Guest guest Posted November 27, 2010 Report Share Posted November 27, 2010 My wife and I no longer accept new Medicare...unless... -age into Medicare as current patient - ie turn 65yo -grandpa moves to town and we see the family -unattached patient who gets admitted to the hospital when I am on call - although I don't like seeing them because they tend to be pretty complicated. -referral from ER when I am on call for the hospital Many of the practices do the same. One of the local Internists makes patients come for an Annual Preventive Exam and they have to pay cash - not sure how much - to make his 50%+ Medicare practice can stay afloat. He's not sure what he will do now that an " Annual Exam " is covered by Medicare -- his past system would be illegal. He is thinking about doing a Non-Covered Benefit fee - but that gets dicey - IMHO. Locke, MD What are others doing? Opting out or hanging in there to see if Medicare is saved again. ly I can't imagine making it with the planned cuts and > 60% of my practice is Medicare. I would want to charge my Medicare patients an additinal fee but that would be illegal. I don't think a NCB will hold up in my practice anyways. It's more than maddening to be repeatedly placed in this postion! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2010 Report Share Posted November 28, 2010 We stopped taking Medicare while the current Congress was dinking around with the legislation. We saw a significant downturn in our number of new patients. We have time and room on the schedule to see more patients. We live in an area with a LOT of people aging into Medicare and many providers not taking Medicare. So we opened back up to Medicare. We are in “wait and see” mode to see what happens with SGR. For a while, we didn’t think it was going to matter since we were going to sell our practice. But now that we are not selling our practice we will have to cross that bridge when we get to it. Right now, we need to continue taking all new patients. When our schedule is too busy to handle, we will stop taking some new patients. I’d love for Anthem to be the first, actually. But if Medicare cuts go below what anthem is paying, then it would have to be Medicare. Pratt Office Manager Oak Tree Internal Medicine P.C www.prattmd.info From: [mailto: ] On Behalf Of Locke Sent: Saturday, November 27, 2010 2:46 PM To: Subject: Re: Medicare Fears My wife and I no longer accept new Medicare...unless... -age into Medicare as current patient - ie turn 65yo -grandpa moves to town and we see the family -unattached patient who gets admitted to the hospital when I am on call - although I don't like seeing them because they tend to be pretty complicated. -referral from ER when I am on call for the hospital Many of the practices do the same. One of the local Internists makes patients come for an Annual Preventive Exam and they have to pay cash - not sure how much - to make his 50%+ Medicare practice can stay afloat. He's not sure what he will do now that an " Annual Exam " is covered by Medicare -- his past system would be illegal. He is thinking about doing a Non-Covered Benefit fee - but that gets dicey - IMHO. Locke, MD What are others doing? Opting out or hanging in there to see if Medicare is saved again. ly I can't imagine making it with the planned cuts and > 60% of my practice is Medicare. I would want to charge my Medicare patients an additinal fee but that would be illegal. I don't think a NCB will hold up in my practice anyways. It's more than maddening to be repeatedly placed in this postion! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2010 Report Share Posted November 28, 2010 We have not taken any new Medicare patients in the last 6 years because of fear of payment cuts. Over time the percent of our patients in Medicare has fallen to less than 10 percent. Not only do we have to go through this Payment uncertainty every year, older patients also take more time for any level of service in my opinion. If you mess up Medicare rules by accident there are potential criminal penalties. With commercial insurance the worst they can do is ask for money back and then kick you out of their panel. Sent from my iPadLarry Lindeman MD What are others doing? Opting out or hanging in there to see if Medicare is saved again. ly I can't imagine making it with the planned cuts and > 60% of my practice is Medicare. I would want to charge my Medicare patients an additinal fee but that would be illegal. I don't think a NCB will hold up in my practice anyways. It's more than maddening to be repeatedly placed in this postion! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2010 Report Share Posted November 29, 2010 A MDC patient who pays something is more profitable than an empty appointment slot. ________________________________________ From: [ ] On Behalf Of Pratt [karen.oaktree@...] Sent: Saturday, November 27, 2010 9:48 PM To: Subject: RE: Medicare Fears We stopped taking Medicare while the current Congress was dinking around with the legislation. We saw a significant downturn in our number of new patients. We have time and room on the schedule to see more patients. We live in an area with a LOT of people aging into Medicare and many providers not taking Medicare. So we opened back up to Medicare. We are in “wait and see” mode to see what happens with SGR. For a while, we didn’t think it was going to matter since we were going to sell our practice. But now that we are not selling