RE: getting paid for paps Re: Re: Solo advice

[Guest guest]

, you have earned the right to rant away any time you want!!And, make

note, as usual, all great points.I'll hold your soapbox so it's ready

for you whenever you want to climb up and holler your thoughts.Timps -- by the way, what exactly is a " soapbox? " Do any of us

actually own one for lecturing? Have you ever seen one? The only soapboxes I

have are little cardboard things holding the Irish Spring! ;-)On Fri, December 5, 2008 10:58 am EST,

Brady, MD wrote:

OK,

So here is a small rant. How stupid isthis? Why do we need to cloud our minds with all this insanity? As we movetoward a different system, I for one would love to see a payment where I getone amount of money for every visit regardless of complexity. Patient shows upin the office, I get $50 or $75 or whatever (combined with aper member per month rate based on patient satisfaction

with the office(ex. HYH results)). Simplifying the payment system would

immediately eliminatea HUGE amount of administrative stuff which greatly

increases the overallcosts. Make it simple, allow me to focus on my patient

not on stupid codeswhich change with the winds.

[Practiceimprovemen t1] Solo advice> >

I need some advice. I am opening my cash-only practice in January and given

the economy > am realistic about how fast it will grow. I am

absolutely convinced it can be successful, but > the ramp up

will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will

take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities

may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are

> others solving this? > > Thanks -> >

Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> > Yahoo! Groups

Links> > > > http://docs.yahoo.com/

info/terms/>------------ ---------

--------- ------

[Guest guest]

, you have earned the right to rant away any time you want!!And, make

note, as usual, all great points.I'll hold your soapbox so it's ready

for you whenever you want to climb up and holler your thoughts.Timps -- by the way, what exactly is a " soapbox? " Do any of us

actually own one for lecturing? Have you ever seen one? The only soapboxes I

have are little cardboard things holding the Irish Spring! ;-)On Fri, December 5, 2008 10:58 am EST,

Brady, MD wrote:

OK,

So here is a small rant. How stupid isthis? Why do we need to cloud our minds with all this insanity? As we movetoward a different system, I for one would love to see a payment where I getone amount of money for every visit regardless of complexity. Patient shows upin the office, I get $50 or $75 or whatever (combined with aper member per month rate based on patient satisfaction

with the office(ex. HYH results)). Simplifying the payment system would

immediately eliminatea HUGE amount of administrative stuff which greatly

increases the overallcosts. Make it simple, allow me to focus on my patient

not on stupid codeswhich change with the winds.

[Practiceimprovemen t1] Solo advice> >

I need some advice. I am opening my cash-only practice in January and given

the economy > am realistic about how fast it will grow. I am

absolutely convinced it can be successful, but > the ramp up

will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will

take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities

may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are

> others solving this? > > Thanks -> >

Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> > Yahoo! Groups

Links> > > > http://docs.yahoo.com/

info/terms/>------------ ---------

--------- ------

[Guest guest]

, you have earned the right to rant away any time you want!!And, make

note, as usual, all great points.I'll hold your soapbox so it's ready

for you whenever you want to climb up and holler your thoughts.Timps -- by the way, what exactly is a " soapbox? " Do any of us

actually own one for lecturing? Have you ever seen one? The only soapboxes I

have are little cardboard things holding the Irish Spring! ;-)On Fri, December 5, 2008 10:58 am EST,

Brady, MD wrote:

OK,

So here is a small rant. How stupid isthis? Why do we need to cloud our minds with all this insanity? As we movetoward a different system, I for one would love to see a payment where I getone amount of money for every visit regardless of complexity. Patient shows upin the office, I get $50 or $75 or whatever (combined with aper member per month rate based on patient satisfaction

with the office(ex. HYH results)). Simplifying the payment system would

immediately eliminatea HUGE amount of administrative stuff which greatly

increases the overallcosts. Make it simple, allow me to focus on my patient

not on stupid codeswhich change with the winds.

[Practiceimprovemen t1] Solo advice> >

I need some advice. I am opening my cash-only practice in January and given

the economy > am realistic about how fast it will grow. I am

absolutely convinced it can be successful, but > the ramp up

will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will

take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities

may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are

> others solving this? > > Thanks -> >

Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> > Yahoo! Groups

Links> > > > http://docs.yahoo.com/

info/terms/>------------ ---------

--------- ------

[Guest guest]

Amen !

