New Grad Salary: Negotiations

[Corpsman2PA]

[QUOTE=joanna.nola;346889] I have no idea if they are going to come back to me and say: "Actually, we pay ou NPs (some crazy low number) starting" or something like that. Then I'm not sure I'll have much grounds for negotiation. I have no idea what NPs make in my state--I know there is a ton more of them than us. That is what I'm worried about. I've had a few meetings with management and will meet again with guy who does the hiring next week. They've already indicated they want me. [QUOTE=joanna.nola;346889]

Personally, if a future employer were to try and low ball me by justifying it with new grad NP pay, I'd respectfully decline/ counter with reasons why I'm not a new grad NP. I would rather them want me for what I can offer THEM, not on how little I'm willing to be paid. Like EMEDPA says (I think it was Emedpa), pick a number and stick with it.
It sounds like you're mind is set on working here though, so hopefully you can pull off the salary you want. Sometimes the benefits of job location, scope, and other factors tug a lot harder than salary does. Keep us posted!

[joanna.nola]

Thanks, Corpsman2PA: You are right there are other factors for me w/ this clinic: I went to PA school to serve my (mostly uninsured/low income) community, loan repayment, 5 blocks from my house. Still, I'm going to give them a number and see what we can do with it. I agree that some of this is about respect, knowing I am worth it (and we, as professionals, are worth it). I think we all need to lift the profession in this way. I responded a few weeks back to a person who walked away from a job offer that she thought she really wanted, but through advice on the PA Forum, she realized wasn't the best deal. She got multiple job offers in the wings, and I thanked her for not taking something that brings down the profession.

[joanna.nola]

First off, happy PA week! I got great news this week! So I thought I'd reply to everyone who gave me good advice way back in July. The news is that I've gotten the job I wanted (in a community clinic near my house) & the salary was more than I intended to ask for (glad I didn't throw out a number first!) The offer: 90K with good benefits (and all the things you'd expect: 2K CME, malpractice w/ tail, pay for professional orgs and certs etc). This is high for my city/state/region (some of my preceptors with ten years of experience were in the 80's). Most of my classmates are starting in the 70's. In fact, I'm advising some of my fellow grads to ask for more now. Goes to show that a FQHC does not necessarily mean low-paying. The administration's expectations of me are high, so I'm glad my salary reflects this. (This has also made me realize, perhaps NPs make more in my region?? The clinic(s) have only hired docs and NPs and they gave me a standard NP contract (replaced w/ PA...except in a few spots). I fully expected to counter-offer regardless of what they gave me (I had a counter-offer carefully prepared!!), but the number I'd come up with (based on AAPA report) was actually below their offer! So I decided to not counter in the end. All in all, I'm very happy.
The only thing is that they don't want me to start for a couple months (they are in the process of changing lots of things right now in all their clinics). I'm enjoying the time, I'm going to travel and go to the AFPPA conference in Phoenix, and I'm also keeping busy shadowing in an HIV clinic, derm clinic, and hopefully volunteering at a homeless clinic soon. Need to keep those skills sharp!! I also think I should prepare myself for billing and all that stuff. I only barely brushed on how that works in school and rotations...Any advice on that??
Anyway, thanks again to the PA forum community!! We need to share these victories and push our colleagues to ask for more: we are worth it!!!! Again, happy PA week!

[sunny2spot]

Regarding billing, and this is 1.5 yr old knowledge I'm culling from so anyone feel free to correct me, there are two major things I would brush up on:

1. Billing for procedures (suturing, I+Ds, etc). Not sure if your clinic is set up for minor procedures, but since (as you mentioned previously) you'll be getting incentives based on RVU, you'll want to make sure if someone comes in with an abscess or something you'll be able to take care of it in the office and keep that revenue for the clinic.
The coding for these is a little complicated, and this is where things get foggy for me, there's something called a global period AFTER a procedure is performed wherein the initial fee the insurance company pays for that procedure covers everything related to it (suture removal 7 days later). I honestly don't remember for sure, but for most minor procedures the global period is 10 days and once you're outside the global you don't get paid for that visit (a suture removal visit, for instance). I may have that backwards and you actually get paid extra. REGARDLESS haha definitely take full advantage of your derm shadowing because they'll know all about that.

2. Try to look into materials or ask your SP about obstacles he's encountered in terms of billing properly so that the patient doesn't get screwed. For instance, I believe in order to have a panel of STD tests (swabs from pelvic exam) run if the patient asks for it for curiousity's sake and has no other symptoms, then you have to include a diagnosis of high-risk sexual behavior or the insurance company will put up a fight.

Document thoroughly.

Also something useful I'm sure you'll be able to make use of -- you can bill for telling someone they should stop smoking, but you have to document that 3-5 minutes of smoking cessation counseling was done and then include a diagnosis of Tobacco abuse.



Good luck and congrats girl, that's awesome.

[joanna.nola]

Thank you so much, Sunny! Good point that I should ask about billing when I shadow (doing the derm shadowing--my dad's dermatologist- next week; been in an HIV clinic this week).

I think I might start another thread about billing to glean some more advice, too.