In years gone by, I spent far too much time removing small skin bumps in the office. At the time, I was sharing space with another doctor who was profiting by any service I provided. His staff scheduled me with tons of things that simply made me no money. [Meanwhile his stuff diverted some of my better business into his schedule as opposed to mine.]
The facts of life are that medicine is a business and when I am paying a huge chunk of change to overhead, I need to make that back or I operate at a loss.
Patients frequently don’t understand why I cannot remove their moles for what their insurance pays and make a profit. Well, Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
I know what you’re thinking. “Did he fire six shots or only five?” Well, to tell you the truth, in all this excitement I kind of lost track myself. But being as this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you’ve got to ask yourself one question: Do I feel lucky?
Well, do ya, punk?
Harry Callihan, from the movie Dirty Harry
It was a small article in the Wall Street Journal on 8 August 2011: “Zoll Medical Falls As LifeVest May Face Reimbursement Revisions.” No doubt most doctors missed this, but the implications of this article for our patients discovered to have weak heart muscles and considered at high risk for sudden cardiac death could be profound.
That’s because Medicare (CMS) is considering the requirement for the same waiting period after diagnosis of a cardiomyopathy or myocardial infarction as that for permanent implantable cardiac defibrillators (ICDs). To this end, they issued a draft document that contains the new proposal for their use. Read more »
*This blog post was originally published at Dr. Wes*
Seven months into 2011, things look very different than they did this time last year at my office. Not only have I been using an electronic medical record for nine months now, but I’ve also been submitting claims electronically (through a free clearinghouse) using an online practice management system. I’ve also begun scanning patients’ insurance cards into the computer, as well as converting all the paper insurance Explanation of Benefits (EOBs) into digital form. I’ve even scanned all my office bills and business paperwork and tossed all the actual paper into one big box. As of the first of the year I even stopped generating “daysheets” at the end of work each day. After all, with my new system I can always call up the information I want whenever I need it.
How did such a committed papyrophile get to this point? It is the culmination of a process that actually began last summer with the purchase of an adorable refurbished little desktop scanner from Woot ($79.99, retails for $199, such a deal!) The organizational software is useless for my purposes, but it does generate OCR PDFs, which makes copying and pasting ID numbers from insurance cards into wherever else they need to be a piece of proverbial cake. The first step was to start Read more »
*This blog post was originally published at Musings of a Dinosaur*
“I don’t have the time…I don’t get reimbursed for that.” This is an all too common refrain from primary care physicians and practice managers when ever the subject of improving physician-patient communications comes up.
I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine…physicians in small primary care practices spend about 3.5 hours/week just on dealing with insurance-related paperwork. Then there’s keeping up with recommended treatment guidelines, journals, and IT issues and routine staffing issues…not to mention routine patient care, much of which they in fact do not get paid for. Physicians do have it rough right now.
But Doctors Can Sometimes Be Their Own Worst Enemies
Currently, in just about every State, Read more »
*This blog post was originally published at Mind The Gap*
An article by Brian Klepper and Paul Fischer at Health Affairs has me all fired up. Finally these two health experts are calling it like it is. The Wall Street Journal, New York Times and EverythingHealth have written before about the way primary care is undervalued and underpayed in this country and how it is harming the health and economics of the United States.
A secretive, specialist-dominated panel within the American Medical Association called the RUC has been valuing medical services for decades. They divvy up billions of Medicare and Medicaid dollars and all insurance payers base their reimbursement on these values also. The result has been gross overpayment of procedures and medical specialists and underpayment of doctors who practice primary care in internal medicine, family medicine and pediatrics). These payment inequities have led us to a shortage of these doctors and medical costs skyrocket as a result. As Uwe E. Reinhardt says, “Surely there is something absurd when a nation pays a primary care physician poorly relative to other specialists and then wrings its hands over a shortage of primary care physicians.”
Klepper, Fischer and author Kathleen Behan make a bold suggestion. Let’s quit complaining about the RUC and their flawed methodologies. Let’s quit admiring the problem of financial conflicts of interest and the primary care labor shortage. It’s time for the primary care specialty societies, Read more »
*This blog post was originally published at ACP Internist*