Re: Billing for phone management of medicare pts

[Guest guest]

Theres codes and theres payment.

This isn't covered to my knowledge.

Matt in Western PA

Billing for phone management of medicare pts

There used to be a code for managing nursing home pt nurse phone calls, medication adjustments, etc but

it isnt accepted any longer it seems. Is there a way to do this, or does the pt have to come in for office visit?

I have several pts who require alot of this kind of care, taking alot of time etc, but claims rejected.

[Guest guest]

I think this may be covered under care plan oversight -- I'm currently looking into this as well.

To: Sent: Saturday, November 19, 2011 11:49 AMSubject: Re: Billing for phone management of medicare pts

Theres codes and theres payment.

This isn't covered to my knowledge.

Matt in Western PA

Billing for phone management of medicare pts

There used to be a code for managing nursing home pt nurse phone calls, medication adjustments, etc but

it isnt accepted any longer it seems. Is there a way to do this, or does the pt have to come in for office visit?

I have several pts who require alot of this kind of care, taking alot of time etc, but claims rejected.

[Guest guest]

this may not be helpful to others -  but- I try to see people then I billThe NH calls  and wants this or that and I say I will be over later. 

And  when I do see them I document all those calls  I have had all those coumadin  adjustments  and family visits and so I  up grade the visit level. becasue it documents the complexity of the care. I really hate this  practicing of medicine by  phone an d  fax. PLease call  this in, order that etc  How many thigns  do we see differntly when we see the  patietns  or how many things   do we  back track on  or find a small error about? At least I do. I am not that bright . Medicine is  hard. I need time to think and not " just " call this in or " just do that " It comes back to bite me later.I look up millions of things. I do I find this calling in ofmeds to be  bizarre Why do we now have  to  have articles written (latest FPM)that tell us to see and assess to prescribe?? nuts!! When  did we get away form that basic idea  anyway?( rhetorical .I know the answers)

so ,  I see people I admit that most of my NH work is a 4min walk. I go to others but I deliberately designed the practic etc make the work  possible Shall I  stay  at home and work in my fuzzy slippers and robe and not see and  examine the DVT that the nurses think is cellulitis?(The nurses a re  fabulous but they are not MY eyes). Obviously SOME of our work could be done by phone and   is not reimbursed   Sometimes In reduce the volume of NH faxes and  phone calls sign off sby  saying  that  these orders wait to be sign ed til I come in--I have a folder at the NH   and when I am there I sign  off.I am there for a visit which I bill for  I cannot  get rid of all of the pain of NH owrk but you can  system out/redesign your work flow for  some of it..

 

I think this may be covered under care plan oversight -- I'm currently looking into this as well.

To: Sent: Saturday, November 19, 2011 11:49 AM

Subject: Re: Billing for phone management of medicare pts

 

Theres codes and theres payment.

 

This isn't covered to my knowledge.

 

Matt in Western PA

Billing for phone management of medicare pts

 

There used to be a code for managing nursing home pt  nurse phone calls,  medication adjustments, etc but

it isnt accepted any longer it seems.  Is there a way to do this,  or does the pt have to come in for office visit?

I have several  pts who require alot of this kind of care, taking alot of time etc,  but claims rejected. 

--      MD          ph    fax

[Guest guest]

I agree on seeing the patient. I am planning on using care plan oversight for visiting nurse orders that must be renewed monthly even if I've left them a written note or called it in. I spend a lot of time talking to nurses even tho I visit weekly to monthly on my home bound. Apprarently they are required to talk to me despite my note left for them and then they have to send me their forms to be signed because my written note on the table isn't "enough". I can write orders for new patient and then have to sign an avadavit that I saw this patient in the past 30 days for Medicare. Upcoding my actual visit which is already long doesn't help because I've yet to be paid for prolonged physician visits no matter how I split the codes between the first

1/2 hour and the second 1/2 hour. One day I saw the patient, took twenty minutes to call the orders to the supervisor, then had to reiterate those orders to the nurse providing the care, on and on it goes! Silly stuff even when I have seen the patient! The Medicare "avadavit" really is obnoxious to me. I wouldn't be calling in orders if I hadn't see the patient!

To: Sent: Sunday, November 20, 2011 11:33 AMSubject: Re: Billing for phone management of medicare pts

this may not be helpful to others - but- I try to see people then I billThe NH calls and wants this or that and I say I will be over later. And when I do see them I document all those calls I have had all those coumadin adjustments and family visits and so I up grade the visit level. becasue it documents the complexity of the care. I really hate this practicing of medicine by phone an d fax. PLease call this in, order that etc How many thigns do we see differntly when we see the patietns or how many things do we back track on or find a small error about? At least I do. I am not that bright . Medicine is hard. I need time to think and not "just" call this in or"just do that" It comes back to bite me later.I look up millions of things. I do I find this calling in ofmeds to be bizarre Why do we now

have to have articles written (latest FPM)that tell us to see and assess to prescribe?? nuts!! When did we get away form that basic idea anyway?( rhetorical .I know the answers)so , I see people I admit that most of my NH work is a 4min walk. I go to others but I deliberately designed the practic etc make the work possible Shall I stay at home and work in my fuzzy slippers and robe and not see and examine the DVT that the nurses think is cellulitis?(The nurses a re fabulous but they are not MY eyes). Obviously SOME of our work could be done by phone and is not reimbursed Sometimes In reduce the volume of NH faxes and phone calls sign off sby saying that these orders wait to be sign ed til I come in--I have a folder at the NH and when I am there I sign off.I am there for a visit which I bill for I cannot get

rid of all of the pain of NH owrk but you can system out/redesign your work flow for some of it..

I think this may be covered under care plan oversight -- I'm currently looking into this as well.

To: Sent: Saturday, November 19, 2011 11:49 AMSubject: Re: Billing for phone management of medicare pts

Theres codes and theres payment.

This isn't covered to my knowledge.

Matt in Western PA

Billing for phone management of medicare pts

There used to be a code for managing nursing home pt nurse phone calls, medication adjustments, etc but

it isnt accepted any longer it seems. Is there a way to do this, or does the pt have to come in for office visit?

I have several pts who require alot of this kind of care, taking alot of time etc, but claims rejected.

-- MD ph fax

[Guest guest]

i dont go to the nursing home at all.

they .. hmm... hop on the bus... and come see me.

grace

>

>  

> >I think this may be covered under care plan oversight -- I'm currently

looking into this as well.

> >

> >

> >

> >

> >To:

> >Sent: Saturday, November 19, 2011 11:49 AM

> >Subject: Re: Billing for phone management of medicare

pts

> >

> >

> > 

> >Theres codes and theres payment.

> > 

> >This isn't covered to my knowledge.

> > 

> >Matt in Western PA

> > Billing for phone management of medicare pts

> >>

> >> 

> >>There used to be a code for managing nursing home pt  nurse phone calls, 

medication adjustments, etc but

> >>it isnt accepted any longer it seems.  Is there a way to do this,  or does

the pt have to come in for office visit?

> >>I have several  pts who require alot of this kind of care, taking alot of

time etc,  but claims rejected. 

> >

> >

>

>

> --

>

>

>

>      MD

>     

>     

> ph    fax

>

>