Annual review, need help renegotiating

[waselews]

   Hello, I am still rather new to the derm world and I am coming up on my first annual review. I could really use some help with negotiation, in terms of salar and bounus strucutre.  I have been working as a PA for almost 2 years and working in dermatology for about 14 months. I had a three month training period where I was paid 5,200 per month (working well over 50 hours/wk.) Then I began seeing my own patients making 83,000/year with a 5% monthly productivity bonus after 10,000 collections for the practice. I usually work 4 1/2 days per week and 6 days once a month when we are open on a Saturday. I work on average 40 hous work weeks, get 2 weeks paid vacation, one week CME, holiday time, and $1500 for CME yearly.  I am coming up for my annual review and expect my supervising physician to start by making me an offer. I see about 20-25 patient per day plus new patients with my supervising physican.  The new patient visits are all billed under his name. I usually stay for the whole visit, write prescriptions, perform the surgery, etc.

  Just to calrify things, new patients are never put on my schedule. I am not sure why he has structured things in this matter, but obviously this effects my productivity. Initally he had told me that I am not allowed to see new patients, however I knew this not to be true.  When I confronted him he said our billing company had advised him to do things this way. Billing has explained to me that there is a lot more verification needed before a new paitent can be scheduled with me as some insurances are not reimbursing for new patient visits with a PA. We see a lot of medicaid  patients so this may be why I am running into this problem. Any how, I would appreciate some advice on how to structure my salary and bonus structure given my years of experience and the limitation with aquiring new patients. I am wondering if I should be compensated more in my base salary for this reason? Also, the current bonus structre may have been fine for my first year, but now I feel it is a little too low. Please let me know any advise you may have. I would really appreciate your help.

[Purrpa]

Sorry I'm late to the party. Hmmm...You see new patients WITH the physician, then write Rx, do procedures, etc. - sounds like a "shared visit" to me. Hope the practice isn't billing "incident to". To bill under physician name & get 100% reimbursement, the physician must see the pt on the 1st visit & perform ALL services on that visit. The PA can then see the pt on subsequent visits & bill at 100%.

 

I would check the AAPA website - they have an article on understanding "incident to", or even google "incident to" & review the criteria carefully.