Re: Set up to run on Medicare

[Guest guest]

Pamela, We like MEDIARE. We hope for more reimbursement for good care coordination, but we set our clinic up to run on medicare. and I set up our clinic to be profitable at medicare rates. All E/M codes were put into a time based formula back in 2004 when we started. After some ALLGEBRA I calculated in our location medicare pays 120-135 per hour. Being both internists, we have 25% of our patients that are medicare, but they represent 50%-60% of our visits. We use eMDs for scheduling, documentation, and billing, statements, and collections. This allows us to save. Zero FTEs/MD. We bill medicare and all our other payors once per

week using eMDs Bill module takes maybe 5 minutes. All coding is done at time of visit takes 10sec to one minute. We receive automatic electronic remit advice daily, which allows me to tract any rejected claims <1% AND CORRECT them efficiently. Both Medicare and BCBS pay within 14-21 days. The ERA takes 30 minutes once per week to electronically post. Secondaries are usually electronically linked so I just wait 30 more days. If the checks don't come in I take 10 minutes to address accounts receivable and bill the patients with POS an electronic to paper statement service. Takes about 10 minutes once per month. Cost is only $50-60 with postage $40-50. This previously took 4-5 hours myself. This portion of my clinic and medicare I love. Have only had two claims automatically threatened to be recouped. A 99214 with only 2 diagnoses

but well over 30 minutes was down coded by Today's Options. We lost the appeal both in time in our appeal and final outcome. Certainly not worth the $10-20 reclaimed. Also, lost home care charge x2 in 2009 and 2010, but eventually recoded to "correct" CODE so the did not atke any money. Spent hours on phone tress with 10 layers of operators till found someone smart enough to just have me change the code to the one they were paying correctly in 2009 2010. It was not my fault they incorrectly paid a code that was retired. I realy should not have taken these so personlly, but all the rumors of RAC audits and fraud and abuse really messes with your mind when the documents threaten to send to collections and extend coding investigations if these types of billing errors continue. I know now they aren't looking for me. Only 2-3 claim payment errors in 3

years. Would cost them dearly to review my code compliant charts. I really don't like the threat of reimbursement cuts every year, but medicare has found a way to pay me 10% more over the last 8 years and with meaningful use of $44K each for and I, I cannot complain about cost of improvement and "Change" in healthcare. If I was running the large hospital clinic in town, I would hate medicare rates. They wouldn't pay the overhead. The doctors there have closed to new medicare and medicaid patients. Good luck with your documentary, be careful because most people will not feel sorry for their doctor, the one that spends 5-10 minutes in a rush. Most do not have the doctor patient relationship of an

IMP. BUT REMEMBER IMPs patients are your patients not your friends. A missed diagnosis and a bad outcome and you may still wind up in malpractice case. Old family doctor really invested in community was recently sued by family of 18 y/o girl. She had headache and went to ER. CT negative went home. Felt better and was seen in follow up by above MD. Only a little tingling in thumb. Reassured and sent home. Major stroke after carotid dissection. Lost malpractivce case for failure to diagnose further evaluate dissection, 20% at fault withg er 80%. To: Sent: Sunday, December 18, 2011 6:24 PM Subject: Re: Medicare Take Backs

are there any docs out there who really enjoy dealing with Medicare?

I tend to think we all are taking much undeserved abuse, but if I am

misrepresenting docs please let me know. . .

Pamela

>

> pamela,

>

> i speak only for myself. one thing i ask of you is not to misrepresent me (though i was going to say 'those of us') who are really really sick of this medicare joke.

>

> be mindful truly that your practice is not the same as mine and as some may know here i am not an IMP since my patient load is still high. i could dial down, back off hours, lay off everybody and move my practice into my house but my demographics dont allow extra dollars off whatever's left from social security.

>

> though i dont have a solution in mind, what's leeching my time away from my family are these preauths for imaging and drugs, attestations, oodles of paperwork for this paperless office, and calling people from god knows where and god knows what they do to help me 'run my office more efficiently'.

>

> tell you honestly, i am ready to start all over again in another part of the world beyond this silly system of 'payers' that have deep pockets and even longer arms into politicians pockets all at the cost of my patients' blood and my own bloody sweat.

