How does wRVU works for Inpatient consultation?
Let's assume that I did full initial interview (99255) , and wrote 4 follow-up notes (I could not find CPT) for one consultation, will this considered as 1 wRVU or 4wRVU or 0wRVU?. I have heard that medicare and many private insurance companies have eliminated the use of CPT for consultation all together... (Source: Student Doctor Network)
Source: Student Doctor Network - November 9, 2022 Category: Universities & Medical Training Authors: Batman's Underwear Tags: Psychiatry Source Type: forums
Insurance companies are shameless
Joined large private practice group out of fellowship, application submitted in June to be credentialed for company. Told 90-120 day processing.
Followed up weekly, told “should be good by mid-November, all is complete in August”.
Last week told “missing education verification”.
This week told “application is lost, resubmit and wait 90-120 days”
This happened to one of our surgeons too. CEO got on phone with insurer and lost their mind, threatened to essentially drop the entire company...
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Source: Student Doctor Network - November 8, 2022 Category: Universities & Medical Training Authors: GlowInTheDark Tags: Pain Medicine Source Type: forums
Tail Insurance
After 6.5 years at my current gig, I am making a switch to another group. I currently have a claims-made policy with The Doctors Company and need to purchase tail. I have a quote ($21k) from TDC but I've been told I can shop around for better prices from other insurance companies. I've only had TDC, so I was hoping members here could chime in with the names of malpractice insurance companies I can contact?
Thank you! (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2022 Category: Universities & Medical Training Authors: Folken Tags: Anesthesiology Source Type: forums
What insurance to get paneled with?
I'm currently paneled with Blue Cross, which has been cool, but I'm looking to panel with another insurance to get my numbers up even more. I'm looking to panel with one more. I've thought about medicare, but I generally don't see geriatrics. Anyone know, generally, which one to get paneled with between Cigna, United, and Aetna? I've heard bad things about United, and Cigna, but unsure about Aetna. Anyone have advice in this? Thanks for any help! (Source: Student Doctor Network)
Source: Student Doctor Network - November 6, 2022 Category: Universities & Medical Training Authors: StayOnTop Tags: Psychiatry Source Type: forums
Outpatient Job Offer, Independent Contractor?
I'm hoping for some feedback regarding a job offer I've received, current PGY4 in a large city.
I would be working as an independent contractor/1099 in a physician owned outpatient private practice. The practice has 3 MDs and a few PAs. They are offering a 75/25 split. The practice only takes 1 insurance or cash pay. They estimate billing about 80% 99214 +90833 which is reimbursed at ~240 for a 30 min appointment, similar for cash pay (however most pts have insurance). Staff helps with...
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Source: Student Doctor Network - November 3, 2022 Category: Universities & Medical Training Authors: theusual Tags: Psychiatry Source Type: forums
Patient calls for procedures
A few times per day the nurses get calls from patients who want to come in and have a procedure repeated.
If less than a year, I tell them to schedule it. If more than a year I get an OV to determine what is going on.
I am told from admin that it is needed for insurance precert. What is everyone else doing? (Source: Student Doctor Network)
Source: Student Doctor Network - November 2, 2022 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
Help
I have been a pharmacist for a while and recently went back to the three letter Come Satan company. Recently got moved up to PM position. I have a tech that’s out right bullying me into doing stuff I’m not comfortable with. Here is what I mean.
I had an rx for C-II for a 29 y/0 who’s been on the Med for about 2 years. While processing the script Insurance rejected it for PA. I faxed it to MD as per standard procedure. The tech in question was not around at the time. Then pt called an I...
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Source: Student Doctor Network - November 2, 2022 Category: Universities & Medical Training Authors: Xarelto-10 Tags: Pharmacy Source Type: forums
Your own health insurance when going DPC or concierge
Besides receiving coverage through a spouse’s plan, what are you guys doing as far as a catastrophic plan since they are illegal for anyone over 30? (Source: Student Doctor Network)
Source: Student Doctor Network - November 1, 2022 Category: Universities & Medical Training Authors: mark v Tags: Family Medicine Source Type: forums
UHC United Healthcare requiring NDA before signing on as provider, anybody familiar with this!
