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MD wanted to partner with me?
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MD wanted to partner with me? - June 26, 2006 4:54:00 AM
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cowboybuboy
Posts: 51
Joined: June 15, 2005
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I wonder if I can partner with a physician in my area to operate a PT clinic for him and he can pay me per patient?
Have any of you done a similar set-up?
My doctor asked me if I can see his patients for physical therapy in his clinic. I think he has worker's comp for most of them.
What do suggest?
Thanks!
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Re: MD wanted to partner with me? - June 26, 2006 1:11:00 PM
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FLAOrthoPT
Posts: 1011
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From: West Palm Beach
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devil went down to georgia...
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Re: MD wanted to partner with me? - June 26, 2006 1:27:00 PM
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hmgross
Posts: 286
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From: Minnesota
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:eek:
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Holly Gross PT
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Re: MD wanted to partner with me? - June 26, 2006 1:49:00 PM
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drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
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Lot of legal implications associated with this set up. Find a lawyer with a lot of experience in this area.
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Re: MD wanted to partner with me? - June 28, 2006 7:01:00 AM
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TLB
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From: Arizona
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As long as you can get 100.00 per pt. visit I dont see a problem........
He's lookin for a soul to steal
He's in a bind
Cause he's way behind
And he's willin to make a deal
_____________________________
Todd
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Re: MD wanted to partner with me? - June 28, 2006 11:41:00 AM
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Alex Brenner PT MPT OCS
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From: Kentucky
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he came across a young cowboy sawing on the fiddle and playing it hot..
sorry, I couldn't resist.
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Alex Brenner, PT, MPT, OCS
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Re: MD wanted to partner with me? - June 28, 2006 12:33:00 PM
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TLB
Posts: 346
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From: Arizona
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And the DOC jumped up on a hickory stump and said, "Cowboy let me tell ya what.
I guess you didn't know it, but I'm a rehab specialist, too
And if you'd come to work for me, I'll make more money than you.
Cowboy, I hope you know were just having a little fun but I do have a serious question for you. Why can't you just pay him a reasonable rent for space and do your own thing?
_____________________________
Todd
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Re: MD wanted to partner with me? - June 28, 2006 2:24:00 PM
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FLAOrthoPT
Posts: 1011
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From: West Palm Beach
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glad some people caught on..but really...seems to fit the song
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Re: MD wanted to partner with me? - June 28, 2006 7:04:00 PM
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cowboybuboy
Posts: 51
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I don't have the reimbursements set up yet. I've thought of that already but how would I bill for those patients?
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Re: MD wanted to partner with me? - June 28, 2006 7:12:00 PM
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cowboybuboy
Posts: 51
Joined: June 15, 2005
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Any ideas on how I can start with worker's comp, private insurance and blue cross blue shields? I don't want to start with medicare yet since I don't have that much money to start with. I believe the doctor would understand if I propose to rent a space from him.
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Re: MD wanted to partner with me? - June 28, 2006 8:57:00 PM
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TLB
Posts: 346
Joined: September 13, 2002
From: Arizona
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Check these guys out.
http://www.ptpn.com/
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Todd
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Re: MD wanted to partner with me? - June 29, 2006 7:00:00 AM
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KIDPT23
Posts: 222
Joined: May 20, 2002
From: Illinois
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Beware of PTPN!! First they would not allow our company in because there were other facilities in the area that were utilizing them, it is over $3000 dollars a year to use them, and you are bound by the reimbursement rates that they have set up with the insurances. The other issue I have seen is that you pay them $3000 plus and by the time you fill out all the paperwork, have it all submitted to the individual carriers, and when their board reviews your credentials, you will be at about 6-8 months before you are considered in network and longer depending on when they update their provider list.
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Re: MD wanted to partner with me? - June 29, 2006 7:18:00 AM
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drbuddy
Posts: 429
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From: Pennsylvania
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For private insurance and the blues, just contact those companies and let them know you are a PT and want to become a provider. They will send you an application. Warning - call them once per week to check on the status of your application. If not, they will set it to the side, lose it, forget about it, etc. No lie, call them once per week. Warning #2 - check fee schedules for some of the smaller insurance companies, even one like UHC. Some set per visit rates at ridiculous amounts like $30-40 no matter what you do. Warning #3 - it can take many months to get approved and get your provider numbers. For some companies, it took me 3-4 months of messing around. So, start now if you plan on going out on your own at all in the future.
