RE: [practicemgt] Medicare Screening Colonoscopies - Waived fees and Extra fees

[Guest guest]

This really is no different than what we were posting on this listserv or another one a year or so ago. Many FPs do skin biopsies and wait for the pathology to come back before billing as removal of a malignant lesion pays more than removal of a benign or unknown lesion and benign lesions are usually not covered. Also, our GI counterparts have long been dealing with the opposite problem in that screening wasn’t covered but diagnostic was so if something was found, the patients were happier.  There isn’t a happy medium I guess.  Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: practicemgt@... On Behalf Of Falball@...Sent: Sunday, January 29, 2012 7:35 AMTo: Practice Management IssuesSubject: Re: [practicemgt] Medicare Screening Colonoscopies - Waived fees and Extra fees Smart Insurance companies aren't they?A law and rule gets created and they find ways to get around it and dictate complianceto the physicians, in order for them to get paid. Learn the rules, use the rules.There is no other choice. Do this and survive, don't do this and perish.Maybe this is what should have been discussed with thesewriters?Maybe the public needs the education and the government needs to realizethe more they throw around rules, laws and regulations the more those controllingthe money get around them. Falball Here is the USA Today article. Locke, MDhttp://yourlife.usatoday.com/health/healthcare/insurance/story/2011-12-28/Preventive-care-Its-free-except-when-its-not/52261004/1 Preventive care: It's free, except when it's notUpdated 12/28/2011 10:35 PM CHICAGO – Bill Dunphy thought his colonoscopy would be free.Bill Dunphy, a 61-year-old small business owner, thought his colonoscopy would be free under the nation's year-old health care law. But when the doctor removed two non-cancerous polyps, turning a preventive screening into a diagnostic procedure, it allowed his insurance company to bill him $1,100.His insurance company told him it would be covered 100 percent, with no copayment from him and no charge against his deductible. The nation's 1-year-old health law requires most insurance plans to cover all costs for preventive care including colon cancer screening. So Dunphy had the procedure in April. snip/snip Locke, MD---You are currently subscribed to practicemgt  as: falball@...To unsubscribe or to manage your settings, please go to http://members.aafp.org/members/cgi-bin/myaafp.pl?op=subscriptions & type=lists---You are currently subscribed to practicemgt  as: qualityfp@...To unsubscribe or to manage your settings, please go to http://members.aafp.org/members/cgi-bin/myaafp.pl?op=subscriptions & type=lists