Guest guest Posted June 29, 2008 Report Share Posted June 29, 2008 Hi Friends! I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2008 Report Share Posted June 29, 2008 I don't think it is necessarily a big mistake to sign up with Medicare to get started. It will bring you a lot of patients, which you need in the first year. You can reevaluate participation with Medicare every December, and you can close to new Medicare patients at any time. But you could make an argument that, when getting started, you are better off seeing a patient with an insurance that underpays you than you are sitting at your desk with nothing to do. Of course, that assumes you'll be willing to drop that low-paying insurance when you get busy enough to afford to, whether it be Medicare or any other low paying insurance. Subject: MedicareTo: Date: Sunday, June 29, 2008, 4:11 AM Hi Friends! I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2008 Report Share Posted June 29, 2008 Malar, You can actually opt out of Medicare four times a year as a participating provider (quarterly) and anytime you want to as a nonparticipating provider. Unless you are unfortunate enough to live in a state where Medicare is the highest payer, I would have to disagree that signing up with Medicare is worth it at this point, even to " get new patients. " It always takes at least 6 months for Medicare to get payment to the doctor, no matter how many hours you are put on hold. When I started my IMP in 2005 as a nonparticipating Medicare provider, it took 9 months for Medicare to get the first checks to my patients. My bottom line did not take the beating that time, just my reputation (patients started wondering if I was " running a scam, " as I was the first nonparticipating provider in Durango). My position before my IMP with a community health center took 8 months to receive my first payment and 9 months at my urgent care job, and both of those positions had full-time staffers working on exclusively on provider payment. When I moved my office last August, it took Medicare almost three months to get checks to my patients, and nothing had changed EXCEPT my business address. Payment of physicians is not Medicare's top priority, ever. They are also notorious for holding physician payments when it suits them for end-of fiscal-year reasons (ie to make the budget look more balanced than it really is.). Another version of the interest free loan. My personal opinion is that time is better spent marketing to individuals who value primary care services, not bowing the the extraordinarily broken system and ending up with individuals that equate health care with their insurance. Good luck. I truly wish I could give you some words of hope. Durango, CO I don't think it is necessarily a big mistake to sign up with Medicare to get started. It will bring you a lot of patients, which you need in the first year. You can reevaluate participation with Medicare every December, and you can close to new Medicare patients at any time. But you could make an argument that, when getting started, you are better off seeing a patient with an insurance that underpays you than you are sitting at your desk with nothing to do. Of course, that assumes you'll be willing to drop that low-paying insurance when you get busy enough to afford to, whether it be Medicare or any other low paying insurance. Subject: MedicareTo: Date: Sunday, June 29, 2008, 4:11 AM Hi Friends! I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say " Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time " . I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2008 Report Share Posted June 30, 2008 Funny you should post this around July 4th. I opted out of Medicare two years ago on Independence Day. It was the **best** July 4th ever for me. Now, every time I see fireworks I celebrate my freedom from Medicare. BTW - I never turn patients away for lack of money. Still see older folks though about half stayed and half migrated onward. This month's FPM has great article on how to opt out. Best of luck in the new practice! Pamela > > Hi Friends! > I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e- mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. > I don't think anyone works at CMS, just lets the phone ring or have it say " Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time " . I realy want to complaint to someone ( like everyother physician in US) - what a joke! > Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe. > Thanks, > Malar > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2008 Report Share Posted July 1, 2008 I have to politely disagree with the statement below. We are participating with Medicare; they are towards the low end but not our worst payer. We are paid within 21 days of seeing the patient about 85% of the time; within 60 days the rest of the time. In our area, in order to get new patients, we would not see patients if we didn’t participate with the patient’s insurance. That’s usually the second question out of the patient’s mouth, right after “Are you accepting new patients?” Malar, good luck with your new practice! Pratt Oak Tree Internal Medicine San Ramon, CA From: [mailto: ] On Behalf Of Sent: Sunday, June 29, 2008 2:22 PM To: Subject: Re: Medicare It always takes at least 6 months for Medicare to get payment to the doctor, no matter how many hours you are put on hold. