2 years certification and get paid like 100 grand? WTF? AND, they usually keep themselves out of insurance groups so they can then bill patients whatever they want (usually backed by PE groups when they do this). How do surgeons feel about surgical assistants doing this? Or does it not matter to them.

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[LucidSplash]

Just found out these people get like a 2 years certification and get paid like 100 grand? WTF? AND, they usually keep themselves out of insurance groups so they can then bill patients whatever they want (usually backed by PE groups when they do this). How do surgeons feel about surgical assistants doing this? Or does it not matter to them.

Surgical FA need both the classroom time as well as a few hundred hours of clinical time before they are certified.

Generally they are highly skilled individuals and work with surgeons who do not have residents. They are an essential part of surgery outside of major academic centers.

So no. I don’t have a problem with what they are paid. Do you?

 

[Neopolymath]

Surgical FA need both the classroom time as well as a few hundred hours of clinical time before they are certified.

Generally they are highly skilled individuals and work with surgeons who do not have residents. They are an essential part of surgery outside of major academic centers.

So no. I don’t have a problem with what they are paid. Do you?

He's likely referring to surprise billing by them when speaking about pay. A lot of FA's in my experience are in questionable cases (random Ortho cases that absolutely don't require them and they don't do hardly anything) and also billing OON. People signing 6 forms in pre-op don't even know that an FA will be there and they don't know if insurance will cover. They are in pre-op so they aren't going to say hold on I need to check to make sure this will be ok with insurance if they even see it in the first place.

 

[deleted941485]

He's likely referring to surprise billing by them when speaking about pay. A lot of FA's in my experience are in questionable cases (random Ortho cases that absolutely don't require them and they don't do hardly anything) and also billing OON. People signing 6 forms in pre-op don't even know that an FA will be there and they don't know if insurance will cover. They are in pre-op so they aren't going to say hold on I need to check to make sure this will be ok with insurance if they even see it in the first place.

I feel like nowadays if your OON you probably should be getting to these patients before they hit the preop holding area

 

[scoopdaboop]

He's likely referring to surprise billing by them when speaking about pay. A lot of FA's in my experience are in questionable cases (random Ortho cases that absolutely don't require them and they don't do hardly anything) and also billing OON. People signing 6 forms in pre-op don't even know that an FA will be there and they don't know if insurance will cover. They are in pre-op so they aren't going to say hold on I need to check to make sure this will be ok with insurance if they even see it in the first place.

Yeah that's what I was talking about. I think this is what inflates salaries for some of them. Kind of sad that this type of stuff is allowed to happen, and obviously a patient who is not informed in the business of medicine won't know anything about it.

 

[Matthew9Thirtyfive]

I sure as **** didn’t make that much as a surgical assistant. But I was hospital employed. Made about $35/hr per diem, no benefits. Would have made about $25/hr with benefits.

 

[Neopolymath]

I sure as **** didn’t make that much as a surgical assistant. But I was hospital employed. Made about $35/hr per diem, no benefits. Would have made about $25/hr with benefits.

You were an FA not a CST?

 

[Matthew9Thirtyfive]

You were an FA not a CST?

I have done both.

 

[DoctwoB]

Personally I would not work with any first assistant the billed OON for my patients. The first complaint I got they’d be donzo. Luckily I’m paid by RVU and so I’m more then happy to scrub my partners cases and vice versa. It’s fun and can be educational as well.

 

[Smurfette]

Ours are employed by the hospital so they aren't billing patients separately for their services, they are salaried.
They are paid well but also take pretty frequent call.
While I certainly am aware that some places have independent SAs that bill their services, I think that is less common now than it used to be as payment of the assistant is not guaranteed...CMS does not allow payment for an assistant for some cases even if one was used. And some cases will only pay if you specify in your op note exactly what your SA did. So that can get complicated as well.

 

[LucidSplash]

Ours are employed by the hospital so they aren't billing patients separately for their services, they are salaried.
They are paid well but also take pretty frequent call.
While I certainly am aware that some places have independent SAs that bill their services, I think that is less common now than it used to be as payment of the assistant is not guaranteed...CMS does not allow payment for an assistant for some cases even if one was used. And some cases will only pay if you specify in your op note exactly what your SA did. So that can get complicated as well.

All places I have experienced they were hospital employed as described here, probably why I didn’t consider OON billing etc.

 

[droliver]

The whole RNFA/Surgical Assistant model is blowing up as a) there was a lot of sketchy practices with the whole OON thing (which is the financial model of most salary lines) and b) they were frequently being used on cases where no special skill were required beyond a scrub tech. The three cities I've lived and trained in all frequently used to have a pool of them on staff, but they have all dropped them because the cost was too high. Likewise, several OON groups all failed as they couldn't collect and practices stopped using them when you had furious patients calling over being in collections for outrageous OON charges. We have proctored a number of RNFA's, and not one could find employment in that role and ended up just being circulating RN's again because that's what hospitals will hire them for.

 

[OrganRepo]

You are all failing to realize that independent first assistants are OON because insurance companies refuse to contract with them. Why would they when they can just deny you or pay you medicare rates regardless of what you bill. You have no recourse. So alot of FA's bill high in an attempt to make something when and if they do get a check. I was an independant FA for 8 years, I never billed a patient more than a few hundred dollars once I was flatly denied for service via there insurance dispite being nessessary and standard of care. I also ensured that when a patient scheduled surgery they are fully aware that I and the anesthesia provider are separate billing entities. Litteraly everytime someone has made a claim of some outrageous billing practice by a FA I have dug in and low and behold its just an EOB not a bill.

 

[jwk]

You are all failing to realize that independent first assistants are OON because insurance companies refuse to contract with them. Why would they when they can just deny you or pay you medicare rates regardless of what you bill. You have no recourse. So alot of FA's bill high in an attempt to make something when and if they do get a check. I was an independant FA for 8 years, I never billed a patient more than a few hundred dollars once I was flatly denied for service via there insurance dispite being nessessary and standard of care. I also ensured that when a patient scheduled surgery they are fully aware that I and the anesthesia provider are separate billing entities. Litteraly everytime someone has made a claim of some outrageous billing practice by a FA I have dug in and low and behold its just an EOB not a bill.

Trust me on this - you are a BIG exception to the rule in your billing practices.