Do you know how much your SP makes?

[cbrsmurf]

If you do know, how did you find out?

[Grinder993]

If you do know, how did you find out?

The ER docs in the group average b/w $350,00 and $450,00 per year. I have seen my billing sheet, I know that I bill on average $25,000 per month, but I am paid a fraction of that. I wish they would allow us to "eat what we kill" and just collect what we bill. But then they couldn't make a profit off of us.

[SoCal_PA]

The ER docs in the group average b/w $350,00 and $450,00 per year. I have seen my billing sheet, I know that I bill on average $25,000 per month, but I am paid a fraction of that. I wish they would allow us to "eat what we kill" and just collect what we bill. But then they couldn't make a profit off of us.

 

 

Would you be able to reveal your earnings? Curiosity

[physasst]

The ER docs in the group average b/w $350,00 and $450,00 per year. I have seen my billing sheet, I know that I bill on average $25,000 per month, but I am paid a fraction of that. I wish they would allow us to "eat what we kill" and just collect what we bill. But then they couldn't make a profit off of us.

 

The national average for ER physicians is far lower. More like 240k per year. Also, remember that billing and collecting are two very different things.

[Grinder993]

The national average for ER physicians is far lower. More like 240k per year. Also, remember that billing and collecting are two very different things.

My group is one of the highest paid in the state. High acuity, high volume ED. Most ER MD positions I see posted are on average for $150-$200/hr. That is about $350,000/yr.

[Grinder993]

Would you be able to reveal your earnings? Curiosity

Sure. My pay is productivity based, but averages out to about $85/hr. However, I am an independent contractor without benefits.

[rcdavis]

The national averages include the very small ED with volumes of 5-18 k/year.. Where you get dollars for sleeping, and rarely are EM trained.

 

Since 2000, the last two groups I worked for had 100% em trained docs, and the range was 175/hr(low) to 270/ hr, (high, with program of guaranteed min plus percentage RVU collected)

 

These numbers are from groups serving hospitals with greater than 75,000 visits/year. And represent group collection ability... Which,as physassist point out, is a miserable percentage of total billed.

 

A good way to determine your billed rate is te E/M coding app in iTunes, which breaks down current RVU values for levels 1-5 in EM, critical care, surgery, and procedures.

 

I see between 4-6 patients/hour( mostly major players, with extra credits given for EKGs lacs, reductions, lines, etc) and average 50% of monthly total as level 4, 20% level 5, 10% critical care( probably too low, I don't bill high enough), and 18% level 3, 2% level 2( I do not see very many non sick patients)

 

And I average $100-125 / patient. generating $400-600hr. I get paid about $80-90/ hr.

 

I have no problems with my level of pay, and do not disparage the docs what they make.

 

I know these numbers because we all have access to the payroll spreadsheets, which list provider, hrs worked, patients seen, procedures done, billable units/hour, salary paid ( basic), bonus for exceeding 4rvu/hr, total, and for the docs) a separate column which shows how many cosigns/pa, and an additional bonus to them of a percentage of what the co-signed records collected.. (which can REALLY increase a doc's/hr rate!), also on the spread sheet are, for the docs,what the its of the PA IS..( the pa salary comes from the docs, not the management company)

 

So, the docs hourly rate is a compilation of collections plus a large percentage of pa collections, minus the hours cost of the pa for the fraction of time ( cosigned charts) the pa worked...

 

Note, none of my groups have a subsidy from the hospital.. The group lives on what it kills,and is able to collect.

[ventana]

The ER docs in the group average b/w $350,00 and $450,00 per year. I have seen my billing sheet, I know that I bill on average $25,000 per month, but I am paid a fraction of that. I wish they would allow us to "eat what we kill" and just collect what we bill. But then they couldn't make a profit off of us.

 

 

BILLED amounts are worthless....

 

Have to see collections

 

if you are billing out $25k per month you likely collect about $10-12k (maybe more if you have a great billing company and good payer mix)

 

But at 15k/month, that is $150,000k per year (8 weeks time off) in gross receipts - if you follow the 50/50 formula (common for docs) you should get about $75k per year in salary..