>

> so so sad... im slowly eaten away by cynicism and im fighting to my last drop of strength and rocky road ice cream.

>

> sigh.

> grace

>

[Guest guest]

I like Medicare for the most part too.  It is the easiest insurance to deal with.  Usually if we have a denied claim it is pretty easy to figure out why, the denial codes make sense.  Very few denials.  The government fee decreased and increases after the fact cause this $0.05 extra payments and take backs that are ridiculous.  But that is uncommon.  I don’t know what others are talking about with documentation and paperwork.  I bill for the hospital without any paperwork, just submit the bill.  The only time we need to send info is when Medicare is secondary or with a 99215 but that is SOP, you know if you code it you will have to defend it.  Discussion is for this list. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of EglySent: Monday, December 19, 2011 7:46 AMTo: Subject: Re: Set up to run on Medicare Pamela, We like MEDIARE. We hope for more reimbursement for good care coordination, but we set our clinic up to run on medicare. and I set up our clinic to be profitable at medicare rates. All E/M codes were put into a time based formula back in 2004 when we started. After some ALLGEBRA I calculated in our location medicare pays 120-135 per hour. Being both internists, we have 25% of our patients that are medicare, but they represent 50%-60% of our visits. We use eMDs for scheduling, documentation, and billing, statements, and collections. This allows us to save. Zero FTEs/MD. We bill medicare and all our other payors once per week using eMDs Bill module takes maybe 5 minutes. All coding is done at time of visit takes 10sec to one minute. We receive automatic electronic remit advice daily, which allows me to tract any rejected claims <1% AND CORRECT them efficiently. Both Medicare and BCBS pay within 14-21 days. The ERA takes 30 minutes once per week to electronically post. Secondaries are usually electronically linked so I just wait 30 more days. If the checks don't come in I take 10 minutes to address accounts receivable and bill the patients with POS an electronic to paper statement service. Takes about 10 minutes once per month. Cost is only $50-60 with postage $40-50. This previously took 4-5 hours myself. This portion of my clinic and medicare I love. Have only had two claims automatically threatened to be recouped. A 99214 with only 2 diagnoses but well over 30 minutes was down coded by Today's Options. We lost the appeal both in time in our appeal and final outcome. Certainly not worth the $10-20 reclaimed. Also, lost home care charge x2 in 2009 and 2010, but eventually recoded to " correct " CODE so the did not atke any money. Spent hours on phone tress with 10 layers of operators till found someone smart enough to just have me change the code to the one they were paying correctly in 2009 2010. It was not my fault they incorrectly paid a code that was retired. I realy should not have taken these so personlly, but all the rumors of RAC audits and fraud and abuse really messes with your mind when the documents threaten to send to collections and extend coding investigations if these types of billing errors continue. I know now they aren't looking for me. Only 2-3 claim payment errors in 3 years. Would cost them dearly to review my code compliant charts. I really don't like the threat of reimbursement cuts every year, but medicare has found a way to pay me 10% more over the last 8 years and with meaningful use of $44K each for and I, I cannot complain about cost of improvement and " Change " in healthcare. If I was running the large hospital clinic in town, I would hate medicare rates. They wouldn't pay the overhead. The doctors there have closed to new medicare and medicaid patients. Good luck with your documentary, be careful because most people will not feel sorry for their doctor, the one that spends 5-10 minutes in a rush. Most do not have the doctor patient relationship of an IMP. BUT REMEMBER IMPs patients are your patients not your friends. A missed diagnosis and a bad outcome and you may still wind up in malpractice case. Old family doctor really invested in community was recently sued by family of 18 y/o girl. She had headache and went to ER. CT negative went home. Felt better and was seen in follow up by above MD. Only a little tingling in thumb. Reassured and sent home. Major stroke after carotid dissection. Lost malpractivce case for failure to diagnose further evaluate dissection, 20% at fault withg er 80%. To: Sent: Sunday, December 18, 2011 6:24 PMSubject: Re: Medicare Take Backs are there any docs out there who really enjoy dealing with Medicare?I tend to think we all are taking much undeserved abuse, but if I ammisrepresenting docs please let me know. . .Pamela>> pamela,> > i speak only for myself. one thing i ask of you is not to misrepresent me (though i was going to say 'those of us') who are really really sick of this medicare joke.> > be mindful truly that your practice is not the same as mine and as some may know here i am not an IMP since my patient load is still high. i could dial down, back off hours, lay off everybody and move my practice into my house but my demographics dont allow extra dollars off whatever's left from social security.> > though i dont have a solution in mind, what's leeching my time away from my family are these preauths for imaging and drugs, attestations, oodles of paperwork for this paperless office, and calling people from god knows where and god knows what they do to help me 'run my office more efficiently'.> > tell you honestly, i am ready to start all over again in another part of the world beyond this silly system of 'payers' that have deep pockets and even longer arms into politicians pockets all at the cost of my patients' blood and my own bloody sweat.> > so so sad... im slowly eaten away by cynicism and im fighting to my last drop of strength and rocky road ice cream.> > sigh.> grace>

