Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 Excellent observation on what gets in the way for patients. There is a growing research base that supports your observation. From this base and observation grows the work of relationship based care that is one of the pillars of our practices and our IMPs study. We're going to be exploring how we understand what really matters to patients so that we can help them get to their goals. Group visits: look at: www.improvingchroniccare.org for a group visit starter kit. The kit's approach has to be modified to your practice. RE: billing group and individual visits: This must be managed carefully, as there is a gray zone and some insurers are concerned about potential fraud in this arena. Tread carefully as you bill for activity devoid of individual face-to-face, as this is generally not supported by insurers. When a patient in our group wants some face time during a group, we do a five minute round-robin in the exam room. A few want a brief face-to-face at check in or at check out. All of this individual activity is billable if you document appropriately. Aside from some small pilots I do not know of any insurer that will pay for group activity. I generally have 2/3 of the group attendees interacting in a very brief or longer visit. Gordon At 11:23 AM 2/4/2006, you wrote: Just wanted to pick your brains about group visits. I have some patients that would be willing to do a group visit, but still want an individual appointment also. Do any of you who are doing group visits have anything to share on this? I'm thinking that the billing of both these visits may raise eyebrows at the insurance companies. Lynn, your idea of connecting patients with similar health issues and goals is wonderful. So many times it is the social isolation that is the actual culprit for patients not reaching their goals. Boyce vboyce@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 Excellent observation on what gets in the way for patients. There is a growing research base that supports your observation. From this base and observation grows the work of relationship based care that is one of the pillars of our practices and our IMPs study. We're going to be exploring how we understand what really matters to patients so that we can help them get to their goals. Group visits: look at: www.improvingchroniccare.org for a group visit starter kit. The kit's approach has to be modified to your practice. RE: billing group and individual visits: This must be managed carefully, as there is a gray zone and some insurers are concerned about potential fraud in this arena. Tread carefully as you bill for activity devoid of individual face-to-face, as this is generally not supported by insurers. When a patient in our group wants some face time during a group, we do a five minute round-robin in the exam room. A few want a brief face-to-face at check in or at check out. All of this individual activity is billable if you document appropriately. Aside from some small pilots I do not know of any insurer that will pay for group activity. I generally have 2/3 of the group attendees interacting in a very brief or longer visit. Gordon At 11:23 AM 2/4/2006, you wrote: Just wanted to pick your brains about group visits. I have some patients that would be willing to do a group visit, but still want an individual appointment also. Do any of you who are doing group visits have anything to share on this? I'm thinking that the billing of both these visits may raise eyebrows at the insurance companies. Lynn, your idea of connecting patients with similar health issues and goals is wonderful. So many times it is the social isolation that is the actual culprit for patients not reaching their goals. Boyce vboyce@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 Excellent observation on what gets in the way for patients. There is a growing research base that supports your observation. From this base and observation grows the work of relationship based care that is one of the pillars of our practices and our IMPs study. We're going to be exploring how we understand what really matters to patients so that we can help them get to their goals. Group visits: look at: www.improvingchroniccare.org for a group visit starter kit. The kit's approach has to be modified to your practice. RE: billing group and individual visits: This must be managed carefully, as there is a gray zone and some insurers are concerned about potential fraud in this arena. Tread carefully as you bill for activity devoid of individual face-to-face, as this is generally not supported by insurers. When a patient in our group wants some face time during a group, we do a five minute round-robin in the exam room. A few want a brief face-to-face at check in or at check out. All of this individual activity is billable if you document appropriately. Aside from some small pilots I do not know of any insurer that will pay for group activity. I generally have 2/3 of the group attendees interacting in a very brief or longer visit. Gordon At 11:23 AM 2/4/2006, you wrote: Just wanted to pick your brains about group visits. I have some patients that would be willing to do a group visit, but still want an individual appointment also. Do any of you who are doing group visits have anything to share on this? I'm