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Billing vs reimbursement


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I work as a dermatology PA and am paid a percentage of each patients visit.  I’m a new grad and when I was hired, my supervisor asked me to look up codes and estimate how much I could generate for the practice, and then base my salary off that.  A few months in, he disclosed that we are only reimbursed 30-40% of what we bill for. So obviously, my estimates were off and I am making far less than I thought I would. I get 40% of each visit. Ex: if we bill 99212 ($90) we are reimbursed $30-40, and I get ~$15.

Is this standard? I know my percentage seems high but it makes me wonder how anyone could have a lower percentage with such low reimbursement.  
 

I am trying to figure out if I am being mislead. 
 

thank you!

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The only thing I see wrong is that you're billing a 99212. That's 10 minutes of provider time for the E&M visit and same-day records review and charting. After those are added in, even the simplest visits are 99213s (20 minute time, inclusive) if you're keeping good records.

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On 4/4/2022 at 5:49 PM, Nels7777 said:

I work as a dermatology PA and am paid a percentage of each patients visit.  I’m a new grad and when I was hired, my supervisor asked me to look up codes and estimate how much I could generate for the practice, and then base my salary off that.  A few months in, he disclosed that we are only reimbursed 30-40% of what we bill for. So obviously, my estimates were off and I am making far less than I thought I would. I get 40% of each visit. Ex: if we bill 99212 ($90) we are reimbursed $30-40, and I get ~$15.

Is this standard? I know my percentage seems high but it makes me wonder how anyone could have a lower percentage with such low reimbursement.  
 

I am trying to figure out if I am being mislead. 
 

thank you!

thank you for sharing 

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