[Guest guest]

egads  On the case! My husband  woke up one day   several yrs  ago  with a horner;s syndorme  lots of tests/er visit/neuro visit no one read the ct  well.  Carotid dissection missed until he saw opthalmology three days  later.Who tracked the films down after he left, and called PCP who called me and said where is he? and I  said at a conference so PCP called ER at that institution who went to   t he  conference center and hauled him out.

 Could a  been dead  He is alive With a resultant  raders syndorme tic doloreaux  pain syndrome that a PCP resident figured out after another emergent mri for why he was in such painI didn;t sue anyone But I   know who did their work that week and who I will never send a patient to

(oh and then he was admitted, lovenox was brand new, Lovenox is q 12 h ; at 22 hrs they discharged him from observaiton where noone had come to see him except me ---and there was NO ONE at the  Mecca's desk   I had to ask a third yr medical student whom I  found when I wandered around , how to get to the  floor----and  the dietary lady with the tiny pencil and he   had had no second dose of lovenox Dont; get me started( then there is how much I had to shell out to buy it and how long it took me to get reimbursed)

  I admire what can do about  billing and running his office  wow , as I admire most all  IMPS What a case. oy.

Jean

 

Pamela, We like MEDIARE.  We hope for more reimbursement for good care coordination, but we set our clinic up to run on medicare.

  and I set up our clinic to be profitable at medicare rates.  All E/M codes were put into a time based formula back in 2004 when we started.  After some ALLGEBRA I calculated in our location medicare pays 120-135 per hour.  Being both internists, we have 25% of our patients that are medicare, but they represent 50%-60% of our visits.  We use eMDs for scheduling, documentation, and billing, statements, and collections.  This allows us to save. Zero FTEs/MD.  We bill medicare and all our other payors once per

week using eMDs Bill module takes maybe 5 minutes.  All coding is done at time of visit takes 10sec to one minute.  We receive automatic electronic remit advice daily, which allows me to tract any rejected claims <1% AND CORRECT them efficiently.  Both Medicare and BCBS pay within 14-21 days.  The ERA takes 30 minutes once per week to electronically post. Secondaries are usually electronically linked so I just wait 30 more days.  If the checks don't come in I take 10 minutes to address accounts receivable and bill the patients with POS an electronic to paper statement service.  Takes about 10 minutes once per month.  Cost is only $50-60 with postage $40-50.  This previously took 4-5 hours myself.  This portion of my clinic and medicare I love.

 Have only had two claims automatically threatened to be recouped.  A 99214 with only 2 diagnoses

but well over 30 minutes was down coded by Today's Options.  We lost the appeal both in time in our appeal and final outcome.  Certainly not worth the $10-20 reclaimed.  Also, lost home care charge x2 in 2009 and 2010, but eventually recoded to " correct " CODE so the did not atke any money.  Spent hours on phone tress with 10 layers of operators till found someone smart enough to just have me change the code to the one they were paying correctly in 2009 2010.  It was not my fault they incorrectly paid a code that was retired. 

 I realy should not have taken these so personlly, but all the rumors of RAC audits and fraud and abuse really messes with your mind when the documents threaten to send to collections and extend coding investigations if these types of billing errors continue.  I know now they aren't looking for me.  Only 2-3 claim payment errors in 3

years.  Would cost them dearly to review my code compliant charts. I really don't like the threat of reimbursement cuts every year, but medicare has found a way to pay me 10% more over the last 8 years and with meaningful use of $44K each for and I, I cannot complain about cost of improvement and " Change " in healthcare.

