Re: Advice needed, opening practice in 3 weeks

[Guest guest]

Medicare allowed that for me - I believe you can bill for the prior 18 months of care with them. Most insurance companies are not so forgiving and will only pay after the contract is signed. It sounds as though you are "moving" rather than starting anew, so you might chat with the provider reps and ask them what they will do for you.Hi guys,I'm opening my solo FP office on Jan. 2 (Amazing Charts, EZ claim, ina hospital income guarantee). I have no payer contracts yet. BCBS isin process, Medicare is dragging their feet on my reassignment.May I just see insurance pts "for free," hold the claims and submitthem once I'm credentialed? If yes, do I collect the copay?ThanksEugene Usow, Ded in Florida.

[Guest guest]

Eugene,First of all, congratulations on making the leap. Hopefully it will turn out to be wildly successful for you.My understanding is that for most 3rd party insurers, the key date is when you become a networked or participating provider, not when you submit the claim. For example, they will not pay for a visit on Jan. 15th if you weren't approved to be a participating provider until Jan. 16th. Medicare is the exception, and allows you to submit claims for visits that took place prior to being approved as a Medicare provider, but I can't remember how far back. But there is a way to see people with 3rd party insurers and still submit a claim, and that is as an "out of network provider". Some people have insurance that pays for seeing someone outside the network, but it pays less. Patients would probably need to pay you first, then submit a claim to their insurer for partial reimbursement. I didn't realize this until after the fact. Until then, I charged all patients the cash rate whether they had insurance or not, and collected at the time of service.Since you're not yet an in-network provider, no copays are required. Best of luck to you! SetoSouth Pasadena, CAHi guys,I'm opening my solo FP office on Jan. 2 (Amazing Charts, EZ claim, ina hospital income guarantee). I have no payer contracts yet. BCBS isin process, Medicare is dragging their feet on my reassignment.May I just see insurance pts "for free," hold the claims and submitthem once I'm credentialed? If yes, do I collect the copay?ThanksEugene Usow, Ded in Florida.

[Guest guest]

2 followup questions:

To see Medicare pts prior to contracting, do I use the

non-participating fee schedule?

If I see somebody out of network on a 3rd party payer, how much should

I charge them? My cash fee schedule?

Thanks.

Eugene Usow

>

> > Hi guys,

> >

> > I'm opening my solo FP office on Jan. 2 (Amazing Charts, EZ claim, in

> > a hospital income guarantee). I have no payer contracts yet. BCBS is

> > in process, Medicare is dragging their feet on my reassignment.

> >

> > May I just see insurance pts " for free, " hold the claims and submit

> > them once I'm credentialed?

> >

> > If yes, do I collect the copay?

> >

> > Thanks

> >

> > Eugene Usow, DO

> > scared in Florida.

> >

> >

> >

>

[Guest guest]

I belive only Medicare/Medicaid will pay claims retoactively. Yes, you can see

the pt's for free but don't bother submitting non-Medicare/Medicaid claims

before you're signed up. We did not collect co-pays until were credentialed:

some told us we could & others we could not. If on an income guarantee, them I

would just let your sponsoring hospital eat the initial losses.

>

>

> Date: 2006/12/15 Fri AM 07:46:51 EST

> To:

> Subject: Advice needed, opening practice in 3 weeks

>

> Hi guys,

>

> I'm opening my solo FP office on Jan. 2 (Amazing Charts, EZ claim, in

> a hospital income guarantee). I have no payer contracts yet. BCBS is

> in process, Medicare is dragging their feet on my reassignment.

>

> May I just see insurance pts " for free, " hold the claims and submit

> them once I'm credentialed?

>

> If yes, do I collect the copay?

>

> Thanks

>

> Eugene Usow, DO

> scared in Florida.

>

>

>

>

>

[Guest guest]

Thanks for the advice everybody.

Income guarantee does not kick in until 6 weeks into practice (it is

very much reimbursement and cash receipts based), so I need to find a

way to make a few bucks early on.

This part of Florida is 30-40% uninsured folks, lots of

construction/housing industry here, and plenty of seasonal residents.

I'm the only FP on staff at the sponsoring hospital.

The pediatricians in town have a 2 week wait for new patients.

I'm planning to advertise some kind of deal that undercuts the urgent

care places (like $60 office visits, same day appointments, etc).

Also, with taking extra hospital unassigned call, I can pick up some

patients.

I'm going door to door meeting the Primary care docs, pharmacists,

dentists, chiros. My wife's hairdresser and nail lady has a stack of

my cards and brochures. I'm having an open house for the entire

Medical community 2 days after opening.

My only concern with seeing people " for free " is that they may expect

that type of arrangement in the future, and spread the word to folks

that I'm running a " free clinic. "

Any opinions?

Thanks again

Eugene Usow

> > > >

> > > > > Hi guys,

> > > > >

> > > > > I'm opening my solo FP office on Jan. 2 (Amazing Charts, EZ

> > > claim, in

> > > > > a hospital income guarantee). I have no payer contracts yet.

> > > BCBS is

> > > > > in process, Medicare is dragging their feet on my reassignment.

> > > > >

> > > > > May I just see insurance pts " for free, " hold the claims and

> > > submit

> > > > > them once I'm credentialed?

> > > > >

> > > > > If yes, do I collect the copay?

> > > > >

> > > > > Thanks

> > > > >

> > > > > Eugene Usow, DO

> > > > > scared in Florida.

> > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> > >

> >

> >

> >

>