[NP-Clinical] Re: Billing Awarness

[Tracy Klein]

If there is a signed contract stating that this is the bonus and there are three of you, have you thought of having an attorney write a letter regarding the originally contracted agreement? 
   
  Tracy Klein, WHCNP, FNP
  Portland, Oregon


  -----Original Message-----
From: np-clinical-bounces at nurse.net
[mailto:np-clinical-bounces at nurse.net] On Behalf Of ROY BAULER
Sent: Saturday, February 10, 2007 9:08 PM
To: NP Clinical
Subject: Re: [NP-Clinical] Re: Billing awareness

Marilyn,
I too practice in Iowa. In a setting that sounds very much like yours.
I 
was taken to the cleaners this year by my new corporate hospital group
when 
it came to bonus time. I understood when I signed my new contract with
them 
that our bonus was calculated on our total Work RUVs for the year after
120% 
of our saliery was made in this period. This is how all three of us
ARNP's 
understood this. Now that bonus time has come around they are saying 
something totally different. Anyway, how is your bonus system set up? 
Would you be willing to email me off group with this info and who you
work 
for? We are going to be putting a proposal together for this hospital
corp 
that took over our clinic 1 year ago. With my productivity I would have

made over $14,000 in bonus for the last group that owned our practice in

2006. This current one put me down as $15,630 in the hole. It was a
real 
kick in the teeth for as hard as we work. Unfortunately we do not see
any 
detailed financial report on a monthly basis. We are also expected to
be on 
ER call, do our own hospital admits then turn them over to one of the
docs 
in our group who work on staight productivity. We are saileried at
roughly 
62,000 per year, yeah I know...lousy pay, what can I say...I have to
work 
somewhere.
Thanks..
Lori Ann
----- Original Message ----- 
From: "Marilyn Dean" 
To: "NP Clinical" 
Sent: Saturday, January 20, 2007 4:26 PM
Subject: RE: [NP-Clinical] Re: Billing awareness


> Tracy,
> Iowa is also an independent practice state, but I choose to practice
with 
> 2
> physicians and we now have another nurse practitioner. All four of us
get 
> a
> detailed list of charges, levels of care charged, write offs, and
amount
> collected for each of us. I know how much lab in dollars I order, how
many
> DXA scans I do. Obviously this explains a lot to me and is important
for 
> me
> to understand my bonus calculation. I have chosen to stay with my
original
> base pay of 8 years ago and it has been fun to see my practice grow,
as 
> well
> as my bonus. I bill everything I can under my own numbers, do have 
> hospital
> privileges that require a lot more co-signatures from physician and
have
> chosen not to do hospital, in part because of this and also I am
plenty 
> busy
> and don't need the night hassles, etc. I use my physician's as 
> hospitalists
> when someone needs to be admitted. I hope that helps you with the
clinic
> side of things.
> Marilyn Dean
>
> -----Original Message-----
> From: np-clinical-bounces at nurse.net
> [mailto:np-clinical-bounces at nurse.net]On Behalf Of Tracy Klein
> Sent: Saturday, January 20, 2007 9:50 AM
> To: np-clinical at nurse.net
> Subject: [NP-Clinical] Re: Billing awareness
>
>
> I have a question for those of you who are working in
> a group or physician practice. Are you aware of the
> cost of each of the services you provide? Do you
> receive a monthly statement of billings under your
> name, or are services billed under the physician name
> and number? If you do rounds, how is the practice
> billing your hospital services?
>
> This is of interest to me because I am trying to
> understand what I am seeing in practice (Oregon is an
> independent practice state) which is that most NPs
> don't have access to this information and are still
> not using their own UPIN or billing numbers. In
> addition, it appears that hospitals/practices are
> billing inpatient visits "incident to" the physician,
> which is not legal under Medicare requirements. Are
> there insurance plans which permit this?
>
> This is a huge profit area for MDs, and I am hearing
> about NPs working like this in Oregon for 32.00 an
> hour!!! I can only assume that they have no knowledge
> of what is being billed in their name or how much the
> practice is bringing in. Thoughts and feedback
> appreciated. If you are in a state which requires
> physician collaboration/supervision I'd also like to
> know how your compensation works and how you track
> what is coming in under your labor.
>
> Thanks!
> Tracy Klein, WHCNP, FNP
> Portland, Oregon
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> Receive 6.0 Contact Hours of Pharmacology
> NPCENTRAL.NET/CE/PAIN
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End of NP-Clinical Digest, Vol 11, Issue 24
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