Partners not wanting to share Rvu or billing information

[GUtiger]

I'm cynical when it comes to these things. I wouldn't have joined a practice as an employee with partnership track without having had access to the books for accepting the position.

As a partner it would be inconceivable to not have access at any time to the complete books. My major concern here is that this situation seems absolutely ripe for fraud and theft. More likely the older guys who aren't working as hard are making money off the backs of the younger partners and they don't want to derail the gravy train.

What does the partnership agreement say about access to the financials of the business? You should be able to figure out your rights.

Do these other "partners" have access to your collections now that you, too, are a partner?

I'm afraid that you missed some major red flags from the outset and now have to dig yourself out of a hole with "partners" who don't seem bent toward transparency.

[Jkm]

Retiring partners over 10 years get 400k paid out over 10 years..not vested unless at 6 years. At 6 years get 50% of that and it goes up by 10% until 10 years

[Jkm]

Honestly..I think only the oldest partner looks at collections now. He's the one signing the checks and paying the outgoing bills. I dont think any of the others know or care...they are just happy to not have to deal with contracts, billing or scheduling

[CordMcNally]

I and the other junior partner

Are you just calling yourself a junior partner because you're one of the new partners or is it a tiered partnership?

[jacoavlu]

yeah it doesn’t sound so nefarious if they are asking you to be president. But still strange.

nominal buy in but $400k buy out?

are both retiring partners at 10+ years? Anyone else close to 10 years?

so if you hire no one else then remaining partners have an $800k accounts payable on the books?

[Hank]

If the partners aren’t reviewing the books regularly, you don’t just have a risk of being defrauded by the older partner(s). You also have a greater risk of embezzlement by your front desk if you aren’t looking at the books at least monthly.

[ENT Doc]

You also aren’t holding the billing company accountable by not knowing and reviewing the data.

[Brains428]

Is the volume low or do you happen to be in a bad payor mix? Annual salary seems low for that number of radiologists and being a true private practice. If your practice is structured such to be more towards lifestyle, then maybe the telerad overhead cuts in, especially if you're paying for final reads.

I'm also assuming you're doing at least light IR, if not some higher end stuff.

Something doesn't add up. Perhaps we don't have enough details, but the fact that the information isn't readily available is a huge red flag.

Do the transitional partners have full voting status, or does it graded down to .6 of 1 full vote, or something along the line. A culture change may be necessary.

[zlandar]

As a fellow rad in a larger group (20+ rads) with outsourced billing my thoughts:

1. Any billing company can break down how much rad bill/collect by the month and year. Talk to your current prez and ask him/her that you need to have the billing company send you the 2019 charges/collection to figure out if you need to hire 1 or more rads. If you have powerscribe you can search by rad and see how much work they do.

2. Physicians in any type of significant administrative role (president getting phone calls from hospital admin, office staff, other physicians, etc) will see their productivity drop. It's hard to comprehend how much time admin duties can consume until you have stepped into that role and as a group grows in size so do the administrative duties.

3. What are the "books"? For some medical practices it may be the Quickbooks ledger. I've been a practicing rad for 10+ years and a partner almost as long. I've never bothered to look at the practice Quickbooks until I started handling some of the administrative duties. Assuming your office uses Quickbooks you can ask your staff to get you a login and look at the deposits by month. That should give you a good idea how much money the practice is bringing in.

In my case the office staff only checked to make sure there was enough money in Quickbooks to meet payroll. It's good that the checks don't bounce but no one had a clue how much we would earn during a year until Dec 31st. I also became involved with payroll and mapped out on an Excel worksheet base partner salaries based on last year's revenue. In the process I realized that I grossly overestimated the group office manager's abilities and she was borderline incompetent when it came to finances.

In summary the resistance you are encountering may not be malicious. This could all be a combination of disorganization and office staff in-over-their heads who don't know how to project revenue/expenses.

[Jkm]

We telerad with final reads from 2200 to 0700. Payer mix is good at 2 places...poor at 1. Sure we could make more by taking back some of night, but decided it wasn't worth it in the long run. I know they are afraid of me pushing for rvu based salary...I'm not. I just want to confirm the group is solvent and that it's truly equal pay. There is no junior partner..I just used that term instead of the older ones. Also, I'm not impressed with our billing company and want to see we are getting what we are paying for...I'd like to look for a different billing company to compete with them.

[zlandar]

We telerad with final reads from 2200 to 0700. Payer mix is good at 2 places...poor at 1. Sure we could make more by taking back some of night, but decided it wasn't worth it in the long run. I know they are afraid of me pushing for rvu based salary...I'm not. I just want to confirm the group is solvent and that it's truly equal pay. There is no junior partner..I just used that term instead of the older ones. Also, I'm not impressed with our billing company and want to see we are getting what we are paying for...I'd like to look for a different billing company to compete with them.

Access to payroll allows you to see how much everyone is getting paid on their W2 i.e. salary on a paycheck. There should be an option to run a payroll report. I can run a payroll report of my group practice on the last pay period (Dec 30, 2019) and it will show how much everyone was paid throughout the year.

If you are a S corp (most group practices are) and you receive bonuses (distributions) then those may not be going through payroll. The money may be coming directly out of the group's bank account and you would need to check Quickbooks or the transactions for the group's bank account.

Trying to figure out whether a billing company is doing a good job or not would require you hiring a competent biller of your own to verify their work. If you are looking for another blling company don't use Zotec. Our group started using them and it's been a constant battle trying to correct their screw-ups.

[Jkm]

Everyone has given me some great points. Thanks for sharing your thoughts and insight. I have 2 weeks to decide what my next course of action. I'm debating on directly speaking with the oldest partner in group this next week versus sending a formal letter to group for this to be added to agenda to discuss or by asking our group lawyer what their opinion on this matter is....

[Jkm]

I will update what happens after the meeting

[jacoavlu]

Outside perspective with very limited info. Two retiring partners don’t sound like workhorses. Another older partner. You’re going to have $1.2M buyouts payable soon. If you can make it work with the bodies you have, would probably not hire imminently. You should have a good feel for how busy your days are and how they might be with fewer bodies. There is also always the option of less vacation to replace lost FTE. Unless you see an avenue to growth.

[Tim]

"old by billing company that they were instructed not to give me that information"
If you are formally appointed, the person that instructed them no longer has the authority. You actually should have documentation of that. The billing company needs to follow that. It is not placing blame, it is a change in management.
You can not accept responsibility with closed access. It is not vindictive, it is common sense. This is simply a governance issue. Solve it. They worked in a closed fashion. Now the group has a different approach.