CT Surgery Reimbursement

[SteveyTI]

Cardiothoracic & Vascular Surgery PAs:

I work for a busy practice primarily in the operating room with minimal clinic or rounding responsibilities.

We have been looking over the finances and are seeing that our collections are far below the cost of each PA to the practice. We are near the 50th percentile in wages.

I am curious how others in the these subspecialties do? Are you profitable for the practice? I feel like we should be, so we are trying to analyze and figure out why our collections are not much better.

Feedback is much appreciated.

[rguler]

I have worked in General Surgery for 8 years and I am being told my assisting fees do not cover my salary (92K).  I would also like to know if this is affecting other PA’s in surgical specialties as I anticipate looking for a new job soon and hope to stay in some type of surgery.  If reimbursement for assisting is going down It may be difficult to find jobs that make for an excellent mix of OR, clinic, and hospital that I have enjoyed so much!

I would appreciate input on this as well as I have always been salary and not included in any billing/reimbursement information. 

[SedRate]

On 5/6/2019 at 3:29 PM, rguler said:

I would also like to know if this is affecting other PA’s in surgical specialties as I anticipate looking for a new job soon and hope to stay in some type of surgery.  If reimbursement for assisting is going down It may be difficult to find jobs that make for an excellent mix of OR, clinic, and hospital that I have enjoyed so much!

I would appreciate input on this as well as I have always been salary and not included in any billing/reimbursement information. 

I do not see my numbers but have been told I barely make my salary from billable items alone. But only 1/2-2/3 my day is work in the OR. The rest is clinic, rounds, and charts. These are nonbillable tasks covered in the global surgical package. I believe approximately 20% of the package is attributed to post-op care, so you can deduce that a $1000 surgery breaks down to $200 allocated to post-op care such as rounds and clinic. Therefore, I am more profitable also covering the rounds and post-op clinic. The doc could do those but would be most profitable doing surgeries which pay more (approximately 70% of the package). Add to that your 13.6% assist fee and you're producing $336 for assisting, rounds and clinic per surgical patient during the 10 or 90 days of global. If you're also doing consults and seeing new patients or non-global established patients in the clinic, you're making the company even more. For example, the surgeon makes $200/hr and you're paid $50/hr. If you see a new patient at $150, you actually MAKE the company money (+$100) versus the surgeon who LOSES money (-$50). 

So doing a healthy mix of OR, clinic and hospital will actually work in your favor. Yes, you're not directly billing for your rounds or seeing post-ops, but these are necessary. It's either you do it at a lower rate or the doc does it at a higher rate. It's the company's choice. If the company is smart, they'll learn how to allocate your man hours appropriately to be the most productive. If the company isn't smart, then you can do what I did and break this down for them and explain why I should be paid more money than what I currently collect. You can even go so far as explaining the benefit of having a PA to reduce the workload for the surgeon, which in turn improves production and longevity. This is not something they can bill for, either. 

[cheeseastronaut]

On 5/6/2019 at 6:29 PM, rguler said:

I have worked in General Surgery for 8 years and I am being told my assisting fees do not cover my salary (92K).  I would also like to know if this is affecting other PA’s in surgical specialties as I anticipate looking for a new job soon and hope to stay in some type of surgery.  If reimbursement for assisting is going down It may be difficult to find jobs that make for an excellent mix of OR, clinic, and hospital that I have enjoyed so much!

I would appreciate input on this as well as I have always been salary and not included in any billing/reimbursement information. 

What were your clinic and OR roles as a general surgery PA?