Wayne,

I agree with you 100%. I amgoing to stop doing GYN exams as well because I am tired of not being paid forthem. Most of the big insurers in my area bundle the GYN exam with therest of the annual exam fee. I have begged, I have pleaded and I havecursed but nothing changes. I do not do

Paps on men and I get the samereimbursement for their annual exams as I do for the women on whom I do Paps and I donot have to collect specimens, clean and sterilize equipment, review testresults and call men about their results. So, from now on, most of mywomen will just have to take another day off work and go to a gynecologistand pay another copay to get their Paps done. I am

done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities may force that decision. > So the question - how can a male

provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> >

[Guest guest]

I don't recognise those codes. Are they Medicaid/Medicare codes?

To: Sent: Friday, December 5, 2008 9:29:06 AMSubject: Re: getting paid for paps Re: Re: Solo advice

I get paid for

G0101 and Q0091, plus usually a urine 81002.

I never do it on the same day as a preventive.

To: Sent: Friday, December 5, 2008 8:13:27 AMSubject: Re: getting paid for paps Re: Re: Solo advice

Back when we were doing these exams, we found a special code. Well, actually BCBS asked us to use it to prevent confusion. But Aetna and other companies paid on it also. When I get in I"ll try to look it up.

To: lstrouseinsightbb (DOT) com; practiceimprovement 1yahoogroups (DOT) comSent: Thursday, December 4, 2008 6:08:56 PMSubject: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I

guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am

opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > >

> ------------ --------- --------- ------> >

[Guest guest]

I don't recognise those codes. Are they Medicaid/Medicare codes?

To: Sent: Friday, December 5, 2008 9:29:06 AMSubject: Re: getting paid for paps Re: Re: Solo advice

I get paid for

G0101 and Q0091, plus usually a urine 81002.

I never do it on the same day as a preventive.

To: Sent: Friday, December 5, 2008 8:13:27 AMSubject: Re: getting paid for paps Re: Re: Solo advice

Back when we were doing these exams, we found a special code. Well, actually BCBS asked us to use it to prevent confusion. But Aetna and other companies paid on it also. When I get in I"ll try to look it up.

To: lstrouseinsightbb (DOT) com; practiceimprovement 1yahoogroups (DOT) comSent: Thursday, December 4, 2008 6:08:56 PMSubject: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I

guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am

opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > >

> ------------ --------- --------- ------> >

[Guest guest]

I agree in principle. I'd say, $85/visit + $50/month/patient. Period. If patient is not satisfied with the service at your office, they should change doctors. Your penalty is in the total loss of revenue for that patient. If no one will come to you , then you will change. No need to nickle & dime you on the monthly fee.

To: Sent: Friday, December 5, 2008 10:58:28 AMSubject: RE: getting paid for paps Re: Re: Solo advice

OK,

So here is a small rant. How stupid is this? Why do we need to cloud our minds with all this insanity? As we move toward a different system, I for one would love to see a payment where I get one amount of money for every visit regardless of complexity. Patient shows up in the office, I get $50 or $75 or whatever (combined with a per member per month rate based on patient satisfaction with the office (ex. HYH results)). Simplifying the payment system would immediately eliminate a HUGE amount of administrative stuff which greatly increases the overall costs. Make it simple, allow me to focus on my patient not on stupid codes which change with the winds.

getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just

recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I

do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the

economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> >

[Guest guest]

I agree in principle. I'd say, $85/visit + $50/month/patient. Period. If patient is not satisfied with the service at your office, they should change doctors. Your penalty is in the total loss of revenue for that patient. If no one will come to you , then you will change. No need to nickle & dime you on the monthly fee.

To: Sent: Friday, December 5, 2008 10:58:28 AMSubject: RE: getting paid for paps Re: Re: Solo advice

OK,

So here is a small rant. How stupid is this? Why do we need to cloud our minds with all this insanity? As we move toward a different system, I for one would love to see a payment where I get one amount of money for every visit regardless of complexity. Patient shows up in the office, I get $50 or $75 or whatever (combined with a per member per month rate based on patient satisfaction with the office (ex. HYH results)). Simplifying the payment system would immediately eliminate a HUGE amount of administrative stuff which greatly increases the overall costs. Make it simple, allow me to focus on my patient not on stupid codes which change with the winds.

getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just

recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I

do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the

economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > > > ------------ --------- --------- ------> >

[Guest guest]

Yes, Wayne they are Medicare, but all payers recognize them.

