Help! Contract negotiation - Page 2

Register Today!
  1. Apr 9, '12 by
    Juan is right on the money with this. No pun intended.

    I have a moonlighting job that pays by encounter, but I am an employee so they cover malpractice, 401k and social security tax. The latter is what would make you pay a higher percentage into your taxes if you proceed as an independent. I wouldn't do it.

    Having also worked hourly, I wouldn't go back from working per encounter back to hourly. The $$ is ridiculous if you can negotiate per encounter. There are 4 things to negotiate for in your contract.

    1. Subsequent visit encounter
    (this will be a smaller amount but should be in the mid 30's-40's if employed or higher if contracted as independent)

    2. Admit encounter
    (depending on the complexity and respective E&M coded, this could be in the $100 range per encounter)

    3. Discharge encounter
    (again, depending on complexity this should range in the $100 range)

    4. Coverage and call.
    (Most groups will not reimburse you for taking call if you are rounding that particular day. It's simply understood that if you are rounding at a particular facility, you should take call for that facility as well. HOWEVER, I would recommend a cut-off time, maybe 5pm or 6pm. Night call should be reimbursed separately. Also set a max # of facilities you will take call for, depending on historical patient census at those facilities and call volume. Ask for this info, they should know, otherwise they will stick you with the "needier" facilities and you'll feel like a sucker. Ask me how I know.
    My advice to you is set a MINIMUM of pt encounters per day, say maybe 15. This will make taking call palatable. If less than 15, you should negotiate an on-call rate.)

    Keep in mind that while #2 and #3 will reimburse you more $$ they also require more work. #2 requires you be thorough and gather all relevant information, write up an H&P and make a global plan for pt goal and likely disposition when DC time comes around.

    #3 requires that you write up DC orders and write a discharge note. All of this takes time, which will vary from pt to pt as they are dependent on complexity.

    I'm sure there's some other info I'm forgetting but I'll let others chime in.

    Just remember that YOU WILL GENERATE REVENUE for the practice. Make sure they compensate you fairly and don't be timid in reminding them that without you THEY ARE LOSING OUT on potential revenue.

    Best of luck.
    xenogenetic and Spoiled1 like this.