BeeBon Posted November 16, 2011 Share Posted November 16, 2011 As a new graduate I'm totally overwhelmed with trying to find an insurance policy. I have so many questions, but don't know where to look. Aren't PA's generally covered by the supervising physician? Why do I need a policy if that's the case? How do I know how much coverage I need? What aspects of the policy do I need to concern myself with? Basically I need to be schooled on the whole topic all together. Any suggestions? Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 17, 2011 Moderator Share Posted November 17, 2011 your employer should provide this should be in your employment contract that they are responsible for providing it at their expense if it is you should be covered would NOT buy your own policy - lawyers only sue when they might get some $$$ and if you have a 1m/3m policy they will likely sue you..... search threads - lots of talk on this Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 17, 2011 Moderator Share Posted November 17, 2011 I have never and would never take a job that did not include 100% malpractice paid by the employer. Link to comment Share on other sites More sharing options...
Contrarian Posted November 17, 2011 Share Posted November 17, 2011 Have had my own policy for 12yrs. I pro-rate the cost for any employer(s) I have. Right now it is divided by 2. When I renew next month, it will be divided by 3. Yes... EVERY emplyer should provide a policy... but I've found that having my own allows me to work anywhere on a moments notice (Locum for instance) and give me a peace of mind knowing that regardless of where I work, if something haappens, I WILL have a legal team dedicated to ME as their priority. Versus them focusing on my SP primarily and then me secondarily. The myth about having a policy as a bad thing because it attracts lawsuits is utter nonsense. They aren't going to NOT sue you because YOU don't have a policy in your name. Lawyers are gonna sue everyone who touched the patient and was remotely involved in the poor outcome... regardless of whether or not they have a policy. Why...??? They play odds... and want judgements againts all providers on record just incase you do come across some cash (lotto ticket, inheritence, assets such as property, etc) If they didn't sue folks without malpractice policies... NO physician would have one... since this would be a simple cost effective way to protect against suits...:heheh: I'll quote the esteemed and renowned philosopher... Flava-Flav on this one... "Don't believe the hype" YMMV Contrarian Link to comment Share on other sites More sharing options...
BeeBon Posted November 17, 2011 Author Share Posted November 17, 2011 Thanks for the feedback, I should mention that the position is temporary, for a research trial. Also the Doc is going to cover all or most of the expense of the insurance. He just wanted me to find a few quotes. That is where I'm having trouble. I'm not sure what I should look for in a policy. Link to comment Share on other sites More sharing options...
NoClinic4Me Posted November 17, 2011 Share Posted November 17, 2011 I'd recommend getting your own policy only if the employer offered one is inadequate (you can decide what that is yourself). I agree that in Contrarian's situation an individual policy would help you practice wherever and whenever you want at a moments notice. It may take longer otherwise. Link to comment Share on other sites More sharing options...
hum1doug Posted November 17, 2011 Share Posted November 17, 2011 I have been doing some of my own research as this is new to me also. This is a summary of what I've learned so far: There are different categories of policies based on risk of the practice, where Family Med is Cat 1 and least expensive and ER/Surg over 10hrs/wk is Cat 3 and more expensive. Each state, and further some counties of different states, have different rates. There are two basic types of coverage: Claims and Occurrence Claims coverage will protect you only while you are actually paying them for an active policy. It seems to be what employers want to offer because it starts out cheaper (beneficial for an employer if PA doesn't last). The annual premium quote I got for Cat 3 in Arizona for example is $2027 for $1/3mil and the rate increases annually for the first 5 yrs (as risk increases) and tops off at $6333 at 5th year PROBLEM: If you are involved is a suit that comes up after you no longer have the policy you have NO protection. i.e. a pt you see in Jan files a suit in May, but you quit (and policy was cancelled) in February .. you're hosed. SOLUTION to problem above is to purchase tail coverage. PROBLEM with that is rate STARTS at max premium ($6333) and is prorated down the longer you have the claims policy. If you have a claims policy you will HAVE to get tail coverage at some point ..or leave yourself vulnerable. If you have the same policy for 10 years THEN tail coverage is included without further charge. Occurrence coverage will protect you from any suit that is filed from an event that occurred when you had the active policy even if filed after you cancel the policy. DRAWBACK is that the cost starts, and stays at the 5yr rate. For example above that would be $6333 annually. (forever I think... until of course they decide rates need to be increased just like any other insurance policy ..home, auto etc.) It all has to be paid up front at once unless you want to go with a special financing company that charges 15% interest. I was told that the policy could be prorated and you would get some back if policy was canceled before the year term was up, but not sure if that just applied to my special case of having to change an occurrence to claims policy (I'll explain below). Premiums for part time work is less. I was quoted part time is