Medicare

[Guest guest]



Okay, thanks. That is what I thought.

Dr. Layman

Medicare

I no longer want to accept new Medicare patients. This is in attempt to wean Medicare patients from my practice. For the time being I will continue treating existing Medicare patients. My receptionist thinks maybe I don't have this option since I accept assignment. Is this correct? Do I have to continue accepting Medicare patients if I accept assignment?

Dr. Layman

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[Guest guest]

It seems unconstitutional to me that participating docs do not have the right to turn away medicare patients when they choose to do so. It seems that it would be fair for participating DCs to be able to choose when they have "enough" medicare patients for a while and when they're willing to take on more medicare. Any of our attorneys want to give an opinion on this?

Janet L Rueger, DCCertified BodyTalk Practitioner149 Clear Creek Dr., # 105Ashland, OR, 97520541-690-6799bodytalk@...

On Aug 18, 2010, at 9:43 AM, cote@... wrote:

That is interesting, a little while ago I had a newly medicared patient (I don't know if that is really a word) and she did not have a PCP. She presented with a multitude of symptoms that made me suspicious of an underlying serious problem, so I wanted to refer her out for testing and imaging. To my surprise NONE of the PCPs in Silverton (over 20 of them) were accepting new Medicare patients. I finally pulled a church connection and appeal to the doc's Christian goodness and got her in. She was DX with cancer a week later and received proper treatment. All of that to say that it seems to be common practice to have limited space for Medicare patients with the MDs why not us. Cote DCSilvertonSent from my Verizon Wireless BlackBerryFrom: AboWoman@...

Sender:

Date: Wed, 18 Aug 2010 12:25:18 -0400<hbf4747@...>; <Oregondcs >Subject: Re: Medicare

Listserv and Dr. Layman,

if you accept assignment, it is in violation to say 'I no longer accept Medicare patients' whether they're new or existing. You must opt out. This is an absolute rule.

Keep in mind that if a medicare aged patient is in an auto accident and you accept them for this; and for some reason the claim goes belly up; you must bill medicare if the patient requests it. You would bill as a non-par provider if you've gone thru the process of declining your assignment status. You would not be able to bill the patient for ANY services that medicare doesn't cover, unless you have them sign the ABN form at the ONSET of the auto claim. That way they understand from the onset of the services provided that they may be responsible for 'uncovered' services if medicare is billed. If you turn away medicare patients when you're an assigned medicare provider, you could be in legal trouble with medicare.

Herb's correct that if you, in fact, have no current openings for any new patients, you can refer them out to a colleague; even if you're an assigned medicare provider. However, if this is challenged, and your schedule book is brought fwd as evidence, it could also result in violation if you did in fact have an opening. I've never heard of this happening in all my years in regulation. I've never heard of it happening in any state during 6 yrs of listening to all the other state board presidents at annual meetings. Still, you should be aware, that most savvy investigators will request the schedule book for any questionable activities/complaints that may involve that function.

Minga Guerrero DC

Re: Medicare

Dr. Layman,

If a medicare patient calls your office and you chose not to see them the humane thing to do is to tell them that you are fully booked and offer to send them to a colleague. I know that there are a number of D.C.'s in the Salem area who would be happy for the referral. If you can't think of anyone to send them to you're welcome to have them call my office and we will channel them or care for them ourselves.

Herb Freeman D.C.

Medicare

I no longer want to accept new Medicare patients. This is in attempt to wean Medicare patients from my practice. For the time being I will continue treating existing Medicare patients. My receptionist thinks maybe I don't have this option since I accept assignment. Is this correct? Do I have to continue accepting Medicare patients if I accept assignment?

Dr. Layman

[Guest guest]

Janet, if you think Medicare rules are outrageous, wait till you see the implementation of Obamacare... It won't be pretty,but at least the lawyers will be making a living if we aren't. R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818----- Medicare

I no longer want to accept new Medicare patients. This is in attempt to wean Medicare patients from my practice. For the time being I will continue treating existing Medicare patients. My receptionist thinks maybe I don't have this option since I accept assignment. Is this correct? Do I have to continue accepting Medicare patients if I accept assignment?

Dr. Layman

____________________________________________________________Banks Forced to Forgive Credit Card DebtFind Out How Much of Your Debt Can Be Erased.LowerMyBills.com

[Guest guest]

The recent thread concerning accepting new Medicare patients has been interesting. To quote McClelland, "You always have a choice in whether or not you accept a patient for care.This is not dependent on participation status." Just keep in mind, when you adjust that Medicare patient you must bill Medicare. Also, if you do not treat and thus bill Medicare for one year they may drop you from their system. Then if you change your mind at some later time you may have to go through that oh so fun reenrollment process.

J. Holzapfel, DCAlbany, Oregon541-928-4060

[Guest guest]

I do not believe the nutrition evaluation is covered by Medicare. We collect from the patient for that appt. Simler, MS, RD, Manager for Weight Loss Surgery and Osteoporosis ProgramsValleyCare Health System925-416-6712 >>> "mannfrd" <mannfrd@...> 9/7/2011 8:34 AM >>> Is anyone submitting to Medicare for reimbursement for the nutrition component? If so, what diagnosis code(s) do you use. Do you see them individual or do you ever submit for a group class?Thanks to anyone who can give me any insight.

