Re: SOLO IMP $$$$ EXCEEDS salaried! ~ in only 2 months of practice

[Guest guest]

Thanks for the great advice!Frederick Elliott MDBuffalo, NY

,I am totally solo and mostly do my own billing. I've reduced overhead to well under 30K- probably closer to 20K. I see on average 20 patients per week which I have pushed into 3 patient days per week. It wasn't very efficient stretching them across 4 days. I do see patients when needed for urgent visits on other days. I do more phone and email visits now also- with more high deductible plans out there, patients like the virtual visits when possible.I cannot handle more than 25 visits a week easily in my set up. I tend to be excruciatingly detail oriented about some things which means I spend too much time doing things others can do much faster. I also find that I become WAY too distracted by a variety of projects and interests. If I could focus better, I could probably see 30-35 per week. But, I also provide

too much 'free care' in between these visits. Advice: don't start out giving your time away in order to build your client base... it is SO hard to start charging for what you once did for free more casually. As you are looking at your future financials, be sure to check out the fee schedules from insurances that you will accept and to look up the CMS physician fee schedule for your area if you don't already know these numbers (http://www.cms.gov/apps/physician-fee-schedule/overview.aspx). If you are bringing your current patients with you, then you likely know what your encounter code distribution and patient financial demographic will be like. Do not be optimistic in your estimations- plan for low numbers and then be pleasantly surprised later on hopefully. I am fortunate to be in an area with higher reimbursement than many.I limit Medicare and no longer do any Medicaid (they screwed up for months on my billing and I gave up on them).

It makes no sense for me to see these patients in my region and as an independent, unsubsidized practice. I miss the geriatrics but I do like to eat and to think I will have a roof over my head when I'm geriatric.And, if you, or anyone else, is looking for a great practice site under the Big Sky, the other half of my office suite is available and perfect for a practice!Carla To: " " < > Sent: Wednesday, August 29, 2012 11:02 AM Subject: Re: SOLO IMP $$$$ EXCEEDS salaried! ~ in only 2 months of practice

May I ask what your patient volume typically is, Carla?Frederick Elliott MDFuture IMP 2013Buffalo, NY

So, if the goal is a low salary of 120K and this IMP works 52 weeks a year, each week 3 days with 5 patients each day, he has to collect $153 per patient encounter. If you add in 30K expenses and subtract 4 weeks of holidays, sick time, CME time etc, one would have to collect $208 per patient encounter to net 120K. Maintaining that level of collection/coding will be challenging as new patients turn into established patients.Anyone want to share their average collection per encounters to help those who are planning to leap into IMPdom? To make it meaningful, it would be important to know the distribution of your encounter codes. My collection average has been between $111 and $120 the last time I looked. Have not checked my distribution recently but do a lot of 99214s and 40-64 y/o

preventive exams. And as an NP, my reimbursement is 15% less than a physician's.Carla To: Sent: Wednesday, August 29, 2012 6:19 AM Subject:

SOLO IMP $$$$ EXCEEDS salaried! ~ in only 2 months of practice

Got this e-mail this morning from a local IMP.

I helped him open his practice recently and

have been feeding him overflow patients from

my practice:

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Hey,

Here are some quick numbers you will LOVE! In only my

second month of practice, with only working 3 days per week

and only averaging 5 patients per day.....I have grossed more

money in the month of August than my monthly gross pay

at the big group practice! Can you believe it? I used to

work 4 days per week and average 20 patient per day,

was stressed out/burned out, constantly had tons and

tons of notes and work etc, etc....

Thank you for all you do

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Yay! Happy Wednesday Y'all

)

Pamela

Pamela Wible, MD

3575 St. #220

Eugene, OR 97405

www.idealmedicalcare.org

"(S)He is the best physician who is the most ingenious inspirer of hope."

~ Coleridge