For WC, it will depend on state law. In this case, if the MD is on a company panel, he might be able to refer to whomever he wants and it will be covered. In this case, that would be you.
You will probably come across many networks that are "closed". Check their provider list and see if it looks like their is enough providers in your area. Or, maybe you have other things to offer that their current providers do not, such as speaking a different language, specializing in certain patient populations, gender, etc. Also, you can probably have your MD call up and tell them they want you in the network (if the MD is also in that network). For that to work, you might have to be the MD's employee.
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Re: MD wanted to partner with me? - June 29, 2006 9:11:00 AM
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cowboybuboy
Posts: 51
Joined: June 15, 2005
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Wow! Thanks for the info.
I guess my other question is, do I need to have a medicare number to be a provider?
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Re: MD wanted to partner with me? - June 29, 2006 9:58:00 AM
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drbuddy
Posts: 429
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From: Pennsylvania
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Not sure. You might as well get it though. Why wouldn't you? You can still refuse to care for people with Medicare (I think).
The medicare number is not as bad becuase it is retroactive. Should you wish to start taking medicare patients, you can treat them and hold the claims until you get issued a number. There is a deadline, but it is several months. This is not the case with other carriers. If you see a patient today and get your provider number tommorrow, you will still be considered out of network for all claims prior to the date you became a provider.
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Re: MD wanted to partner with me? - June 30, 2006 2:35:00 PM
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jlharris
Posts: 468
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From: Nebraska
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As I understand it, PT's can not "opt out" of being a provider for medicare. It's something you would really need to look into before refusing to see medicare pt's. Heck, and being a provider may not proclude you from choosing not to see any medicare pt's.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
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Re: MD wanted to partner with me? - June 30, 2006 3:29:00 PM
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SJBird55
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From: Michigan
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With BCBSM, when I filled out their paperwork to be a provider, even though I became a provider months after I applied because of the time it took to be issued a provider number, I COULD submit claims for services that were done prior to receiving my provider number because BCBSM used the dates that I had on my forms as the date that my provider number would be in effect. If you aren't sure, just call provider enrollment and someone in that department would be able to answer when you have provider status with them.
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Re: MD wanted to partner with me? - July 1, 2006 2:12:00 PM
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cowboybuboy
Posts: 51
Joined: June 15, 2005
Status: offline
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So, do I need to rent a place first before I get to be a provider to these insurance companies?
Thanks!
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Re: MD wanted to partner with me? - July 12, 2006 9:26:00 AM
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bhenchodh
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Joined: April 4, 2006
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I was offered a similar proposition many months ago by a GP. I refused after consulting with my NJ state PT board. They told me I would be in strict violation of an NJ by-law and other issues. Don't even consider sharing the profits (Stark's law). The one with billing is that if you are consistently seeing patients in one building from one MD and are sharing offices then PT billing has to be incident - to MD visits. MD has to bill under his provider number. My suggestion: find out who heads the illinois PT board. Its always a professor in one of your local university DPT programs. find out the school e-mail and then send your concerns. Include your full name. See what happens. If he/ she don't respond then find another board member's e-mail. Maybe one of your own professors is now serving on the state board if you graduated in illinois. It wil not be an official answer but the unofficial answer will be fast and the tone of the wording will let you know how seriously your state board takes this PT/ MD casual partenrship issue.
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Re: MD wanted to partner with me? - October 28, 2006 8:50:00 PM
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PainFreeMan
Posts: 42
Joined: October 26, 2006
From: Texas
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Hey Cowboy,
Not sure what state you are in. Here in Texas if you are going to be working under the same roof as your MD friend, and if the MD has a Medicare provider’s number, you fall into the “incident to” rule. This means you and only you (PTAs do not fall under this rule), can provide services for Medicare patients and be billed under the MD. The MD can cut you a check later as a contracted labor or as an employee. Now if you want to bill under yourself, you MUST have a Medicare Provider’s number….and that can take some time to get….maybe as long as 6 months or so. Hope this helps.
Doug
_____________________________
Douglas Lu, DC, PT, MPT
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