Telehealth side work compared

The one figure you can know beforehand

A video precepting half-day is priced per hour of student time. Four hours with a student on camera is four logged hours, and the rate is the one you picked when you opened your hours. At the floor of the NPhours band those four hours come to $48; at the ceiling they come to $80. Sixty of those hours make a half-block. Nothing about that number depends on how many patients turn up.

The other three pay by output, not by clock, which is why nobody can quote you a Saturday figure for them without seeing the contract. What you can do is read the pay clause and convert it into an hourly estimate yourself. In each case below, the sentence to hunt for in the agreement is named. Write the estimate down before you accept, because the estimate is what you are actually agreeing to.

The telehealth panel shift

Direct-to-consumer and payer-sponsored panels usually pay per completed visit, sometimes with an hourly floor for a scheduled block, sometimes with a bonus above a visit threshold. Look for three lines in the contract: the fee for one completed encounter, whether a no-show or an incomplete intake pays anything, and whether the hourly floor survives a slow queue. Multiply the visit fee by the number of visits the queue realistically delivers in an hour.

The setup is the heaviest of the four. Expect credentialing, payer enrolment where claims are billed, malpractice coverage in the states you cover, a training module on the vendor's own record system, and separate licences for every state the panel serves. Weeks can pass between signing and your first shift. Compact status covers registered nurses, not advanced practice, so each state where a patient sits wants its own APRN licence.

Asynchronous chart review

Store-and-forward work pays per chart or per case: intake questionnaires triaged for refills, utilisation and coverage reviews, e-consults answered in writing. The clause to find is the fee per completed review, the turnaround window attached to it, and whether a case you decline or escalate still pays. Then time yourself on ten charts. Reviewers routinely find that a fee which looked fine per chart becomes thin once the harder cases are averaged in.

Onboarding is lighter than a live panel but not light. There is a platform to learn, a documentation standard to match, and often a quality audit on your first batch. Licensure still follows the patient: the state where the person receiving the advice is located governs, so a reviewer working a national queue is buying and renewing licences as a cost of doing business. Ask which states the queue actually feeds you.

Health content writing

Writing pays per word, per piece, or occasionally per hour of review. The contract lines that matter are the fee, how many revision rounds are inside it, whether a spiked draft is paid at all, and who owns the byline and the copyright. A per-word rate is easy to compare and easy to misjudge: a clinically accurate piece with citations takes far longer per word than a listicle, and the fee rarely reflects that.

No licence is required to write, which cuts both ways. Nothing stops you starting on Saturday, and nothing stops anyone else either, so the rate is set by a wide market rather than by your credential. Expect an unpaid sample, a slow first month, and a real rate that only climbs once an editor stops sending changes. Of the four, this is the one where your hourly return depends most on repetition.

What four hours of video precepting looks like

The student joins your video room at eight. You take the first patient together, then hand over the second: the student takes the history on camera, leaves the room to present, and you go back in for the pieces that need you. Follow-ups on stable medication, results review, chronic disease check-ins and counselling visits all work by video. At noon the student logs the hours and you attest to them.

The setup is credential work, not credentialing. An active unencumbered licence, board certification in the population you teach, and two years of practice in that population since you were certified. After that it is the program's paperwork and a 90-minute orientation. Because the patient is your own patient in your own state, no new licence is bought and no payer enrolment is opened.

Setting the four side by side

Rank them on how many weeks pass before the first dollar arrives. Writing is fastest to start and slowest to pay well. Chart review sits in the middle on both. A panel shift pays reliably once you are through credentialing, which is the longest runway of the four and the one most likely to stall on a licence application. Precepting starts when a program signs, and the figure never has to be estimated.

Then rank them on what happens when Saturday gets taken by something else. Visits and charts simply do not get done and do not pay. A writing deadline moves once, politely. A rotation is a commitment to a student, so it is the one to think hardest about before saying yes. If you want the four sitting in a single ranked list with the setup time attached, that comparison lives on the income options page.

Questions

Sources: IRS Form 1099-NEC

Written by

Dagny H., EA

An enrolled agent. Pays the two halves of every block, issues the 1099-NEC each January, and keeps the state tax-credit table current. Will not compute your liability; will tell you what to ask your preparer.