Dental X Ray

Thursday Troubleshooter: Should associate be compensated for time spent on X-rays?

March 26, 2014
Dentist associate wonders about practice's X-ray policies

QUESTION: I am an associate currently working as an independent contractor for an office where they do not provide any compensation for the X-rays taken on patients. The office manager says that the reason is because the assistant takes the X-rays and he/she gets the credit for completing that action while the doctor gets the credit of the exam. By definition of the exam, it includes the use of any aids, including images present.

My argument is that I am responsible for the interpretation of the images taken, and my license is what is being used to claim reimbursement.

Can they continue this practice of not providing compensation if I demand none of the X-rays be claimed to insurance under my name, and use the owner dentist’s license? Also, how will this be different when no insurance is used?

Regarding the billing of the service, the doctor who authorized the images and read the images should be identified as service provider on the claim form. The owner doctor, practice, or other authorized individual/group can have the check issued to them. This meets the requirements established for proper billing compliance. Who gets credit (paid) for the service is subject to the employment agreement between the associate and owner doctor. My experience has been that the authorizing doctor is given credit for the service.

My experience is that the associate should agree to what procedures he will be compensated for prior to signing his or her employment agreement with the employer. The Employment Agreement should in part outline what procedures the associate gets paid for in the hope of avoiding any misunderstandings between the parties.

It doesn’t matter of the associate is getting paid per hour or per diem. However, if the associate is compensated based on his or her production or collections, then the procedures performed are important to identify in advance. In my experience, 99 out of 100 times the associate gets paid for his or her own procedures, along with the exam portion of the patient’s hygiene visit. X-rays are seldom mentioned.

I agree with Dr. Shelburne. If the office is billing medical, the NPI of the providing doctor has to match the line item and the payment can go to the office NPI address. I agree that if the doctor is reading, he should receive a percentage of reading the film. He does not have to get credit for taking the film.

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