Re: letter to discharge pt

May 5, 2009

WHy bother with this dischrage business, takes you time and paper and a s tamp and energy. SHe will probably not call you agian IF she does decide then if you want ot see her or remind her it was not a good fit. If she says I was just having a bad time /a bad life/ forgot her zyprexa:) we would like to come in-- then consdier seeing htem Who cares about false accusation that you spent only 5min so what? People say that all the time. I got people that complain I throw them out after half an hr .What ,I shoudl move in with them?

These folks need youI do not see that she is physcially harmful toyou(safety a reason fro dishcarge Proceed cautiously and be here for them.My two centsNo one will agree with meI do not disharge people ecxept if they have bad street drugs in their urine- and actually I usually just willnot give them drugs. I still will see htem.Not that they come back then.

Jean

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line " if not due to trauma " . To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.

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May 5, 2009

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

I had the same thought. Maybe she is getting offensive as

a defense and this was an abuse or she is afraid it would be seen as abuse.

How does a 14 yo injure their rotator cuff?

From:

[mailto: ] On Behalf Of dannielle harwood

Sent: Tuesday, May 05, 2009 11:06 AM

To:

Subject: Re: letter to discharge pt

I

am wondering what the cause of the injury was? Was the story reasonable? Is

this mom acting funny because she thinks her daughters injury is being

investigated? Perhaps she has a history of a CPS investigation? Just a

thought....

Dannielle

Harwood, M.D.

-----

Original Message -----

From:

To: practiceimprovement1

Sent: Tuesday, May 05,

2009 8:22 AM

Subject:

letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently

as mom called in a panic, sever arm pain for several weeks, not sleeping...so

they come in...ends up been rotator cuff, girl back to normal on nsaids. This

was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a

single page form asking if this was do to injury. I wait but nothing so I call

mom up...well she freaks out saying I don't know why you are charging for the

visit, you only spent 5 mins with her (not true), you are not the kind of

doctor we are looking for (after our visit in feb, they were very happy). so I

am thinking mom thinks I am billing her, so I reassured her she only needs to

fill out this form so insurance will pay me, I am not billing her, she could

come to office and I would help her fill out...its only one line " if not

due to trauma " . To make a long stiry short, she was very rude

and hung up on me. She must have some pysche problem. What I don't like is

the false hood accusations. So I better get out now. It is not worth the

headaches. What should I say in the letter and how do I know she received it.

She might be a little transient too so address might not be good.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use, publish,

discuss, disseminate or otherwise distribute it. If you are not the intended

recipient, or if you have received this transmission in error, please notify

the sender immediately and confidentially destroy the information that email in

error.

May 5, 2009

Same exact thought occurred to me. Over-reaction means there's more to the story.She protests too much, methinks.GI had the same thought. Maybe she is getting offensive as a defense and this was an abuse or she is afraid it would be seen as abuse. How does a 14 yo injure their rotator cuff? From: [mailto: ] On Behalf Of dannielle harwoodSent: Tuesday, May 05, 2009 11:06 AMTo: Subject: Re: letter to discharge pt I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....Dannielle Harwood, M.D. letter to discharge pt I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

Daughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.

I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guys

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line " if not due to trauma " . To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

A long time ago we had a "nice" new family come in at the begining of the year, our first year open so we only have about four months experience with billing and customer service issues... So Jan. 2005 the whole family comes in, in short order for full physicals and one or two other things and then doesn't want to come in for follow up care. The dad who was step dad to the teenage kids, mom recently remarried to him, was a local Teamster with very decent traditional Indemnity type BC/BS plan. They all had a modest deductable and no restrictions on where to go and no requirements to declare a PCP with the carrier...

So this family blew us off for the entire set of bills because ever last dime they owed was from their $250 a piece, $750 per year for the family deductable... I called the house once or twice and the new wife was so agressive and acting offended as I tried to explain how a traditional plan works and this is their portion to pay before the plan kicks in. She was giving me all sorts of bull stories about I've got family coming in and I don't have time for this right now, and making false statements about everything while acting dumb about the plan and how it works. She was claiming the plan always paid for everything which is pure bull because I know these plans well as the practice manager, they pay an 80/20 split after the deductable is met. Furthermore she went on to lie about how they never got any bills from any of the other and previous doctors....

