out of network referrals and preauthorizations// malpractice//hospital systems?

[Guest guest]

Hi All,

I am new to the listserv. I am a general internist who is thinking of going out

on my own. Currently electively unemployed. Went to hospice for a year, but

resigned a few mos ago. Been feeling inspired to go out on my own and do what

you all do everyday.

Been reading all about your wiki posts... hope none of these Qs are redundant,

hidden somewhere that I didn't make to in cyberspace

1a) I will likely take some insurances to start, but it keeps bugging me because

I don't know how it works if a patient sees me out of network and they need a

CTscan or a referral to a specialist. Do they then go back to their in-network

provider that they've never met?

1b) For unemployed patients, have you the doctors tried to talk to neighborhood

consultants and radiology establishments for their cash prices? Should I? The

idea of PIFATO is very encouraging, but what happens when the patients need more

than what I can provide?

2) Looking into malpractice. With the two carriers in NY that offer occurrence

malpractice, the rate is $24-$26/yr. I have always been taught that occurrence

is the best, but have any of you had experience with the program offered as a

partner of AMWA (American Women's Medical Assoc)-- The Star Doctor's Insurance

Program (a special program just for Women offered by the Wood Insurance Group)?

http://www.stardoctorinsurance.com/ins_program_info.cfm

Lenghthy application for a claims-made policy... Does being an owner change

whether claims made is appropriate?

3)I am also talking to area hospital systems. Many practices have been bought up

by them in the last few years, and I have not established an LLC yet-- until I

find out from the hospitals what my options are. What made each of you decide

against joining the hospital? I imagine the answer is autonomy and soverignty

over your work, which I am starting to crave.

4) Do any of you incorporate home visits in your practices? I left hospice due

to the administrative quagmires, but I loved the work of home visits. I will

probably cut out hospital visits. Do most of you do that/leave the hospital

work)?

5)I am writing a lot... four topics in one post... in the future shall I

separate them out?

Judy