Re: [SPAM]Re: Are we required to take Medicare patients?

[Guest guest]

Yes, the Medicare patients themselves are generally "good people" with problems we can help, and they are certainly deserving of our help; but they are enrolled in a "bad system." And, by taking them on, we are involving ourselves in a system that, as Dr. points out, could--and certainly would if all we saw were Medicare patients--bankrupt our practice (perhaps that was their intent; to design a system that is financially unfeasible). (:-)

RR.

[sPAM]Re: Are we required to take Medicare patients?

All:We no longer bill medicare, or deal with them in any way but stillhave a fair number of medicare benficiaries as patients...they paycash. LEGALLY. The truth is, only a PATIENT can "opt"out of medicare.Medicare is an "entitlement" (you can use it if you want) not a"mandate" (you must use it or else).I will not post how to do this for the 15th time...but anyone who isinterested should get a ID and log into the OeognDCs homepage so that you can access the bounty of archived posts that exist on thesubject.I used to feel diffrently about medicare 6-7 years ago...I felt thatit was workable and 'doable'...but then about 2-3 years ago I actuallysat down and really looked at our office numbers...the REAL"nitty-gritty".Our hourly overhead was about 100/doctor-hour (i know some of you havemuch less than that, good for you) according to the last ACA randomsample survey that I have seen (it was from about 6-7 years ago) theavg. DC overhead per doctor-hour was about 76/hour for a single doctoroffice...and overhead has not gone down as we all know....so thenationwide avg is prolly pushing up toward 100/doctor-hour. (clinic hours)I was very good at billing medicare...our office was expert at it infact. I would say we were better at it than 95+% of the chiros in thisstate. But even with our expertise I found that my office overhead fordealing with medicare beneficiaries went up to about about$110/doctor-hour due to extra doctor time and extra staff time needed.We had numerous scenarios wherein a staff member was paid 15-17/hourwhile spending a full hour chasing down 26 dollars from medicare!!!!!After very careful analysis I found that my average collection formedicare patients was about 125/doctor-hour...hey a profit of 15/hour!My high school niece makes 17/hour off the books baby-sitting back inNY.I recently paid a guy 200/hour for a coupla hours to slap morter onour chimney!!! C'mon kids. Now granted this is only MY office, otherdocs might run their office different but to the best of my knowledgewe are a pretty mean and lean operation. So, I was profiting 15/hourper patient....and, I saw that the percentage of medicare bennies wasslowly and steadily going upward.....you see where things are going?I envisioned an office that was 25% medicare patients with me making15/hour on these patients!!!!!So we got out!!!!NO REGRETS VERY Good business decision..In fact, to stay in (for me)would have been self-destructive, not only to me, but to my otherpatients so it was the only rational decision that was possible. I wasNOT showing COMPASSION by staying in. I was NOT being HUMANE byparticipating in this system.. I was just slowly DESTROYING my practice. So nowadays we see a smaller number of medicare-eligibles, bout halfas many as before (the folks have chosen to opt out of their own freewill...these are very pleasant and responsible seniors BTW, most ofwhom work out and have a positive mindset and are NOT walking chemicalexpriments etc.) but we operate at about 80/hour profit margin withthem...very SUSTAINABLE. :-)Finally:Every office is unique..some of you might be making 30-60/doctor-hourprofit or more off of these patients...others might be more likeus...but I urge you to check out the bottom line in your individualcase..the 'bottom line' for us was this: Medicare was UNSUSTAINABLEand therefore DESTRUCTIVE and therefore UNACCEPTABLE. So we are donewith that bone-headed, screwed up, deMENTED system. I have neverlooked back. Now if they raise the reimbursement rate by about 10dollars per adjustment, we will re-visit.P.S. The ICA is the only chiro organization with a sane attitudetoward medicare. They have consistently pushed and asked for a changein federal law that would simply allow chiros the same option to optout that MDs already have. But the ACA has fought that approach andpushed for MORE inclusion into a system that is very difficult to makea fair profit in.Cheers. > > I've read that some offices in the US don't take Medicare patientsatall. Are we, as PAR with Medicare, obligated to take allMedicarepatients or can we tell them we don't accept Medicare?If wecan tell them we don't accept, it is my understanding that wecan'ttake them on as a cash patient. Am I correct?Thanks,Jo YipOfficeAssistant to Dr.Hartje__________________________________________________________Dreamingof getting away? Click here for an island experience in Hawaii.> > > > > > > > > __________________________________________________________> Get the power of Windows + Web with the new Windows Live.> http://www.windowslive.com?ocid=TXT_TAGHM_Wave2_powerofwindows_012008>