our practice we will have to cross that bridge when we get to it. Right now, we need to continue taking all new patients. When our schedule is too busy to handle, we will stop taking some new patients. I’d love for Anthem to be the first, actually. But if Medicare cuts go below what anthem is paying, then it would have to be Medicare. Pratt Office Manager Oak Tree Internal Medicine P.C www.prattmd.info<http://www.prattmd.info> ________________________________ From: [mailto: ] On Behalf Of Locke Sent: Saturday, November 27, 2010 2:46 PM To: Subject: Re: Medicare Fears My wife and I no longer accept new Medicare...unless... -age into Medicare as current patient - ie turn 65yo -grandpa moves to town and we see the family -unattached patient who gets admitted to the hospital when I am on call - although I don't like seeing them because they tend to be pretty complicated. -referral from ER when I am on call for the hospital Many of the practices do the same. One of the local Internists makes patients come for an Annual Preventive Exam and they have to pay cash - not sure how much - to make his 50%+ Medicare practice can stay afloat. He's not sure what he will do now that an " Annual Exam " is covered by Medicare -- his past system would be illegal. He is thinking about doing a Non-Covered Benefit fee - but that gets dicey - IMHO. Locke, MD On Sat, Nov 27, 2010 at 3:20 PM, Myria > wrote: What are others doing? Opting out or hanging in there to see if Medicare is saved again. ly I can't imagine making it with the planned cuts and > 60% of my practice is Medicare. I would want to charge my Medicare patients an additinal fee but that would be illegal. I don't think a NCB will hold up in my practice anyways. It's more than maddening to be repeatedly placed in this postion! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2010 Report Share Posted November 29, 2010 One thing we all forget is that one day, sooner for some of us than others, we will be the ones on Medicare. Every person over 65 is on Medicare even if they have a secondary. Who will take care of us when we are old? That being said, we do need to be paid for our work. I had ~ 20% Medicare, my biller told me, and she said I was more than doing my share. So I started taking only 1-2 new Medicare pts/month. I do not drop my pts when they become Medicare age, and I too also take pts' mothers/fathers. And as someone said, if the schedule has openings, it's better to see a Medicare pt than to sit there doing nothing. Ellen (Cutting Medicare with the EMR Hi TECH stuff going on will also decrease the supposed amt we can be reimbursed for EMR. But they have been talking about cuts for yrs. Will they really do it? Hard to imagine. Every Congressman/woman has a mother/father on Medicare. Time will tell). > We have not taken any new Medicare patients in the last 6 years > because of fear of payment cuts. Over time the percent of our patients > in Medicare has fallen to less than 10 percent. Not only do we have to > go through this Payment uncertainty every year, older patients also > take more time for any level of service in my opinion. If you mess up > Medicare rules by accident there are potential criminal penalties. > With commercial insurance the worst they can do is ask for money back > and then kick you out of their panel. > > Sent from my iPad > Larry Lindeman MD > > On Nov 27, 2010, at 4:20 PM, Myria <myriaemeny@... > > wrote: > >> What are others doing? Opting out or hanging in there to see if >> Medicare is saved again. >> ly I can't imagine making it with the planned cuts and > 60% of >> my practice is Medicare. >> I would want to charge my Medicare patients an additinal fee but that >> would be illegal. >> I don't think a NCB will hold up in my practice anyways. It's more >> than maddening to be repeatedly placed in this postion! >> > Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2010 Report Share Posted November 29, 2010 RE is taking Medicare worth it? 1) You must remember that in some places Medicare is BEST payor (California, NJ, NY); so no, in those places a 25% cut in pay may NOT be sustainable. 2) Taking "anyone" no matter what is paid is NOT necessarily a good thing; for ex, in PA, the state pays $23/visit. Many of these folks are VERY complex, and can take up time that could be better spent taking care of better paying pts. 3) Everyone has a line in the sand...taking "every pt" isn't always the best thing to do, imho. Matt in Western PA Re: Medicare Fears One thing we all forget is that one day, sooner for some of us than others, we will be the ones on Medicare. Every person over 65 is on Medicare even if they have a secondary.Who will take care of us when we are old? That being said, we do need to be paid for our work. I had ~ 20% Medicare, my biller told me, and she said I was more than doing my share. So I started taking only 1-2 new Medicare pts/month. I do not drop my pts when they become Medicare age, and I too also take pts' mothers/fathers. And as someone said, if the schedule has openings, it's better to see a Medicare pt than to sit there doing nothing.Ellen(Cutting Medicare with the EMR Hi TECH stuff going on will also decrease the supposed amt we can be reimbursed for EMR. But they have been talking about cuts for yrs. Will they really do it? Hard to imagine. Every Congressman/woman has a mother/father on Medicare. Time will tell).