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You aren’t the only one needing anti bitter pill today. 

BTW, nice improvement in typing.

My credit card accepting ability is costing me between $25-30

per month and I got a Virtual Terminal card swiper that attaches to PC with USB

port for one time purchase of $77 or something but it was a special.

I do collect $200-300 usually/mo in credit card payments.  I

find the use picks up if you have one.  I don’t know how many people you

have walking out the door as they forgot to get cash or their wife didn’t

give them a check, etc.  We get some people paying by credit card when they get

their bills and also some HSAs are visa and mastercard accounts and patients

pay co-pays with this.  I would be just a little bit poorer without accepting

them.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Jean

Antonucci

Sent: Wednesday, January 02, 2008 12:10 PM

To: 'Kathy Saradarian '; ' '

Subject: credit card payment

I feel back to square 1 here

Naureen mohammed posted a link to a place that must have been just a one

time special offer for her that electmer.com I think it was. wants 600.00

to get a credit card terminal That is too big an expense for me thoguh I

have not yet looked on ebay for a cheap used one.

I get under 10 requetss a year for credit cards but it seemed like I was

starting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out

ofmy pocket every month for something i would useonly occaisionally. I was

hoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.

paypal will let you invoice by email then the patietn pays by credit card

but what good is that if they don't pay me I ams till chasing them down

yes?

Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22

a month and thent his is 500 a year and that is 125 a year

for pete's sake

But everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc "

I need anti- bitter pills today.

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

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ok ok sprinkle a little sugar in

I got disgusted THEN I hit the internet.again. after i emailed you guys

I have found north american bankcard they seem legit

it is " visa master card rule " that if you do not have at least one

transaction pe r month they hit you up for a 25.00 fee that month

notwithstanding free terminal or expensive terminals good rates or bad.

SO I got northamerican bankcard to offer me a dial up pay as i go 10.oo a

month deal with 2.95% plus 19 cnets per transaction.No terminal lease or

purchase.I f I do at least t one a month and Kathy is right I am sure that

as i can be telling folks i offer it i will get more(but medicaid and

medicare are my life . mediciad you cannot deny becasue of no copay and

medicare does not have one) then you can get a free terminal 10.00 a month

1.59% plus 19cents plus daily batch out fee 35 cents( so say cost of about

12.00 something on a 100.00 fee if i did only one in a month- but my

billing people only charge 8% but if i do more than one well then i do

better) but free terminal .Must do that for 36months

MAybe there is hope.

I figured out money last night

I made 8,000 more than last year This should be good.

But I do not make much.

Well what the hell. Buck up as my husbdna says No baby-isms No boo hooing I

could be in a concnetation camp or in a cardboard box under a railroad

trestle( HI larrry)

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

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that sounds great Jean.if you don't get one transaction a month, just use your own credit card and charge yourself $5 then pay yourself back. I bought a cheap swiper from ebay for $70 a few years ago and it has worked great.I had a great credit card deal initially no monthly fee no statement fee and low transaction fees but over the past 6 months they instituted all of the above and now it is a lot more. So I am looking to switch companies and will shop around on the internet soon too. I'm not sure I understand this but I think if I charge through my paypal merchant account there are no monthly fees etc, just a per transaction fee and percentage of sale fee. I have to get the patient to log in and enter their credit card, that could also be a lot slower and more error prone but I am wondering if I should switch over altogetherI'm wondering what all those fees were you were quoted from paypal? My account as far as I can tell is 'free'. tell us how the company you are using works out?LynnTo: qualityfp@...; From: jantonucci@...Date: Wed, 2 Jan 2008 12:49:55 -0500Subject: RE: credit card payment

ok ok sprinkle a little sugar in

I got disgusted THEN I hit the internet.again. after i emailed you guys

I have found north american bankcard they seem legit

it is "visa master card rule" that if you do not have at least one

transaction pe r month they hit you up for a 25.00 fee that month

notwithstanding free terminal or expensive terminals good rates or bad.

SO I got northamerican bankcard to offer me a dial up pay as i go 10.oo a

month deal with 2.95% plus 19 cnets per transaction.No terminal lease or

purchase.I f I do at least t one a month and Kathy is right I am sure that

as i can be telling folks i offer it i will get more(but medicaid and

medicare are my life . mediciad you cannot deny becasue of no copay and

medicare does not have one) then you can get a free terminal 10.00 a month

1.59% plus 19cents plus daily batch out fee 35 cents( so say cost of about

12.00 something on a 100.00 fee if i did only one in a month- but my

billing people only charge 8% but if i do more than one well then i do

better) but free terminal .Must do that for 36months

MAybe there is hope.

