I'm waiting for someone here to start describing reasons why thats not possible
1. That's assuming a 0% no-show rate. 10% would still be low, but a big cut right there.
2. That's assuming 100% collections. That can be hard to achieve for many practices.
3. That's assuming every payer pays that amount, not a mix of several with lower payments.
4. That's assuming a full panel with no intakes or discharges, which doesn't really happen at any point in a practice.
5. It takes a long time to fill a panel / schedule to that degree.
6. Depending on the demographics, as much as 30% of people tend to no-show intakes. So making no money and not adding a patient to your practice takes away a lot of potential payments.
7. Intakes would take up the slot for at least 2 follow-ups and pay much less per hour, even when attended.
8. Patients are always going in and leaving, so you need to account for that long-term attrition.
9. Not every consult leads to a follow-up. You need to account for an immediate attrition rate.
10. Fourteen 30-minute follow-ups per day can be exhausting, especially if there are major trainwreck cases. How many intakes are you also going to have that day?
11. Seven clinical hours + lunch + admin time is often a lot longer than 8 hours. I would rather take a longer lunch and cut an hour off the beginning and end of the day.
12. It's hard to run lean enough to have no employees if your panel is ~600. Honestly, it's hard outside of the practices that are very heavy on psychotherapy (~50).
13. Even if your practice is 500 patients, that's at least 500-750 hours of intakes, if 100% of consults led to a perfect follow-up case to bill 99214+90833.
14. Not everyone needs a 99214+90833. Forcing them into that isn't good medicine and is also insurance fraud. Seeing stable adult ADHD without any comorbidities is almost always a 99213, and there might not be any indication for the add-on. Same thing with any other stable single-problem visits.
15. Not a terribly huge market for people wanting to see a telepsychiatrist but who also want someone local who still doesn't have an office for occasional in-person visits.
16. If you aren't local, why would someone want to see you over any other non-local?
17. No controlled substances for tele-only. Even if you like that aspect, it does mean you're limiting your clientele.
18. If you're tele-only, why would someone choose to see you instead of any of the companies that already offer this service?
19. How many days did you calculate working per week? I would much rather work 4 days a week with at least 6 weeks of not working per year. Four 6-hour days (10-4, working through lunch) a week is only 24 hours per week. That's more like 4 intakes and 40 follow-ups per week, assuming 100% show rates.
20. 24 hours per week x 46 weeks is 1,100 hours a year. Subtract at least 600 hours the first year for intakes, and even if you max out the remaining 500 hours that year, it's only 500 hours at that rate.
21. Factor in the above attrition rates, it looks nowhere near as nice as initially described.