Question 1

Who does PSR support?

Accepted Answer

PSR supports three groups: solo independent assistants (CSFAs, SA-Cs, PAs, RNFAs) who want to simplify their back office and keep 80% of collections; keystones — respected, high-volume assistants who want to build a team in their market and earn ownership in their regional entity; and hospitals or health systems who want to convert employed (W-2) surgical assistants to 1099 contractors without disrupting a single case.

Question 2

Is this an employment opportunity?

Accepted Answer

No. Everyone who works with PSR is a 1099 independent contractor. PSR is the structure; they stay independent. If you are looking for employment, PSR is not the right fit.

Question 3

How does the 80/20 split work?

Accepted Answer

PSR's management fee is 20% — full stop. That covers facility contracts, op notes, CPT codes, billing and collections, credentialing, compliance, recruiting, group malpractice, and benefits access. You keep 80%. A full private practice runs 40–50% overhead. PSR's model cuts that in half.

Question 4

What does PSR handle operationally?

Accepted Answer

Everything non-clinical: facility contracts, op notes, CPT coding, billing and collections (partnering with the nation's largest surgical billing company), credentialing, compliance, recruiting, staffing, backfill and travel coverage, and group malpractice. You upload face sheets to Google Drive. That's your administrative job.

Question 5

Is PSR a national organization?

Accepted Answer

Yes. PSR is based on the Mississippi Gulf Coast but operates with more than 700 assistants and providers across 48 states. The national reach gives PSR real operational scale while maintaining founder-led accountability.

Question 6

What does 'ownership in your regional entity' mean?

Accepted Answer

PSR is an MSO with a regional equity model — not a legal franchise. Keystones earn a genuine ownership stake in their regional sub-entity (their market), not PSR as a whole. Each regional entity is majority-owned by the parent; Chris is always the controlling owner. Operators own and grow their market on national infrastructure.

Question 7

What is included for hospitals?

Accepted Answer

PSR takes your employed (W-2) surgical assistants off the payroll and onto PSR as 1099 contractors — without disrupting a single case. The same assistants, same surgeons, same cases. PSR holds all facility contracts, handles credentialing, scheduling, compliance, and the full revenue cycle. You shed the salary, benefit load, and hire-fire-credential burden and gain a scalable roster.

Question 8

How do I know if PSR is a good fit?

Accepted Answer

The best way to find out is to start a conversation. PSR's founder, Christopher L. Sweebe, is personally involved in evaluating new professional relationships. Reach out and we'll take the time to understand your situation before making any recommendations.

Question 9

Show me the real savings — is this just cost-shifting?

Accepted Answer

You already pay a 20–30% load on top of salary for benefits, payroll taxes, and PTO. We take the whole assistant off your books; the commercial majority of cases bills to insurance, and you only cover the government slice we can't collect, at a set rate. Even against your fully-loaded FTE cost, you save on every assistant — and we'll bring the one-assistant model on paper, not 'trust me.'

Question 10

How's the set rate calculated, and what stops it ballooning?

Accepted Answer

It's a formula: case count, your payer mix, and the fair-market value of an assistant in your market, applied only to the cases we can't reimburse. FMV-anchored, transparent, and it recalculates as your payer mix moves — never arbitrary, never a black box.

Question 11

What stops my people from walking once they're your contractors?

Accepted Answer

Nothing about your OR changes — the same assistants keep doing the same cases. They're not being removed; they're getting a better deal. And instead of carrying the hire-fire-credential burden, you get a roster you can scale at a fraction of an FTE.

Question 12

When one's out or quits, who backfills, and how fast?

Accepted Answer

That's what the roster and our travel layer are for — a gap gets filled from our network, not dumped on your OR director at 6 a.m. The coverage commitment is in the contract. Depth of network is the whole reason to use us over a single W-2 who, if they call out, leaves you with nobody.

Question 13

Why do my people say yes — and are the benefits as good?

Accepted Answer

Because most assistants want the autonomy and higher take-home of going independent but are scared of the parts that come with it — self-employment tax, buying their own malpractice, setting up retirement. We remove every one: group malpractice, health insurance, retirement, tax structure, and we teach them to run it. They keep 80% and get a path to ownership. And if a few want to stay W-2, we run alongside them — nobody's forced.

Question 14

Bad outcome in my OR — who's liable, who carries the malpractice?

Accepted Answer

PSR carries a group malpractice policy that covers every assistant in the network, at real limits, with your facility named and protected. A facility's policy doesn't extend to a contractor anyway — so the coverage that responds is ours, not yours. You're better protected than with a W-2 you self-insure.

Question 15

Is converting employees to 1099 even legal? Who's liable if it's misclassification?

Accepted Answer

Two parts. First, we're the contracting party and the payer, so the classification risk sits with PSR, not your hospital. Second, this is a real model, not a relabeling trick: our assistants contract through us, run their own practice, work multiple facilities, and carry their own business risk — the control genuinely moves. The IRS and DOL both ask the same core question, and as of 2026 the federal posture has shifted toward making independent-contractor classification easier. The entire 1099 anesthesia profession runs this exact way. We structure it with healthcare counsel and check the stricter state standards market by market.

Question 16

Has this been blessed by counsel? Clean on Anti-Kickback and Stark?

Accepted Answer

We don't put this in front of a hospital until our healthcare regulatory counsel signs off. Two things keep it clean: the rate you pay is fair-market-value and formula-driven, never tied to referrals; and money flows one direction — you pay us for a defined service, we never pay you for sending us cases.

Question 17

If it doesn't work, can I unwind it?

Accepted Answer

Yes. These are still your cases and relationships — if it ends, the assistants convert back or you bring coverage in-house. We build clean termination terms with a transition runway, so you're never left exposed. We win by performing, not by trapping you.

Frequently Asked Questions

General FAQ

For Hospitals

Still Have Questions?