Home Forums Coronavirus and the private practice

Bert is really going to bash me for going off topic.

I don't think it is off topic. This is mostly happening because of one reason.

Just to be sure since we have more kits than New York City, everyone is using their VZV/HSV kits. Any RTM media will do.

koby is testing sicker patients or patients more likely to have Covid-19 with a 33% positivity rate. Jimmie is testing less sick people and getting and is getting an 11% positivity rate.

The U.S. is, I believe, only less than a few countries such as Italy with a 20% positivity rate. With wide-scale testing, your positivity rate goes down. The U.S. limits the tests as Ken said to the sickest patients, i.e. hospitals and nursing homes and ICUs.

But, it's all the governors and the WHO who are causing all this.

John, those home LabCorps tests are particularly ridiculous since I would bet 98% of people do a nasal swab and maybe 2% get a naso-pharyngeal sample.

you can see it in their faces when you hit the posterior nasopharynx with the swab

Looks like the labcorp at home test only requires nasal sample, not nasopharygeal.

https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test

This is one of many emails I get on webinars. I'm sorry, but I read this and I can't help but laugh. So, I am supposed to worry about sending a parent an email telling their kid has strep. So, this is important but testing and the government getting their act together isn't. It's called priorities.

Why you should Attend:

Be prepared for the ever changing landscape with HIPAA
This once rarely enforced law has changed and you need to know what's going on!
Protect your practice or business!
What factors might spurn a HIPAA audit?are you doing these things?
Why are the Feds enforcing after all these years?


We will be discussing some of the changes taking place in Washington with the Health and Human Services in regards to the enforcement of the HIPAA laws already on the books. I will go over some of the new changes affecting covered entities and business associates. I will also be discussing factors might cause an unwanted visit or letter from the Office of Civil Rights and how to prepare for the audit and deal with the Feds.

What a cluster F Covid-19 is:
No good treatment; no vaccine in the near future, if ever; the best tactic so far is social distancing which lowers the peak effect but does it extend the time frame so that the area under the curve remains the same.
Then there is the other costs to society: unemployment, greater debt, isolation/depression, no f'in baseball to watch, demonstration of how vulnerable we are on how outsourcing effects us in time of need.
Rant over for now.

Yeah, but you can always get a tattoo in Georgia. The tattoo artist just has to be licensed in tattooing and injection of disinfectant.

For the life of me I can't understand why some sports can't be played with a televised audience. If they didn't let players sit in the dugout and pile on & high five after runs, it's built in social distancing. No sliding or stealing bases of course. And golf. C'mon pros, show us some action!

They can.

Another update about telehealth billing... I verified with our state medical association that Texas has a payment parity law - so telehealth should be paid at the same rate as in-office. I wondered if it's because I had the wrong PoS. I had billed with PoS 02 for telehealth but I saw that some payer guidelines say to use 11. So I did some corrected claims and will report back.

We haven't had to test any patients. There's been a few parents testing positive and asking for advice for their kids. Also, fortunately, Houston has open community testing centers now so can send patients to test there.

Telehealth Update.
You can confirm this in your various areas but it appears for the elderly/Medicare patients without the ability to do video calls we can now get paid for telephone telehealth "office" visits the same as video telehealth "office" visits. Retroactive to March 1. This rights a prior wrong.

Cut and pasted from my e-mail:
In response to efforts by the AMA, the Centers for Medicare & Medicaid Services (CMS) announced this afternoon that it will increase payments for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110, and the payments are retroactive to March 1, 2020.


This is a major victory for medicine that will enable physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high-speed Internet. Several Federation groups have contacted the AMA in recent weeks about telephonic visit payment parity.


he AMA also worked with Senator Hyde-Smith (R-MS), along with Senators Shaheen (D-NH), Manchin (D-WV), and Moran (R-KS), to spearhead the attached letter to HHS Secretary Azar and CMS Administrator Verma on the same topic. The letter sent on April 29 had 37 signers and included the following requests:


Increase Medicare payment rates for telephone-based evaluation and management (E/M) codes (99441-99443) to bring payments for these codes equal to Medicare’s established in person visit codes (99212-99214) that will ensure that patients without advanced video-sharing capabilities are able to get care virtually, while helping to sustain physician practices.
Immediately provide guidance to Medicare Administrative Contractors (MACs) to ensure that recent CMS guidance and rules are followed appropriately to enable the payment of telephone E/M claims.
Provide Members of Congress with a briefing on CMS efforts to address this issue by May 8, 2020.

Hope this is helpful.

In case anyone is interested... I rebilled telehealth 99213s with POS 11 instead of 02 (and modifier 95) and they were adjusted to pay more - same rate as in-office. This is for the major commercial payers.

Serene,
Same here and medicare and major commercial payers paying same rate as in-office. Which is very good news!!!!!

Serene,

Are you looking for a job?

Well a tad off topic, and I don't want to start any politics, but if I were a reporter, I would ask the president* "Do you know why it's called Covid-19?

Well they couldn't name it "19th Nervous Breakdown" cause The Stones already used that name.

LOL. I was bringing it up because the reporters could ask trump why the name? If he knew, he could say because it started in 2019. Then they could ask him why does he claim he heard nothing about it until much later.

Again, I should be careful. One, someone may have another opinion and we don't want to get into a flame war. Or, second, more likely everyone would chime in and it would go on forever.

Great post though!

Bert, thanks for the compliment. Honestly, it's almost a fun game trying to get around insurance payers' attempts to not pay. The only one that stumps me is when they won't pay a claim because "the patient hasn't replied whether they have other insurance or not."

We have been fighting here to get the full office rate reimbursement for telehealth visits got to have my biller do something else

There is a special place in hell for insurance companies.

This is the best definition I found. This is what insurance is supposed to be fore. Not to pool clients' risks, then do everything to not cover that client.

Insurance is a contract, represented by a policy, in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured.Mar 25, 2020

There was a list of the 7 types of insurance. Then it listed health, life...etc.

Actually, it should be:

Bad insurance
Badder insurance
Even badder insurance
Baddest insurance
Even more baddest insurance
ETc.

Insurance is a good idea, but in practice it is easily scammed, rendering it useless or harmful.
Of course, medical insurance isn't insurance at all. It is prepaid health care. Something the AMA railed about for years -- until they finally got bought off.

Insurance policy is to Delay, Deny, Defend, Starts at prior authorizations.

Curious how are other office screening patients at their practices?
Do you guys keep the main entrance to the office closed and screen patient after they enter the lobby or screen them over the phone before they are allowed to enter?
Does every patient get asked about symptoms and get a temperature check?
How do you separate sick from well patients in the lobby?
With Flu season approaching, I m not sure if we will be able to test and treat all patient in the parking lot while patient is seated in the car. There may be days when going out may not be easy because of rain or snow or cold temperature.

We don't separate them. If someone needs a test we either send them to the central testing center or test them in-house. We test no one in the parking lot. I guess in Maine it doesn't scare us too much.