Would you sign out a biopsy for $20?

[stickyshift]

So, I've heard that the going rate for outreach specimens is 40% of Medicare in our area. So, a colon, cervical, or skin biopsy which Medicare would normally pay around $50 for will get you $20.
To put things in perspective, a guy fresh out of residency, being paid $150,000 (which is kind of low) would have to sign out 7500 biopsies/year to earn his keep.
What do you think?
Who accepts these contracts?

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[LADoc00]

So, I've heard that the going rate for outreach specimens is 40% of Medicare in our area. So, a colon, cervical, or skin biopsy which Medicare would normally pay around $50 for will get you $20.
To put things in perspective, a guy fresh out of residency, being paid $150,000 (which is kind of low) would have to sign out 7500 biopsies/year to earn his keep.
What do you think?
Who accepts these contracts?

40% medicare?!
WHAT? WHAT??

that is impossible. and criminal.

Where I am 200% Medicare is the going rate.

Do not come where I am and contaminate my fertile lands...

 

[stickyshift]

40% medicare?!
WHAT? WHAT??

that is impossible. and criminal.

Where I am 200% Medicare is the going rate.

Do not come where I am and contaminate my fertile lands...

I hope you're kidding about the 200% Medicare, or I'm going to cry.

 

[docbiohazard]

I'd gross ID only some well cleaned hip hardware or an intact tissue expander for that...

 

[djmd]

I'd gross ID only some well cleaned hip hardware or an intact tissue expander for that...

Zero-zero Dog!

 

[Farles]

It all depends on who's paying and what sort of agreement they have. For instance, here our standard client bill (billing straight to the sending doc) is 2x Medicare but "special pricing" can take that down to 40% of Medicare. If it's a 3rd party payor (private insurance, etc) and they don't have a special contract, then we do 3x Medicare. But again, they can negotiate big discounts. Billing is such a tangle of special agreements and contracts it makes your head hurt.

 

[stickyshift]

It all depends on who's paying and what sort of agreement they have. For instance, here our standard client bill (billing straight to the sending doc) is 2x Medicare but "special pricing" can take that down to 40% of Medicare. If it's a 3rd party payor (private insurance, etc) and they don't have a special contract, then we do 3x Medicare. But again, they can negotiate big discounts. Billing is such a tangle of special agreements and contracts it makes your head hurt.

Just think about the profit that the clinician "client" is making off of your work.

 

[Farles]

Just think about the profit that the clinician "client" is making off of your work.

The really sad thing is that there are still pods that undercut us at 40% Medicare.

 

[LADoc00]

I hope you're kidding about the 200% Medicare, or I'm going to cry.

Nope...sorry for the bad news, my lowest non-medicare payor is 125% medicare and Im going to renegotiate that even.

 

[stickyshift]

Nope...sorry for the bad news, my lowest non-medicare payor is 125% medicare and Im going to renegotiate that even.

So what's your leverage with the payer? Do you threaten to go non-par?
Do you ever go non-par with a major payer?