Most Recent Posts
A Tale of Woe: Only Partial Backups
by beagle - 08/19/2025 7:26 PM
Can someone please tell me what is going on here!
by ChrisFNP - 08/18/2025 11:13 AM
no office note but it was billed
by ChrisFNP - 08/15/2025 1:25 PM
Removing a medication
by ChrisFNP - 08/14/2025 9:30 AM
How to get in touch with tech support
by ChrisFNP - 08/08/2025 10:08 AM
Prior approval of meds
by ChrisFNP - 08/04/2025 11:13 AM
License Agreement
by ChrisFNP - 07/31/2025 3:16 PM
July Contribution
by Bert - 07/30/2025 8:34 AM
Member Spotlight
Posts: 53
Joined: July 2021
Newest Members
sne787, Dr. Christine Se, ozonr666, ESMI, It's me
4,597 Registered Users
Previous Thread
Next Thread
Print Thread
Rate Thread
#51773 02/07/2013 7:14 AM
Joined: Feb 2005
Posts: 2,002
Leslie Offline OP
Member
OP Offline
Member
Joined: Feb 2005
Posts: 2,002
Ok, now I am really ticked off.
As most of you know, there has been increasing demand from diabetic supplies suppliers for copies of patients charts in order to satisfy Medicare. In the past, docs only had to complete a standard form stating we did indeed prescribe testing more than once a day and why. I have been battling with a local pharmacy that continues to demand I send them copies of the patient's chart for the last 2 years because of a Medicare audit. I have continued to refuse saying they have no right to any information other than what pertains to her diabetic supplies. They keep quoting me the HIPPA codes and I keep telling them I do not care about HIPPA, I care about the rights of my patient to protect her medical history from pharmacy techs and cashiers. I told them I would complete a form or draft a letter stating that I have prescribed TID-QID testing for this insulin-dependent diabetic but they continue to demand copies of her entire chart. Yesterday they told me if I did not send them they would "put a block on my NPI number" whatever the Hell that means. I again refused and told them I would release medical records to the patient and she can then do whatever the Hell she wants to with them. I am so sick of all these entities believing they have a right to patient information which has nothing to with them. Same with FMLA forms. I refuse to tell a family caretaker's employer my patient's medical history. We as physicians have GOT to step up to the plate and stop these kinds of intrusions.!!! We have GOT to embolden patients and employees. We have GOT to do what is right, not what is expected.

OK, climbing down now.


Leslie
Hospital Employed Physician Who Misses The Old AC

"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
Leslie #51775 02/07/2013 8:17 AM
Joined: Nov 2005
Posts: 2,367
Likes: 2
Member
Offline
Member
Joined: Nov 2005
Posts: 2,367
Likes: 2
It might be passive aggressive but give the patient a CD with password protected PDF and do not give the password. I bet you never get a call, because no one is really looking at it.

Another option is to tell the pharmacy to have the patient call them so the can discuss other options to get their supplies. They may decide that mail order really isn't that bad.

If they want to "block" you, it can go two ways. I suspect they need you more than you need them.


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
Leslie #51777 02/07/2013 9:23 AM
Joined: Apr 2006
Posts: 124
Member
Offline
Member
Joined: Apr 2006
Posts: 124
We have stopped honoring all requests from diabetic medical suppliers. We have been fighting for two years now over such issues, and ultimately discover that the patient doesn't realize they are receiving certain things.. They think the MD is the one who intiated the orders!
So we have explained to the companies.. not to send the requests to us in any form.. but to MAIL Them to the patient, who can chose to bring them to the next phyical exam.
We explain to the patient our preference of utilizing their normal pharmacies for their supplies.
In the past, when someone has argues that Medicare is requiring x, y, z.. We ask for a copy of that request, specific to the patient, and tell them to have Medicare contact us directly for the information.
We do supply a mini letter, explaining the pt was seen in our office on such and such date, for this disease management.

It is heart-wrenching that in the era of individual privacy protection rights, it seems like the patient is being strip searched no matter what he/she does... and has no voice to say.. NO.