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2008 Report Share Posted July 2, 2008 and Malar, My comment below was regarding when you initially sign up or change anything to do with your practice and payment from Medicare. In my 15 years of practice, Medicare has not gotten it right, and it always took many months to get my first payment. I do not want to mislead any new practices into thinking Medicare is some " nirvana. " Once you are signed on with Medicare and have waited the obligatory many months to receive your first paycheck, you receive their low payments quite promptly---that is if they are processing claims. Evidently, according to the AP press, all our Medicare pay is on hold and no claims will be processed until Congress reconvenes after their 4th of July vacation. Nice. Way to go CMS. We need to re-train America that health insurance DOES NOT EQUAL health care. That second question patients are asking needs to become a thing of the past. Respectfully, Durango, CO Will be free from the insurance cartel in 30 days, but who is counting? I have to politely disagree with the statement below. We are participating with Medicare; they are towards the low end but not our worst payer. We are paid within 21 days of seeing the patient about 85% of the time; within 60 days the rest of the time. In our area, in order to get new patients, we would not see patients if we didn't participate with the patient's insurance. That's usually the second question out of the patient's mouth, right after "Are you accepting new patients?" Malar, good luck with your new practice! Pratt Oak Tree Internal Medicine San Ramon, CA From: [mailto: ] On Behalf Of Sent: Sunday, June 29, 2008 2:22 PMTo: Subject: Re: Medicare It always takes at least 6 months for Medicare to get payment to the doctor, no matter how many hours you are put on hold. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2008 Report Share Posted July 2, 2008 My experience is similar. They pay promptly if you are in the system, everything about you is to their liking, and congress is currently doing it's job to appropriate the funds. The delays come when you initially enroll, if you change your office address, if you drop out of a group, or join a new group, or for any other reason change your billing ID numbers. For any of these situations, expect a 3-4 month delay in payments. Another recent 3 month delay occured when they started using the NPI number. They had my ID mixed up with a group I had dropped out of in 2004. We called and explained we had not been in that group for 4 years, they said yeah, we know, we're working on it... It took 3 months for them to straighten it out. Meanwhile, no payments during that period. Makes you wonder if you were an ally of our goverment in say, Iraq and were depending on them to ship you some needed equipement or ammo, would you get it before being wiped out by your adversaries? > > > I have to politely disagree with the statement below. We are > > participating with Medicare; they are towards the low end but not our worst > > payer. We are paid within 21 days of seeing the patient about 85% of the > > time; within 60 days the rest of the time. > > > > > > > > In our area, in order to get new patients, we would not see patients if we > > didn't participate with the patient's insurance. That's usually the second > > question out of the patient's mouth, right after " Are you accepting new > > patients? " > > > > > > > > Malar, good luck with your new practice! > > > > > > > > Pratt > > > > Oak Tree Internal Medicine > > > > San Ramon, CA > > > > > > ------------------------------ > > > > *From:* [mailto: > > ] *On Behalf Of * > > *Sent:* Sunday, June 29, 2008 2:22 PM > > *To:* > > *Subject:* Re: Medicare > > > > > > > > It always takes at least 6 months for Medicare to get payment to the > > doctor, no matter how many hours you are put on hold. > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2008 Report Share Posted July 2, 2008 Or how about this dilemma: " Do I want my health insurance or my health? " This was submitted at the town hall meetings I led on designing an idea medical clinic. Folks tend to get stuck in unhealthy jobs just for health insurance. Pamela Pamela Wible, MD Family & Community Medicine 3575 St. #220 Eugene, OR 97405 (541)345-2437 roxywible@... www.idealmedicalpractice.org What would health care look like if patients designed it? www.idealmedicalpractice.org > > > > > > > > > I have to politely disagree with the statement below. We are participating with Medicare; they are towards the low end but not our worst payer. We are paid within 21 days of seeing the patient about 85% of the time; within 60 days the rest of the time. > > In our area, in order to get new patients, we would not see patients if we didn't participate with the patient's insurance. That's usually the second question out of the patient's mouth, right after " Are you accepting new patients? " > > Malar, good luck with your new practice! > > Pratt > Oak Tree Internal Medicine > San Ramon, CA > > > > > > From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimprovement 1yahoogroups (DOT) com] On Behalf Of > Sent: Sunday, June 29, 2008 2:22 PM > To: Practiceimprovement 1yahoogroups (DOT) com > Subject: Re: [Practiceimprovemen t1] Medicare > > > > > > It always takes at least 6 months for Medicare to get payment to the doctor, no matter how many hours you are put on hold. