Transitioning from a Non-pain
Practice to a Part-time Pain
Practice:
While this represents an excellent method of
"testing the waters" , there are some
caveats. If you are in a group practice, then
all billing numbers are in the group practice
name, and you cannot bill separately to
insurance, Medicare, or Medicaid without
new identifying numbers. If you have no
issue with collections for your pain services
being received by the group, then there is
not a problem with respect to billing.
Practice to a Part-time Pain
Practice:
While this represents an excellent method of
"testing the waters" , there are some
caveats. If you are in a group practice, then
all billing numbers are in the group practice
name, and you cannot bill separately to
insurance, Medicare, or Medicaid without
new identifying numbers. If you have no
issue with collections for your pain services
being received by the group, then there is
not a problem with respect to billing.
Billing for anesthesia and for pain medicine have little in common. See the section on coding and
billing.
Transitioning from Part Time Pain Management to Full Time Pain
Management:
If one remains in the same group, then the process is relatively simple if a. your partners do not
insist on taking part of your collected income b. the anesthesiology on-call duties are reduced or
eliminated c.you are given autonomy in your schedule to permit advertising, networking, and
growth of the pain practice, and d. the group can appreciate the need for seeding the pain practice
with funds to achieve an operational status. Some anesthesiology or PM&R groups may see a pain
physician's higher income and may become quite jealous over such, especially if the group has
seeded money for initial operations. If the group is based on total equity in income, the pain
management model will not work within such a system when some docs become full time pain and
others are full time anesthesia. If on the other hand, the group adopts the financial philosophy,
"You eat what you kill". then a pain unit may be viable providing the financing of the start up can be
agreed upon.
If a person is leaving one group and going full time pain management, then there are several
sequential items that must be handled in order, lest one may have no income for 6 months.
Credentialing with insurers, changing DEA licensure addresses, setting up the office infrastructure,
referral sources, etc. are all important with respect to the process (see "Making the Jump" in the
next chapter)
Transitioning from One Full Time Pain Practice to Another: If the new
practice is in the same city as the old, non-compete clauses commonly prevent physicians from
engaging in this practice. Of course, a physician may "buy" his way out of the non-compete clause
if the old group is amenable to such. However. if the physician making the transition is well known
in the community and would potentially take large numbers of patients with him, it is unlikely the old
group would agree to this. Some clauses prevent practice anywhere within 50 miles of the old
practice. Tips to the wise: if at all possible, remain friendly with the former employer, the staff of the
former employer, and anesthesiologist in the hospital. See "Making the Jump" in another section.
billing.
Transitioning from Part Time Pain Management to Full Time Pain
Management:
If one remains in the same group, then the process is relatively simple if a. your partners do not
insist on taking part of your collected income b. the anesthesiology on-call duties are reduced or
eliminated c.you are given autonomy in your schedule to permit advertising, networking, and
growth of the pain practice, and d. the group can appreciate the need for seeding the pain practice
with funds to achieve an operational status. Some anesthesiology or PM&R groups may see a pain
physician's higher income and may become quite jealous over such, especially if the group has
seeded money for initial operations. If the group is based on total equity in income, the pain
management model will not work within such a system when some docs become full time pain and
others are full time anesthesia. If on the other hand, the group adopts the financial philosophy,
"You eat what you kill". then a pain unit may be viable providing the financing of the start up can be
agreed upon.
If a person is leaving one group and going full time pain management, then there are several
sequential items that must be handled in order, lest one may have no income for 6 months.
Credentialing with insurers, changing DEA licensure addresses, setting up the office infrastructure,
referral sources, etc. are all important with respect to the process (see "Making the Jump" in the
next chapter)
Transitioning from One Full Time Pain Practice to Another: If the new
practice is in the same city as the old, non-compete clauses commonly prevent physicians from
engaging in this practice. Of course, a physician may "buy" his way out of the non-compete clause
if the old group is amenable to such. However. if the physician making the transition is well known
in the community and would potentially take large numbers of patients with him, it is unlikely the old
group would agree to this. Some clauses prevent practice anywhere within 50 miles of the old
practice. Tips to the wise: if at all possible, remain friendly with the former employer, the staff of the
former employer, and anesthesiologist in the hospital. See "Making the Jump" in another section.