Published Apr 9, 2014
I am an FNP working with a base salary plus bonus potential. Basically, if I see >300 patients per month, I earn 17% of my net income for the practice. My company is changing the bonus structure, however, to a work RVU model (which has not yet been fully explained to me but my basic understanding is that I will now receive roughly $9 per patient with the quota remaining at at least 300 patients per month in order to be bonused out). The new system was implimented last month and, of course, I am now earning less, which was expected. My concern, though, is that I found out about what I feel is a questionable tally system that I am uncomfortable with.
Last month, I got married so I was out of the office for a week and half. This left me with a total of only 301 patients for the month (a "month" was explained to me as including the last three days of the previous month and excluding the last three days of the current month -- ie: January 29-February 25). I was not bonused for last month because I was told that the accounting department doesnt always count the way that it was explained to me so that any patients that werent counted for that month will go onto the next months numbers... this sounds fishy to me and obviously I was frustrated because I didnt not receive my bonus despite the fact that I saw >300 patients within the dates that I was previously told would be considered for the month.
Is it reasonable for them to change the way that they count the "month" each month? I asked my regional director if he could tell me how they were changing the count and I was told that there was no way he could keep up with that to tell me because its always different.
zmansc, ASN, RN
Did they give you an explanation of how patient numbers are counted in writing? What does your contract specify? I would think changing the formula is in fact changing your contract as well, unless the contract states that they can change the formula without notifying or getting your approval.
I'm no lawyer, but typically in law it's either spelled out in writing and signed by both parties or it has to be "fair and equitable" to both parties. Unless you gave them permission, this does not sound like it meets that standard to me. Now that doesn't necessarily mean squat when it comes to what you should do about it! lol There are far too many possible personal issues to give any kind of advice like that. But, at first glance it does not sound like a situation that is being handled in a reasonably professional or fair manner with the information provided here.
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