I am curious as to others' experiences on being paid salary, hourly, productivity, or a combination?

I am an FNP working 32hr/wk in a women's health setting.  I am being paid a lower-than-average salary with no raise for 2 years. Up until recently I was not billing much because of administrative roles.

I have recently started billing more and want to know what is a reasonable % of revenue to be paid (by my practice)? My collaborating physicians are paid by productivity but I can't get the actual #/percentage. I do not expect to be paid at the same rate, but would like to know what it reasonable.  Thank you.

That will depend on  how often you require a consult with your collaborating physician.

Almost never= 70-80 %, depending on area, of NET PROFIT. 

 This is almost never done, however, because of NP's dependance on their collobarators.  In almost every state, we must have them to practice and they know it.  We only aide this attitude by settling for less.

Hey Erin,

I think a good rule of thumb would be to ask for 40% of profit from you productivity after doubling what it costs to pay you during the year. In other words, you are salaried for $80,000 per year plus benefits. That costs your company $110,000 to employ you. So after you bill for and collect $220,000 you will then get 40% of any additional profit from your collections.

Troy

I work for an organization that started paying nps on purely productivity about 3 years ago.  It has actually increased my annual pay by about $20,000 or more.  At this point, all speciaties--fp,peds, gyn, are being paid the same basic.  We are payed vu.  currently 26.75 per work rvu.  Interestingly, last year, we were $30.50 per work rvu.  Recent changes by medicare in the rvu values of office visits (they are worth more now) actually decreased our "conversion factor".  It has still netted me a nice raise, even so.  The first thing I would recommend is asking for a productivity report--how many rvu's are you producing. 

 Our company looks to "community standards" to set rates.  Mean RVUs produced by NP's becomes the goal.  Mean salary for NPs in the area.  then they divide the mean salary by the productivity to determine the factor per rvu that we are paid. 

 It was a very scary transition for us, but overall, has been very beneficial.  I believe we all saw how undervalued we were. 

Troy-

I am a FNP Student who plans to graduate May 2009.  In class were discussing different benefits to bargain for when establishing a contract with potential employers.  The one thing that was discussed when focusing on production bonuses was to make certain that the bonus is based off the amount of services billed, not that amount of collections recieved.  I noticed that your reply to Erin was the opposite.  Have you found this to be true with most employers?

Thank you,

Andy  

Hi Andy,

As a practice owner, I only wish it were true about getting paid based on services billed. Unfortunately, it does not work that way.

For example, I can bill out $100.00, yet the insurer may only "allow" $60.00, sometimes less. Then of course, there are those visits that are denied - the individual didn't have coverage that month, the code you billed for was not covered, the service you performed is now bundled, etc. Assuming your office gets the full amount in the above example, that would mean they would recieve 60% of the amounts billed. Many office are operating on a 50% overhead (often times more). That brings this amount in the example down to 30%.

Something to think about....