Retina collection

[newby000]

Could you please comment on retina collection schemes? Seems like there is some variation from practice to practice.
From what I gathered, your collection is the clinical and surgical work ( discounting the facility fee unless you own shares in the center) you do plus or minus a certain percentage of your drug money. How is the drug money contributed to your collection? Do you typically see that added to your collection as an associate or partner? What percentage is added to your collection? What is the average percentage take home for a partner vs associate vs pe? Would appreciate any input. Thank you

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[AQ888]

Bump. Would also be interested in knowing what the typical overhead rates for different practices are?
Also, can someone please comment on the different salary models, with some practices offering a base + bonus vs X% of total collections

 

[Openglobetrotters]

From my understanding, as a employee, your collection is your physician fee.

Drugs such as intravitreal medications, facility fee and diagnostics like OCT macula are NOT part of the collections (designated health services). This is to avoid anti-kickback and stark laws. Some practices don’t know this and include diagnostics part of collections, but it should not be if you’re an employee.

So production bonus is usually 20-30% of over 2-3x your net collections, but unfortunately net collections does not (should not) include things like facility fee, drugs, and diagnostics.

When you become partner, that changes and those fees can be distributed either based on production (eat what you kill) or split evenly between partners.

 

[dantt]

From my understanding, as a employee, your collection is your physician fee.

Drugs such as intravitreal medications, facility fee and diagnostics like OCT macula are NOT part of the collections (designated health services). This is to avoid anti-kickback and stark laws. Some practices don’t know this and include diagnostics part of collections, but it should not be if you’re an employee.

So production bonus is usually 20-30% of over 2-3x your net collections, but unfortunately net collections does not (should not) include things like facility fee, drugs, and diagnostics.

When you become partner, that changes and those fees can be distributed either based on production (eat what you kill) or split evenly between partners.

I know people who get 40% as employees including drug rebate...

 

[Openglobetrotters]

I know people who get 40% as employees including drug rebate...

I guess it’s at the Practices’ discretion?

https://www.retinalphysician.com/issues/2017/nov-dec-2017/coding-q-ampa-designated-health-services-what-y

 

[newby000]

It has been my understanding that it varies significantly from practice to practice, though I am not quiet sure how it works for PEs, and whether they get better drug rebates due to their bargaining powers.
AQ888, it is typically like openglobetrotter mentioned, a certain base and 2 or 3 times of that you start getting 20-40% of your collection. It really varies, some has less buy in Some has more, all of these are considered in the calculation.
Pe is different as there is no buy in but you may be given options to buy shares in the company, and they may give you a straight up percentage of your collection, with initial base until you build up your practice.
I am not sure how much percentage goes up once you become a partner though.

 

[dantt]

I guess it’s at the Practices’ discretion?

https://www.retinalphysician.com/issues/2017/nov-dec-2017/coding-q-ampa-designated-health-services-what-y

It is indeed at the practice's discretion. I'm just giving OP and whoever else is reading an idea of how much money is involved. If you're getting 20% professional fees only, they are making TONS of money off of you. It hurts to think how bad you're getting screwed.

 

[newby000]

Can you please comment on collection in PE practices? Is the rebate added to your collection pool? Regarding the Percentages, I have heard any where from straight 33% to increasing up to 40% with higher collection amount.

 

[mjohnsonets]

The total number varies from practice to practice and practice model to practice model. There are trade-offs anywhere you go.

In short, as a retina doc you're likely looking at 30-40% take home of what you collect in a multi-specialty and 35-45% of what you collect take home in a retina only practice. These are averages and I've heard better or worse in both types of groups and there are differences in urban and rural practices. I did not include base salary because I'm just commenting on the general amount you should make per dollar collected. As for PE practices, that is varied as well at this point but I would say generally falls in the 30-40% range once you're busy. The PE group will pay you a higher base upfront.

There are other models as well that are more complicated and based on collections pools.

As for Stark law, it does prevent many from being paid for DHS including drug costs but as a partner, there are more creative ways to work around that as others have noted.