Work at a Medicaid Office vs. PPO?!

[LolaLu]

Hi All, I would really appreciate other dentists opinions on here as I've only been practicing a year.

I'm a General Dentist at a Medicaid office in a LARGE city. Now it isn't a dental dreams type office, & we see some PPO as well (about 1-3 a day), BUT at the end off the day I see about 15-20 patients everyday (very difficult low income patients), and it gets very tiring as you can imagine (along with the incompetence of the front desk and dental assistants). BUT, with all the BS I deal with, I make about MINIMUM ~12-19k a month. [I had 550 daily guarantee for 6 months but after a few mths I made more off collections as I was doing more].





My full time job right now I work four days a week.



But I have two interviews for two seperate part time jobs, both offering two days a week.

SO...these TWO part-time jobs are both in downtown Chicago at PPO/FFS offices. [I can tell you about one office right now, the other we have a interview set up]. First office is offering me $525 for three months then 35% collections. Second office, waiting on interview.

Let's say they both give me $525/550- I'm looking at minimum $8/9k a month. BUT, I would hope after my collections and with a year of working at a Medicaid mill I can make more than that? I'm just not sure...



My DREAM, is to make the same amount of money I'm making now by seeing less patients with better insurances. Is this possible? Or will I be taking a salary cut as I transition into these new offices but later on make about the same I am now...if not more?


Extra info-I am a independent contractor now and will stay on for the part time jobs.

Thanks in advance for your opinions and help!

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[TucsonDDS]

Can't tell you what to do but I will warn you that you probably don't truly meet Independent Contractor status. If your current employer sets your schedule, books your patients, sets your fees etc then you most likely don't hit all the requirements to be an IC. A lot of employers try to classify their dentists as ICs due to them saving their portion of employment taxes. Unfortunately these employment taxes are then passed onto you. This alone would make me want to question how ethical the company is. If you get audited you may find that you are in for a hassle.

 

[allDAT]

Does your current job get you any closer to where you want to be 5 years from now?

Advice I got that I wish I followed was to get a job in a practice you want to buy. Not because you’re going to buy the place, but because you’ll get a sense for what you do and don’t like. It sounds like you don’t like high volume and low fees. So you may want to try something else.

A positive is that Medicaid offices are almost always hiring so you’ll be able to return to the same type of work if you choose. As opposed to landing a very well run PPO/cash gig that is hard to come by.

 

[LolaLu]

Can't tell you what to do but I will warn you that you probably don't truly meet Independent Contractor status. If your current employer sets your schedule, books your patients, sets your fees etc then you most likely don't hit all the requirements to be an IC. A lot of employers try to classify their dentists as ICs due to them saving their portion of employment taxes. Unfortunately these employment taxes are then passed onto you. This alone would make me want to question how ethical the company is. If you get audited you may find that you are in for a hassle.

Oh wow that has me a little worried... because the first thing EVERY dentist told me was ALWAYS INCORPORATE . And so I decided to go the S corp route. If you don't mind me asking, what route did you go? W-2?

 

[LolaLu]

Does your current job get you any closer to where you want to be 5 years from now?

Advice I got that I wish I followed was to get a job in a practice you want to buy. Not because you’re going to buy the place, but because you’ll get a sense for what you do and don’t like. It sounds like you don’t like high volume and low fees. So you may want to try something else.

A positive is that Medicaid offices are almost always hiring so you’ll be able to return to the same type of work if you choose. As opposed to landing a very well run PPO/cash gig that is hard to come by.

What a great way to put this! Simply put, no.... because in 5 years I want to be able to do dentistry to not be breaking my back and neck doing occlusals for less than $30....

I don't want to say that money is everything but I don't want to go to these PPO offices making diddly squat...especially when those dental school loans are looming over my head..

 

[TanMan]

Hi All, I would really appreciate other dentists opinions on here as I've only been practicing a year.

I'm a General Dentist at a Medicaid office in a LARGE city. Now it isn't a dental dreams type office, & we see some PPO as well (about 1-3 a day), BUT at the end off the day I see about 15-20 patients everyday (very difficult low income patients), and it gets very tiring as you can imagine (along with the incompetence of the front desk and dental assistants). BUT, with all the BS I deal with, I make about MINIMUM ~12-19k a month. [I had 550 daily guarantee for 6 months but after a few mths I made more off collections as I was doing more].





My full time job right now I work four days a week.



But I have two interviews for two seperate part time jobs, both offering two days a week.

SO...these TWO part-time jobs are both in downtown Chicago at PPO/FFS offices. [I can tell you about one office right now, the other we have a interview set up]. First office is offering me $525 for three months then 35% collections. Second office, waiting on interview.

