RE: Re: Medicare Take Backs

[Guest guest]

They are doing audits and erroneously downcoding, which then requires an appeal.  We're still waiting to hear back on our appeals.  This is after they have already held the claim for at least 30 days, even though you send the visit note the day after the notice comes in the mail.  Add to 5010 requirements and 27.4% threatened cuts, and people wonder why doctors who are barely making it as it is want to leave the profession....

Pratt

 

What take backs? Can somebody explain this?

I stopped taking Medicare but want to understand

what they are pulling now. . .

Pamela

> >>>>

> >>>> any idea where can I get a cheap peak flow meter for my office?.

> >>>> thanks, adolfo

> >>>>

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> >>> 

> >>> 

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> >> I can't believe that medicare is taking money back from 18 months ago!  If I supbmit a bill after 12 months I can't get paid but now Obama care rate changes means they can take money from 18 months ago.  SO some patients have died some are in nursing homes and I have 4 patients to track down!  the low checks are ridiculous but this is infuriating.!

> > 

> >

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> -- 

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>      MD

>     

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> ph    fax

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[Guest guest]

agree mostlyI live off medicare I recognize manycannot but that is not always Medicares fault itis cost ofliving/ malpractice other difficulties I think that its biggest problem is its bureaucracy  and  rules  which make alot of the waste Berwick complains about(nurses document every second of when they gave a flush etc for observation hospital patietns) MCR means well but needs to be simpler/cleaner well run  and far less disparate. By that  I mean - we see the folks in NYstte unable to be paid for what I get paid for That is a bad problem.

Jean

 

Overall I'm happy with medicare. Our Financial Intermediary is Noridian and they have been fair, friendly and easy to deal with. In my opinion, medicare, overall, does more good than harm. The real issue is the threat of medicare cuts that never get resolved. That is the big reason why I don't take more medicare patients - I feel the need to diversify and not be dependent on one payer that has a 20% pay cut looming out there seemingly forever. THAT is very very bad for medicare patients. I have been audited (as medical director for hospice) and got to deal with the darker side of Noridian through the audit. I thought it was all done fairly. I know good doctors get swept into bad audits and it is certainly a problem, but as a taxpayer, I do want our government to catch the abusers. I don't agree with paying headhunters to do the audits, but I don't think medicare has evil intentions because they are doing audits. Just my opinion.

Though unnecessary to state, my opinion is just for individuals on this listserv and I do not want it copied or shared in any other forum.

Stew Mones MD

Eugene, Oregon

> >

> > 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]

Our intermediary is Trailblazer and they are much easier to deal with than Humana or some of the others. Better some money than empty appointments.

From: [ ] On Behalf Of Stew Mones [monestew22@...]

Sent: Sunday, December 18, 2011 8:46 PM

To:

Subject: Re: Medicare Take Backs

Overall I'm happy with medicare. Our Financial Intermediary is Noridian and they have been fair, friendly and easy to deal with. In my opinion, medicare, overall, does more good than harm. The real issue is the threat of medicare cuts that never get resolved.

That is the big reason why I don't take more medicare patients - I feel the need to diversify and not be dependent on one payer that has a 20% pay cut looming out there seemingly forever. THAT is very very bad for medicare patients. I have been audited (as

medical director for hospice) and got to deal with the darker side of Noridian through the audit. I thought it was all done fairly. I know good doctors get swept into bad audits and it is certainly a problem, but as a taxpayer, I do want our government to

catch the abusers. I don't agree with paying headhunters to do the audits, but I don't think medicare has evil intentions because they are doing audits. Just my opinion.

Though unnecessary to state, my opinion is just for individuals on this listserv and I do not want it copied or shared in any other forum.

Stew Mones MD

Eugene, Oregon

> >

> > 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]

If I can find one.....I'll have to do a search in our system to find one.  I'm not online with work until Wednesday....and then gone until the 4th.

 

 

please send me a copy. I spoke about docs getting 1-3 cent checks from Medicare & I think I really impacted the publicwith the abuse we suffer at the hands of Medicare & others:http://www.klcc.org/OnlineAudioFeature.asp?programid=16

Liste in. Lots'o'laughs. . . Pamela

> > >> > > any idea where can I get a cheap peak flow meter for my office?.> > > thanks, adolfo> > >> >> >> >> >> >> >

> > I can't believe that medicare is taking money back from 18 months ago!

> > If I supbmit a bill after 12 months I can't get paid but now Obama care> > rate changes means they can take money from 18 months ago. SO some > > patients have died some are in nursing homes and I have 4 patients to track> > down! the low checks are ridiculous but this is infuriating.!> >> >> >

> >> >> >> > --> >> >> >> > MD> > > > > > ph fax

> > > >> >> > > >> > > > -- > * Pratt*>

-- Pratt