How much to pay a collaborating doc

platon20 · Jan 7, 2007

why do you need a collaborating doc? I thought all the states allowed independent practice by now

Trauma Columnist · Jan 7, 2007

Nope - very few of the states allow independent practice. I practice in IL and we must have a collaborating MD.

Editorial Team / Admin · Jan 7, 2007

NPs cannot practice independently in all states, platon20. Most require collaborative agreements of some kind.

caldje · Jan 7, 2007

NPs cannot practice independently in all states, platon20. Most require collaborative agreements of some kind.

Don't just consider what the law allows either. Most insurances also require collaboration/supervision for payment. What good is your own clinic if you cant get paid for your work?

chris

Editorial Team / Admin · Jan 8, 2007

Don't just consider what the law allows either. Most insurances also require collaboration/supervision for payment. What good is your own clinic if you cant get paid for your work?
chris

Thanks for pointing that out, caldje. Yes, if dealing with medicare/medicaid especially in LTC reimbursements, the NP must have collaborative agreement with physician. That's Federal law.

core0 · Jan 8, 2007

I'm thinking of opening an independent clinic in the same town where I have been working. I would need to collaborate with a physician to provide chart review and consultation. I've been practicing for 9 years, so I'm pretty independent. Any idea how much I would pay a physician for this service? I'm in the Midwest.
Thanks!
Chelle

Nobody has answered your original question so I'll take a crack at it. It really depends on how much you need from the physician. If there is onsite responsibility or true supervision it will be one amount. If you simply need a name on a piece of paper then that's another. I have never heard of a SP making more than 10% of collections. I have seen a number such as $1000-1500 per month bandied around for collaboration. If you need someone for billing (most insurance companies will only reimburse an MD) then 5-10% of collections (not billings) seems fair. Finally it is generally recommended that you have at least two physicians on board so if one gets run over by a bus you do not get shut down.

Take a look at this post. It is more specific to PA's but it has some nice pearls in it from someone who has been there:

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David Carpenter, PA-C

cgfnp · Jan 8, 2007

If you're independent and don't think you'll use much clock time of the physician, then I'd offer them an hourly consult fee, such as $300/hr. It sounds huge but if you think about it, if they only have to sign a few charts you may only need an hour or two per month. Even at two hours/month you're saving yourself around $5K/yr. Now if you'll be calling them every day, I'd offer them something like a monthly like someone else mentioned. You may also save some $$$ if you can swing a larger up front fee for a contracted year of consultation (like $5-8,000 lump sum).

core0 · Jan 9, 2007

If you're independent and don't think you'll use much clock time of the physician, then I'd offer them an hourly consult fee, such as $300/hr. It sounds huge but if you think about it, if they only have to sign a few charts you may only need an hour or two per month. Even at two hours/month you're saving yourself around $5K/yr. Now if you'll be calling them every day, I'd offer them something like a monthly like someone else mentioned. You may also save some $$$ if you can swing a larger up front fee for a contracted year of consultation (like $5-8,000 lump sum).

If the physician is smart he will look at it as time (revenue) and risk. How much time does it take and what additional liability do they incur by signing up. For example if there is a requirement to be on site to sign papers 4 hours per week - figure best income per hour plus travel time. If they are liable for your acts then the amount paid better be worth that. If they are really smart they stratify your risk by the patient population and your experience.

From your point of view you get what you pay for. It might be easy to get someone to agree to come in and sign papers, but for you this is a business that may go under or be closed if they don't do that. You need them to take this seriously and pay them appropriately. In the end it will depend on what you really need in a collaborating Doc and what they expect from it. Humans being humans, you will probably get anything from "I want $100K" figuring your making twice that and they should get half to whatever who may never do what you need to do. I would see if there are any state resources for this and consider hiring someone who has done this to help (ie a consultant). This is likely to vary hugely from state to state.

David Carpenter, PA-C