Re: Re: curve ball

[Guest guest]

I

thought that in much of the country, Medicare patients often have trouble

finding primary care physicians that will see them. If that’s the case,

why would you accept any insurance that paid less than Medicare? Perhaps that’s

the only way you can avoid seeing an all geriatric practice?

Dan

RE:

Re: curve ball

Annie,

I have about 30% Medicare which comprises about 50% of my daily visits.

Sadly, Medicare is my best payor, with most of my other payors (Aetna,

Cigna, BC/BS, United) paying 80% of Medicare rates.

I instituted the " annual fee " 3 years ago and it has been

well received. I made it voluntary, to allow those who truly can't afford it

the opportunity to stay with the practice, AND to skirt any regulatory

skirmishes.

Ira Warshaw

Norht Palm Beach, FL

[Guest guest]

Ira: Please with some specifics, how do you ask for the payment and any comntracts to sign? Ira Warshaw wrote: Annie, Most of my Medicare patients do pay it, usually happily, and since it's voluntary, which allows it to glide under any regulatory concerns, the one's for whom it would be a true hardship, don't have to pay. The folks I only see every 2 or 3 years

for an acute problem might not pay it...but MANY do! I try to make a point of NOT knowing who has paid, a I feel my whole practice is "Value Added" service. IraAnnie Skaggs <askaggsfayettefamilymed> wrote: So if it is voluntary, what percentage of patients pay it? Do any Medicare beneficiaries? My Medicare numbers are close to yours, but though they are more likely to appreciate my care enough to pay extra than are young people, I still believe most would balk …. Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 5:31 AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the

practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs <askaggsfayettefamilymed> wrote: Who pays your “modest annual fee”? I have 815 active charts and I’m pretty

sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re:

Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm

Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster.

Everyone is raving about the all-new Yahoo! Mail beta.

[Guest guest]

Ira: Please with some specifics, how do you ask for the payment and any comntracts to sign? Ira Warshaw wrote: Annie, Most of my Medicare patients do pay it, usually happily, and since it's voluntary, which allows it to glide under any regulatory concerns, the one's for whom it would be a true hardship, don't have to pay. The folks I only see every 2 or 3 years

for an acute problem might not pay it...but MANY do! I try to make a point of NOT knowing who has paid, a I feel my whole practice is "Value Added" service. IraAnnie Skaggs <askaggsfayettefamilymed> wrote: So if it is voluntary, what percentage of patients pay it? Do any Medicare beneficiaries? My Medicare numbers are close to yours, but though they are more likely to appreciate my care enough to pay extra than are young people, I still believe most would balk …. Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 5:31 AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the

practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs <askaggsfayettefamilymed> wrote: Who pays your “modest annual fee”? I have 815 active charts and I’m pretty

sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re:

Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm

Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster.

Everyone is raving about the all-new Yahoo! Mail beta.

[Guest guest]

, I sent out a letter (happy to forward a copy off list if you'd like) explaining what was happening with medical reimbursements and asking patients to "support quality medical care", and as I noted, a significant number have over the past 4 years. Ira Brock DO wrote: If the fee is “voluntary” then

why would anyone pay it? Where I’m at voluntary would equal “no thanks.” -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 5:31

AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs <askaggsfayettefamilymed> wrote: Who pays your “modest annual fee”? & nb! sp;I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000

patients (hard to know with so many seaso! nal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. ! Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a

week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000

[Guest guest]

, I sent out a letter (happy to forward a copy off list if you'd like) explaining what was happening with medical reimbursements and asking patients to "support quality medical care", and as I noted, a significant number have over the past 4 years. Ira Brock DO wrote: If the fee is “voluntary” then

why would anyone pay it? Where I’m at voluntary would equal “no thanks.” -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 5:31

AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs <askaggsfayettefamilymed> wrote: Who pays your “modest annual fee”? & nb! sp;I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000

patients (hard to know with so many seaso! nal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. ! Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a

week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000

[Guest guest]

Dan, You're exactly right...if I want to see younger families, I have to participate in these dreadful plans. Irapracticeimprovement1@... wrote: I thought that in much of the country, Medicare patients often have trouble finding primary care physicians that will see them. If that’s the

case, why would you accept any insurance that paid less than Medicare? Perhaps that’s the only way you can avoid seeing an all geriatric practice? Dan -----Original Message-----From: [mailto:.at.yahoogroups.compracticeimprovement1 (DOT) at.dg.mailshell.com] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 2:31 AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FL Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000

[Guest guest]

Dan, You're exactly right...if I want to see younger families, I have to participate in these dreadful plans. Irapracticeimprovement1@... wrote: I thought that in much of the country, Medicare patients often have trouble finding primary care physicians that will see them. If that’s the

case, why would you accept any insurance that paid less than Medicare? Perhaps that’s the only way you can avoid seeing an all geriatric practice? Dan -----Original Message-----From: [mailto:.at.yahoogroups.compracticeimprovement1 (DOT) at.dg.mailshell.com] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 2:31 AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FL Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000