State medicaid has no idea what's going on
We are reducing capacity at our small hospital affiliated outpatient clinic due to providers leaving. Hospital admin talked with Medicaid because we're stuck sending many patients back to PCPs. Medicaid gave the hospital a list of all the Medicaid psychiatrists/nps in the region....
Half the list was social workers or psychologists.
45% were inpatient only doctors, retired doctors, people who've moved away, or locums who previously covered inpatient only but are now gone.
The other 5%...
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Source: Student Doctor Network - May 29, 2022 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Mentioning Medicaid in Personal Statement
Hi all I just wanted advice on my personal statement. Is it a red flag or too "political" to talk about Medicaid? I wanted to emphasize how myself having Medicaid made it difficult finding participating providers. I also wanted to talk about how my clinical experience has involved working in an impoverished area as an ER tech and most patients don't have insurance or have Medicaid and it affects the way they are able to receive proper healthcare. For example they are less inclined to see...
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Source: Student Doctor Network - May 27, 2022 Category: Universities & Medical Training Authors: sdac Tags: Pre-Medical (MD) Source Type: forums
Providing contract work and TMS at same location?
Trying to figure out the logistics of a scenario. Currently providing med management at a location where I am an hourly contractor. They have no desire for rTMS due to costs but are happy to "give" me an extra room if i were to buy a machine/hire staff/etc and provide services there for their patients who are heavily Medicaid who does cover it now in my state. I also have a 1 day a week PP in a different area so i am credentialed with all ins. except medicaid.
Would I have to update my...
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Source: Student Doctor Network - April 25, 2022 Category: Universities & Medical Training Authors: finalpsychyear Tags: Psychiatry Source Type: forums
$4M PayDay for Spine Surgeon Whistleblower
It's like a feeding frenzy in the HOPD for employed spine surgeons...
"Waldref’s office said Yam will receive $4.1 million from the settlement. As well, Medicare, Medicaid and other affected federal insurance programs will receive $10 million. The remainder will be returned to the federal Treasury, Waldref said."...
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Source: Student Doctor Network - April 21, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Payor mix at top hospitals
Overall excellent. Most are 40-50%+ commercial. No wonder they can have nice lobbies and no wonder why they care about USNWR.
Payer mix in the nation's top 20 hospitals
Becker's calculated the payer mix within the nation's top ranked hospitals to determine the share of their patients covered under commercial plans, Medicare, Medicaid, Medicare Advantage, uninsured/bad debt, and charity care.
www.beckerspayer.com
Payer mix in the nation's top 20 hospitalsJako...
Source: Student Doctor Network - April 7, 2022 Category: Universities & Medical Training Authors: nimbus Tags: Anesthesiology Source Type: forums
Radonda Vaught case shows the corruption of state regulatory boards
I've been following this case and honestly this corruption needs to be called out. This nurse accidently did a med error potentially causing a patient death. She reported the error and did all the thing she was suppose to do and was then fired. Vanderbilt swept the situation under the rug to try to avoid bad publicity. Someone made a tip to medicaid and after they threatened to cut reimbursement the nursing board who had cleared Radonda reopened the case and pulled her license and they are...
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Source: Student Doctor Network - March 25, 2022 Category: Universities & Medical Training Authors: Proudfather94 Tags: Topics in Healthcare Source Type: forums
Pain management clinic owes Medicaid $1 million for “upcoding”
Wallingford pain medicine practice to pay $1M in Medicaid billing settlement
www.nhregister.com
“The state alleges PCA coded almost all of its claims “second most complex level of service” regardless of what care service was actually provided.”
Sounds like they billed mostly 99214 as a pain clinic…which begs the question which part of pain management was not considered complex? Hold onto your butts, the audits are coming…. (Source: Student Doctor Network)
Source: Student Doctor Network - March 20, 2022 Category: Universities & Medical Training Authors: Agast Tags: Pain Medicine Source Type: forums
Should the government pay for flu vaccines for everyone?
With the covid vaccine being provided by the government free of charge, it got me thinking if we should have a similar process for the flu vaccine. I am not sure what other vaccines the government provides for free. I know in my state the hep B vaccine is provided by the state for newborns, but unsure if any others are. The local health department does provide vaccination, but it is run through your insurance/medicaid - not free per se.
I know there are those that fall into "healthcare...