So what is the real cause for all this garbage??? It is a well thought out, well planned in advance scam on the family's, parents part to free themselves of their annual deductable, skip out on some new unsuspecting doc and her office, and then return to their regular doc of record for the rest of the year, now only paying a few dollars for any level 3-4 established patient office visits that they may need. I forget how we found out in the long run, but we did find out that they had a regular PCP in a larger group, never signed out of there, and were continuing to get care from them all along... I'll bet ya that the next year, they hunted the Penny Saver or the phonebook for the next sucker new practice in town to pull the same bull on and get out from under their deductable again for that year... We doc's should be allowed to share this kind of info on deadbeat patients especially if the FTC wants to make us "Creditors" as they are attempting to

do...

But I gather this is just the flailing around of some family that just doesn't want to have to own up to paying for their medical care. Unfortunately, get used to it... What else can I tell ya... Fool me once ya know...

To: Sent: Tuesday, May 5, 2009 12:38:08 PMSubject: Re: letter to discharge pt

Daughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.

I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guys

On Tue, May 5, 2009 at 8:05 AM, dannielle harwood <dharwood100@ sbcglobal. net> wrote:

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

Ditto... and you do not need proof to call CPS if there is any concern...not that I am recommending that, just a thought.

To: Sent: Tuesday, May 5, 2009 11:46:45 AMSubject: Re: letter to discharge pt

Same exact thought occurred to me. Over-reaction means there's more to the story.

She protests too much, methinks.

G

I had the same thought. Maybe she is getting offensive as a defense and this was an abuse or she is afraid it would be seen as abuse. How does a 14 yo injure their rotator cuff?

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of dannielle harwoodSent: Tuesday, May 05, 2009 11:06 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] letter to discharge pt

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in

error.

May 5, 2009

,So let me get this straight. The family 'used up' their deductible on their annual physical exams with you. Then proceeded to get their regular care, sick visits etc from the doc they usually go to. So why doesn' t this other doc wonder why this family never gets physical exams with him/her? Seems like he/she might be wondering. Did other doc ever request medical records? KathleenA long time ago we had a "nice" new family come in at the begining of the year, our first year open so we only have about four months experience with billing and customer service issues... So Jan. 2005 the whole family comes in, in short order for full physicals and one or two other things and then doesn't want to come in for follow up care. The dad who was step dad to the teenage kids, mom recently remarried to him, was a local Teamster with very decent traditional Indemnity type BC/BS plan. They all had a modest deductable and no restrictions on where to go and no requirements to declare a PCP with the carrier... So this family blew us off for the entire set of bills because ever last dime they owed was from their $250 a piece, $750 per year for the family deductable... I called the house once or twice and the new wife was so agressive and acting offended as I tried to explain how a traditional plan works and this is their portion to pay before the plan kicks in. She was giving me all sorts of bull stories about I've got family coming in and I don't have time for this right now, and making false statements about everything while acting dumb about the plan and how it works. She was claiming the plan always paid for everything which is pure bull because I know these plans well as the practice manager, they pay an 80/20 split after the deductable is met. Furthermore she went on to lie about how they never got any bills from any of the other and previous doctors.... So what is the real cause for all this garbage??? It is a well thought out, well planned in advance scam on the family's, parents part to free themselves of their annual deductable, skip out on some new unsuspecting doc and her office, and then return to their regular doc of record for the rest of the year, now only paying a few dollars for any level 3-4 established patient office visits that they may need. I forget how we found out in the long run, but we did find out that they had a regular PCP in a larger group, never signed out of there, and were continuing to get care from them all along... I'll bet ya that the next year, they hunted the Penny Saver or the phonebook for the next sucker new practice in town to pull the same bull on and get out from under their deductable again for that year... We doc's should be allowed to share this kind of info on deadbeat patients especially if the FTC wants to make us "Creditors" as they are attempting to do... But I gather this is just the flailing around of some family that just doesn't want to have to own up to paying for their medical care. Unfortunately, get used to it... What else can I tell ya... Fool me once ya know...From: <elaine2mdgmail>To: Sent: Tuesday, May 5, 2009 12:38:08 PMSubject: Re: letter to discharge ptDaughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guysOn Tue, May 5, 2009 at 8:05 AM, dannielle harwood<dharwood100@ sbcglobal. net> wrote:I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....Dannielle Harwood, M.D. [Practiceimprovemen t1] letter to discharge ptI am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. -- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

No I assume they never told him what their trick was or he would be concerned or worried about them too... I'm just blown away by the set of brass ones on this one particular family... And everyone was so nice and friendly and how much they apperciate this smaller office and the better level of care and concern... Yeah, yeah, layer it on.... Pisses me off so.