 If I was running the large hospital clinic in town, I would hate medicare rates.  They wouldn't pay the overhead.  The doctors there have closed to new medicare and medicaid patients.

 Good luck with your documentary, be careful because most people will not feel sorry for their doctor, the one that spends 5-10 minutes in a rush.      Most do not have the doctor patient relationship of an

IMP. BUT REMEMBER IMPs patients are your patients not your friends.  A missed diagnosis and a bad outcome and you may still wind up in malpractice case.  Old family doctor really invested in community was recently sued by family of 18 y/o girl.  She had headache and went to ER.  CT negative went home. Felt better and was seen in follow up by above MD.  Only a little tingling in thumb.  Reassured and sent home.  Major stroke after carotid dissection.  Lost malpractivce case for failure to diagnose further evaluate dissection, 20% at fault withg er 80%.

     

To:

Sent: Sunday, December 18, 2011 6:24 PM Subject: Re: Medicare Take Backs

 

are there any docs out there who really enjoy dealing with Medicare?

I tend to think we all are taking much undeserved abuse, but if I am

misrepresenting docs please let me know. . .

Pamela

>

> pamela,

>

> i speak only for myself. one thing i ask of you is not to misrepresent me (though i was going to say 'those of us') who are really really sick of this medicare joke.

>

> be mindful truly that your practice is not the same as mine and as some may know here i am not an IMP since my patient load is still high. i could dial down, back off hours, lay off everybody and move my practice into my house but my demographics dont allow extra dollars off whatever's left from social security.

>

> though i dont have a solution in mind, what's leeching my time away from my family are these preauths for imaging and drugs, attestations, oodles of paperwork for this paperless office, and calling people from god knows where and god knows what they do to help me 'run my office more efficiently'.

>

> tell you honestly, i am ready to start all over again in another part of the world beyond this silly system of 'payers' that have deep pockets and even longer arms into politicians pockets all at the cost of my patients' blood and my own bloody sweat.

>

> so so sad... im slowly eaten away by cynicism and im fighting to my last drop of strength and rocky road ice cream.

>

> sigh.

> grace

>

--      MD          ph    fax

[Guest guest]

Thanks I use Practice Management as my EHR.Initiallt signed up for a clearing house/billing service and it was a nightmare.  Now I have a someone local doing all the United Healths and Medicaid directly via their websites. These are a majority of my patients coverage.

 Would CMS have a direct link too?  I'm in RIThanks,Debra

 

Debra, We use eMDs EHR & PM software and Availity Clearing house.  Must register with your local CMS payor. Can find most of this info on CMS website.

 Where are you located and what PM software do you use. 

To: Sent: Wednesday, December 21, 2011 9:00 AM

Subject: Re: Set up to run on Medicare

 

HI Everyone,

  I am just getting set up with taking Medicare.

  Can I have some info on how you bill them?  Clearing house, web site, directly etc.

Thanks,

Debra

 

egads  On the case! My husband  woke up one day   several yrs  ago  with a horner;s syndorme  lots of tests/er visit/neuro visit no one read the ct  well.  Carotid dissection missed until he saw opthalmology three days  later.Who tracked the films down after he left, and called PCP who called me and said where is he? and I  said at a conference so PCP called ER at that institution who went to   t he  conference center and hauled him out.

 Could a  been dead  He is alive With a resultant  raders syndorme tic doloreaux  pain syndrome that a PCP resident figured out after another emergent mri for why he was in such painI didn;t sue anyone But I   know who did their work that week and who I will never send a patient to

(oh and then he was admitted, lovenox was brand new, Lovenox is q 12 h ; at 22 hrs they discharged him from observaiton where noone had come to see him except me ---and there was NO ONE at the  Mecca's desk   I had to ask a third yr medical student whom I  found when I wandered around , how to get to the  floor----and  the dietary lady with the tiny pencil and he   had had no second dose of lovenox Dont; get me started( then there is how much I had to shell out to buy it and how long it took me to get reimbursed)

  I admire what can do about  billing and running his office  wow , as I admire most all  IMPS What a case. oy.

