Medicare/Medicaid

[Guest guest]

I am following this with great interest. I will open my practice next July 1, 2008. I anticipate a lot of patients with Medicare/Medicaid as I serve many patients with disabilities; ranging from deafness (was certified sign language interpreter) mental retardation, cerebral palsy, autism, etc. etc. Was in special education prior to becoming a physician. This is my niche and I love it. Now how can I keep my practice afloat and do what I love? Some of my straight Medicaid patients intend to pay me cash. I simply don't see how I can afford to do 1/2 hour visits at 27.95 for Medicaid. Still if the patients won't get their blood draws covered or x-rays then I'm no good for them either! I had thought my Medicare/Medicaid group would simply pay the co-pay portion since I intend to take Medicare but not Medicaid. I had one long term family that has Medicaid and I

will do some kind of barter for them. Is barter really illegal? And if I see these Medicaid patients for a reasonable fee it's illegal? If I see the Medicaid patients is it real that their blood work and stuff won't be paid for? (since I intend to stay credentialed for per diem work at the CHC maybe this is mute point?) Where do I find these out as facts? i.e. professional courtesy was rumored to be illegal but it's not --- but can put you at risk other ways. What additional work would it be to charge an additional "non-medical" fee but for access? Although I doubt many of my intended panel of patients could afford it. Can I charge this additional under LLC and/or S corp? I wanted to put in a lift to get quads from wheel chair to exam table for wheelchair bound patients but am told I can't get funding unless

I'm non-profit. (Apparently there are about 600 patients not getting care in the area due to this lack of accessibility.) I am not interested in waiting and working that hard to form a non-profit. Thanks everyone in advance for your input.

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