This upcoming January 4, 2010 will prove an important date for any physician who prescribes durable medical equipment for their patients to use in the home. The Centers for Medicare and Medicaid Services (CMS) have implemented an internet-based enrollment process for Medicare termed PECOS, another progeny of the 1996 HIPAA legislation. PECOS stands for Provider Enrollment, Chain and Ownership System and was created in large part to prevent fraud. Yet when I called the PECOS helpline, fraud was not a concern, and it was explained to me that PECOS is an internet version of my Medicare Application.
Since my practice makes house calls, we treat a variety of home-bound patients unable to make it to a doctor’s office without great effort. We care for stroke patients, quadriplegics, those with end-stage pulmonary disease, and many simply weakened by the effects of advanced age. Most need equipment like mattresses to prevent recurrent pressure sores, wheelchairs, nebulizer machines, or oxygen. A patient depends on their physician’s ability to order anything necessary, and it is imperative this be done without creating an exorbitant financial burden or by denying them a Medicare benefit already paid for. But, according to our Home Supplier, if we haven’t enrolled by January 4 then our Medicare & Medicaid patients will have to pay 100% of the cost for any equipment prescribed. Read more »
Over 25 years ago I witnessed a crime, committed by my family doctor. I was waiting to pay for my visit when an elderly, dignified, but obviously poor woman pulled out her checkbook, clicked open her pen, and asked, “How much do I owe?”
The receptionist’s answer piqued my interest and admiration, “The doctor said no charge, we’ll just bill your insurance.” I still remember the gratitude conveyed by her body language as she said, “Thank him for me,” returned her checkbook to her purse and left. Naïve to the complexity involved in medical billing, I was unaware that anything wrong had been done and did not resent having to pay for my office visit since our family could afford to pay; however, he eventually served time in jail for what I have always considered crimes of compassion. Perhaps I lack the details of his legal case to properly consider his actions but I’ll never forget the respect shown him by my home town in rural Tennessee after his time had been served; my family among many he continued to care for. Read more »
In 2005, I was invited to participate in an innovators’ workshop by the Harvard Interfaculty Group, funded through a grant from the Robert Wood Johnson Foundation. The question at the meeting was this:
“If primary care is critical to a vibrant and cost effective healthcare system, and
If primary care is going extinct, which most now predict;
Who is out there innovating new primary care systems and what is their vision?”
During the four years since this conference, I’ve found that this question is first and foremost when it comes to changing primary care.
I felt honored and surprised to be invited to the meeting. After all, our practice and its innovations are simple and are based on the following: Read more »
“To see what is in front of one’s nose needs a constant struggle…” George Orwell
Do you know what the “P” in HIPAA stands for?
If you said “privacy” you are quite wrong. HIPAA stands for Health Insurance Portability and Accountability Act and was originally intended to guarantee health insurance when someone changed jobs. But the word “portability” is a far cry from “privacy.”
Since April 14, 2003, patients have been required to sign these forms, creating the durable illusion that our medical records are private. We sign HIPAA forms when we see our dentists, doctors, and upon receipt of a host of other health-related services. Yet your personal health information is anything but private — and the more legislation Congress passes the more public this information becomes. Read more »
I was interviewed about my participation in DocTalker Family Medicine, a new type of medical practice that dramatically reduces the administrative burden of healthcare. The solution is easy: transparent fees, low overhead, reliance on technology, and no insurance paperwork. Patients who are tired of waiting to see a doctor, or filling out insurance forms, can get immediate care, generally for under $50. The average patient in our practice spends under $300/year on their primary care – and carries insurance for catastropic events.
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