We just had a patient sign out without telling us cause or why... She needed a visit, she would level messages and I kept trying to call her back to no avail and boom, just got her release from another office. We went the distance for this family with lots of interesting "issues" and this is the way they pay us back??? Heck our son's on in the same hockey league together and I talk hockey with the kid when Mom needs to have private time to discuss serious adult stuff. One day they come out and this little guy and I are talking hockey and I'm praising him for how well he has advanced in just the short time I have known him (I was one of his Mini-Mite coaches last season too!) and we're talking hockey and the plays he's involved on and choices to be made in the heat of the moment on the ice.... After they leave, turns to me and says; "Did you see the look on so and so's face, you just made his day the way you talk to him like just another

hockey friend, not like some little kid.. Did you see him beaming ear to ear???"

Sometimes ya just can't tell what the heck is going on in people's head in this business. I find some people are very selfish, fickle and will try something else in a drop of the hat... Let's 'em go to the big factory practice down the street. They may get their referal out a day or two faster, but for that they get a hour's wait for a 5 minute visit with the doctor of the day or even just an NP (no offense to any here) where nobody has any continuity of care, hand on the door knob kind of visit...

We discussed this a while back on the AC board and we all agreed that once signed out because of a disagreement, we'll never allow a patient back in again. The only patient we have made an exeption to on this was on very nice bipolar patient really does have the old classic psycho-genic type meddlesome mother who keeps trying to get the daughter to sign out of here because she herself as a probably borderline signed out of here in a huff early on in our first year of business... I think back at the AC board started this policy and the thread on it and and I subscribe to it. Such a fickle patient is a train wreck, problem just waiting to happen... You're not happy and want to leave, go... But don't ever expect to come back... Obviously we make the standard and human exceptions of change of insurance or moving out of town and then returned to town, those are legitimate reasons to leave without malic. But other than that, we make it

a rule to never take a patient back after the sign out with problems...

To: Sent: Tuesday, May 5, 2009 3:31:44 PMSubject: Re: letter to discharge pt

,

So let me get this straight. The family 'used up' their deductible on their annual physical exams with you. Then proceeded to get their regular care, sick visits etc from the doc they usually go to.

So why doesn' t this other doc wonder why this family never gets physical exams with him/her? Seems like he/she might be wondering. Did other doc ever request medical records?

Kathleen

A long time ago we had a "nice" new family come in at the begining of the year, our first year open so we only have about four months experience with billing and customer service issues... So Jan. 2005 the whole family comes in, in short order for full physicals and one or two other things and then doesn't want to come in for follow up care. The dad who was step dad to the teenage kids, mom recently remarried to him, was a local Teamster with very decent traditional Indemnity type BC/BS plan. They all had a modest deductable and no restrictions on where to go and no requirements to declare a PCP with the carrier...

So this family blew us off for the entire set of bills because ever last dime they owed was from their $250 a piece, $750 per year for the family deductable.. . I called the house once or twice and the new wife was so agressive and acting offended as I tried to explain how a traditional plan works and this is their portion to pay before the plan kicks in. She was giving me all sorts of bull stories about I've got family coming in and I don't have time for this right now, and making false statements about everything while acting dumb about the plan and how it works. She was claiming the plan always paid for everything which is pure bull because I know these plans well as the practice manager, they pay an 80/20 split after the deductable is met. Furthermore she went on to lie about how they never got any bills from any of the other and previous doctors....

So what is the real cause for all this garbage??? It is a well thought out, well planned in advance scam on the family's, parents part to free themselves of their annual deductable, skip out on some new unsuspecting doc and her office, and then return to their regular doc of record for the rest of the year, now only paying a few dollars for any level 3-4 established patient office visits that they may need. I forget how we found out in the long run, but we did find out that they had a regular PCP in a larger group, never signed out of there, and were continuing to get care from them all along... I'll bet ya that the next year, they hunted the Penny Saver or the phonebook for the next sucker new practice in town to pull the same bull on and get out from under their deductable again for that year... We doc's should be allowed to share this kind of info on deadbeat patients especially if the FTC wants to make us "Creditors" as they are attempting to

do...

