[NP-Clinical] contracts and negotiating for new clinic

Sun May 13 12:46:35 PDT 2007

Paula,
I used the same billing service my physician used...I pay them 7.5% on what 
I receive in payments/net. This takes a lot of  headache and paperwork off 
of you. I think I pay too much and have not always been happy with my 
billers but it is too difficult with all the different directions I am 
pulled to change billlers right now. The going rate is probably 5% to 8% of 
your net. They are responsible for all insurance issues and client billing 
interaction. I only made $35,000 my first year in practice so that is why I 
recommended that you consider part-time work to supplement at first. There 
is also a significant delay until insurance payments come in. I worked as a 
part-time clinical educator for the first 1-2 years as well. Now I bring in 
with my part-time practice what most NPs make fulll-time. The problem as I 
see it is what if you build up a great practice and the MDs decide at some 
point they want to replace you with someone cheaper. Unless the practice is 
yours from day one then you are always vulnerable. If I can answer any other 
questions or give you support let me know!
Cindy

>From: Paula Sumner <nurse_healer at yahoo.com>
>Reply-To: NP Clinical <np-clinical at nurse.net>
>To: NP Clinical <np-clinical at nurse.net>
>Subject: Re: [NP-Clinical] contracts and negotiating for new clinic
>Date: Sat, 12 May 2007 21:58:54 -0700 (PDT)
>
>THANK you Cindy,
>   Great advice, and very encouraging.   I'll negotiate with him about 
>insurance, What kind of service do you recommend to handle the insurance 
>billing?  Parttime NP jobs are hard to find in this area-I have been 
>looking for school purposes. I have thought of taking the retail 
>job-minimum hrs at 32 a week while building this paractice. The MD was 
>discouraging of this-we only talked on the phone a bit today, I meeting 
>with him tues, and am suppose to have some ideas to present to him.
>   paula
>
>Cindy Jensen <cindyjensennp at hotmail.com> wrote:
>   Paula,
>I my opinion, set up your own practice, offer to pay the physician overhead
>and rent in 6 months, collect as much money upfront/have a reasonable cash
>price for visits, accept Medicare and Medicaid because no one else does and
>they may let you see patients now and submit billing later once your
>credentialing is finished, apply for credentialing with every decent
>insurance in town, pick up extra hours to pay the bills at other
>offices/walk-in clinics temporarily until your own practice is stable. I 
>can
>offer this advice because I've done it myself. Don't sell yourself short 
>and
>expect the physician to assume all the financial risk now/and later...all
>financial reward. Own your own career/practice. Chiropractors, physicians,
>dentists, optomotrists are all examples of professions where owning your 
>own
>practice is expected and considered rewarding financially and otherwise.
>This has the potential to change your life. Don't run away from
>opportunity...run towards it.
>Just my 2 cents,
>Cindy
>Owner of one part-time internal medicine practice and one full-time travel
>clinic with three locations in the Seattle-Tacoma region.
>
>
> >From: Paula Sumner
> >Reply-To: NP Clinical
> >To: NP Clinical
> >Subject: Re: [NP-Clinical] contracts and negotiating for new clinic
> >Date: Sat, 12 May 2007 21:10:25 -0700 (PDT)
> >
> >Thanks, Patti,
> > They say when one door closes another opens, and this is really my dream
> >job (I hope). i need to give it a shot. I just wish he had an offer, bit
> >he did give several possibilities, I just need to see the numbers-base 
>pay
> >plus %. His concern is low pt numbers right now, but they are beginning a
> >marketing campaign in June.
> >
> > He is not taking insurance but charging $50 a half hour and giving a
> >superbill to the patients to file. Added charges are for labs and ekgs 
>when
> >warrented. I wonder how this will fly with insurance companies and
> >medicare if I am not listed provider. I guess I will have to warn the pts
> >that the ins co. may not reimburse them.
> >
> > We talked about doing group visits but neither of us is sure how to
> >charge for those. I am wondering if would be open to prepaid pts-like
> >self-insured-again, I am not sure how this works. Gads I have to much
> >info, i just haven't had to put it to work, lol. Grad school fried my
> >brain, lol,
> > Paula
> >
> >pattinp at verizon.net wrote:
> > Congratulations, Paula, on this opportunity!!! I know how hard you have
> >worked to find a job like this. IMHO you are selling yourself short if 
>you
> >are asking for $70-75,000/year salary. You have so many skills to bring 
>to
> >this practice - adult Western medicine practice, your CAM skills, and
> >phlebotomy skills are a real asset!!! You should be starting out at at
> >least a minimum of $80-90,000/year salary!! Don't sell yourself short; I
> >once heard a nurse consultant tell us in a seminar that people equate 
>your
> >worth with the amount you charge...something to think about.
> >
> >Patti Robertson (NP of VA)
> >
> > >From: Paula Sumner
> > >Date: 2007/05/12 Sat PM 04:03:04 CDT
> > >To: np-clinical at nurse.net
> > >Subject: [NP-Clinical] contracts and negotiating for new clinic
> >
> > >I knowÂ this has been discussed ad nauseum, but i am need of some quick
> >tips for a meeting on tuesday. I am being invited to join a brand new
> >integrative med clinic. I am being given the opportunity to build my own
> >primary care (adult) practice with some features like urgent care on
> >saturday, and maybe sports and work physicals.Â It has been opened 4 wks
> >and the pts are just trickiling in. The PA quit already 'she wasn't ready
> >to return to work'.
> > Â
> > I can start with no income or bennies--that is it would be my own
> >practice to build or
> > I can be offered some sort of base salary plus % still no bennies.
> >overhead is $30/hr. There is a receptionist and RN. And a temp 
>plebotomist
> >(the doc was excited to know i could draw blood, etc).
> > Â
> > The doc does not know how much to pay an NP (I said $50/hr or
> >70-75k/yr)-he said once the clinic got busy i'd be making more than that. 
>Â
> > i need advice on those who have go!
> >ne before me.Â Do you have a sample contract to share? Haveyou beenin on
> >the start-up of a new clinic where funds are low? What did you negotiate? 
>Â
> > Thank you, Paula
> > >
> > >Paula J. Sumner RN, MSN, HTP, CHt
> > >Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
> > >3500 Westgate Dr., Suite 504-G
> > >Durham, NC 27707 (now Carborro too.)
> > >919-490-4656, 8#
> > >
> > >http://paulajsumner.byregion.net Referral ID#10102918
> > >
> > >http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
> > >
> > >http://www.letstalkcounseling.com/sites/paulasumner
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> >
> >
> >
> >Paula J. Sumner RN, MSN, HTP, CHt
> >Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
> >3500 Westgate Dr., Suite 504-G
> >Durham, NC 27707 (now Carborro too.)
> >919-490-4656, 8#
> >
> >http://paulajsumner.byregion.net Referral ID#10102918
> >
> >http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
> >
> >http://www.letstalkcounseling.com/sites/paulasumner
> >
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>
>
>Paula J. Sumner RN, MSN, HTP, CHt
>Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
>3500 Westgate Dr., Suite 504-G
>Durham, NC 27707  (now Carborro too.)
>919-490-4656, 8#
>
>http://paulajsumner.byregion.net  Referral ID#10102918
>
>http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
>
>http://www.letstalkcounseling.com/sites/paulasumner
>
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