 

As PA's wee sometimes FAR overestimate our our revenue generation (have seen it over and over on this board) and get big heads about how much we are doing. We really need good hard data on receipts (actual cash in hand) to our employer before we have any right to talk about "how much we are worth"

 

You have every right to see what is being billed for codes on the patients you are seeing - as it is your license on the line if accused of fraud billing, but good luck on getting the billing (gross receipts) from an employer if they don't want to give it to you.....

 

 

 

I know ho much many of my SP's make as I have had, at times, conversations with them in the past on income, or they leave a tax document on the printer (really happened)....

 

Anyways, open communication about your desire to learn the billing to ensure there is not fraud on the billing end is very real. Also, many EMR's now have reports that tell the information right in them.....

[Grinder993]

BILLED amounts are worthless....

 

Have to see collections

 

if you are billing out $25k per month you likely collect about $10-12k (maybe more if you have a great billing company and good payer mix)

 

But at 15k/month, that is $150,000k per year (8 weeks time off) in gross receipts - if you follow the 50/50 formula (common for docs) you should get about $75k per year in salary..

 

As PA's wee sometimes FAR overestimate our our revenue generation (have seen it over and over on this board) and get big heads about how much we are doing. We really need good hard data on receipts (actual cash in hand) to our employer before we have any right to talk about "how much we are worth"

 

You have every right to see what is being billed for codes on the patients you are seeing - as it is your license on the line if accused of fraud billing, but good luck on getting the billing (gross receipts) from an employer if they don't want to give it to you.....

 

 

 

I know ho much many of my SP's make as I have had, at times, conversations with them in the past on income, or they leave a tax document on the printer (really happened)....

 

Anyways, open communication about your desire to learn the billing to ensure there is not fraud on the billing end is very real. Also, many EMR's now have reports that tell the information right in them.....

 

My SP's will not allow us (PAs/NPs) to see the monthly billing sheets or the P & L sheets that the "partner MDs" review every month. Much like your printer incident, I stumbled upon one last year. Information I was not supposed to know and they do not want us to know. I have asked them in the past to let me review my billings and collections and they refuse.

[EMEDPA]

the ER docs I work with make right around 360k/yr for 10-14 8-9 hr shifts/mo.

a friend of mine(an er doc) interviewed with the group and told me what they make.

[ventana]

My SP's will not allow us (PAs/NPs) to see the monthly billing sheets or the P & L sheets that the "partner MDs" review every month. Much like your printer incident, I stumbled upon one last year. Information I was not supposed to know and they do not want us to know. I have asked them in the past to let me review my billings and collections and they refuse.

 

 

This is a very real issue

 

It is your pin and your license on the line, and for the employer to withhold info is not cool.

 

They can and do and certainly you have ZERO right to the P&L statements or any other "partner level" paperwork. However, it is your license and you have a right to review your own (and only your own) billing and receipts. but again good luck on pushing this through....

 

i wonder - is there any PA / JD out there that could comment on the legality of withholding the billing and receipts from a provider as the liability for errors ultimately falls to the provider? Maybe ask them to sign and indemnity clause if they do not let you review data..... (better polish up your CV if you do this...)

 

Or better yet, start your own company!

[Grinder993]

This is a very real issue

 

It is your pin and your license on the line, and for the employer to withhold info is not cool.

 

They can and do and certainly you have ZERO right to the P&L statements or any other "partner level" paperwork. However, it is your license and you have a right to review your own (and only your own) billing and receipts. but again good luck on pushing this through....

 

i wonder - is there any PA / JD out there that could comment on the legality of withholding the billing and receipts from a provider as the liability for errors ultimately falls to the provider? Maybe ask them to sign and indemnity clause if they do not let you review data..... (better polish up your CV if you do this...)

 

Or better yet, start your own company!

 

Good advice and am 1 step ahead. I have already started my own business and we opened the doors this week. I became so remarkably disenfranchised with the state of emergency medicine, I just couldn't do it anymore. I have opened my own clinic. I have an offsite SP.