thinking that the billing of both these visits may raise eyebrows at the insurance companies. Lynn, your idea of connecting patients with similar health issues and goals is wonderful. So many times it is the social isolation that is the actual culprit for patients not reaching their goals. Boyce vboyce@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I heard you could bill 99214/99213 as you would be spending time with them each separately and then having them attend a lecture/presentation, and Q & A.My goal this winter is to start a 1 year obesity workshop that will meet monthly. I plan t use many complementary methods including aromatherapy etc... with the patients. They will be involved in weekly phone calls with each other using motivational interviewing techniques I will teach them, Really looking forward to it. Hope the billing part works too!Pamela I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I heard you could bill 99214/99213 as you would be spending time with them each separately and then having them attend a lecture/presentation, and Q & A.My goal this winter is to start a 1 year obesity workshop that will meet monthly. I plan t use many complementary methods including aromatherapy etc... with the patients. They will be involved in weekly phone calls with each other using motivational interviewing techniques I will teach them, Really looking forward to it. Hope the billing part works too!Pamela I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I participated in a group visit symposium at the SGIM meeting in Chicago in 2003; at the time I was doing quarterly group visits since 2000 on problem diabetics (a1c>8.6) for the group ( ~10 FTE's). The skinny - you can bill for the individual time OR complexity - so if you're juggling meds ( tuning the insulin or metformin) you are darn close to a 99214 if you also do the standard ros and pe too.....I had ~1/2 99213 and 1/4 99212 and 1/4 99214....but I'd run though 10 patients in 2 hours. The business works/the satisfaction is very high but we ( DHMC-GIM) found the infrastructure was a hidden 'cost'. For the population I was seeing, we also had trouble with recruitment....we'd invite 30 patients and get 2-3 interested....so we stopped offering this service. Yes the folks who came had better a1c's so the CMS angle is also a plus! Adam Brock DO wrote: I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START withdiabtetesI googled' it and got a nice littel improving chronic care guideHere ismy questionBilling.!If I take a vital sign or do foot exams on eacH PERSON- then it is ok tobill some maybe lower level of visit for each?i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FORSPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXTPERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT.and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYSWILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5Pm or osmething.. then something personal for eachperson 1 hr totoal andset up a series of say threeevisits to start?any of you doing this? thanks you Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2006 Report Share Posted July 20, 2006 I participated in a group visit symposium at the SGIM meeting in Chicago in 2003; at the time I was doing quarterly group visits since 2000 on problem diabetics (a1c>8.6) for the group ( ~10 FTE's). The skinny - you can bill for the individual time OR complexity - so if you're juggling meds ( tuning the insulin or metformin) you are darn close to a 99214 if you also do the standard ros and pe too.....I had ~1/2 99213 and 1/4 99212 and 1/4 99214....but I'd run though 10 patients in 2 hours. The business works/the satisfaction is very high but we ( DHMC-GIM) found the infrastructure was a hidden 'cost'. For the population I was seeing, we also had trouble with recruitment....we'd invite 30 patients and get 2-3 interested....so we stopped offering this service. Yes the folks who came had better a1c's so the CMS angle is also a plus! Adam Brock DO wrote: I would like to hear what others say about the group visits. I was under the impression that insurances do not pay for these at all & that you are not allowed to code the pt’s all individually as if you had seen them separately. group visits Ok I have decIded I am ready to try group visIts I want to START withdiabtetesI googled' it and got a nice littel improving chronic care guideHere ismy questionBilling.!If I take a vital sign or do foot exams on eacH PERSON- then it is ok tobill some maybe lower level of visit for each?i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FORSPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXTPERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT.and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYSWILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5Pm or osmething.. then something personal for eachperson 1 hr totoal andset up a series of say threeevisits to start?any of you doing this? thanks you Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2006 Report Share Posted July 21, 2006 We have our group visits at the end of the day to avoid the " next patient walking in " problem. Remember that group visits can serve many purposes and to choose the one that suits pt needs the best. Some group visits are really just elaborate patient