WOW-making $ as an IC

NedRN · Jun 19, 2014

As I'm sure you know, the certification for an FA requires 2,000 hours of practice. That is your starting point and may take you several years, as long as becoming a CRNA. In any case, to get in good with a surgeon, you need to be in the game. Only then will he/she become interested. I've heard the reimbursement rules have changed, but it used to be that an FA could bill privately at 50% of the surgeon fee. Obviously that is really good pay so if you get in with an orthopod doing 10 totals a week, you are doing even better than a CRNA.

A dozen years ago I was doing an assignment in Frederick MD and the local hospital used a local outside FA group that employed scrub techs through PA's, all making the same money. It took a lot of time before I figured out how this was possible - the reimbursement (or bill rate) was the same no matter the individual credentials and apparently not even certification was required. I doubt that is true any more, but if true, you did not even need your RN, a CFA would have sufficed for your current game plan.

Around the same time frame in New Hampshire, a staff RN I worked with also did ortho FA with one surgeon. He meet with patients prior to surgery to explain that he privately billed and got his own consent. He did OK between a couple cases a week there, and part time on the heart team the rest of the week (with the massive call required). Last year I worked at a California hospital that provided RNFA's for any surgeon who wanted one. That was a local culture thing that I think came about because of the need to attract surgeons to a remote area. I'm not sure how the economics of hospital employed RNFAs work otherwise, but both travel and staff RNFAs do not make more than $5 an hour over regular RNs. One place where you think that would be an exception would be an RNFA who can harvest vein, but generally that doesn't seem to be the case.

I don't meet a lot of private scrubs or FAs of any flavor in recent years, most are PA's working directly for the doc doing scut work outside the OR such as rounds, clinics, and post ops for sub six figure salaries. Frankly, given the economics of billing insurance for the FA, I don't understand why every surgeon doesn't have a PA (or the rarer NP) with prescriptive authority.

If you want to work and not private bill working with a specific surgeon (or two), you will effectively be forming your own agency, and your hourly bill rate will most likely fall between $60 and $70 an hour. If you are willing to travel, that would be guaranteed hours plus call.

FutureORCRNFA · Jun 21, 2014

Thank you NedRN! I appreciate the time you took to answer my Q:up: