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I don't know PA laws in NY but I agree that most of the lawyers that I met with, I had to educate them.  I actually had to do the foot work and bring them copies of all the state laws.  Then they studied them and then could help me.

 

Regarding "fairness."  A PA ownership is stepping into a sea of unfairness. You just have to learn to swim within that cesspool.  I had to let the unfairness roll off my back or I would have gone insane, and I'm not joking.

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I owned my own practice in Queens, NY for many years.  My arrangement with the CP was a flat $2000 per month and I took care of everything else.  We had a written contract by his attorney which was quite good.  I was approached by a large hospital to buy the practice from me for a significant amount of money.  Suddenly, the CP's wife decided it was her husbands practice not mine.  5 months later with lawyers back and forth, the attorney general's office in NY declared that it was MY practice.  End of story.  I got the $$$.  He got nada!

The moral here is always have a written contract and always determine who gets what if the practice is sold.  Remember this is a business and I don't care if the CP is a blood relative get it in writing otherwise it never happened.

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Remember this is a business and I don't care if the CP is a blood relative get it in writing otherwise it never happened.

“You can choose your friends but you sho' can't choose your family, an' they're still kin to you no matter whether you acknowledge 'em or not, (and it makes you look right silly when you don't).” ― Harper Lee, To Kill a Mockingbird 

 

My point is you get see people's true colors regardless if they are family or not when it comes to MONEY!  

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If you are considering owning your own practice, words of wisdom. Try your best to avoid doing any any business with insurance companies. We are moving in that direction, but it could be too late to save us.

 

Insurance companies have taken years off my life and I'm serious about it. When I tell peple some of the things they have done, people say "Sue them!"  That is a Disney movie view of the world. It takes tens, if not hunderds of thousands of dollars to sue an insurance company. We have one suit started now and it is draining finanically and emotionally.

 

This is just today:

 

 One insurance informed us that they will not pay us the thousands of dollars they owe us because we never signed a re-credentialing form they sent us on July 31. We had them look at their files. They learned that they sent it to the wrong address (not even close to the one they have on file). After my staff wasted their entire day on hold with them, the conclusion is . . . sorry pal, no money for you even if it was our fault.

 

Athem had been refusing to pay claims because “A legal provider did not see the patient while they were here.”  On the phone today they told my staff that they consider Physician Assistants and Medical Assistants the same so they cannot pay for the visit unless a real provider like a Physician, Chiropractor or Nurse Practitioner saw the patient.  Of course this is not Athem’s real policy but the stupid pencil pushers (handler of claims) understanding. But my staff has spent hours on the phone with them and they cannot fix what has been done.

 

We has had an insurance send our $2,000 to the wrong practice, but then say it is their policy that once a claim is paid, they cannot it repay it two someone else, although they admit they paid it to the wrong practice.

 

This is the daily drip of insurance companies. Do we sue them all?  When would I find the time to actually see patients?  Where would I find the money?

 

There needs to be a class-action suit worth a few billion dollars to stop this behavior as it is only getting worse.

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New one today.  Insurance is denying all claims over the past two months because my contract with them expired.  It expired on July 31. They sent a notice renewal to our old address (5 years old) in June.  We sent them, 5 years ago, a change of address and have it on file. They say, sorry buddy but it is your fault that we forgot to change your address and we sent the notice to the wrong one so therefore we are not paying the few thousand that we owe you and per our contract, you cannot bill the patient.

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Mike, do you send these notices and results to AAPA.? I know they are largely unresponsive to practice owners but it would be interesting to send it anyway and see if they do anything about it. 

 

Insurance companies suck, that is for sure, when it comes to PAs.  Jenna Dorn should get a copy of your issues.  Seriously, do it.  If they don't respond we should sue AAPA for not supporting PAs, too. 

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This is not a PA issue. This is a small independent practice issue. A couple of friends, both physicians, who tried to hold out from selling to the mega medical-care factories, both went bankrupt for the same reason. Denials, paperwork, prior auths, more denials, intimidation. 

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After five long and hard years, I agreed to sell and merge my practice with a local neurology group today.  Running a medical practice these days is like tea around the Mad Hatter's table. For a rational man, which I am, it can drive you mad . . . and almost did. I loved so much about being my own boss but the constant drip of barriers and complexities have finally gotten to me and I am very, very tired.

 

I can say it was a great success. From the days we opened our doors we were overwhelmed with patients and we have treated over 3,000 new patients.  I have fought battle after battle to keep things going . . . battles with insurance companies that refuse to pay, battles with malpractice insurers who refused to write policies for PA-owned practices, battles with pharmaceutical companies who refused to call own us or allow me to buy Botox because it was a PA-owned practice, battles with local hospital groups who refused to allow referrals to me because it was a PA-owned practice and battles with attorneys who wanted to make it illegal for PAs to own practices in the State of Washington.

 

So I have three weeks to wrap up things here and then I go on a sabbatical to a remote castle on the shore of Malta for a month. There I hope to regain my sanity, finish writing a book (about Plato) and to see if my passion for medicine and will come back as a (well-paid may I add) employee of someone else.

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