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The first job!! help please!!


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Hello everybody

Im finishing PA school this month and taking my boards in ocotober. Currently im on my last clinical rotation with an internal medicine doctor - pulmonary ,critical care and sleep medicine. He gave me a really good offer that cant be turned down for a new graduate. He also wants me to start right away after i get my license. I will be full time in his outpatient clinic by myself M-F no call with half day block for him everyweek to sign some of the charts and see some patients , he will be taking care of inpatients mainly between two hospitals ( 60 patients/day avg with procedures) and the hospital is across the street from the clinic, the other one is 15 minutes away. the thing is Im the first PA he will ever hire and his manager doesnt know the paperwork needed to be done so i have to do everything basically.

 

I did some research and i found that i must have the following :

1-of course i will get my license - he paid for the exam and the license fee

2- DSA which i found copies on aapa and other websites- he will fill it up and sign it and will be kept on site

3- He will provide me malpractice with tail

4- DEA# which i wont be able to get at least a month after i graduate ( is it legal to use his DEA till i get mine??)He is paying for it

Am i missing anything else??

The other thing that i havent found online at all is : He wants to bill under his name - the question is : with all types of insurances in general is it legal that i see the patients and his biller bills under his name without him seeing them? Remember im gona be signing all the charts/his signature will be on 5% of them only. Im talking about established and new consults!!

Also for the PAs who work in the same setting - i would appreciate it if you guys gimme advice on anything that will help me.

Since im gona be the first PA , it is my responsibility to make sure everything is done right and by the book

Thanks alot for your help

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Hello everybody

Im finishing PA school this month and taking my boards in ocotober. Currently im on my last clinical rotation with an internal medicine doctor - pulmonary ,critical care and sleep medicine. He gave me a really good offer that cant be turned down for a new graduate. He also wants me to start right away after i get my license. I will be full time in his outpatient clinic by myself M-F no call with half day block for him everyweek to sign some of the charts and see some patients , he will be taking care of inpatients mainly between two hospitals ( 60 patients/day avg with procedures) and the hospital is across the street from the clinic, the other one is 15 minutes away. the thing is Im the first PA he will ever hire and his manager doesnt know the paperwork needed to be done so i have to do everything basically.

 

I did some research and i found that i must have the following :

1-of course i will get my license - he paid for the exam and the license fee

2- DSA which i found copies on aapa and other websites- he will fill it up and sign it and will be kept on site

3- He will provide me malpractice with tail

4- DEA# which i wont be able to get at least a month after i graduate ( is it legal to use his DEA till i get mine??)He is paying for it

Am i missing anything else??

The other thing that i havent found online at all is : He wants to bill under his name - the question is : with all types of insurances in general is it legal that i see the patients and his biller bills under his name without him seeing them? Remember im gona be signing all the charts/his signature will be on 5% of them only. Im talking about established and new consults!!

Also for the PAs who work in the same setting - i would appreciate it if you guys gimme advice on anything that will help me.

Since im gona be the first PA , it is my responsibility to make sure everything is done right and by the book

Thanks alot for your help

 

Take a look here:

http://www.aapa.org/your_pa_career/interviewing_and_contracts.aspx

Take a specific look at the pre-employment checklist.

 

For reimbursement look here:

http://www.aapa.org/uploadedFiles/content/Common/Files/RI_3rdParty_v4%20-%20052711%20UPDATED.pdf

 

With a log in look at this link:

http://www.aapa.org/your_pa_career/licensing_and_certification/resources/item.aspx?id=1570

 

To answer specific questions:

1. DEA: No you may not use his. You only need this for schedule drugs so unless you a prescribing schedule meds you can start without this. Most pharmacies will want your NPI which you can get pretty quickly.

2: Billing - look at the reimbursement. For private billers its up to them. Some will want you to bill under his name others yours. Its up to the billers to contact the insurers and find this out. For Medicare unless its incident to (which it won't be since he's not in the office) all billing happens under you. Its a federal offense (ie Medicare fraud) to bill under his name. Not the best way to start your career.

 

The biggest thing that concerns me is you haven't mentioned orientation. You will be taking care of fairly sick patients and you have no mention of orientation. If you are going to be running a clinic by yourself you should probably define this better.

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Hi, wow! How exciting to get a job offer on your last rotation! As I read this I am concerned about your supervision. Not sure of your background, but seems quite overwhelming as a new PA and being the first PA he's ever hired to be "running the clinic" doesn't seem wise...maybe you've already considered this, just thought I'd bring it up!

 

Best

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hi guys, thanks for your help and your concerns, sorry i didnt mention alot.

Ive been in the medical field for so long 9 years , this is actually my second profession. I have pretty solid knowledge and i feel very comfortable seeing and treating patients.

I have gotten an offer from every doctor i rotated with during my school which is pretty good but no good offers. This doctor's wife actually was a patient during my family practice rotation and he was with her. He liked me and he offered to take me as student for my internal medicine rotation , so i started with him and i ended up taking my elective with him 2 months total ( average 12 hours a day between inpatient and outpatient ). He prepared me very well and assign lots of readings regarding most of the cases he gets, im pretty good in reading PFTs and sleep studies now beside too many other stuff. So basically he oriented me really well and before i finish in 1 week he offered me the job. So i think he planned for it but didnt want to tell me till i finish school. Regarding the schedule: its M-F from 8-5 , the good thing is that the clinic is on campus but different building like right across the street from the office. he is always available.

 

Regarding prescriptions: the two months with him we never ordered scheduled II , the most we ordered was schedule IV but there are alternatives. so im not worried. Since i can use his DEA for just non-scheduled drugs it works for me till i get mine.

 

the second important thing is yes we get a pretty good amount of medicare patients : does that mean he cant bill medicare patients without seeing them? they have to be billed under my name? I already set up a date to meet up with his biller , her office is in another location.

Thanks everybody for the help , i appreciate it

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hi guys, thanks for your help and your concerns, sorry i didnt mention alot.

Ive been in the medical field for so long 9 years , this is actually my second profession. I have pretty solid knowledge and i feel very comfortable seeing and treating patients.

I have gotten an offer from every doctor i rotated with during my school which is pretty good but no good offers. This doctor's wife actually was a patient during my family practice rotation and he was with her. He liked me and he offered to take me as student for my internal medicine rotation , so i started with him and i ended up taking my elective with him 2 months total ( average 12 hours a day between inpatient and outpatient ). He prepared me very well and assign lots of readings regarding most of the cases he gets, im pretty good in reading PFTs and sleep studies now beside too many other stuff. So basically he oriented me really well and before i finish in 1 week he offered me the job. So i think he planned for it but didnt want to tell me till i finish school. Regarding the schedule: its M-F from 8-5 , the good thing is that the clinic is on campus but different building like right across the street from the office. he is always available.

 

Regarding prescriptions: the two months with him we never ordered scheduled II , the most we ordered was schedule IV but there are alternatives. so im not worried. Since i can use his DEA for just non-scheduled drugs it works for me till i get mine.

 

the second important thing is yes we get a pretty good amount of medicare patients : does that mean he cant bill medicare patients without seeing them? they have to be billed under my name? I already set up a date to meet up with his biller , her office is in another location.

Thanks everybody for the help , i appreciate it

For meds you use your license and NPI for non scheduled meds. Once you get your DEA you can use that for scheduled meds. They will usually want the SP NPI sometimes DEA. However, they shouldn't be using the DEA to track physicians.

 

For billing Medicare patients are billed under your NPI and reimbursed at 85%. There is something called incident to billing but it really doesn't apply in your situation.

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