Member Forum

Expand all | Collapse all

direct pay while doing hospitalist moonlighting

  • 1.  direct pay while doing hospitalist moonlighting

    Posted 08-14-2018 14:20

    Can someone enlighten me if I can:
    1. have a direct pay model integrative consultant practice
    2. and still do moonlighting as a hospitalist as per diem
    3. can i still see medicare patients with my direct pay consultancy?
    4. do i need to opt out?

    IMP Guest

  • 2.  RE: direct pay while doing hospitalist moonlighting

    Posted 08-15-2018 04:58

    Happy to help answer questions about DPC – we've helped over 500 docs convert to dpc free.



    1. The technical answer is that you can't do both: accept medicare in the hospital and do a dpc membership in your clinic.
    2. But there's also a few works arounds:
      1. Dr. Phil has a great website on opted out moonlighting options -
      2. Locums billing allows you to be opted out if the hospital is willing to bill under the medical directors NPI
      3. Dr. Haseeb at still works the hospital but has been able to work with the team so that he only sees non-medicare patients and that's worked well.
    3. Some doctors in the start up phase will:
      1. Not opt out so they can keep a medicare job opportunity so they have + cash flow while the clinic is growing
      2. Which means they just don't accept medicare aged patients in the dpc clinic until they're ready to stop moonlighting


    Feel free to contact me directly anytime either by email or cell. and C 316.734.8096



  • 3.  RE: direct pay while doing hospitalist moonlighting

    Posted 08-15-2018 08:38
    You cannot have Medicare patients pay you directly in your consultative practice for services that are covered under medicare. In other words, if you are a medicare participating physician, and see a medicare patient for a medicare covered service, the patient may not pay you directly.

    If you opt out of Medicare, you opt out everywhere (you can’t opt out for the consultative practice, and remain in as a per diem).

    If you see a Medicare patient in your consultancy and provide non-medicare covered services, you may bill them directly for those non-covered services. You should have a written agreement in place, and I’d recommend discussing with a lawyer that knows this stuff, as making a mistake is potentially very costly.

  • 4.  RE: direct pay while doing hospitalist moonlighting

    Posted 08-15-2018 11:25
    I'm confident you can do this but you should call your Medicare administrator to get the specifics on how.

  • 5.  RE: direct pay while doing hospitalist moonlighting

    Posted 08-16-2018 14:04
    I'm not a lawyer, but perhaps if you form a corporation of your direct pay model, and you are an "employee".

    If your corporation does not have a contract, nor credentialed with, Medicare,
    your "employer" should be able to refuse Medicare billing,
    and Medicare care should not be able to insists that the they be billed through you as an "employee"?

    Just a thought.

    Milton (Moshe) Stern, M.D.
    Staten Island, New York
    He [Hillel] used to say: If I am not for myself, who is for me?
    And if I am only for myself, what am I?
    If not now when? (Avot 1:14)