Announcement

Collapse
No announcement yet.

500-750k psych job, what's the catch?

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • #16
    Originally posted by Kamban View Post

    Compared to your current $60/RVU with benefits you should get $30 extra per RVU because of lack of benefits and HCOL compared to Midwest. Not $30/RVU. I would not touch that with a ten foot pole. So you want to work twice as hard, supervise, get burnt out because it is South Florida. Even your PA would get more per RVU. Are they joking.

    If you take it, you are a sucker.
    Thank you all for your feedback, that answers some of my questions.

    Other than the subjective value that I would give to live in South FL (hence less pay) ; I also was wondering in general about this RVU offer vs a collections offer: They also initially offered 65% of the collections. Would it be better to ask for a % of the collection instead? How much? /
    And assuming that 65% of their collections = $30/RVU; is that expected in that market ( meaning insurances don't pay enough, or its hard to collect ?)

    Comment


    • #17
      Originally posted by hypercube View Post

      Thank you all for your feedback, that answers some of my questions.

      Other than the subjective value that I would give to live in South FL (hence less pay) ; I also was wondering in general about this RVU offer vs a collections offer: They also initially offered 65% of the collections. Would it be better to ask for a % of the collection instead? How much? /
      And assuming that 65% of their collections = $30/RVU; is that expected in that market ( meaning insurances don't pay enough, or its hard to collect ?)
      $30 per wRVU sounds really really bad.
      Is this a MCD CMHC type place or what? Even if so, terrible. Ask the clinic about their payor mix, collections data etc. But taking % of collections, you are relying on the clinic being efficient in actually collecting / billing properly which may be a huge problem and one you may be unable to control in any way.

      Comment


      • #18
        Originally posted by childay View Post

        $30 per wRVU sounds really really bad.
        Is this a MCD CMHC type place or what? Even if so, terrible. Ask the clinic about their payor mix, collections data etc. But taking % of collections, you are relying on the clinic being efficient in actually collecting/billing properly which may be a huge problem and one you may be unable to control in any way.
        It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
        I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?

        Comment


        • #19
          Originally posted by hypercube View Post

          It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
          I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?
          The WRVU comes from a survey of practicing psychiatrists so it does represent an average across practice types and payer mix. A poorly run MCD only practice could definitely collect less than $65 /wRVU. But a well run MCD only clinic will always be an FQHC, tribal affiliated, or block grant funded for the very reason that FFS MCD is money losing. There is no way your practice is collecting only $30 because they would be out of business. You take $30, you will be getting screwed, no two ways about it.

          Comment


          • #20
            Originally posted by hypercube View Post

            It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
            I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?
            I'm in UT and our docs doing ect at the academic medical center, along with inpatient, make around 400-500k/ year working 4 weeks on, 2 weeks off, 8 inpatients per day. With excellent benefits.

            Comment


            • #21
              Originally posted by hypercube View Post
              "The psych median conversion factor is ~$60 per wRVU"

              Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

              I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
              I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

              Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

              Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

              Thanks for any help

              Fyi I’m fm/pcp south texas...$44/rvu

              Comment


              • #22
                Originally posted by NumberWhizMD View Post
                You can certainly purchase recent MGMA data to verify for yourself, but I find it hard to believe it's that low. And if it is, you have to determine if it's worth it to live in South Beach for over 50% less of what you could make pretty much anywhere else.
                I was in Miami Beach a week and a half ago. Utterly shocked at the number of trashy people walking around. Even at the Fountainebleu, there were low class folks who made Las Vegas look sophisticated and classy. I’m hardly svelte, but there were folks entirely too hefty for the fishnets and see through clothing they were wearing.

                Slow service, weak mixed drinks, automatic 18% gratuities and a food and drink offering that seemed to suggest that southern Italian cheap pasta was haute cuisine and American macrobrews were the pinnacle of brewing excellence.

                In fairness, the wine selection was okay at the local liquor stores even if the beers were terrible. Plus the Cuban and Colombian restaurants were pretty dang good. Still, the overall experience was trashier than Vegas or Cabo, which really takes some effort.

                Comment


                • #23
                  Originally posted by wideopenspaces View Post

                  I'm in UT and our docs doing ect at the academic medical center, along with inpatient, make around 400-500k/ year working 4 weeks on, 2 weeks off, 8 inpatients per day. With excellent benefits.
                  Does the weeks on include weekends? If not, this is amazing as 8 inpatients per day and ECT seems like half a day of work.

                  Comment


                  • #24
                    Plz update us after 6 months on this job.

                    Comment


                    • #25
                      Originally posted by sweetnpsycho View Post

                      Does the weeks on include weekends? If not, this is amazing as 8 inpatients per day and ECT seems like half a day of work.
                      They do 2 weekends, covering another docs patients, along with their own and then get the other 2 weekends off while that doc covers theirs. The ones who don't do any ECT make a lot less, I think closer to 300k. Apparently ECT pays well.

                      Comment


                      • #26
                        Originally posted by Zaphod View Post
                        Plz update us after 6 months on this job.
                        After such a strong response from the forum, I am having serious doubts If I take it, for sure will update you guys

                        However, I still don't get the percentage of collections vs RVU question; if $30/RVU = 65% collections; they either:

                        1. Are poorly managed and not collecting enough
                        2. Insurances over there are really stingy compared with other parts of the country
                        3. They are charging too much of a premium to guarantee $/RVU vs me taking that risk.

                        If I am missing something, please let me know. I wonder if I should counter with a higher collection percentage instead? How much is reasonable in those types of cases? Do people ask for 100% collections ( or even higher than 100% collections)

                        Comment


                        • #27
                          Originally posted by wideopenspaces View Post

                          They do 2 weekends, covering another docs patients, along with their own and then get the other 2 weekends off while that doc covers theirs. The ones who don't do any ECT make a lot less, I think closer to 300k. Apparently ECT pays well.
                          Are they all still starting ECT at 4AM?
                          “Work” is a four letter word for good reason.

                          Comment


                          • #28
                            Originally posted by hypercube View Post

                            After such a strong response from the forum, I am having serious doubts If I take it, for sure will update you guys

                            However, I still don't get the percentage of collections vs RVU question; if $30/RVU = 65% collections; they either:

                            1. Are poorly managed and not collecting enough
                            2. Insurances over there are really stingy compared with other parts of the country
                            3. They are charging too much of a premium to guarantee $/RVU vs me taking that risk.

                            If I am missing something, please let me know. I wonder if I should counter with a higher collection percentage instead? How much is reasonable in those types of cases? Do people ask for 100% collections ( or even higher than 100% collections)
                            Never ask for % of collections when you

                            1. Do not know the insurances of the patients
                            2. Have no idea what each insurance pays for each code for their patients
                            3. Have no clue or control on what type of patients you will get. You will be an employee. The other partners will get better paying patients and you will get the low paying insurances and Medicaid. Protest won't help since you have already moved from Midwest to FL and probably settled there. What can you do - quit and leave?
                            4. You have no control how the staff will bill and collect.

                            Please look for a better job.

                            Comment


                            • #29
                              Originally posted by Lithium View Post

                              Are they all still starting ECT at 4AM?
                              Yes, it is literally 4am. I would never in a million years do it but my friend who does, doesn't seem to mind. She's mostly upset she doesn't get more ect shifts!

                              Comment


                              • #30
                                Originally posted by wideopenspaces View Post

                                Yes, it is literally 4am. I would never in a million years do it but my friend who does, doesn't seem to mind. She's mostly upset she doesn't get more ect shifts!
                                Hard pass..

                                Comment

                                Working...
                                X