To: Sent: Monday, December 8, 2008 11:57:20 AMSubject: Re: getting paid for paps Re: Re: Solo advice

I don't recognise those codes. Are they Medicaid/Medicare codes?

From: nancy blake <nancycblake@ yahoo.com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Friday, December 5, 2008 9:29:06 AMSubject: Re: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo advice

I get paid for

G0101 and Q0091, plus usually a urine 81002.

I never do it on the same day as a preventive.

From: Wayne Coghill <cwayne59verizon (DOT) net>To: Practiceimprovement 1yahoogroups (DOT) comSent: Friday, December 5, 2008 8:13:27 AMSubject: Re: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo advice

Back when we were doing these exams, we found a special code. Well, actually BCBS asked us to use it to prevent confusion. But Aetna and other companies paid on it also. When I get in I"ll try to look it up.

To: lstrouseinsightbb (DOT) com; practiceimprovement 1yahoogroups (DOT) comSent: Thursday, December 4, 2008 6:08:56 PMSubject: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I

guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am

opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > >

> ------------ --------- --------- ------> >

[Guest guest]

Yes, Wayne they are Medicare, but all payers recognize them.

To: Sent: Monday, December 8, 2008 11:57:20 AMSubject: Re: getting paid for paps Re: Re: Solo advice

I don't recognise those codes. Are they Medicaid/Medicare codes?

From: nancy blake <nancycblake@ yahoo.com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Friday, December 5, 2008 9:29:06 AMSubject: Re: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo advice

I get paid for

G0101 and Q0091, plus usually a urine 81002.

I never do it on the same day as a preventive.

From: Wayne Coghill <cwayne59verizon (DOT) net>To: Practiceimprovement 1yahoogroups (DOT) comSent: Friday, December 5, 2008 8:13:27 AMSubject: Re: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo advice

Back when we were doing these exams, we found a special code. Well, actually BCBS asked us to use it to prevent confusion. But Aetna and other companies paid on it also. When I get in I"ll try to look it up.

To: lstrouseinsightbb (DOT) com; practiceimprovement 1yahoogroups (DOT) comSent: Thursday, December 4, 2008 6:08:56 PMSubject: getting paid for paps Re: [Practiceimprovemen t1] Re: Solo adviceSo, what cpt are folks using if someone comes in just for pap/breast exam?In order to get paid, I started using a 99214 and then using the icd-9s V72.31/V76.10.It was going fine and I was satisfied that the payment was reasonable for the appointment.But, just recently a patient with a high-deductible plan reported that the appt should have been billed differently so she would not have to pay out of pocket and have it added to her deductible. The insurance company would pay for preventive care ... I

guess the ICD-9 codes aren't sufficient and don't make the issue obvious! (sorry for sarcasm).So, what do folks use for private insurance when it's just a pap/breast appt?Any help with this is greatly appreciated.Tim

Wayne,

I agree with you 100%. I am going to stop doing GYN exams as well because I am tired of not being paid for them. Most of the big insurers in my area bundle the GYN exam with the rest of the annual exam fee. I have begged, I have pleaded and I have cursed but nothing changes. I do not do Paps on men and I get the same reimbursement for their annual exams as I do for the women on whom I do Paps and I do not have to collect specimens, clean and sterilize equipment, review test results and call men about their results. So, from now on, most of my women will just have to take another day off work and go to a gynecologist and pay another copay to get their Paps done. I am done.

[Practiceimprovemen t1] Solo advice> > I need some advice. I am

opening my cash-only practice in January and given the economy > am realistic about how fast it will grow. I am absolutely convinced it can be successful, but > the ramp up will surely be slower than it would have been a couple of years ago. Therefore, > I'm getting very serious about controlling overhead so I can make it through the lean months, > and perhaps years, it will take to get the practice where it needs to be. I've not been overly > excited about practicing with no support, but the economic realities may force that decision. > So the question - how can a male provider realistically practice solo-solo without a > chaperone available for gyn exams, or focused cardiac exams for that matter? How are > others solving this? > > Thanks -> > Chad Costley> chadcostley@ ... > >

> ------------ --------- --------- ------> >