The Time Has Come, Sink or Swim.... Soar or Crash & Burn.... Suggestions???

[Guest guest]

Well Folks the time has finally come upon us.... We have been pretty broke and just sort of attempting to ride out the insane wave of what was a perfect storm in our personal lives with family illness and being more than just a bit over whelmed with all of that, two kids, a crumbing school district, a crumbing healthcare system that wants us to work for peanuts if not even for free while constantly increasing its demands upon us for more BS busy work, reviews, prior auths, you all know the drill....

So needless to say it is hard to pay for CME, travel, Room & Board (that's why we missed you all last year at Camp BTW...), close the shop, perhaps even child care while we're away or their travel expenses too...., G & E, Med Mal (don't go there right now.... Shhheeeesssshhhh) Rent, Debt Service both professional and educational, so has not kept up on her CME and will soon no longer be Board Certified nor can we honestly say, Yes she has been keeping up with 50 plus credits of CME every year on average.... No way, no how... So now it is time to Re-Up with our HUGE local BC/BS Monster, Excellus who controls at least 60 if not even 70% of our market... They are requesting such data which we can not HONESTLY provide (but could BS our way thru and see what happens, not a great idea but an option none the less...) and so it looks like that perhaps for Medicare and one or two smaller privates we are about to go full private

business relationship cash only...

The problem is we have not thought this through very well and it sort of snuck up on us the Re-Instatement timing and so we have not properly marketed it, nor have we done other proactive things like consider dropping Medicare too so we can fully impliment the reverse model from the old system and to add to it all we here in NYS have the problem of collecting membership fees, retainers as a form of Selling Insurance which really is a problem here with our state insurance dept.... They really are going after people for this bullshit here. Now I had a quick once over with our lawyer and he felt that he MIGHT be able to help us get around this as long as we are not assuming ANY risk like offering to cover an unplanable, unfortuitous quantity of visits or needs for care, IE no offter of None Covered Benefits as the reason for the fee charged... But I have said in the past a true "retainer like Model" which offers NOTHING in return other than we promise

to keep the Panel Small and managable so we don't have a 2,500-3,000 patient panel but instead a more managable 500-1,000 patient panel which would allow us to reamain a full half hour on average office visit slot practice with better after hours access to your doctor via her personal cell phone, and off hours visits if mutually convenient, perhaps including the forementioned "DMV line and at the Hockey Rink, and Noble" like odd visits where doc and patient attempt to hook-up for some form of a mutually convienient time and place on weekends and evenings when possible... This combined with an office visit fee of about $20-$30 per visit (thinking about $25 bucks to start and perhaps somewhere near the magic number of a buck a day $350-$500, per person perhaps with a max of 3 or 4 for larger families)... At the same time we have a few patients right now who would be a much better catch at semi-normal full charges which are just above what the

majors charge right now and let them come in and simply pay cash on the barrel each and every time....

Lastly, the Lawyer a really decent and ethical man who has been a trusted advisor since before we even opened years ago, said to make sure he est'ed properly he would want about $2,500 (plan for it so not to be taken by suprise) to research this whole thing, perhaps "request a Ruling" from the state insurance dept and then help us craft a good, all "I" and "T" properly crossed and dotted sign on letter for our patients to acknowledge and accept our new business model... That is a tough one to come up with right now although I could once again over impose of family and see if my mom might care to help us out... AGAIN....

So there you have it, Licensed docs who are perfectly legal to practice medicine in the state they reside in being cut off from the spiget and supply of money that is supposed to be their main sorce of income from the 3rd party assholes who are supposedly "Pre-Screening" us when in fact it is their "starvation therapy" (An insiders r Based term for cutting off one's benefits as long as possible in Worker's Comp to force the then Starving Patient to go out and do something , anything to make a subsistance living so as to bust them at "working" or doing something to then allow them to cut them off....) that is the cause of our lack of finances to be able to afford jumping thru their hoops and hitting their marks in the first place... ya can't make this shit up... I swear ya just can't.... Gotta love... "I'm Moving to Australia" (a 1,000 points to the first member to properly source that quote....

Love to hear what you all have to say. Are there any other NY based IMP's out there that might want to share in the Legal Opinion, research fees in exchange for us all learning what we need to know in terms of implimenting such a model here in NYS??? Our Lawyer Bruce is a regular commentator and advisor for the local country medical society and is extremely well respected in terms of safely and properly advising his Doctor clients in all matters like these... SO perhaps if about half a dozen of us all pitched in together to share his fees, we could all for about $500 or less get the same sage advice on the particulars of how to deal with this in our state.... I think this might be a great all for one kind of way to handle this.... Let me know....

&

Village Medical of CNY