[FSUnoles]

this is a very interesting conversation. I am in the middle of contract negotiations with a rotation site i am at and the topic of revenue has been brought up. Its interesting in seeing what we are actually pulling in and billing for. They notified me i would be billing under the physician and it got me worried about what i was actually producing once i started to get quick enough to start making the practice money.

 

i do know in the specialty im in (ENT) they start off their new grad Docs at 170k

[Grinder993]

this is a very interesting conversation. I am in the middle of contract negotiations with a rotation site i am at and the topic of revenue has been brought up. Its interesting in seeing what we are actually pulling in and billing for. They notified me i would be billing under the physician and it got me worried about what i was actually producing once i started to get quick enough to start making the practice money.

 

i do know in the specialty im in (ENT) they start off their new grad Docs at 170k

 

$170,000 for a new grad ENT specialist?? That sounds EXTREMELY low.

[physasst]

$170,000 for a new grad ENT specialist?? That sounds EXTREMELY low.

 

Depends on where you are at.

 

I know that we are predicting between a 20% (best case scenario) and 40% (armageddon) reduction in reimbursements over the next five years. We're already re-engineering the delivery here to try and improve on that. This is going to have an effect on every provider. We didn't get a raise this year, which was the first time in over 13 years.

 

Benefits are being changed, cut, and becoming much more expensive. The physicians have already been told that there may be pay cuts down the road, but they are trying to wait as long as possible, as they don't want to do that.

 

The next five years is going to be VERY interesting.

[FSUnoles]

$170,000 for a new grad ENT specialist?? That sounds EXTREMELY low.

 

yea i check the MGMT data and the starting for ENT is between 150-200k nationally. I think it just might be the ENT specialty. I know my doc says the reimbursement for sx has gone down tremendously in the past decade

 

 

 

i found some old 2010 data on physician salary to give you guys an idea2010 MGMA Physician Compensation Survey Summary.pdf

[Gordon, PA-C]

The ENT docs in my area start at 250k and get up to 350k within 2-3 years.

 

A brand new ENT doc MIGHT make 170k in an "elite" academic medical center like Harvard where they can pay peanuts because people want the "respect" the name affords, but in any other workplace there's no way they start that low.

 

The median income is 370k for all ENTs according to MGMA

[Acebecker]

Can anyone recall the formula for calculating a salary? I think that it's something like this: your benefits + salary + bonus should equal roughly 1/3 of your collections, right? Is that the same for docs as for PAs/NPs?

[rcdavis]

That's about right for the PAs.

Except the bonus should be excluded from the

1/3 total collection rule. The bonus should be determined seperatly, by some productivity formula which may make your bonus pay you a higher percentage of collections over a certain amount than a 1/3 aggregate.

 

The docs are a little different.. It depends if they are an employee of a large corporation, or a partner in a group, or own their own business.

 

Obviously, owning the business means to take home anything that his left over after all the bills are paid.

 

Partners usually get a guarantee and tgen a percentage of corporate profits, the percentage either distributed equally if single speciality group, or by RVU ontribution percentage if multispecialty ( which assures that the pulmonary and GI guys, who contribute more to the pool than the general internists get a little more of the pool than the others)

 

The corporations usually pay regional specialty averages... And bonus by RVU production. They separate physician salary from facility salary, as they usually bill separately from the physicians, and cover their "cost" in their own billing.

 

Remember.. And this is something the corporations and administrators everywhere, STILL cannot get their mi ds around..

The only person who generates any income for the company/clinic/partnership/institution, is the physician.

The administrator adds NOTHING to. The pot.

 

It is the physician's signature which generates the income from which all the ancillary bills are paid..

 

No physician, no income.

 

As more and more docs become employees, that fact will become less and less appreciated.

[ventana]

last time I read a good article it said that about 55% of collections went to Doc pay and bennies, with the PA being about 42%

 

Obviously we are contributing more (as a percentage) to the overhead then a doc (which I don't think is fair as we are both revenue generators)

 

I totally agree with RC that the fact we are revenue + some how gets lost in the corp world...... love the fact that the business manager tells me "how the world is" when they do not bring in a single dollar to the practice and I generate over 300k.......

 

hence why I am out on my own....

[jmj11]

From the original question: Yes. I'm the one who pays him.