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Supervising midlevels as only income..

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  • #16
    Originally posted by Dontgetthejab View Post

    Keep in mind my numbers are based on 2020 cms physician fee schedule. The 2021 cme fee schedule actually increased the payment for outpatient visits up to about 20-30% more (caveat is not sure if all payers are honoring the cms increase), so I could be underestimating bigely depending on his payers
    Wait, do you actually know the figure in question?

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    • #17
      Originally posted by ENT Doc View Post

      Wait, do you actually know the figure in question?
      Not off the top of my head, although there is a calculator online where u can type in each cpt code and get a “ 2021 wrvu”.
      My health system still pays me on the 2020 wrvu .
      I can tell u this much: 2020 fee schedule has a 99214 as 1.5wrvus, 2021 has it as 1.97wrvus.
      so if you multiple the wrvu by the dollar multiplayer then u have an answer. The multiplier is different for Medicare vs commercial insurance so that’s thr wild card

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      • #18
        That guy/gal has it figured out. Good for him/her. All of us other lackeys better show on time tomorrow.

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        • #19
          Originally posted by Dontgetthejab View Post

          Not off the top of my head, although there is a calculator online where u can type in each cpt code and get a “ 2021 wrvu”.
          My health system still pays me on the 2020 wrvu .
          I can tell u this much: 2020 fee schedule has a 99214 as 1.5wrvus, 2021 has it as 1.97wrvus.
          so if you multiple the wrvu by the dollar multiplayer then u have an answer. The multiplier is different for Medicare vs commercial insurance so that’s thr wild card
          You can’t look at it like that. That’s only revenue. And the multiplier is only for hospital employed not private practice owners. You would need to know more specifics about psych CPT billing, payer mix and contracted rates. Furthermore, that only gets you to (potential) revenue. It doesn’t tell you what actually collect and doesn’t tell you about overhead, including midlevel salaries, benefits, etc. The profit at the end of all that is the number you’re after.

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          • #20
            Originally posted by ENT Doc View Post

            You can’t look at it like that. That’s only revenue. And the multiplier is only for hospital employed not private practice owners. You would need to know more specifics about psych CPT billing, payer mix and contracted rates. Furthermore, that only gets you to (potential) revenue. It doesn’t tell you what actually collect and doesn’t tell you about overhead, including midlevel salaries, benefits, etc. The profit at the end of all that is the number you’re after.
            Yea I’m only posting for ballpark revenue, not take home. Sure There are other variables at play.
            regarding the private practice, I think payers are using cms wrvus as a guide but I’m not the expert. They do have to pull the number their paying private practice from somewhere though

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            • #21
              Originally posted by Dontgetthejab View Post

              Yea I’m only posting for ballpark revenue, not take home. Sure There are other variables at play.
              regarding the private practice, I think payers are using cms wrvus as a guide but I’m not the expert. They do have to pull the number their paying private practice from somewhere though
              What hospitals get paid and what private practice gets paid are very different. Reduced facility payment on PFS and added “facility fee” under OPPS for hospitals and just the PFS for private. Hospitals then turn around and just reimburse based on wRVU, which is only one component of the pay they receive. They keep the rest. As for private payers, hospitals will have more negotiating power and higher rates (either by reduction of their chargemaster or % above Medicare). And even that is market dependent. So it’s really hard to know even the basic revenue let alone collections for a practice like this unless you were very familiar with this model, volume, and payer mix in this market. Then comes overhead which gets into a whole separate discussion. Anyhow, I’m sure the doc is doing just fine.

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              • #22
                I would imagine he is billing 100% as incident to services since he is supervising them? My guess is the gross is in the $3.5 million range. Depending on how business savvy his midlevels are psych in my area runs $150,000-$200,000 each per year for full time and there is minimal overhead in psych.

                Also if anyone is interested in making an offer I in fact might sell my spouse for 25% over market value. Ha.

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                • #23
                  Originally posted by StateOfMyHead View Post
                  Also if anyone is interested in making an offer I in fact might sell my spouse for 25% over market value. Ha.
                  Gently used?

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                  • #24
                    Originally posted by Dontgetthejab View Post
                    Psychiatrist in town no longer seeing patients and instead has 7 midlevels....busy clinic. What do u think he takes home? Owns his own Private practice
                    Originally posted by Dontgetthejab View Post
                    Yea I’m only posting for ballpark revenue, not take home.
                    Consistency.

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                    • #25
                      Hope he has a good malpractice policy , because it sounds like he will probably end up needing to use it.

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                      • #26
                        Originally posted by Random1 View Post
                        Hope he has a good malpractice policy , because it sounds like he will probably end up needing to use it.
                        That's what I was thinking. I won't do PP because my own liability makes me too nervous, can't imagine taking it on for 7 mid-levels. No amount of money would be worth that constant fear.

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                        • #27
                          Originally posted by wideopenspaces View Post

                          That's what I was thinking. I won't do PP because my own liability makes me too nervous, can't imagine taking it on for 7 mid-levels. No amount of money would be worth that constant fear.
                          I will say he has ran it like this for close to 10yrs...

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                          • #28
                            Originally posted by Lithium View Post

                            Are you married? If so, how much would you sell your spouse for? Would you take an offer for 25% above market?
                            Some accept a substantial loss to get out of that situation. Just saying. Spouses can be financially advantageous of huge losses.

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                            • #29
                              Originally posted by Tim View Post

                              Some accept a substantial loss to get out of that situation. Just saying. Spouses can be financially advantageous of huge losses.
                              Sorta like a timeshare?

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                              • #30
                                Originally posted by childay View Post

                                Sorta like a timeshare?
                                More like a closed end lease. Prenup with a buyout. No mileage though.

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