Let's say they both give me $525/550- I'm looking at minimum $8/9k a month. BUT, I would hope after my collections and with a year of working at a Medicaid mill I can make more than that? I'm just not sure...



My DREAM, is to make the same amount of money I'm making now by seeing less patients with better insurances. Is this possible? Or will I be taking a salary cut as I transition into these new offices but later on make about the same I am now...if not more?


Extra info-I am a independent contractor now and will stay on for the part time jobs.

Thanks in advance for your opinions and help!

IC status works well if you are planning to open your own office since you can buy equipment and use pretax income to buy the equipment and expense it all against your income, v. if you were an employee and have to use post-tax income to buy your equipment.

My question is why would you want to set an artificially lower income target/ceiling? Get the best of both worlds, the heavy flow of a medicaid office with PPO/FFS patients. That way, you can work less hours and make more. I don't think you should agree to a fixed rate for such a long period of time. 525 is a complete ripoff and they are probably just finding a sucker every 3 months to rotate at that 525 rate (check around and see if they rotating doctors every 3 months). I'm not a believer in minimums and I would prefer to see if the office has the volume of patients to feed your production + percentage... or set up your own office for cheap and make way more money than being an associate.

Better insurances is kind of an oxymoron. Insurance payouts in bigger cities are on the race to the bottom. Some pay as bad as medicaid already. I find that PPO insurance patients are better than medicaid or HMO patients, if you're burning out on medi patients. Adult dentistry is just so much easier than children's dentistry and much easier to automate. Occlusals at 30 dollars sound just terrible; in order to make any profit, you need to be done in about 30 seconds to a minute with 30 dollar fills. The trick is just being faster with these lower compensation plans. Set your target production per minute (or hour) and know how much time you have allocated to each procedure.

 

[charlestweed]

I've only been practicing a year.
I make about MINIMUM ~12-19k a month. [I had 550 daily guarantee for 6 months but after a few mths I made more off collections as I was doing more].
My full time job right now I work four days a week.

I think earning $12-19k/month (that should be more than $150k a year) for working only 4 days a week is pretty good. And you've only been practicing for a year. There are dentists, who have been practicing longer and work more days per week than you, and they make less than $150k a year.

I'd stay at this current job, if I were you. I know it's not an ideal working environment but finding an ideal place to work at is nearly impossible. The place that can afford to pay you well usually has to cut cost elsewhere (cheap supplies, lack of assistants and hygienists, low tech equipment etc). The place that has high tech modern equipment and hygienists, who do all the cleanings for you, has too much overhead and can't afford to pay you well. If you keep doing what you are doing right now, you will become faster.....then doing a filling for $30 on a medicaid patient will no longer be an issue because it will take you much less time (than what you have to spend right now) to do it.

Since you only work 4 days a week right now, why not accept one of the two 2 days/wk job offers and work 6 days/wk? After a month, you should know if you like this new PT job or not. If it's bad, then quit and continue to work at your current job. It doesn't hurt to work 6 days a week for only a brief period.

 

[Rambunctious]

Hi All, I would really appreciate other dentists opinions on here as I've only been practicing a year.

I'm a General Dentist at a Medicaid office in a LARGE city. Now it isn't a dental dreams type office, & we see some PPO as well (about 1-3 a day), BUT at the end off the day I see about 15-20 patients everyday (very difficult low income patients), and it gets very tiring as you can imagine (along with the incompetence of the front desk and dental assistants). BUT, with all the BS I deal with, I make about MINIMUM ~12-19k a month. [I had 550 daily guarantee for 6 months but after a few mths I made more off collections as I was doing more].





My full time job right now I work four days a week.



But I have two interviews for two seperate part time jobs, both offering two days a week.

SO...these TWO part-time jobs are both in downtown Chicago at PPO/FFS offices. [I can tell you about one office right now, the other we have a interview set up]. First office is offering me $525 for three months then 35% collections. Second office, waiting on interview.

Let's say they both give me $525/550- I'm looking at minimum $8/9k a month. BUT, I would hope after my collections and with a year of working at a Medicaid mill I can make more than that? I'm just not sure...



My DREAM, is to make the same amount of money I'm making now by seeing less patients with better insurances. Is this possible? Or will I be taking a salary cut as I transition into these new offices but later on make about the same I am now...if not more?


Extra info-I am a independent contractor now and will stay on for the part time jobs.

Thanks in advance for your opinions and help!

I will tell you right now the way private insurance is going its almost better to be working with Medicaid patients. Yes you have to bust your ass to see so many patients a day, but you will get paid well, vs trying to convince and beg Delta Dental to pay for a crown that's desperately needed. i have two offices that are 100% medicaid and I'm happy. Each practice sees 40 patients a day on average and produces 1.2-1.4 million a year. It just depends on how you want to practice.