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[Guest guest]

If the patient has diabetes and is not getting MNT elsewhere, why could we not submit to medicare if we cover diabetes and nutrition info. Actually, any info we cover that assists the patient with weight loss would help with their diabetes. What are others doing?

a Serafino-Cross, MS, RD, LDN

Baystate Health

Springfield, MA

In a message dated 9/7/2011 1:45:22 P.M. Eastern Daylight Time, vsimler@... writes:

I do not believe the nutrition evaluation is covered by Medicare. We collect from the patient for that appt.

Simler, MS, RD, Manager

for Weight Loss Surgery and

Osteoporosis Programs

ValleyCare Health System

925-416-6712

>>> "mannfrd" <mannfrd@...> 9/7/2011 8:34 AM >>>

Is anyone submitting to Medicare for reimbursement for the nutrition component? If so, what diagnosis code(s) do you use. Do you see them individual or do you ever submit for a group class?Thanks to anyone who can give me any insight.This message and any included attachments are from ValleyCare Health System and are intended only for the addressee(s). The information contained herein may include trade secrets or privileged or otherwise confidential information.Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail.

[Guest guest]

Medicare pays for 3 hours per year for diabetes and CKD, Stages1-3 only. BTW, they only way they will pay is if you are listed as a provider - you will need to sign up first before submitting.Sent from my iPhoneOn Sep 11, 2011, at 9:20 AM, Humnut413@... wrote:

If the patient has diabetes and is not getting MNT elsewhere, why could we not submit to medicare if we cover diabetes and nutrition info. Actually, any info we cover that assists the patient with weight loss would help with their diabetes. What are others doing?

a Serafino-Cross, MS, RD, LDN

Baystate Health

Springfield, MA

In a message dated 9/7/2011 1:45:22 P.M. Eastern Daylight Time, vsimler@... writes:

I do not believe the nutrition evaluation is covered by Medicare. We collect from the patient for that appt.

Simler, MS, RD, Manager

for Weight Loss Surgery and

Osteoporosis Programs

ValleyCare Health System

925-416-6712

>>> "mannfrd" <mannfrd@...> 9/7/2011 8:34 AM >>>

Is anyone submitting to Medicare for reimbursement for the nutrition component? If so, what diagnosis code(s) do you use. Do you see them individual or do you ever submit for a group class?Thanks to anyone who can give me any insight.This message and any included attachments are from ValleyCare Health System and are intended only for the addressee(s). The information contained herein may include trade secrets or privileged or otherwise confidential information.Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail.

[Guest guest]

The guidelines for MNT are much more

liberal and based on medical needs but they are still available only to those

who have those two diagnoses. And you do have to be a Medicare provider. So

you would be directly reimbursed or you can reassign your benefits to a

hospital, etc. Also, if you go for a year without billing, you lose you

provider status and have to reapply.

Beverly Millison MS RD/LD CDE

Registered/Licensed Dietitian &

Certified Diabetes Educator

Metabolism Matters

972-724-1885 (home & office)

817-905-8705 (cell)

[Guest guest]

Listees,

Dr. Danno raised a good question. Attached is my Medicare guru's response. No change in Medicare RVUs are expected but codes will be reviewed. I will keep you posted. Y'all have a good weekend.

J. Holzapfel, DCAlbany, Oregon541-928-4060

Please note: forwarded message attachedFrom: " McClelland" <susan@...><kjholzdc@...>Subject: RE: MedicareDate: Fri, 16 Sep 2011 18:28:38 -0400

No, I do not expect there to be a change in RVUs.  However, the codes are up for review, again, in 2012 (all codes are reviewed every five years). VTVTVTVTVTVTVTVTVTVTVTVTVTVTVT                                   Go Hokies!  #11 McClelland, FICCMcClelland Consulting LLCBlacksburg, VA " The world is moving so fast these days that the man who says it can't be done is generally interrupted by someone doing it. " -- Harry Emerson Fosdick (1878 - 1969) From: CAC@... [mailto:CAC@...] Sent: Friday, September 16, 2011 5:52 PMcac@...Subject: Fw: Medicare Can anyone answer this question or is it too soon??? J. Holzapfel, DCAlbany, Oregon541-928-4060 Subject: MedicareDate: Thu, 15 Sep 2011 13:45:41 -0700Hey Are the RVU's for medicare going up or down in 2012 Thanks Danno

[Guest guest]

This topic may have already been discussed; if so I'm sorry to be bringing it up

again.

What is going on with Medicare denying coverage on medications? Is anyone else

having this trouble? What have you done to get your loved one their

medications?

Thank you!

Bedard, PLA

Ricky, andra and 's Mom

Mothers on a Mission, Inc.

6515 Stanley Avenue #4

Berwyn, IL 60402

708-217-3196

www.mothersonamission.net

www.noewait.net

I thought I would have to teach my children about the world, but instead I have

to teach the world about my children~~ Unknown

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