Acebecker Posted December 28, 2011 Share Posted December 28, 2011 Hey all - Got a phone call a few weeks ago that has come with a new job offer. I currently work in government run medicine so I'm not savvy on production based pay. The new job is offering a base of $60k with a production bonus of 10% based off of what I bill. The pitch is that almost everyone makes $25k in bonuses annually, paid out a quarter at a time, and many of the providers make more than that with the opportunity to make a $40k bonus a real possibility. The job is going to be in urgent care where I'll be working 3 10s per week with every 5th weekend coverage. I will see an average patient load of roughly 30 with a max of about 50 on crazy busy days. Thus I will see approx 1000 patients each quarter. So the question, is this production bonus legit? Will I be able to pull in the money they're saying? I don't have any clue what a level 2 vs level 3 visit is billed out at... I don't know what I'll bill for sutures or splinting. I'm looking at the #s and thinking I'll have to bill an average of $80-90/visit to make the same average annual income as I make now. Does that sound reasonable? Thanks for reading. Andrew Link to comment Share on other sites More sharing options...
Jason09 Posted December 28, 2011 Share Posted December 28, 2011 I would honestly talk with a couple of PAs there and ask them their opinions on the production incentive compensation and ask politely if they didn't mind telling you how much they were pulling in quarterly from incentives. I am on base+incentive pay and like it but have heard a lot of horror stories from companies saying one thing then their billing department is a nightmare and they make squat. Not saying this is the case but the easiest and best way in my opinion is to check with the current PAs. Believe me you will get good at billing/charging really quick. If you are weak in that area the next time you go to a conference or see advertisements for a medical billing/RVU course take it. Link to comment Share on other sites More sharing options...
Doc Savage Posted December 28, 2011 Share Posted December 28, 2011 Also to consider... Medicare is facing a 25% cut for Physician reimbursements... I do not know how this will affect PA's? They just passed an extension to hold off the cuts for 2 more months... but then what? I am assuming that this urgent care would take Medicare? Something else to consider... It may be a good or bad thing. I think if you make between 78-90K I would stay right where I was for now. Especially with the uncertainty of the cuts coming. Who knows maybe the cuts will make non-production based providers make less because we will all be getting big pay cuts and bonus may be the only way to offset the huge paycuts we may be facing. Just my opinion, but if it were me, I would wait and see how it all unfurls. http://www.ama-assn.org/amednews/2011/11/14/gvl11114.htm Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 29, 2011 Moderator Share Posted December 29, 2011 60k+ production sounds low. many places do 80k+ production. also 85k (60+25)isn't that great for someone with a bit of experience, it's actually below avg. Link to comment Share on other sites More sharing options...
Acebecker Posted December 29, 2011 Author Share Posted December 29, 2011 By the 2009 AAPA census data, I would actually be pretty competitive in Washington with my experience. Keep in mind I'm still technically a new grad, though I have been working for a few months now. The mean/median salary is almost the same and both are around the $80k mark. Adjusting for inflation I would be right at the mean/median if I made $85k to start. I am going over the contract with their accountant tomorrow and I'll try to talk to the PA who is there now and see how things shook out for her. Yes, I do want the job and I am trying to find excuses to take it, but I think that beside all the salary talk there is a big issue that is fantastic: working only 3 days/wk would be outstanding. I am trying not to be blind about it, so I appreciate all the feedback. Andrew Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 29, 2011 Moderator Share Posted December 29, 2011 3 days/week is nice but if the shifts are brutal it can get difficult. I have done almost every shift arrangement out there from 4-24 hr shifts. I did 3 x 12.5 hrs/week for a few years and was seeing 50+ on a busy shift. pretty brutal. 4 tens was really nice because I had a 3 day weekend every week. my preference is for longer shifts with lower volumes(best of both worlds). Link to comment Share on other sites More sharing options...
quarternote Posted December 30, 2011 Share Posted December 30, 2011 Keep in mind when you are considering salary the cost of living in that/your area. Where I am gas has been under $3 gal lately. At its highest it was still one of the lowest cost areas. I can rent a nice apartment for $800 mo. Or buy a nice house in a golf course neighborhood cheap. If I were in Atlanta the same apartment would be $1500 or more. My salary is lower than the census but in actual PA's in my area Im actually in the top. Guess they didn't take time to take the survey. Link to comment Share on other sites More sharing options...