considered 24 hrs/wk or less and then premium is discounted 35% Interesting fact: Florida does not require physicians to carry malpractice insurance. Here is an explanation I found: http://www.floridamalpractice.com/med20.htm SO... PAs and NPs cannot get occurrence coverage in the state of Florida because that would leave open the potential for him/her to be the only one "with deep pockets". In my case I will do seasonal work in Az, and probably find something part time or PRN when I return to Fl. It was recommended that I get occurrence (if I have to cover myself) and it would automatically be converted to a claims policy when I renewed the next year in Fl .... but if I call as soon as I return the occurrence rate would be prorated and my return would probably pay for most of the next year's premium. I was quoted $1500 for first yr of Fl claims going up to $5600 at 5th year. Tail = $5200 at 5 yrs and decreases approx $1000/yr after that .. if started then.. i.e. you quit practicing after 7 yrs your annual tail coverage premium would be $3100 (again..forever I think as long as you want protection). This is the data I collected during a long conversation with a rep from HPSO (healthcare providers service organization). It was the only company I had heard of (because of the junk mail they've sent) and I haven't done any comparisons ...nor did I get a policy ... just data collecting I have NO IDEA if the information above is representative of PA malpractice in general or how competitive the rates are. I am hoping some of the seasoned civilian practicing PAs will pipe in and confirm/clarify and offer other suggestions or experience with different companies. Question I have is if a company has a group policy can some employees have occurrence and another claims? Looks like I will be offered claims but will ask for occurrence. I think since it can be prorated it will be a better way to go than tail coverage. I also saw somewhere to make sure your coverage matches your SP's policy. Don't know if that is just recommended or company/state law requirements. Sorry... seems all my posts are ending up being longer than a chapter in Harrison's Int Med book ... am I killing ya? (if ya even got this far..lol). Just motivated to learn and share about the business aspect of clinical practice. OK.. Not really sorry. If you're not interested you haven't gotten this far anyway. 8-) Link to comment Share on other sites More sharing options...
Contrarian Posted November 17, 2011 Share Posted November 17, 2011 ^^ Correct^^ Thing is... once the policy matures thats the rate you pay from then on... In my case... I've been paying the same rate for about 6 yrs... and can work in FL... and AZ interchangeably as long as I have a State license for both. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 17, 2011 Moderator Share Posted November 17, 2011 working"on a moments notice" as a pa is almost impossible. remember the medical board/sp requirement? in oregon you are looking at a min of 6 weeks(more often 8-12) for paperwork, in WA it's more like 2 weeks. california is around a month or so. locums assignments take weeks to set up, even if you have a state license. federal facilities are a bit easier but still not a next day kind of thing. the only place I have worked "on a moment's notice" is on disaster medical teams overseas. no papewwork, just go and do the work. that's one reason I like it so much.... Link to comment Share on other sites More sharing options...
quirkymedic Posted November 17, 2011 Share Posted November 17, 2011 working"on a moments notice" as a pa is almost impossible. remember the medical board/sp requirement? in oregon you are looking at a min of 6 weeks(more often 8-12) for paperwork, in WA it's more like 2 weeks. california is around a month or so. locums assignments take weeks to set up, even if you have a state license. federal facilities are a bit easier but still not a next day kind of thing.the only place I have worked "on a moment's notice" is on disaster medical teams overseas. no papewwork, just go and do the work. that's one reason I like it so much.... LOL! I started my credentialing for a per diem spot with a well known EM group here in Ca back in May. (I had worked at this hospital previously, but not as a PA- so they know me and who I am). My paperwork just came through this week and my first day is tomorrow. Good thing I'm not starving or anything! 6 months is a ridiculous amount of time to get credentialed somewhere per diem! Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 18, 2011 Moderator Share Posted November 18, 2011 The myth about having a policy as a bad thing because it attracts lawsuits is utter nonsense.They aren't going to NOT sue you because YOU don't have a policy in your name. Lawyers are gonna sue everyone who touched the patient and was remotely involved in the poor outcome... regardless of whether or not they have a policy. Why...??? They play odds... and want judgements againts all providers on record just incase you do come across some cash (lotto ticket, inheritence, assets such as property, etc) If they didn't sue folks without malpractice policies... NO physician would have one... since this would be a simple cost effective way to protect against suits...:heheh: I'll quote the esteemed and renowned philosopher... Flava-Flav on this one... "Don't believe the hype" YMMV Contrarian could not disagree more - and this is from 'personal' experience having worked as a claim adjuster and negotiator prior to being a PA I can say with 100% confidence that having a large policy will make you a target. I remember better then a 1/2 dozen cases where after disclosures and discovery it was learned that there was no policy backing up the at fault person and the atty would always (except for one where the guilty party