Mercy Medical Clinic
OM for Solo IM
Leslie #51778 02/07/2013 9:50 AM
Joined: Feb 2005
Posts: 2,002
Leslie Offline OP
Member
OP Offline
Member
Joined: Feb 2005
Posts: 2,002
Wendell, sounds like a good but time-consuming and expensive solution.

Chazli, I have done most all of the things you mentioned. This happens to be a local pharmacy! I tell the diabetic suppliers not to contact me about any extraneous supplies such as heating pads, back braces, knee braces, shoes, etc. If the patient needs those things, they can specifically request them from me and we can discuss them. I have even gone so far as to file Medicare Fraud complaints with DME houses because they have been illegally soliciting my patients. These complaints went nowhere! So much for Obamas plan to stop fraud and abuse.Make me the villain. Why would a script for the testing supplies not suffice for a Medicare audit? If the script I wrote says "Test TID" and I have 120 strips/month then, if the DME houses give more strips and charge Medicare for them that should be easy to track? Why make my job of trying to care for he patient so much more difficult? Ridiculous. Wears me out.


Leslie
Hospital Employed Physician Who Misses The Old AC

"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
Leslie #51780 02/07/2013 9:52 AM
Joined: Feb 2005
Posts: 2,002
Leslie Offline OP
Member
OP Offline
Member
Joined: Feb 2005
Posts: 2,002
Oh, and I lost a patient last year because she wanted me to approve a second pair of diabetic shoes (at almost $500/pair) so she could have an every day pair and a pair to wear to church. I refused telling her I thought that was an excessive burden on our already strapped Medicare program. She got pissed and transferred her records.


Leslie
Hospital Employed Physician Who Misses The Old AC

"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
Leslie #51792 02/07/2013 12:14 PM
Joined: Jan 2012
Posts: 30
Member
Offline
Member
Joined: Jan 2012
Posts: 30
I won't sign for diabetic shoes, period. There is no evidence they are better then a pair of New Balance shoes. Most patients are requesting them because either 1) they are free or 2)a podiatrist is selling them from his office and pushing them on the patients. I only write for needed shoes such as true molded or fitted ones for amputees,etc.


Dave Ray, D.O.
Internal Medicine
Ohio
Leslie #51795 02/07/2013 2:57 PM
Joined: Nov 2005
Posts: 2,367
Likes: 2
Member
Offline
Member
Joined: Nov 2005
Posts: 2,367
Likes: 2
Originally Posted by Leslie
Wendell, sounds like a good but time-consuming and expensive solution.


Not really all that difficult. Print from summary to formal health record and preview so that you can print to PDF. There are a number of free PDF programs (PDFredirect) that will allow you to put a password on the file., then burn to disk.


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
Leslie #51797 02/07/2013 3:07 PM
Joined: Feb 2005
Posts: 2,002
Leslie Offline OP
Member
OP Offline
Member
Joined: Feb 2005
Posts: 2,002
Why should I have to do anything other than write the prescription?


Leslie
Hospital Employed Physician Who Misses The Old AC

"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
Leslie #51799 02/07/2013 5:12 PM
Joined: Nov 2005
Posts: 2,367
Likes: 2
Member
Offline
Member
Joined: Nov 2005
Posts: 2,367
Likes: 2
Originally Posted by Leslie
Why should I have to do anything other than write the prescription?


a) to get them off your back
b) to piss them off (excuse my language)


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
Leslie #51804 02/07/2013 7:50 PM
Joined: Oct 2006
Posts: 305
Member
Offline
Member
Joined: Oct 2006
Posts: 305
Leslie,
The reason we do half the garbage we do is because 90% of physicians and 100% of medical associations don't have the testicular fortitude to stand up for the profession. As a result, we're led around by the nose by every insurance company, PBM, government agency that has a new whim. I can imagine the laughter around the table as they discuss the next stupid thing they can make us do. Aside from your personal integrity and complaining to a few fellow curmudgeons on the AC forum what are you going to do about it. You certainly can't look for representation at the national or state level around here. There's a reason only 10% of practicing MDs belong to the AMA, while over 70% of dentists belong to the ADA. The ADA actually represents the interests of dentists, like any other trade association should. Maybe you could take your concerns all the way to the attorney general. Oh, wait...
Dave
FP

Leslie #51805 02/07/2013 9:08 PM
Joined: Nov 2005
Posts: 2,367
Likes: 2
Member
Offline
Member
Joined: Nov 2005
Posts: 2,367
Likes: 2
So true...