But I gather this is just the flailing around of some family that just doesn't want to have to own up to paying for their medical care. Unfortunately, get used to it... What else can I tell ya... Fool me once ya know...

From: <elaine2mdgmail (DOT) com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Tuesday, May 5, 2009 12:38:08 PMSubject: Re: [Practiceimprovemen t1] letter to discharge pt

Daughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.

I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guys

On Tue, May 5, 2009 at 8:05 AM, dannielle harwood<dharwood100@ sbcglobal. net> wrote:

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 5, 2009

So did you turn the family over to

collections? I always refer patients who put on the “we’ve never

had to pay before” line back to their insurance company and tell them

that we are billing them what their insurance company has told us is their (the

patient’s) responsibility. If they don’t pay, they get late fees,

and then eventually get turned over to collections, which reports to the credit

bureaus if the balance is over $40 (I’m not sending small amounts, but I’m

guessing that this family you’re talking about was in the $100’s).

They don’t like getting hounded by collections and usually pay up.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Bleiweiss

Sent: Tuesday, May 05, 2009 12:16

PM

To:

Subject: Re:

letter to discharge pt

A long time ago we had a " nice " new family come in

at the begining of the year, our first year open so we only have about four

months experience with billing and customer service issues... So Jan. 2005 the

whole family comes in, in short order for full physicals and one or two other

things and then doesn't want to come in for follow up care. The dad who

was step dad to the teenage kids, mom recently remarried to him, was a local

Teamster with very decent traditional Indemnity type BC/BS plan. They all had a

modest deductable and no restrictions on where to go and no requirements to

declare a PCP with the carrier...

So this family blew us off for the entire set of bills

because ever last dime they owed was from their $250 a piece, $750 per year for

the family deductable... I called the house once or twice and the new wife

was so agressive and acting offended as I tried to explain how a traditional

plan works and this is their portion to pay before the plan kicks in. She was

giving me all sorts of bull stories about I've got family coming in and I don't

have time for this right now, and making false statements about everything

while acting dumb about the plan and how it works. She was claiming the plan

always paid for everything which is pure bull because I know these plans well

as the practice manager, they pay an 80/20 split after the deductable is met.

Furthermore she went on to lie about how they never got any bills from any of

the other and previous doctors....

So what is the real cause for all this garbage??? It is a

well thought out, well planned in advance scam on the family's, parents part to

free themselves of their annual deductable, skip out on some new unsuspecting

doc and her office, and then return to their regular doc of record for the rest

of the year, now only paying a few dollars for any level 3-4 established

patient office visits that they may need. I forget how we found out in the long

run, but we did find out that they had a regular PCP in a larger group, never

signed out of there, and were continuing to get care from them all along...

I'll bet ya that the next year, they hunted the Penny Saver or the phonebook

for the next sucker new practice in town to pull the same bull on and get out

from under their deductable again for that year... We doc's should be allowed

to share this kind of info on deadbeat patients especially if the FTC wants to

make us " Creditors " as they are attempting to do...

But I gather this is just the flailing around of some family

that just doesn't want to have to own up to paying for their medical care.

Unfortunately, get used to it... What else can I tell ya... Fool me once ya

know...

From: Elaine

Chu <elaine2mdgmail>

To:

Sent: Tuesday, May 5, 2009

12:38:08 PM

Subject: Re:

letter to discharge pt

Daughter Ice skates twice a week. There was no bruising. A very nice 14

yo girl. Does well at school, in leadership class.

I just got of phone w

insurance. Unless mom fill out these forms, i will not get paid. They suggest I

bill mom directly. I might or just leave it. I am not good with aggressive

people. Something uncomfortable in a doc-pt relationship when the doc feels

threatened. I will send out the bill to her at end of month and then close the

books. C'est la vie. Thanks for the support as usual guys

On Tue, May 5, 2009 at 8:05 AM, dannielle harwood <dharwood100@ sbcglobal. net>

wrote:

I am wondering what the cause of the

injury was? Was the story reasonable? Is this mom acting funny because she

thinks her daughters injury is being investigated? Perhaps she has a history of

a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story-

14 girl seen urgently as mom called in a panic, sever arm pain for several

weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to

normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get

a courtesy copy) a single page form asking if this was do to injury. I

wait but nothing so I call mom up...well she freaks out saying I don't know why

you are charging for the visit, you only spent 5 mins with her (not true), you

are not the kind of doctor we are looking for (after our visit in feb, they

were very happy). so I am thinking mom thinks I am billing her, so I reassured

her she only needs to fill out this form so insurance will pay me, I am not

billing her, she could come to office and I would help her fill out...its only

one line " if not due to trauma " . To make a long stiry short, she was

very rude and hung up on me. She must have some pysche problem. What I

don't like is the false hood accusations. So I better get out now. It is not

worth the headaches. What should I say in the letter and how do I know she

received it. She might be a little transient too so address might not be good.