 

Pamela,

 

We like MEDIARE.  We hope for more reimbursement for good care coordination, but we set our clinic up to run on medicare.

 

and I set up our clinic to be profitable at medicare rates.  All E/M codes were put into a time based formula back in 2004 when we started.  After some ALLGEBRA I calculated in our location medicare pays 120-135 per hour.  Being both internists, we have 25% of our patients that are medicare, but they represent 50%-60% of our visits.  We use eMDs for scheduling, documentation, and billing, statements, and collections.  This allows us to save. Zero FTEs/MD.  We bill medicare and all our other payors once per week using eMDs Bill module takes maybe 5 minutes.  All coding is done at time of visit takes 10sec to one minute.  We receive automatic electronic remit advice daily, which allows me to tract any rejected claims <1% AND CORRECT them efficiently.  Both Medicare and BCBS pay within 14-21 days.  The ERA takes 30 minutes once per week to electronically

post. Secondaries are usually electronically linked so I just wait 30 more days.  If the checks don't come in I take 10 minutes to address accounts receivable and bill the patients with POS an electronic to paper statement service.  Takes about 10 minutes once per month.  Cost is only $50-60 with postage $40-50.  This previously took 4-5 hours myself.  This portion of my clinic and medicare I love.

 

Have only had two claims automatically threatened to be recouped.  A 99214 with only 2 diagnoses but well over 30 minutes was down coded by Today's Options.  We lost the appeal both in time in our appeal and final outcome.  Certainly not worth the $10-20 reclaimed.  Also, lost home care charge x2 in 2009 and 2010, but eventually recoded to " correct " CODE so the did not atke any money.  Spent hours on phone tress with 10 layers of operators till found someone smart enough to just have me change the code to the one they were paying correctly in 2009 2010.  It was not my fault they incorrectly paid a code that was retired. 

 

I realy should not have taken these so personlly, but all the rumors of RAC audits and fraud and abuse really messes with your mind when the documents threaten to send to collections and extend coding investigations if these types of billing errors continue.  I know now they aren't looking for me.  Only 2-3 claim payment errors in 3 years.  Would cost them dearly to review my code compliant charts.

 

I really don't like the threat of reimbursement cuts every year, but medicare has found a way to pay me 10% more over the last 8 years and with meaningful use of $44K each for and I, I cannot complain about cost of improvement and " Change " in healthcare.

 

If I was running the large hospital clinic in town, I would hate medicare rates.  They wouldn't pay the overhead.  The doctors there have closed to new medicare and medicaid patients.

 

Good luck with your documentary, be careful because most people will not feel sorry for their doctor, the one that spends 5-10 minutes in a rush.      Most do not have the doctor patient relationship of an IMP.

 

BUT REMEMBER IMPs patients are your patients not your friends.  A missed diagnosis and a bad outcome and you may still wind up in malpractice case.  Old family doctor really invested in community was recently sued by family of 18 y/o girl.  She had headache and went to ER.  CT negative went home. Felt better and was seen in follow up by above MD.  Only a little tingling in thumb.  Reassured and sent home.  Major stroke after carotid dissection.  Lost malpractivce case for failure to diagnose further evaluate dissection, 20% at fault withg er 80%.

 

 

 

 

 

To:

Sent: Sunday, December 18, 2011 6:24 PMSubject: Re: Medicare Take Backs

 

are there any docs out there who really enjoy dealing with Medicare?I tend to think we all are taking much undeserved abuse, but if I ammisrepresenting docs please let me know. . .Pamela

>> pamela,> > i speak only for myself. one thing i ask of you is not to misrepresent me (though i was going to say 'those of us') who are really really sick of this medicare joke.>

> be mindful truly that your practice is not the same as mine and as some may know here i am not an IMP since my patient load is still high. i could dial down, back off hours, lay off everybody and move my practice into my house but my demographics dont allow extra dollars off whatever's left from social security.

> > though i dont have a solution in mind, what's leeching my time away from my family are these preauths for imaging and drugs, attestations, oodles of paperwork for this paperless office, and calling people from god knows where and god knows what they do to help me 'run my office more efficiently'.