was a mulitmillionare) drop the suit. The law creates rewards through financial indemnicifation - if there is not $$$ there to do this an attorney will NOT spend countless hours going after you. Have seen it many many times Having a policy for you does afford you more protection, but make no mistake (and this is coming from someone that has indeed worked in the legal insurance world not someone taking a guess) an attorney is very unlikely to sue you if you have nothing to take and now policy to go after the limits of. As you nest egg grows (and you have more liablity as your practice patterns expand with more responsibility) and take a higher role in managment of patients it mkes sense to get a policy "just for the insurance" but don't think for a second that it does not put you at increased risk for suit - that is just plan wrong. course the biggest thing putting you at risk for suit is pissing off your patients - listen and be nice and humanistic is always what I try to do and so far so good. also, I priced different policies and there is HUGE differnce with the AAPA sanctioned carrier as one of the most expensive. I found the follow place to have the most competitive rates but I don't know anything more about them Clifton Insurance Agency, Inc Office: 877-212-4368 Ext: 1 Fax: 806-457-1760 Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 working"on a moments notice" as a pa is almost impossible. remember the medical board/sp requirement? in oregon you are looking at a min of 6 weeks(more often 8-12) for paperwork, in WA it's more like 2 weeks. .... Sigh... It takes an average of 3 days to get a practice plan approved by the HPQA-MQDA if all standards are met... and it is faxed to them. If you read that letter they sent you last month (the one requiring all/Most WA PAs to update their Practice Plans)... you would know this. I've had several practice plans approved within 24-48hrs. Actually sent/faxed one in this morning from my practice... then drove south for a hour... saw patients and precepted 2 students... then checked my email before heading north a 3:15 pm... it was APPROVED by 3pm... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 Sigh... It takes an average of 3 days to get a practice plan approved by the HPQA-MQDA if all standards are met. I've had several practice plans approved within 24-48hrs. Actually sent/faxed one in this morning from my practice... it was APRROVED by 3pm... as a pa in washington for over a decade the fastest I have seen is one week and that was for a licensed pa-c to start volunteering at a free clinic in desperate need of their services. you are saying new sp, new practice plan, new site turnaround in 1 day? or sp you have worked with before at place you have worked before with same scope of practice? I have to say your claim sounds too good to be true...what about facility credentialing? having recently spoken to our HR I know for a fact that the fastest my facility will credential any new provider is 45 days....after they get their license approved. maybe it's faster applying for outpt credentialing vs hospital based? I believe you but anyone else I would say was smoking crack if they told me they got a practice plan approved in a single day. ps : didn't get a letter telling me to update my practice plan last mo. Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 New practice (mine) Met the Doc last week... he signed the contract and practice plan last night at about 1900. Faxed this am... returned approved this evening at around 3pm. If the practice plan is straight forward... easy. Remote site could take longer. They actually stated approx 3 days... in the literature they sent all currently licensed PAs last month... when they required us to re-submit our practice plans. All they do is verify that both you and the SP are licensed. Verify the business address. Make sure you meet the thresholds for standard versus remote site. Make sure you are supervised the correct number of hours. This can be done in hrs with a computer and if your doc/sp answers his/her cellphone and/or email. Contact them at the below info and ask about the average lenth of time it takes: Customer Service Specialist II Medical Quality Assurance Commission PO BOX 47866 Olympia WA 98504 360-236-2771 360-236-2795 Fax Website: www.doh.wa.gov/hsqa/mqac As for "Facility Credentialling"... not applicable or pertinent to this discussion. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 fyi insurance costs for individual policies. in primary care/outpt practice they can be quite reasonable(1-2k/yr). if you work surgery/em/ob/etc you are likely looking at > 6k/yr after the "phase in pricing" takes effect- they give you a good rate for the first yr or 2 than keep jacking the rates. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 how is facility credentialing not applicable? pa wants to work at xyz er locums/per diem. he needs both "permission" from the medical board(approved practice plan) AND clearance from the hospital(after the board reviews his application at their quarterly mtg, etc) to work there. Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 Not applicable because "facility credentialing" was NOT part of the initial discussion/assertion. I in particular... and most PAs in general don't work in "Facilities" that require extensive credentialing processes. In case YOU forgot... there is a world beyond the ED and hospitals. If I am working Locums for a Outpatient FP/IM practice... I don't need facility credentialing. To reiterate... The average length of time it takes for a Licensed/Certified PA-C to have a simple straight forward Outpatient Internal Medicine/FP/Psychiatry practice plan approved by Washington State HPQA is listed as being around 3 days... if its faxed to the correct number and all the required elements are met. Working in a outpatient Primary Care setting where the SP is there all the time when the PA-C is praticing... does not require "facility credentialing." Working in a freestanding Inpatient Psych Unit only requires the folks in HR to make a few phone calls. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 the initial discussion was "allows me to work anywhere on a moments notice (Locum for instance) " "most " pa's don't work in primary care anymore. "most " pa's work in specialties. therefore "most " locums jobs are likely in specialties. their place of practice frequently involves a hospital. to work there they have to get credentialed. QED relevance. I challenge you to get approved to work locums at a hospital in less than a month(federal facilities excepted). Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 Ok... You are correct...!!! Anywhere TO ME is limited to MY usual work settings (Outpatient Medicine)... and doesn't include places I don't usually work (Hospitals/EDs/NASA/MARS.. etc) Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 Ok...You are correct...!!! Anywhere TO ME is limited to MY usual work settings (Outpatient Medicine)... and doesn't include places I don't usually work (Hospitals/EDs/NASA/MARS.. etc) actually credentialing to work outside the country(say mars or Haiti...:)) has been easier for me than working inside...." do you want to go to Haiti tomorrow and start work?" "yes". done. one phonecall. approval in the speed of sound.....as opposed to getting credentiled for a federal disaster team...2 yrs...fbi background check, etc... Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 PM me a Email addy... I'll forward you a copy of a "practice plan" approved within 3 days... (look at the fax date on top of all pages ... which is the date HR faxed it to HPQA and compare that date to the one stamped "approval date") Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2011 Moderator Share Posted November 18, 2011 PM me a Email addy...I'll forward you a copy of a "practice plan" approved within 3 days... (look at the fax date on top of all pages ... which is the date HR faxed it to HPQA and compare that date to the one stamped "approval date") not necessary. as I said previously I believed you. I just had never heard of a similar occurrence before. your word is good enough for me. Link to comment Share on other sites More sharing options...
hum1doug Posted November 18, 2011 Share Posted November 18, 2011 So ... back to malpractice insurance .... :wink: Has anybody seen a big difference in different company offerings? Is there reason to really shop around or are most equivalent policies the same ... one you decide how much and what type to get? Has anybody actually had to use their insurance.. guess that would be the test of a good company/policy ... Link to comment Share on other sites More sharing options...
Contrarian Posted November 18, 2011 Share Posted November 18, 2011 Its pretty "uniformed/standard"... From my research... the cost is also pretty equivical... Have never had to use it. Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 18, 2011 Moderator Share Posted November 18, 2011 I posted this above but I think it got lost in the reply's having worked as a claim adjuster and negotiator prior to being a PA I can say with 100% confidence that having a large policy will make you a target. I remember better then a 1/2 dozen cases where after disclosures and discovery it was learned that there was no policy backing up the at fault person and the atty would always (except for one where the guilty party was a mulitmillionare) drop the suit. The law creates rewards through financial indemnicifation - if there is not $$$ there to do this an attorney will NOT spend countless hours going after you. Have seen it many many times Having a policy for you does afford you more protection, but make no mistake (and this is coming from someone that has indeed worked in the legal insurance world not someone taking a guess) an attorney is very unlikely to sue you if you have nothing to take and now policy to go after the limits of. As you nest egg grows (and you have more liablity as your practice patterns expand with more responsibility) and take a higher role in managment of patients it mkes sense to get a policy "just for the insurance" but don't think for a second that it does not put you at increased risk for suit - that is just plan wrong. course the biggest thing putting you at risk for suit is pissing off your patients - listen and be nice and humanistic is always what I try to do and so far so good. also, I priced different policies and there is HUGE differnce with the AAPA sanctioned carrier as one of the most expensive. I found the follow place to have the most competitive rates but I don't know anything more about them Clifton Insurance Agency, Inc Office: 877-212-4368 Ext: 1 Fax: 806-457-1760 So ... back to malpractice insurance .... :wink: Has anybody seen a big difference in different company offerings? Is there reason to really shop around or are most equivalent policies the same ... one you decide how much and what type to get? Has anybody actually had to use their insurance.. guess that would be the test of a good company/policy ... I called around to about 5 different agencies (look in the back of professional journals and do internet search) and there was a fair amount of variation with companies - MAKE sure you quote the EXACT same product with each company - ie claims made 1m/3m and MAKE SURE that you get the 'mature rate' and how it increases year after year to this rate. Aslo, I asked everyone how much their tail coverage would cost and it seemed to be one years premium. Link to comment Share on other sites More sharing options...
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