--

M.D.

www.elainemd. com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

--

M.D.

www.elainemd. com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

May 5, 2009

We also don’t let patients who’ve

moved on come back – our exception is those patients who move over to

Kaiser because of their employer changing insurance plans – we let them

come back to us from Kaiser after they realize that it’s not worth it to

be a number at Kaiser instead of a person with us. But we don’t let them

come back once they’ve switched to another local provider. (We will also

take back the ones who move out of the area and then are relocated back –

happens all the time with AT & T & Chevron headquartered down the

street.)

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Bleiweiss

Sent: Tuesday, May 05, 2009 1:23

PM

To:

Subject: Re:

letter to discharge pt

We discussed this a while back on the AC board and we all agreed that

once signed out because of a disagreement, we'll never allow a patient back in

again. The only patient we have made an exeption to on this was on very nice

bipolar patient really does have the old classic psycho-genic type meddlesome

mother who keeps trying to get the daughter to sign out of here because she

herself as a probably borderline signed out of here in a huff early on in our

first year of business... I think back at the AC board started

this policy and the thread on it and and I subscribe to it. Such a fickle

patient is a train wreck, problem just waiting to happen... You're not happy

and want to leave, go... But don't ever expect to come back... Obviously we make

the standard and human exceptions of change of insurance or moving out of town

and then returned to town, those are legitimate reasons to leave without malic.

But other than that, we make it a rule to never take a patient back after the

sign out with problems...

May 5, 2009

I wouldn’t d/c the patient because

of this. Maybe she was having one of those totally hectic “mom”

days. Shoot, my daughter ice skates, too and with all the time we have to

spend at the skating rink, it makes you a little grumpy sometimes. I’d

send a letter home stating that the insurance company is waiting for

information from them; failure to respond to the insurance company will cause

the insurance company to deny the claim, and then they will be liable. Be nice

in the letter and she will probably respond and you’ll get paid. I would

only discharge the patient if the insurance denies payment (because she doesn’t

mail the form back in) and then she doesn’t pay you for the visit –

you can d/c for “nonpayment for services rendered.”

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of

Sent: Tuesday, May 05, 2009 7:23

AM

To: practiceimprovement1

Subject:

letter to discharge pt

I am

thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom

called in a panic, sever arm pain for several weeks, not sleeping...so they

come in...ends up been rotator cuff, girl back to normal on nsaids. This was in

feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single

page form asking if this was do to injury. I wait but nothing so I call mom up...well

she freaks out saying I don't know why you are charging for the visit, you only

spent 5 mins with her (not true), you are not the kind of doctor we are looking

for (after our visit in feb, they were very happy). so I am thinking mom thinks

I am billing her, so I reassured her she only needs to fill out this form so

insurance will pay me, I am not billing her, she could come to office and I

would help her fill out...its only one line " if not due to trauma " .

To make a long stiry short, she was very rude and hung up on me. She must

have some pysche problem. What I don't like is the false hood accusations. So I

better get out now. It is not worth the headaches. What should I say in the

letter and how do I know she received it. She might be a little transient too

so address might not be good.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

May 6, 2009

Should have sent the account to a collection agency. Wayne CoghillPractice ManagerMidtown Primary Carewww.doctorcoghill.com

To: Sent: Tuesday, May 5, 2009 3:31:44 PMSubject: Re: letter to discharge pt

,

So let me get this straight. The family 'used up' their deductible on their annual physical exams with you. Then proceeded to get their regular care, sick visits etc from the doc they usually go to.

So why doesn' t this other doc wonder why this family never gets physical exams with him/her? Seems like he/she might be wondering. Did other doc ever request medical records?

Kathleen

A long time ago we had a "nice" new family come in at the begining of the year, our first year open so we only have about four months experience with billing and customer service issues... So Jan. 2005 the whole family comes in, in short order for full physicals and one or two other things and then doesn't want to come in for follow up care. The dad who was step dad to the teenage kids, mom recently remarried to him, was a local Teamster with very decent traditional Indemnity type BC/BS plan. They all had a modest deductable and no restrictions on where to go and no requirements to declare a PCP with the carrier...