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Source: Student Doctor Network - January 27, 2022 Category: Universities & Medical Training Authors: Dred Pirate Tags: Pharmacy Source Type: forums
Cataract Surgery Anesthesia Models
We are considering an anesthesia group who's model is out-of-network for all insurances for an eye surgery center. I guess there are a few insurance companies that pay beaucoup bucks for out of network charges. I personally find this a little distasteful and am worried patients will be hit with a surprise charge and this will blow back on us. That being said, I've been told by some of our anesthetists they've been proposed medicaid rates by some insurance carriers and that's not right...
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Source: Student Doctor Network - January 19, 2022 Category: Universities & Medical Training Authors: dantt Tags: Anesthesiology Source Type: forums
What specialties have the least reliance on medicare or medicaid?
With reimbursements being cut every year I'm skeptical that it will improve unless something drastic and unrealistic happens such as physicians uniting to lobby to congress or the majority of physicians not accepting Medicare or Medicaid.
Which specialties deal with these insurances the least? I'm figuring ones that can delve into more cosmetic stuff like plastics and derm and specialties with a high patient variance and practice flexibility like FM. (Source: Student Doctor Network)
Source: Student Doctor Network - December 9, 2021 Category: Universities & Medical Training Authors: Proudfather94 Tags: Medical Students (DO) Source Type: forums
JOb offer thoughts
Looking for some advice on a recent job offer, will be my first job out of residency
Outpatient psychiatry seeing insured patients (no medicaid)
Location: coastal Florida
Base: 240K+RVU bonus (after 4000 rvu it goes to a conversion factor of 45) split up quarterly- bonus after 1000 RVU
Sign-on bonus: 20K
Relocation: 15K
Call bonus: 18K (6 mandatory call weekends per year but 3k per weekend=18K) (option to take more call if wanted at 3000 per weekend)
location is not for profit and qualifies...
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Source: Student Doctor Network - November 20, 2021 Category: Universities & Medical Training Authors: TAMPABOUND Tags: Psychiatry Source Type: forums
Is medicare reimbursement the best?
Just talked with the biller for the company I am working for. I am in the process of getting credentialed with the all the insurance companies, but have not yet. She informed me that medicare reimburses the highest and that I should expect all other insurance providers to fall in between medicare and medicaid rates.
This is so surprising to me given that Medicare reimburses us $204 for a 90792 and $173 for a 99204.
Can anyone confirm this? (Source: Student Doctor Network)
Source: Student Doctor Network - November 17, 2021 Category: Universities & Medical Training Authors: trixter888 Tags: Psychiatry Source Type: forums
CMS cuts physician pay by 7% over 2 years
2021:
The Centers for Medicare and Medicaid Services (CMS) announced a revised Medicare Physician Conversion Factor (CF) of $34.8931. The CF represents a 3.3% reduction from the 2020 CF of $36.0869. The 2021 Anesthesia CF is $21.5600, this is in comparison to the 2020 Anesthesia CF of $22.2016.
CMS Updates 2021 Physician CF to $34.8931, a 3.3% Reduction from the 2020 CF - McDermott+Consulting
The Centers for Medicare and Medicaid Services (CMS) announced a revised Medicare Physician Conversion Factor (CF) of $34.8931. The CF represents a 3.3...
Source: Student Doctor Network - November 16, 2021 Category: Universities & Medical Training Authors: 2021Doctor Tags: Anesthesiology Source Type: forums
Anyone know telepsych companies that allow working abroad?
I understand you can't bill medicare/medicaid when abroad, but are there any telepsych companies that are billing largely insurance or will accommodate a physician who is based internationally? (Source: Student Doctor Network)
Source: Student Doctor Network - October 24, 2021 Category: Universities & Medical Training Authors: jbomba Tags: Psychiatry Source Type: forums
Beggars Can't Be Choosing Wisely
This is an open-book, single question test.
Here is the book:
Centers for Medicare & Medicaid Services Data
Here are the study guides:
Single-Fraction RT for Bone Mets Should Be 'Standard'
In the first-ever 'real world' study of palliative radiotherapy for bone metastases, single and multiple fractions were equivalent.
www.medscape.com (Source: Student Doctor Network)
Source: Student Doctor Network - October 13, 2021 Category: Universities & Medical Training Authors: TheWallnerus Tags: Radiation Oncology Source Type: forums
