Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 I communicate with a lot of my patients via email. I have 400 pts in my panel, and receive ~ 15-20 messages on Mon, trickling down to 5-10 on Friday. About 1/3 to half of these are via email. It's another option for communication I mention to my new patients - in addition to phone and fax. I don't really have to push this option - many people prefer to use it these days(especially night shift workers). I also relay test results via email frequently (my MA and I know which people use email and which ones don't) and it reduces the ancillary questions you get when calling someone with results (and not getting the answering machine). A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 Patient internet use Hi all: I first want to thank everyone for all I've learned by reading your posts on this listserve. My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me. Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them. --Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 I communicate with a lot of my patients via email. I have 400 pts in my panel, and receive ~ 15-20 messages on Mon, trickling down to 5-10 on Friday. About 1/3 to half of these are via email. It's another option for communication I mention to my new patients - in addition to phone and fax. I don't really have to push this option - many people prefer to use it these days(especially night shift workers). I also relay test results via email frequently (my MA and I know which people use email and which ones don't) and it reduces the ancillary questions you get when calling someone with results (and not getting the answering machine). A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 Patient internet use Hi all: I first want to thank everyone for all I've learned by reading your posts on this listserve. My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me. Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them. --Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 , How do you make any money seeing patients for a whole hour? Do you charge for email? Janice RE: Patient internet use I communicate with a lot of my patients via email. I have 400 pts in mypanel, and receive ~ 15-20 messages on Mon, trickling down to 5-10 onFriday. About 1/3 to half of these are via email. It's another option forcommunication I mention to my new patients - in addition to phone and fax.I don't really have to push this option - many people prefer to use it thesedays(especially night shift workers). I also relay test results via emailfrequently (my MA and I know which people use email and which ones don't)and it reduces the ancillary questions you get when calling someone withresults (and not getting the answering machine). A. Eads, M.D.Pinnacle Family Medicine, PLLC phone faxP.O. Box 7275Woodland Park, CO 80863-----Original Message-----From: [mailto: ] On Behalf Of PadmaSent: Saturday, May 06, 2006 10:31 PMTo: Subject: Patient internet useHi all:I first want to thank everyone for all I've learned by reading your posts on this listserve.My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me.Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them.--Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 , How do you make any money seeing patients for a whole hour? Do you charge for email? Janice RE: Patient internet use I communicate with a lot of my patients via email. I have 400 pts in mypanel, and receive ~ 15-20 messages on Mon, trickling down to 5-10 onFriday. About 1/3 to half of these are via email. It's another option forcommunication I mention to my new patients - in addition to phone and fax.I don't really have to push this option - many people prefer to use it thesedays(especially night shift workers). I also relay test results via emailfrequently (my MA and I know which people use email and which ones don't)and it reduces the ancillary questions you get when calling someone withresults (and not getting the answering machine). A. Eads, M.D.Pinnacle Family Medicine, PLLC phone faxP.O. Box 7275Woodland Park, CO 80863-----Original Message-----From: [mailto: ] On Behalf Of PadmaSent: Saturday, May 06, 2006 10:31 PMTo: Subject: Patient internet useHi all:I first want to thank everyone for all I've learned by reading your posts on this listserve.My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me.Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them.--Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 Janice, For my office visits with established pts, I code based on time, mainly. They are usually complex as well (DM, HTN, GERD, chol, etc addressed at the visit). I usually use the prolonged physician services code (ie 99214 + 99354). If the visit was between 40 and 55 minutes, then I just use the 99215 code, again, based on time. I probably lose money on the 99215s, but do ok with the 99214/99354s (must be over 55 minutes). Email – I do charge for this. I have a $60/person/year (proratable) fee to cover this service. I should probably charge more, for the time it usually involves, but did not want to scare people away. I also do Virtual Office Visits, for $20/use (again, should probably charge more – others do $25-$45, but just getting myself and my pts into this). Kaiser is paying for this (both the annual fee and the VOV fee) for their pts in Colorado Springs. Kaiser for Col Spgs is different than the rest of the Kaiser world. They are studying my practice (since opening in 2003). A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Janice Sent: Tuesday, May 09, 2006 6:57 AM To: Subject: Re: Patient internet use , How do you make any money seeing patients for a whole hour? Do you charge for email? Janice Patient internet use Hi all: I first want to thank everyone for all I've learned by reading your posts on this listserve. My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me. Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them. --Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 Janice, For my office visits with established pts, I code based on time, mainly. They are usually complex as well (DM, HTN, GERD, chol, etc addressed at the visit). I usually use the prolonged physician services code (ie 99214 + 99354). If the visit was between 40 and 55 minutes, then I just use the 99215 code, again, based on time. I probably lose money on the 99215s, but do ok with the 99214/99354s (must be over 55 minutes). Email – I do charge for this. I have a $60/person/year (proratable) fee to cover this service. I should probably charge more, for the time it usually involves, but did not want to scare people away. I also do Virtual Office Visits, for $20/use (again, should probably charge more – others do $25-$45, but just getting myself and my pts into this). Kaiser is paying for this (both the annual fee and the VOV fee) for their pts in Colorado Springs. Kaiser for Col Spgs is different than the rest of the Kaiser world. They are studying my practice (since opening in 2003). A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Janice Sent: Tuesday, May 09, 2006 6:57 AM To: Subject: Re: Patient internet use , How do you make any money seeing patients for a whole hour? Do you charge for email? Janice Patient internet use Hi all: I first want to thank everyone for all I've learned by reading your posts on this listserve. My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me. Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them. --Padma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 I also use the extended visit codes on occasion. However, the only problem I see with coding a 40 minute visit as a 99215 just based on time is that it could still be contested in an audit if the “medical necessity” is not there (that term is open to interpretation of course). Remember that CPT rules do not say a 99214 is 25 minutes & on the 26th minute you are into 99215 territory; rather, a 99214 is TYPICALLY about 25 minutes in length. In other words, it goes right back to the old argument we often have here: is a 99215 justified for any visit simply because we sat & talked for 40 minutes? Answer: no, not unless the medical necessity justifies that level of visit. That is why I very rarely use the 99215 code (maybe 2/month, same as 99212-àabout 2/month). To me, 99213 & 99214 are basically the only really usable established E/M codes. In general, I think the extended visit codes are underutilized & the 99215 is over utilized. Re: Patient internet use , How do you make any money seeing patients for a whole hour? Do you charge for email? Janice Patient internet use Hi all: I first want to thank everyone for all I've learned by reading your posts on this listserve. My practice is on schedule to open June 1st, will be resigning within 10 days, my flyers and direct mail cards are getting ready, and contain the basic principles followed by this group. I am a little nervous about my ability to be available 24/7--but will definitely make it work most of the time--will have to figure out how to get some backup when I am at some events with my 6yr old daughter. Another minor concern--At my current SHOVE model practice, they tried to introduce a patient portal for e-mailing and requesting refills/referrals. Over a one year period, we could only convince 3-4 patients to use it--inspite of their complaints about not being able to get through the phone lines, not getting prompt responses, etc. I think quite a few of these patients will be following me. Of the people using secure e-mail and appointmentquest--how many of your patients actually use it? (of course some older folks and those without computers cannot). Have you found an incentive that works? I am thinking of putting a computer in the waiting room and walking the patients through the process if its the first time for them. I hope once they understand my new practice philosophy they will see it is beneficial for them. --Padma Quote Link to comment Share on other sites More sharing options...
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