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 3, 2008 Report Share Posted July 3, 2008 Your best bet at this point would be to speak with staff people in the office of your congressional representative and explain your problem in dealing with Medicare. This approach has helped me get to a real person in the past.Ben Brewer M.D. Medicare Hi Friends! I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2008 Report Share Posted July 6, 2008 Malar, I agree with Ben's comments below -- if you have tried everything and no success -- talk to your congress person. A couple thoughts... 1. Are you trying to call the central CMS offices? Of the regional Medicare offices? You probably need to be contacting the regional offices. The info below may be dated, but try calling your regional office, etc. Also, this link might find a contact for you -- http://www.cms.hhs.gov/apps/contacts/ Or better yet, here -- http://www.cms.hhs.gov/ContractingGeneralInformation/Downloads/02_ICdirectory.pdf 2. Be careful (IMHO) about seeing patients to see patients. If you are slow and take on a lot of Medicare and then have to add staff quickly to manage these Medicare patients -- you may end up with the legendary -- "I lose a little bit of money on each Medicare patient I see -- but I make up for it in volume." I would think seeing a few well insured patients with limited staff (low overhead) is better than seeing lots and lots of Medicare with lots of staff (high overhead) -- I'm sure there is a balance in there somewhere. Good luck. Medicare Contractor & CMS Regional Office Contacts Regarding Hurricane Katrina Issues For the quickest service, CMS asks that you please try to get your question answered/issue(s) resolved in the order listed below. First try---Contact your Medicare carrier or fiscal intermediary with questions regarding billing, coverage, and other issues. Their toll-free provider telephone numbers are listed at: http://www.cms.hhs.gov/medlearn/tollnums.asp Second try, if necessary---Contact the following carrier and fiscal intermediaries (main offices) below only if you are unable to reach a customer service representative via the toll-free telephone numbers, or if they could not answer your question. Trispan - Mutual -1- ext 2273 Cahaba MS - Cahaba AL - Cahaba IA - Palmetto (DMERC) - Palmetto (RHHI) - (South Carolina) ext. 15360 (Florida) Arkansas BCBS (FI and carrier) - TrailBlazer Health Enterprises (FI and carrier) - () prefers e-mail contact: p.lewis@... Third try, if necessary---Contact the appropriate CMS regional office, only if you do not get a helpful response from the contacts above: Atlanta Regional Office ; ; Dallas Regional Office ; ; Kansas City Regional Office (816) 426- 5033; Locke, MD From: [mailto: ] On Behalf Of Ben BrewerSent: Thursday, July 03, 2008 3:20 PMTo: Subject: Re: Medicare Your best bet at this point would be to speak with staff people in the office of your congressional representative and explain your problem in dealing with Medicare. This approach has helped me get to a real person in the past. Ben Brewer M.D. Medicare Hi Friends!I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2008 Report Share Posted July 6, 2008 Hi everyone I appreciate all the comments and advice on this matter. Yes I am calling the regional number and the funny thing is, I tried over this long weekend and the fax machine is engaged. I bet they turn off everything. I bet I will screen before accepting Medicaid patients. Thanks again. You all are so wonderful. I will keep u posted. Thanks Malar [Practiceimprovemen t1] Medicare Hi Friends!I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2008 Report Share Posted July 10, 2008 Thanks to everyone for their suggestions. I did e-mail Congressman Wolf last Saturday. Medicare called me today(wednesday) and later in my mail found a letter from congressman saying that he has contacted Medicare for me Monday. Can U believe this. Thanks Ben and others for all your help on this matter. Malar [Practiceimprovemen t1] Medicare Hi Friends! I am starting my practice July. I signed up for few insurances. The biggest mistake was signing up with Medicare. The thing is, I applied and I am approved with them since April 1st but have not recieved a cofirmation letter. Tried everything, faxed them, e-mailed them, mailed written letter and been holding phone for hours together but unable to speak with a live person. Who do I complain about this? I know you are all thinking, what was I thinking signing up with them. I don't think anyone works at CMS, just lets the phone ring or have it say "Due to unavoidale circumstances there is no one to answer your phone now, please all back a a later time". I realy want to complaint to someone ( like everyother physician in US) - what a joke! Sorry for a frustrated mail. I bet you are all getting busy for the long weekend, I hope u all get some time with your family. Happy July 4th and stay safe.Thanks,Malar Quote Link to comment Share on other sites More sharing options...
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