Items filtered by date: May 2010
What would you think if your doctor told you he was now charging you an annual fee to be his patient?
More and more doctors across the country are asking patients to pay a fee for services that insurance doesn’t cover. Most of us have seen charges for missed appointments, but fees are also being charged for such services as filing out school physicals, work questions and athletic forms, according to USA Today.
William Jessee, president of the Medical Group Management Association says “It’s not unlike the airlines. They’ve gone from all-inclusive to a la carte”.
It appears that the number of doctors charging these fees are in the minority, but the trend is on the rise. Jessee says primary care doctors face increased financial pressures as insurance reimbursements haven’t kept up with costs. More and more doctors are seeking to charge annual administration fees. Tony Brayer, MD, a 20-year old physician who wrote a response piece on OpposingViews.com is in favor of a flat administrative fee of about $125 a year rather than “nickel and diming patients”.
It makes sense to check with insurers before implementing these fees. John Syer, a vice president over provider contracting at WellPoint, which operates 14 BlueCross BlueShield plans, says such fees may violate provider agreements if doctors charge for items insurers consider included in their payments.
An HNA interview with Michael Manere, founder and VP of Total Compliance Solutions
To provide it’s members with the latest information on compliance in the medical practice, HNA interviewed known compliance expert, Michael Manere, VP and founder of Total Compliance Solutions, Inc. Mr. Manere has been at the forefront of the movement to outsource physician’s office regulatory compliance.
It’s comparable to not participating in your company’s 401k to get the match. It is simply money left on the table. That’s how you need to look at point-of-service drug dispensing. It’s easy, with low investment, and your competitors just might be jumping on the bandwagon faster than you are.
The old is new again
A short history lesson is in order here: this is nothing new. Physician drug dispensing was the norm in days gone by, but somewhere along the way doctors gave up this income stream and cheerfully handed it to pharmacists. The time has come for you to reclaim your piece of the pie.
Patient Mix is a tricky road to navigate. Many practices just assume the more patients it sees, the more money it makes! Well, what if you could see different patients and make more? What is patient Mix? Patient Mix is the equation that leads to all the patients you see in your practice. Simply put: How many PPO patients, HMO patients, cash patients, and Medicare patients do I have? For example a typical General Practitioner runs about 85-90% on the large HMO patient mix structure. Meaning you are contracted with the top 5-10 HMO/PPO in your area because they control a large patient base. You contract with them and they fill your waiting room with patients. But are the reimbursements what you want? Usually not. You may think you make up for less money with more volume but this approach is a formula for disaster.
It’s reality folks: in the world of healthcare, going it alone is virtually impossible these days. As a stand-alone, multi-physician practice or sole practitioner, the myriad of requirements and obligations involved in healthcare have made being a small player a real challenge. Hospital chains, both for profit and nonprofit, have become negotiating powerhouses – and their clout guarantees preferential payer contracts.
The Medical Home, AKA Patient-Centered Medical Home (PCMH), is defined as an approach to providing comprehensive primary care that facilitates partnerships between individual patients, and their personal providers, and when appropriate, the patient’s family. The goal of the Medical Home is provide better healthcare for the patient, a less stressful environment for the Doctor, and at less cost to everyone.
The concept of the Medical Home has been in existence since 1967 when it was introduced by the American Academy of Pediatricians to provide better healthcare for children with severe medical problems.
Merriam Webster defines Alternative Medicine as “any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain.” If you’re not well versed in what this term encompasses, it would be in your best interest to get up to speed.