Cigna QZ modifier change
Cigna starting to reimburse 15% less for qz modifier with other insurance companies expected to follow suit… what’s everyone’s thoughts on this? Ultimately pretty good for our profession. Wonder if the rural hospitals allowing crna only care will make a shift. More crnas moving to plastics? (Source: Student Doctor Network)
Source: Student Doctor Network - March 11, 2023 Category: Universities & Medical Training Authors: amyl Tags: Anesthesiology Source Type: forums
CIGNA to cut CRNA QZ Reimbursement by 15%
Other insurers to follow suit?
https://centercare.com/_uploads/Reimbursement-policy-updates-Jan-2023.docx (Source: Student Doctor Network)
Source: Student Doctor Network - March 6, 2023 Category: Universities & Medical Training Authors: DesiredMemberName? Tags: Anesthesiology Source Type: forums
Medicaid insurance and new solo private practice
Hello! I am in the process of opening a solo psychiatric practice this summer and currently getting credentialed with some of the commercial insurers and Medicare. During this credentialing process, a blue cross blue shield agent said, "If you choose not to accept Medicaid Managed Care members, this would be for all health plans, not just for BC/BS. NYS doesn’t allow for providers to pick and choose what MMC policy they can and cannot accept, as it is all or nothing."
To my...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - February 17, 2023 Category: Universities & Medical Training Authors: geripsyched Tags: Psychiatry Source Type: forums
Thoughts on outpatient job
1099. I can set my own schedule, no requirements on number of patients to see. The group handles everything from office space to billing, good front desk support. Option to be fully tele or hybrid. Good collaboration between providers with regular case conference. About 12 docs and 3x that in phd level therapists. They target higher income patient population.
For all of this they give 60% of collected billing. They only take a single insurer and have been with them for a long time. No...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - February 11, 2023 Category: Universities & Medical Training Authors: surfguy84 Tags: Psychiatry Source Type: forums
ChatGPT from OpenAI
Write a Christmas story about cancer patients, radiation oncologists, and preauthorization in the style of George Lucas.
Once upon a time in a galaxy far, far away, there were cancer patients and radiation oncologists. The cancer patients were in need of radiation therapy, but they couldn't get it because their insurance company wouldn't authorize it. The radiation oncologists were trying their best to help the cancer patients, but they couldn't do anything without authorization from the...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 17, 2022 Category: Universities & Medical Training Authors: yesmaster Tags: Radiation Oncology Source Type: forums
neurosurgeons doing pain medicine injections
Holy crap!
I did anesthesia today in a surgicenter for two neurosurgeons who did a bunch of spinal injections.
I was blown away. One of the guys did two level bilateral transforaminal epidural steroid injections, all with an AP projection, no lateral projection - and 4 blobograms. He also did a lumbar sympathetic nerve block for leg pain (no contrast was used), and a bunch of facet injections with needle placements all over the place.
It is no wonder that insurance companies get...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 3, 2022 Category: Universities & Medical Training Authors: epidural man Tags: Pain Medicine Source Type: forums
Failed child boards, now what?
I'm board certified for general psychiatry, but just got my results for child boards and failed. Not distraught, but not sure what this means practically for my career. I see child patients regularly. Frankly, I didn't take the test seriously. No excuses. I'm planning on taking it again next year. (any recommendations? I used BTB and Spiegel qbanks, and did well on them, but didn't find the real thing to be all that similar). My contract with insurers when I signed it required that I be...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 2, 2022 Category: Universities & Medical Training Authors: Voxylife Tags: Psychiatry Source Type: forums
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...
Read more (Source: Student Doctor Network)
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
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...
Read more (Source: Student Doctor Network)
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...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - October 28, 2022 Category: Universities & Medical Training Authors: coroner Tags: Pathology Source Type: forums
How does this inpatient job sound?
Community hospital. Set your own cap, do your own Billings. The hospital is majority Tricare with about 35% private insurers. I've been told my average billings will work out to 85ish an encounter, which seems low. So a patient cap of 15 should generate about 1300 dollars a day. Again seems very low but maybe this is because of Tricare making up a large part of their mix? Also, this is in Socal mind you.
The other thing which seems odd, but maybe it's normal, is the fact you're responsible...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - October 21, 2022 Category: Universities & Medical Training Authors: surfguy84 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
Disposable nasopharyngoscopes
Our clinic is looking into disposable options for nasopharyngoscopes for head/neck patients. Is there a brand that you like? I heard that the scopes can be charged to the patient's insurance company. What codes do you use when billing for the scopes? Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - August 27, 2022 Category: Universities & Medical Training Authors: echod Tags: Radiation Oncology Source Type: forums