> > tell you honestly, i am ready to start all over again in another part of the world beyond this silly system of 'payers' that have deep pockets and even longer arms into politicians pockets all at the cost of my patients' blood and my own bloody sweat.

> > so so sad... im slowly eaten away by cynicism and im fighting to my last drop of strength and rocky road ice cream.> > sigh.> grace>

--      MD          ph    fax

[Guest guest]

Debra, Medicare does have a direct link program, but if you EMR can create an EDI batch then Availity is the way to go. Free. All payors pay within 3 weeks most have EDI numbers with availity. Others Availity sents out a HCFA 1500. Good Luck Keep an eye on the billers and collections. Follow the money or others will for you. To: Sent: Wednesday, December 21, 2011 8:13 PM Subject: Re: Set up to run on Medicare

Thanks I use Practice Management as my EHR.Initiallt signed up for a clearing house/billing service and it was a nightmare. Now I have a someone local doing all the United Healths and Medicaid directly via their websites. These are a majority of my patients coverage.

Would CMS have a direct link too? I'm in RIThanks,Debra

Debra, We use eMDs EHR & PM software and Availity Clearing house. Must register with your local CMS payor. Can find most of this info on CMS website.

Where are you located and what PM software do you use.

To: Sent: Wednesday, December 21, 2011 9:00 AM

Subject: Re: Set up to run on Medicare

HI Everyone,

I am just getting set up with taking Medicare.

Can I have some info on how you bill them? Clearing house, web site, directly etc.

Thanks,

Debra

egads On the case! My husband woke up one day several yrs ago with a horner;s syndorme lots of tests/er visit/neuro visit no one read the ct well. Carotid dissection missed until he saw opthalmology three days later.Who tracked the films down after he left, and called PCP who called me and said where is he? and I said at a conference so PCP called ER at that institution who went to t he conference center and hauled him out.

Could a been dead He is alive With a resultant raders syndorme tic doloreaux pain syndrome that a PCP resident figured out after another emergent mri for why he was in such painI didn;t sue anyone But I know who did their work that week and who I will never send a patient to

(oh and then he was admitted, lovenox was brand new, Lovenox is q 12 h ; at 22 hrs they discharged him from observaiton where noone had come to see him except me ---and there was NO ONE at the Mecca's desk I had to ask a third yr medical student whom I found when I wandered around , how to get to the floor----and the dietary lady with the tiny pencil and he had had no second dose of lovenox Dont; get me started( then there is how much I had to shell out to buy it and how long it took me to get reimbursed)

I admire what can do about billing and running his office wow , as I admire most all IMPS What a case. oy.

Pamela,

We like MEDIARE. We hope for more reimbursement for good care coordination, but we set our clinic up to run on medicare.

and I set up our clinic to be profitable at medicare rates. All E/M codes were put into a time based formula back in 2004 when we started. After some ALLGEBRA I calculated in our location medicare pays 120-135 per hour. Being both internists, we have 25% of our patients that are medicare, but they represent 50%-60% of our visits. We use eMDs for scheduling, documentation, and billing, statements, and collections. This allows us to save. Zero FTEs/MD. We bill medicare and all our other payors once per week using eMDs Bill module takes maybe 5 minutes. All coding is done at time of visit takes 10sec to one minute. We receive automatic electronic remit advice daily, which allows me to tract any rejected claims <1% AND CORRECT them efficiently. Both Medicare and BCBS pay within 14-21 days. The ERA takes 30 minutes once per week to electronically

post. Secondaries are usually electronically linked so I just wait 30 more days. If the checks don't come in I take 10 minutes to address accounts receivable and bill the patients with POS an electronic to paper statement service. Takes about 10 minutes once per month. Cost is only $50-60 with postage $40-50. This previously took 4-5 hours myself. This portion of my clinic and medicare I love.

Have only had two claims automatically threatened to be recouped. A 99214 with only 2 diagnoses but well over 30 minutes was down coded by Today's Options. We lost the appeal both in time in our appeal and final outcome. Certainly not worth the $10-20 reclaimed. Also, lost home care charge x2 in 2009 and 2010, but eventually recoded to "correct" CODE so the did not atke any money. Spent hours on phone tress with 10 layers of operators till found someone smart enough to just have me change the code to the one they were paying correctly in 2009 2010. It was not my fault they incorrectly paid a code that was retired.

