Billing 1st assist

[mikeSpa]

I'm currently employed at my hospital doing surgery. Full time employee

 

Can I go to a different hospital as an independent contractor doing surgical first assist?

 

Has anyone tried this?

 

I called aapa they are not sure the legality of being a full time eployee as a hospital and Independent contractor (in terms of IRS)

 

thanks

[bgdog]

Yes you can, you need a malpractice policy, privileges, a DOS, and somebody to bill for you.

 

Did three cases today.

[mikeSpa]

anyone else have any other experience as a Surgical assist billing only?

 

or both as an employee and part time billing first assist?

 

Why aren't more PAs doing this?

[janissandlin]

I am looking into doing the same thing right now, any recommendations on which malpractice is the best to carry (and least expensive)?

[surgblumm]

I've done this for more than thirty years. As previously mentioned by others , you need a surgeon to sponsor you so there is reason for the institution to have you go to a credentials meeting. You need to gather all of your paperwork and licenses and send them to the Medical staff office or bring them in person. they will place your name as a candidate at the next credentials meeting if there is time and you will sit before this group. They only want to hear about your first assisting expertise and definitely you don't want to come off as an itinerant surgeon who will finish the case if the surgeon should have an MI. Your job would be to either close if appropriate, have the Circulating Nurse call for another surgeon and place wet laps and a sterile towel over the operative site as a good second choice. You will need someone to bill for you and I will usually ask the surgeons biller to do this for a generous 10 % of the recapture. Enjoy as there is more room then ever do do this work. Remember, you are no different then the Doc's, Medicaid is still a poor reimburse option.

Bob Blumm

Former president of American Association of surgical Physician Assistants.

[burnpac]

I am looking into doing the same thing right now, any recommendations on which malpractice is the best to carry (and least expensive)?

I carry a "moonlighting" policy to cover private first assist through the AAPA for plastic surgery, and pay about $1500 annually to cover 20 hours per week.

[burnpac]

I have been doing this for five years now, and bill all first assist and office visits through my corporation. I'm blessed to have a physician partner who gives me the opportunity to do this and keep all the revenue (minus 10% for billing). Don't kid yourself though. It is hard to get rich doing this in the current environment. There are some carriers (Medicare, BC/BS) who will not allow non-physicians to bill independently for first assist services. We use the same billing company, and they keep track of all this and route the money that I have earned to me. Most carriers have no problem paying PAs for first assist directly. However, I would recommend that you do this through a corporation with a separate Tax ID # as if you don't, the carriers will withhold taxes from payments. You also have to be able to survive for a long time as it takes a while for the carriers to pay you for your services. I'm still getting money from surgeries done one year ago. I'm currently contracted with our hospital's IPA, and Kaiser. I'm working on a contract with other HMO's along with my surgeon partner. The walls are coming down for PAs billing independently, and it helps to have a physician partner who is willing to go to bat for your "independence." Luckily, my surgeon partner is in high demand, and has made it clear that any contracts with him have to include me, or the deal is dead.