So this family blew us off for the entire set of bills because ever last dime they owed was from their $250 a piece, $750 per year for the family deductable.. . I called the house once or twice and the new wife was so agressive and acting offended as I tried to explain how a traditional plan works and this is their portion to pay before the plan kicks in. She was giving me all sorts of bull stories about I've got family coming in and I don't have time for this right now, and making false statements about everything while acting dumb about the plan and how it works. She was claiming the plan always paid for everything which is pure bull because I know these plans well as the practice manager, they pay an 80/20 split after the deductable is met. Furthermore she went on to lie about how they never got any bills from any of the other and previous doctors....

So what is the real cause for all this garbage??? It is a well thought out, well planned in advance scam on the family's, parents part to free themselves of their annual deductable, skip out on some new unsuspecting doc and her office, and then return to their regular doc of record for the rest of the year, now only paying a few dollars for any level 3-4 established patient office visits that they may need. I forget how we found out in the long run, but we did find out that they had a regular PCP in a larger group, never signed out of there, and were continuing to get care from them all along... I'll bet ya that the next year, they hunted the Penny Saver or the phonebook for the next sucker new practice in town to pull the same bull on and get out from under their deductable again for that year... We doc's should be allowed to share this kind of info on deadbeat patients especially if the FTC wants to make us "Creditors"

as they are attempting to do...

But I gather this is just the flailing around of some family that just doesn't want to have to own up to paying for their medical care. Unfortunately, get used to it... What else can I tell ya... Fool me once ya know...

From: <elaine2mdgmail (DOT) com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Tuesday, May 5, 2009 12:38:08 PMSubject: Re: [Practiceimprovemen t1] letter to discharge pt

Daughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.

I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guys

On Tue, May 5, 2009 at 8:05 AM, dannielle harwood<dharwood100@ sbcglobal. net> wrote:

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude

and hung up on me. She must have some pysche problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended

recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended

recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 6, 2009

She needs to be billed directly 3 times and sent to a collection agency. I HATE these deadbeats. Wayne CoghillPractice ManagerMidtown Primary Carewww.doctorcoghill.com

To: Sent: Tuesday, May 5, 2009 12:38:08 PMSubject: Re: letter to discharge pt

Daughter Ice skates twice a week. There was no bruising. A very nice 14 yo girl. Does well at school, in leadership class.

I just got of phone w insurance. Unless mom fill out these forms, i will not get paid. They suggest I bill mom directly. I might or just leave it. I am not good with aggressive people. Something uncomfortable in a doc-pt relationship when the doc feels threatened. I will send out the bill to her at end of month and then close the books. C'est la vie. Thanks for the support as usual guys

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D.

letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

May 6, 2009

So , how do you prevent a recurrence? Make those

with deductibles pay upfront?

~ Pamela

>

> I am wondering what the cause of the injury was? Was the story reasonable? Is

this mom acting funny because she thinks her daughters injury is being

investigated? Perhaps she has a history of a CPS investigation? Just a

thought....

> Dannielle Harwood, M.D.

> [Practiceimprovemen t1] letter to discharge pt

>

> I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently

as mom called in a panic, sever arm pain for several weeks, not sleeping...so

they come in...ends up been rotator cuff, girl back to normal on nsaids. This

was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single

page form asking if this was do to injury. I wait but nothing so I call mom

up...well she freaks out saying I don't know why you are charging for the visit,

you only spent 5 mins with her (not true), you are not the kind of doctor we are

looking for (after our visit in feb, they were very happy). so I am thinking mom

thinks I am billing her, so I reassured her she only needs to fill out this form

so insurance will pay me, I am not billing her, she could come to office and I

would help her fill out...its only one line " if not due to trauma " . To make a

long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I

> don't like is the false hood accusations. So I better get out now. It is not

worth the headaches. What should I say in the letter and how do I know she

received it. She might be a little transient too so address might not be good.

>

> --

> M.D.

> www.elainemd. com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

>

> If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

>

> --

> M.D.

> www.elainemd. com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

>

> If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

>

May 6, 2009

Or it could be plain old guilt. Remember mom had put it off and put it off maybe thinking it was going to get better......... And somehow it seems like my patients in IMP office think I can see them pronto! They seem to forget they are not my only patient!