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
Leslie #51807 02/07/2013 9:16 PM
Joined: Nov 2006
Posts: 2,084
Member
Offline
Member
Joined: Nov 2006
Posts: 2,084
Leslie,

I have refused to even respond to any requests for medical diabetic, etc, supplies for over 2 years. I have never been "blacklisted", if that even is possible. I still get several of theses "fraud faxes" every week. So much for those threats.

If patients whine about paying for their strips, I give them hand-written prescriptions -- as long as they give me at least a month of finger-stick sugar readings, showing how often they test. They only get one Rx a year -- sorry Charlie. I lay it out all in a sheet that staff gives to all diabetics.

I have refused to deal with these suppliers after several of my patients answered TV ads (merely requesting information) and "talking" diabetic meters arrived at their homes, allegedly ordered by me. Several hundred dollars were charged to Medicare. I reported these abuses to Medicare and my state attorney's office, but to my knowledge nothing has been done. So much for Obamacare's intent to finance reform with saving billions from Medicare waste and fraud.

Sometimes I think we all are in the same position as Will Smith in I am Legend. Zombie fraudsters have taken over the medical world and it's only a matter of time until they overwhelm us ...


John
Internal Medicine
Leslie #51812 02/07/2013 10:47 PM
Joined: Jan 2012
Posts: 30
Member
Offline
Member
Joined: Jan 2012
Posts: 30
If nothing else, I get some inspiration from reading these posts. We can feel isolated in our long office days with these constant moral/ethical issues and we get inundated with requests/demands that make us feel like we're here to bo the whores of other institutions pushing us around,instead of practicing medicine and interacting with our patients which is what we all really want to do. So many docs just go through the day signing off on every request without stopping to think what the hell they're doing. I know we can't change the "system" individually but I've always said "I can at least try to take care of my little corner of the world and educate a few around me." It truely makes one feel like a rebel or outsider and sometimes question our own methods, but, some interactions like this keeps us grounded and lets us remember that we aren't wrong in our thinking.


Dave Ray, D.O.
Internal Medicine
Ohio
Leslie #51858 02/10/2013 12:49 AM
Joined: Sep 2009
Posts: 2,989
Likes: 5
JBS Offline
Member
Offline
Member
Joined: Sep 2009
Posts: 2,989
Likes: 5
Leslie,
Two issues here: patient privacy and the pita factor. As to the first, of course the pharmacy must have a signed release to get the note; otherwise you don't need to discuss it any further with them.
As to the hassle factor....I am surprised at you! Bev said "wasn't it Leslie who told us to charge for all of those Medicare review charts in the first place?" So tell the pharmacy to fork over a signed release and your chart copying fee, and then you will send the chart.

As to the entities right to the details on an FMLA, work slip, or anything else; these are completed as part of a visit. I usually ask the patient if they would prefer something vague like "the patient has medical issues which may require missing time from work" OR something specific like "the patient may have 8 episodes of watery and mucusy diarrhea daily and may need to miss time from work". If the patient is releasing the information, I let them be my guide.


Jon
GI
Baltimore

Reduce needless clicks!

Moderated by  ChrisFNP, DocGene, JBS, Wendell365 

Link Copied to Clipboard
ShoutChat
Comment Guidelines: Do post respectful and insightful comments. Don't flame, hate, spam.
Who's Online Now
0 members (), 158 guests, and 23 robots.
Key: Admin, Global Mod, Mod
Top Posters(30 Days)
Bert 5
imcffp 3
beagle 2
Top Posters
Bert 12,897
JBS 2,989
Wendell365 2,367
Sandeep 2,316
ryanjo 2,084
Leslie 2,002
Wayne 1,889
This board is dedicated to the memory of Michael "Indy" Astleford. February 6, 1961 -- April 16, 2019




SiteLock
Powered by UBB.threads™ PHP Forum Software 7.7.5