Hi has anyone when credentialling as a provider with an insurance company been asked to sign a blanket NDA to cover "rate fees" and "contractual terms" so as to become enrolled in the provider network? This seems a violation of some law, Stark Law or pushing a physician to practice medicine in the payer's best interest or practicing medicine as business vs. clinical best interest.
I would like to post the NDA for your review but some blip in the footer says I can't.
HIPAA pretty much covers...
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Source: Student Doctor Network - October 29, 2022 Category: Universities & Medical Training Authors: SJellyModo Tags: Anesthesiology Source Type: forums
FDA approves 'SKOUT' - a new AI device to detect colon polyps
https://www.cancertherapyadvisor.com/home/cancer-topics/gastrointestinal-cancers/fda-clears-skout-to-detect-colorectal-polyps-in-real-time-during-colonoscopy/
Interesting article that leads to more questions: Does FDA approval mean gastroenterologists can bill more for using the device vs standard colonoscopy? If so, will insurance companies reimburse for it?
And on the path end, does this mean receiving more or less colon biopsies if this becomes widely adopted? I could see...
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Source: Student Doctor Network - October 28, 2022 Category: Universities & Medical Training Authors: coroner Tags: Pathology Source Type: forums
CMG Reckoning
So lately I've heard a lot of bad news from multiple sources about how CMG's are hurting financially.
I've been hearing about how the No Surprises act has really cut down on pay that CMGs used to receive due to the reconciliation process. I've heard numbers quoted around a 25% payout from the commercial insurance side. I see other threads and hear personally from colleagues about Team Health taking a beating, Envision and USACS in all this debt, APP in crazy debt deals, and Schumacher...
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Source: Student Doctor Network - October 25, 2022 Category: Universities & Medical Training Authors: Pudortu Tags: Emergency Medicine Source Type: forums
High Deductible Health Insurance
I make all really really important life decisions based on your advice - so I hope this will be no different.
Thoughts on high deductible health plan (insurance with an HSA)?
I have read that it is good if you don't use health care much. I never use it -
But my wife is starting to need it more and more - so it's hard to tell how that will go. (Source: Student Doctor Network)
Source: Student Doctor Network - October 24, 2022 Category: Universities & Medical Training Authors: epidural man Tags: Anesthesiology Source Type: forums
How long did it take to fill your insurance based practice?
As the title says, residency graduation is fast approaching and I'm planning to start private practice. Aiming to fill 20 hours a week. I'm going to be in a large metropolitan area in California.
I imagine geography matters, but if I were to get on a couple of the best paying panels, any idea how long I might expect to wait to fill those 20 hours? Assume no major bottle neck in terms of my ability to see new intakes..I could realistically do 5-6 per day. (Source: Student Doctor Network)
Source: Student Doctor Network - October 20, 2022 Category: Universities & Medical Training Authors: yanks26dmb Tags: Psychiatry Source Type: forums
Practicing from abroad legalities
I understand the rules regarding billing CMS and being located outside the US. What I'm wondering is, can a US physician practice abroad and see patients in the US WITHOUT needing a medical license in the country they are physically located in? I imagine different countries have different laws, but does anyone know of at least some countries where a US physician could base themselves and see insurance based patients back in the US (in the state the physician is licensed in)? (Source: Student Doctor Network)
Source: Student Doctor Network - October 19, 2022 Category: Universities & Medical Training Authors: Psychresy Tags: Psychiatry Source Type: forums
SCS for low back pain
What diagnosis codes (for insurance/ Medicare approval) do you use for the 80+ year old, non surgical patient with severe arthritis, severe multilevel stenosis, cauda equines impingement, never had surgery/not offered surgery because of age but wants to try SCS? I think it’s perfectly reasonable to offer this to patients but running into insurance companies who don’t think so because “patient never had back surgery” or doesn’t have “crps”? (Source: Student Doctor Network)
Source: Student Doctor Network - October 11, 2022 Category: Universities & Medical Training Authors: painfree23 Tags: Pain Medicine Source Type: forums