education sessions. Nice, but missing one of the best opportunities we have to help folks improve their health: problem solving. The problem solving group visit is based on cognitive behavioral principles and is pretty simple. Just go to www.HowsYourHealth.org Down the page a bit click on " Problem solving and planning your care. " Walk through the process yourself, pretending to be a patient with (for example) diabetes who has trouble following through with the treatment plan but is still interested in being healthy and living long. This approach applies not just to chronic disease, but to health in general, and you can offer it to any patient who lacks confidence in their ability to manage their own health. Gordon At 09:14 AM 7/20/2006, you wrote: Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2006 Report Share Posted July 21, 2006 Insurers do not cover group visits per se, but they do reimburse for the individual time spent with each person. Since you will be doing the vitals, etc, then you have individual time with each person, and can also code based on complexity. If you don’t have ANY one-on-one time with a person (doesn’t have to be in a separate room BTW), then you can’t file a claim for them. Group visits are fun for you and your patients – enjoy! A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Sent: Thursday, July 20, 2006 7:15 AM To: 'practiceimprovement1 ' Subject: group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2006 Report Share Posted July 21, 2006 Insurers do not cover group visits per se, but they do reimburse for the individual time spent with each person. Since you will be doing the vitals, etc, then you have individual time with each person, and can also code based on complexity. If you don’t have ANY one-on-one time with a person (doesn’t have to be in a separate room BTW), then you can’t file a claim for them. Group visits are fun for you and your patients – enjoy! A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Sent: Thursday, July 20, 2006 7:15 AM To: 'practiceimprovement1 ' Subject: group visits Ok I have decIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2006 Report Share Posted July 21, 2006 I remember several articles in the American Family Physician as well as FPM not too long ago. I did a quick search and located these four promising articles. There are more. http://www.aafp.org/fpm/20040900/39grou.html http://www.aafp.org/online/en/home/practicemgt/codingresources/groupvisitcoding.\ html http://www.aafp.org/fpm/20030500/66grou.html http://www.aafp.org/fpm/20060100/37grou.html Charlie Vargas lin, NC Date: 2006/07/20 Thu PM 08:46:37 CDT To: Subject: RE: group visits Insurers do not cover group visits per se,but they do reimburse for the individual time spent with each person. Since you will be doing the vitals, etc, then you have individual time witheach person, and can also code based on complexity. If you don’thave ANY one-on-one time with a person (doesn’t have to be in a separateroom BTW), then you can’t file a claim for them. Group visits arefun for you and your patients – enjoy! A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Sent: Thursday, July 20, 2006 7:15AM To:'practiceimprovement1 ' Subject: group visits Ok I havedecIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2006 Report Share Posted July 21, 2006 I remember several articles in the American Family Physician as well as FPM not too long ago. I did a quick search and located these four promising articles. There are more. http://www.aafp.org/fpm/20040900/39grou.html http://www.aafp.org/online/en/home/practicemgt/codingresources/groupvisitcoding.\ html http://www.aafp.org/fpm/20030500/66grou.html http://www.aafp.org/fpm/20060100/37grou.html Charlie Vargas lin, NC Date: 2006/07/20 Thu PM 08:46:37 CDT To: Subject: RE: group visits Insurers do not cover group visits per se,but they do reimburse for the individual time spent with each person. Since you will be doing the vitals, etc, then you have individual time witheach person, and can also code based on complexity. If you don’thave ANY one-on-one time with a person (doesn’t have to be in a separateroom BTW), then you can’t file a claim for them. Group visits arefun for you and your patients – enjoy! A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Sent: Thursday, July 20, 2006 7:15AM To:'practiceimprovement1 ' Subject: group visits Ok I havedecIded I am ready to try group visIts I want to START with diabtetes I googled' it and got a nice littel improving chronic care guide Here ismy question Billing.! If I take a vital sign or do foot exams on eacH PERSON- then it is ok to bill some maybe lower level of visit for each? i AM THINKING 4 people TO A GROUP . IT WILLHAVE TO BE INTHE WAITING ROM FOR SPACE PURPOSES- AND THEN i HAVE TO FIGURE SCHeduLING BECASUE IF THE NEXT PERSON WALKS IN ETC TO BE EARLY FOR THEIR VISIT i HAVE TO CONTEND WITH THAT. and MY BUILDING IS SHARED AND i DONOT KNOW PREDICTABLy WHEN THE OTHER GUYS WILL BE HERE- HMM THIS COULD BE TOUGH; uh h. But let's assume I do it at 5 Pm or osmething.. then something personal for eachperson 1 hr totoal and set up a series of say threeevisits to start? any of you doing this? thanks you Quote Link to comment Share on other sites More sharing options...
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