> We have not taken any new Medicare patients in the last 6 years > because of fear of payment cuts. Over time the percent of our patients > in Medicare has fallen to less than 10 percent. Not only do we have to > go through this Payment uncertainty every year, older patients also > take more time for any level of service in my opinion. If you mess up > Medicare rules by accident there are potential criminal penalties. > With commercial insurance the worst they can do is ask for money back > and then kick you out of their panel.>> Sent from my iPad> Larry Lindeman MD>> On Nov 27, 2010, at 4:20 PM, Myria > wrote:>>> What are others doing? Opting out or hanging in there to see if >> Medicare is saved again.>> ly I can't imagine making it with the planned cuts and > 60% of >> my practice is Medicare.>> I would want to charge my Medicare patients an additinal fee but that >> would be illegal.>> I don't think a NCB will hold up in my practice anyways. It's more >> than maddening to be repeatedly placed in this postion!>>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2010 Report Share Posted November 29, 2010 agree , taking medical is masochism...the poor reimbursement I can deal with,the lack of respect from the bean counters, the TARs, the billing hassles, my worst nightmare was not that bad RE is taking Medicare worth it? 1) You must remember that in some places Medicare is BEST payor (California, NJ, NY); so no, in those places a 25% cut in pay may NOT be sustainable. 2) Taking " anyone " no matter what is paid is NOT necessarily a good thing; for ex, in PA, the state pays $23/visit. Many of these folks are VERY complex, and can take up time that could be better spent taking care of better paying pts. 3) Everyone has a line in the sand...taking " every pt " isn't always the best thing to do, imho. Matt in Western PA Re: Medicare Fears One thing we all forget is that one day, sooner for some of us than others, we will be the ones on Medicare. Every person over 65 is on Medicare even if they have a secondary.Who will take care of us when we are old? That being said, we do need to be paid for our work. I had ~ 20% Medicare, my biller told me, and she said I was more than doing my share. So I started taking only 1-2 new Medicare pts/month. I do not drop my pts when they become Medicare age, and I too also take pts' mothers/fathers. And as someone said, if the schedule has openings, it's better to see a Medicare pt than to sit there doing nothing.Ellen(Cutting Medicare with the EMR Hi TECH stuff going on will also decrease the supposed amt we can be reimbursed for EMR. But they have been talking about cuts for yrs. Will they really do it? Hard to imagine. Every Congressman/woman has a mother/father on Medicare. Time will tell).> We have not taken any new Medicare patients in the last 6 years > because of fear of payment cuts. Over time the percent of our patients > in Medicare has fallen to less than 10 percent. Not only do we have to > go through this Payment uncertainty every year, older patients also > take more time for any level of service in my opinion. If you mess up > Medicare rules by accident there are potential criminal penalties. > With commercial insurance the worst they can do is ask for money back > and then kick you out of their panel.>> Sent from my iPad> Larry Lindeman MD>> On Nov 27, 2010, at 4:20 PM, Myria > wrote:>>> What are others doing? Opting out or hanging in there to see if >> Medicare is saved again.>> ly I can't imagine making it with the planned cuts and > 60% of >> my practice is Medicare.>> I would want to charge my Medicare patients an additinal fee but that >> would be illegal.>> I don't think a NCB will hold up in my practice anyways. It's more >> than maddening to be repeatedly placed in this postion!>>> -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2010 Report Share Posted November 29, 2010 Yes, Agreed! And our panel is still only about 12% Medicare, but I think that will be increasing, based on the number of patients that we're seeing " age into " Medicare. Pratt Office Manager Oak Tree Internal Medicine P.C www.prattmd.info Re: Medicare Fears My wife and I no longer accept new Medicare...unless... -age into Medicare as current patient - ie turn 65yo -grandpa moves to town and we see the family -unattached patient who gets admitted to the hospital when I am on call - although I don't like seeing them because they tend to be pretty complicated. -referral from ER when I am on call for the hospital Many of the practices do the same. One of the local Internists makes patients come for an Annual Preventive Exam and they have to pay cash - not sure how much - to make his 50%+ Medicare practice can stay afloat. He's not sure what he will do now that an " Annual Exam " is covered by Medicare -- his past system would be illegal. He is thinking about doing a Non-Covered Benefit fee - but that gets dicey - IMHO. Locke, MD On Sat, Nov 27, 2010 at 3:20 PM, Myria > wrote: What are others doing? Opting out or hanging in there to see if Medicare is saved again. ly I can't imagine making it with the planned cuts and > 60% of my practice is Medicare. I would want to charge my Medicare patients an additinal fee but that would be illegal. I don't think a NCB will hold up in my practice anyways. It's more than maddening to be repeatedly placed in this postion! ------------------------------------ Quote Link to comment Share on other sites More sharing options...
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