Neuro1 Posted December 30, 2011 Share Posted December 30, 2011 I think the reply about cost of living is realistic, whatever your proposed salary might be. PA's in Washington make around 80K ??? Is that in Seattle / Tacoma / Gig Harbor - or - Port Orchard / Chelan / Moses Lake? There is a lot of difference in the cost of living between those areas, just as there is in say, the metro Atlanta area as opposed to Richmond Hill or Macon. If you are making 80K in Seattle, then hopefully you have a spouse who works too.... Link to comment Share on other sites More sharing options...
Acebecker Posted December 30, 2011 Author Share Posted December 30, 2011 This job is in rural Eastern WA, cost of living is much lower than the Metro areas. The salary will be decent. The current PA made $90k this year. She's been at the practice 1.5 years. Other benefits help defray the drawbacks - 2wks CME, 4 wks PTO to start almost immediately, etc. I'm leaning toward accepting the job. I hope I'm not crazy. Link to comment Share on other sites More sharing options...
quarternote Posted December 31, 2011 Share Posted December 31, 2011 How is the retirement? Is there profit sharing? My profit sharing % is decent and if I add the excess % of that (amount that is over what most places in this area pay) back into my salary it increases my Salary decently. Plus I'm now 100% vested. Sometimes there are extra perks that have nothing to do with money. There is something to be said about job satisfaction and wanting to go to work every day. :) keep us posted on your decision. Just some things to think about. Link to comment Share on other sites More sharing options...
Acebecker Posted December 31, 2011 Author Share Posted December 31, 2011 401k with a match after 1 year, profit sharing at the end of the first calendar year. I don't recall the percentages. I have decided to take the job because it means a lot more family time and a huge hourly increase - even if I make only $80k the first year, I have still had an hourly wage increase of $2/hr since I will be working much fewer hours. The big thing is this: the practice is bending over backward to get me on board. They're doing whatever they can to take care of me and mine. This is important and not something that is currently occurring to a significant extent. Thanks for all the replies. Now for another question: does anyone know what a 99214 is biled at? Andrew Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 31, 2011 Moderator Share Posted December 31, 2011 401k with a match after 1 year, profit sharing at the end of the first calendar year. I don't recall the percentages. I have decided to take the job because it means a lot more family time and a huge hourly increase - even if I make only $80k the first year, I have still had an hourly wage increase of $2/hr since I will be working much fewer hours. The big thing is this: the practice is bending over backward to get me on board. They're doing whatever they can to take care of me and mine. This is important and not something that is currently occurring to a significant extent. Thanks for all the replies. Now for another question: does anyone know what a 99214 is biled at? Andrew c a u t i o n the only time you have any ability to negotiate is before you sign on.... DON'T plan on getting a raise EVER if you sign a crappy offer if they are "bending over backwards" as you say - demand $80k base and the same salary... Link to comment Share on other sites More sharing options...
brookspa Posted January 1, 2012 Share Posted January 1, 2012 a % of your billing is fantastic. Its appropriate to bill the majority of your cases as 99213 and often as many 99214s. dont fear the 4s. just do appropriate coding...its easy. If on the other hand it s a % of collections, you will likely ge screwed. Go for all or most of the RVU and you shoould do well. Thats a good vol. and you should easily top 100k. ALL the other advice is sound. Link to comment Share on other sites More sharing options...
quarternote Posted January 4, 2012 Share Posted January 4, 2012 Congrats on your decision. Family time is more important than money. I can get the info on 99214 and pm you later if you still need it. Link to comment Share on other sites More sharing options...
Acebecker Posted January 6, 2012 Author Share Posted January 6, 2012 Would love that information! Thank you. Link to comment Share on other sites More sharing options...
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