Paul,
For the mobile studies (again check your state laws), you actually lease the service. You provide the site, the equipment and the techs by contracting with a vendor. For the vascular studies you then charge for the technical component of the exam while the cardiologist who reads them (in my case this is all worked out by the vendor) charges for the reading. I then pay the vendor a per-test rate for using his equipment and techs. For bone densities, I charge the commercials the whole fee...technical component and readings and then pay a per exam rate to the vendor. For Medicare, I charge only for the reading. The vendor charges for the technical component. I have been doing bone densities like this for several years. I have been doing the vasculars/holters for about 8 months and I have to say, I believe this additional revenue has been very important in keeping my head above water. As far as the argument that one will order more tests if one makes money off them is perhaps a valid point. However, let me also say that I have picked up an enormous amount of disease that would otherwise gone undetected because I am more apt to do the tests. I have picked up 3 critical coronary artery disease patients this month alone because their ECHOs were abnormal (symptoms were minimal and EKGs were non-specific). All 3 ended up with either stents or bypass. Also, there are some commercials, Humana for one, who urge their subscribers to have studies done in the office rather than the hospital which is much more expensive...by about 30%.
I also had concerns initially that the cardiologists would take offense at my doing "their" exams. However, their meat and taters are the caths and stents and if my doing the tests initiate more referrals to them them we should all be happy... and they are.
Leslie