I realy should not have taken these so personlly, but all the rumors of RAC audits and fraud and abuse really messes with your mind when the documents threaten to send to collections and extend coding investigations if these types of billing errors continue. I know now they aren't looking for me. Only 2-3 claim payment errors in 3 years. Would cost them dearly to review my code compliant charts.

I really don't like the threat of reimbursement cuts every year, but medicare has found a way to pay me 10% more over the last 8 years and with meaningful use of $44K each for and I, I cannot complain about cost of improvement and "Change" in healthcare.

If I was running the large hospital clinic in town, I would hate medicare rates. They wouldn't pay the overhead. The doctors there have closed to new medicare and medicaid patients.

Good luck with your documentary, be careful because most people will not feel sorry for their doctor, the one that spends 5-10 minutes in a rush. Most do not have the doctor patient relationship of an IMP.

BUT REMEMBER IMPs patients are your patients not your friends. A missed diagnosis and a bad outcome and you may still wind up in malpractice case. Old family doctor really invested in community was recently sued by family of 18 y/o girl. She had headache and went to ER. CT negative went home. Felt better and was seen in follow up by above MD. Only a little tingling in thumb. Reassured and sent home. Major stroke after carotid dissection. Lost malpractivce case for failure to diagnose further evaluate dissection, 20% at fault withg er 80%.

To:

Sent: Sunday, December 18, 2011 6:24 PMSubject: Re: Medicare Take Backs

are there any docs out there who really enjoy dealing with Medicare?I tend to think we all are taking much undeserved abuse, but if I ammisrepresenting docs please let me know. . .Pamela

>> pamela,> > i speak only for myself. one thing i ask of you is not to misrepresent me (though i was going to say 'those of us') who are really really sick of this medicare joke.>

> be mindful truly that your practice is not the same as mine and as some may know here i am not an IMP since my patient load is still high. i could dial down, back off hours, lay off everybody and move my practice into my house but my demographics dont allow extra dollars off whatever's left from social security.

> > though i dont have a solution in mind, what's leeching my time away from my family are these preauths for imaging and drugs, attestations, oodles of paperwork for this paperless office, and calling people from god knows where and god knows what they do to help me 'run my office more efficiently'.

> > tell you honestly, i am ready to start all over again in another part of the world beyond this silly system of 'payers' that have deep pockets and even longer arms into politicians pockets all at the cost of my patients' blood and my own bloody sweat.

> > so so sad... im slowly eaten away by cynicism and im fighting to my last drop of strength and rocky road ice cream.> > sigh.> grace>

-- MD ph fax

[Guest guest]

With a 27.4% cut coming in January, are you sure you want to start a contract

with Medicare?

Steve

stown, NJ

> >>>

> >>> pamela,

> >>>

> >>> i speak only for myself. one thing i ask of you is not to misrepresent me

(though i was going to say 'those of us') who are really really sick of this

medicare joke.

> >>>

> >>> be mindful truly that your practice is not the same as mine and as some

may know here i am not an IMP since my patient load is still high. i could dial

down, back off hours, lay off everybody and move my practice into my house but

my demographics dont allow extra dollars off whatever's left from social

security.

> >>>

> >>> though i dont have a solution in mind, what's leeching my time away from

my family are these preauths for imaging and drugs, attestations, oodles of

paperwork for this paperless office, and calling people from god knows where and

god knows what they do to help me 'run my office more efficiently'.

> >>>

> >>> tell you honestly, i am ready to start all over again in another part of

the world beyond this silly system of 'payers' that have deep pockets and even

longer arms into politicians pockets all at the cost of my patients' blood and

my own bloody sweat.

> >>>

> >>> so so sad... im slowly eaten away by cynicism and im fighting to my last

drop of strength and rocky road ice cream.

> >>>

> >>> sigh.

> >>> grace

> >>>

> >>

> >>

> >>

> >>

> >

> >

> >--

> >

> >

> >

> >     MD

> >    

> >    

> >ph    fax

> >

> >

>