Re: Re: , please help to check the billing/coding rules [6 Attachm

[Guest guest]

Is regional.

But some have policies against full pay for both services.

I'm in process of credentialling with United Health care (yep I know the "dangers" but several multistate employers have forced the change due to ave rate increases local BCBS of >20%-- mine was 18% but I raised deductable) who told me their "policy" is to pay for the well care at full, but the E & M at 1/2.

BCBS pays both well as long as the plan is a PPO or other with the coverage (we can look it up online for them, at least, others we have to call -- I do this regularly early in year, as well as new pts see for acute and come back for well care update when follow up the chronic problems).

Each is different; and is problematic.

Worst issue with United during rep visit was proposal to pay medicare at 95%!!!!!!!!!!!!!!!!!

They admitted the local hospital wouldn't accept -- hard to believe why! ;-(

I said I wouldn't either.

Next year, the same companies will switch back as few specialists take United (big surprise), but pts will then end up with more out of pocket expenses to cover the other insurance................

Life goes on.

Latest issue is that the main urgicare chain competing with the hospital takes the copay, but then balance bills the ER deductible afterward........... I now post a note that for my pts, I take telephone calls and don't charge copays for that................

Matt in Western PA

Re: , please help to check the billing/coding rules [6 Attachm

The problems with being reimbursed for E & M visits done at the sametime as preventive services must be state/region specific. While I'mnot billing Medicare yet (yes caught in application hell and givingaway care to a few patients), none of the private insurers (includingmedicaid managed care) have given me any problem about re paying forboth cpt codes (as long as I remember to add back in the -25 modifierthat unfortunately the Amazing Charts-EZ Claims import-export utilitycuts off). Preventive care is so underpaid compared to my E & M visitsthat adding on an E & M visit to the CPE makes an hour long CPE visitmuch more reasonable (well, guess that I could do it in less time, butfeels good to me and the patient to spend that much time on a goodhealth assessment and wellness plan).Take care,- Queenan, MDQueenan Family Medicine and Maternity Care"Mindful medicine for whole body, mind, and spirit"1501 East Ave, Ste 211Rochester, NY 14610emilyqueenanOnebox1-

[Guest guest]

I also have not received one cent from medicare for all the work I did last yr!!

I switched from AC because of the mod 25 issue and some rx issues. I use office ally for everything. It is works and is much cheaper

 

The problems with being reimbursed for E & M visits done at the sametime as preventive services must be state/region specific. While I'mnot billing Medicare yet (yes caught in application hell and giving

away care to a few patients), none of the private insurers (includingmedicaid managed care) have given me any problem about re paying forboth cpt codes (as long as I remember to add back in the -25 modifierthat unfortunately the Amazing Charts-EZ Claims import-export utility

cuts off). Preventive care is so underpaid compared to my E & M visitsthat adding on an E & M visit to the CPE makes an hour long CPE visitmuch more reasonable (well, guess that I could do it in less time, but

feels good to me and the patient to spend that much time on a goodhealth assessment and wellness plan).Take care,- Queenan, MDQueenan Family Medicine and Maternity Care " Mindful medicine for whole body, mind, and spirit "

1501 East Ave, Ste 211Rochester, NY 14610emilyqueenan@...1-

-- 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.

[Guest guest]

AC rx problem was I could never get the CA rx format to work Also

the mod 25. I liked the idea of Officeally since it is all integrated

and not expensive. It works for esp web based. I can pull up on my

iPhone too. The they are going to get certification. Also the support

is free and so far no problem. I just started using the evisit ,

online booking and ptally where Pt enter their own demographics. These

are included the monthly fee

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> I, too, was considering using Office Ally.

> How much of a learning curve was it to switch?

> I like that I can really type directly into AC and make a note that is a real

SOAP note and not a bunch of check of lists.

> How much cheaper is Office Ally? I kept AC to be able to do note in real time

while on home visits but could still change my mind.

> Thanks for sharing.

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> To:

> Sent: Thu, January 14, 2010 11:47:42 AM

> Subject: Re: Re: , please help to check the

billing/coding rules [6 Attachm

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> Elaine,

> I am curious as to what rx issues you were having with AC?

> Also, what did you switch to and are things better overall?

> Thanks,

> Sharon

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> On Thu, Jan 14, 2010 at 7:58 AM, <elaine2mdgmail (DOT)

com > wrote:

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> I also have not received one cent from medicare for all the work I did last

yr!!

> I switched from AC because of the mod 25 issue and some rx issues. I use

office ally for everything. It is works and is much cheaper

>

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> On Wed, Jan 13, 2010 at 7:21 PM, Queenan <emilyqueenan@

gmail.com > wrote:

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> The problems with being reimbursed for E & M visits done at the same

> time as preventive services must be state/region specific. While I'm

> not billing Medicare yet (yes caught in application hell and giving

> away care to a few patients), none of the private insurers (including

> medicaid managed care) have given me any problem about re paying for

> both cpt codes (as long as I remember to add back in the -25 modifier

> that unfortunately the Amazing Charts-EZ Claims import-export utility

> cuts off). Preventive care is so underpaid compared to my E & M visits

> that adding on an E & M visit to the CPE makes an hour long CPE visit

> much more reasonable (well, guess that I could do it in less time, but

> feels good to me and the patient to spend that much time on a good

> health assessment and wellness plan).

>

> Take care,

> -

>

> Queenan, MD

> Queenan Family Medicine and Maternity Care

> " Mindful medicine for

> whole body, mind, and spirit "

>

> 1501 East Ave, Ste 211

> Rochester, NY 14610

> emilyqueenan@ Onebox.com <emilyqueenan%40Onebox.com>

> 1-

>

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>

>

> --

> M.D.

> www.elainemd. com <http://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.

>

>

>

>

> --

> Sharon McCoy MD

>

> Renaissance Family Medicine

> www.SharonMD. com <http://www.sharongeorgemd.com/>

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--

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.