I'm with Kathy on this one. Send the form with a letter.

I had the same thought. Maybe she is getting offensive as a defense and this was an abuse or she is afraid it would be seen as abuse. How does a 14 yo injure their rotator cuff?

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of dannielle harwoodSent: Tuesday, May 05, 2009 11:06 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] letter to discharge pt

I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

Dannielle Harwood, M.D..

[Practiceimprovemen t1] letter to discharge pt

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out....its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in

error.

May 6, 2009

Actually I agree with you too.

And if there is hidden abuse it's more likely to show up with an established relationship than sending away.

And my previous post I said Send the form and the letter and attributed to Kathy but it was . Sorry.

I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out....its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche

problem. What I don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

May 6, 2009

Do any of you collect deductibles upfront? Is there a way? Most of our unpaid invoices are because of the money the patients owe towards their deductibles. Sometimes the patients don't understand that they have a deductible to meet.-ArunaTo: From: roxywible@...Date: Tue, 5 May 2009 22:25:40 +0000Subject: Re: letter to discharge pt

So , how do you prevent a recurrence? Make those

with deductibles pay upfront?

~ Pamela

>

> I am wondering what the cause of the injury was? Was the story reasonable? Is this mom acting funny because she thinks her daughters injury is being investigated? Perhaps she has a history of a CPS investigation? Just a thought....

> Dannielle Harwood, M.D.

> [Practiceimprovemen t1] letter to discharge pt

>

> I am thinking I need to discharge a pt. Strange story- 14 girl seen urgently as mom called in a panic, sever arm pain for several weeks, not sleeping...so they come in...ends up been rotator cuff, girl back to normal on nsaids. This was in feb 09. Girls insurance co sends mom ( I get a courtesy copy) a single page form asking if this was do to injury. I wait but nothing so I call mom up...well she freaks out saying I don't know why you are charging for the visit, you only spent 5 mins with her (not true), you are not the kind of doctor we are looking for (after our visit in feb, they were very happy). so I am thinking mom thinks I am billing her, so I reassured her she only needs to fill out this form so insurance will pay me, I am not billing her, she could come to office and I would help her fill out...its only one line "if not due to trauma". To make a long stiry short, she was very rude and hung up on me. She must have some pysche problem. What I

> don't like is the false hood accusations. So I better get out now. It is not worth the headaches. What should I say in the letter and how do I know she received it. She might be a little transient too so address might not be good.

>

> --

> M.D.

> www.elainemd. com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

>

> If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

>

> --

> M.D.

> www.elainemd. com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

>

> If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

>

May 6, 2009

This hasn’t really become a problem

for us. We do try to collect credit card numbers from patients with

coinsurance and/or deductibles so that we can charge them as soon as their EOB

comes in from the insurance plan. How many bills have you sent the patient?

We send 2 as a courtesy. On the 3rd, late fees of $5/month

start accruing. With the 4th invoice comes a late payment

letter, #5 is Late payment letter again, and #6 is pay in 14 days or go to

collections. Sometimes I make phone calls, typically not. I usually

get payment once a late fee is added or after I threaten collections.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Aruna

Sent: Tuesday, May 05, 2009 4:00

PM

To:

practiceimprovement1

Subject: RE:

Re: letter to discharge pt

Do any of you collect deductibles upfront? Is there a

way? Most of our unpaid invoices are because of the money the patients

owe towards their deductibles. Sometimes the patients don't understand

that they have a deductible to meet.

-Aruna

To:

From: roxywiblecomcast (DOT) net

Date: Tue, 5 May 2009 22:25:40 +0000

Subject: Re: letter to discharge pt

So , how do you prevent a recurrence? Make those

with deductibles pay upfront?

~ Pamela

>

> I am wondering what the cause of the injury was? Was the story reasonable?

Is this mom acting funny because she thinks her daughters injury is being

investigated? Perhaps she has a history of a CPS investigation? Just a

thought....

> Dannielle Harwood, M.D.

> [Practiceimprovemen t1] letter to discharge pt

>

> I am thinking I need to discharge a pt. Strange story- 14 girl seen

urgently as mom called in a panic, sever arm pain for several weeks, not

sleeping...so they come in...ends up been rotator cuff, girl back to normal on

nsaids. This was in feb 09. Girls insurance co sends mom ( I get