I figured out money last night

I made 8,000 more than last year This should be good.

But I do not make much.

Well what the hell. Buck up as my husbdna says No baby-isms No boo hooing I

could be in a concnetation camp or in a cardboard box under a railroad

trestle( HI larrry)

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

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I just signed up for the credit card deal that Naureen suggested, so I think the deal is still good. Call the number and tell them that you are a doctor. They give you a free swiper card thing, and the most you pay per month is $11 even if you have no transactions. I also set up the paypal credit card deal ( clemensen helped me). It has no monthly fee and you only pay transaction fees. The disadvantage is that you have no terminal to use, so all info needs to be inputed by hand/computer.

If you go with the electmer.com give them my name or Naureen's as a referral. We get some money back for referring. I gave them Naureen's name , so she should get some type of rebate!

Lee

RE: Vaccine ?sChrissie and ,I have the misfortune of not having any pharmacies that will ordervaccines so must get them for the patient myself. I will only order thereally expensive vaccines if requested like Zostavax and Gardisil. Ibuy things like MMR from other doctors as I have no need for 10 of them.I buy Menactra, Adacel, Td, Pneumovax and Influenza for myself, as wellas Hep B and Hep A. I had to buy 10 doses of pediatric Hep A which isunfortunate as not much need but adult Hep A can be on a dose by dosebasis.Although the VFC program is to supply vaccines for all "uninsured"children (even those with insurance that doesn't cover routinevaccination), I don't participate as not a strong need and a lot ofpaperwork and waste. I tried to send some adolescents to the publichealth clinic only to find out they charge full price for vaccine andfor some reason are not getting them through the VFC program. I amstill at a loss about what to do about this as I don't want to take onthe extra burden of the VFC myself.Medicare Zostavax I am having them pay for before I order.Word of note, Medicare Part B will no longer be paying theadministration for Zostavax (G0034? Or something like that) and thatwill now be "billed" to Part D too, adding to the confusion.Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffingFrom: [mailto: ] On Behalf Of HareschSent: Wednesday, January 02, 2008 10:10 AMTo: Subject: Re: MacFriendly EMRs, Vaccine ?sWelcome, ChrissieI had the same vaccine plan when I started last year(!), but ran intoa couple of issues. Since essentially all pediatric vaccines in NorthCarolina are covered only under the state program, patients cannot getthem paid for through the pharmacy. They have to go to the healthdepartment for that, and lots of people don't like that.The pharmacy can't bill insurance for some vaccines, so patients willend up paying out of pocket if they get them directly from thepharmacy. I have a pharmacy that will store vaccines and dole them outto me one-by-one at their cost. They bill me and I bill the patient'sinsurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, andZostavax (non-Medicare) this way.Zostavax is complicated since paid through Medicare Part D. It meansthat the pharmacy can do the billing, but keeping it frozen until itcan get to me for administration is tricky.I've spent a lot of time trying to make vaccines manageable forpatients. But I'm still managing to avoid the costs of keeping themin-house. Haresch> I am also struggling with vaccine choices. Considering> rx for vaccine to be picked up at pharmacy and> administered in office, avoiding the purchasing piece.> Has anyone tried that? What else are folks doing,> especially in Oregon?

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I just signed up for the credit card offer that Naureen told us about. Did you call them and talk to them directly? If you tell them you are a doctor, they give you the card swiper thing for free. The fees are just $11 per month even if you have no transactions. If you do sign up with them, tell them that either Naureen or I referred you. They will give one of us a rebate/money back! I gave them Naureen's name. Hopefully she got something from them!I also signed up through Paypal, where a pt. can pay online. helped me do it. this is a free account ( no monthly fee). You only pay for transactions.Let me know how you do. Lee wrote: I feel back to square 1 here Naureen mohammed posted a link to a place that must have been just a one time special offer for her that electmer.com I think it was. wants 600.00 to get a credit card terminal That is too big an expense for me thoguh I have not yet looked on ebay for a cheap used one. I get under 10 requetss a year for credit cards but it seemed like I was starting to get enough i would look into it So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out ofmy pocket every month for something i would useonly occaisionally. I was hoping to have say a high transacation fee or a set up fee then pay as i go. no deal. paypal will let you invoice by email then the patietn pays by credit

card but what good is that if they don't pay me I ams till chasing them down yes? Pretty frustating to be a small business One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22 a month and thent his is 500 a year and that is 125 a year for pete's sake But everyone want me to just call in prescriptions "becasue it isn;'t like it is a medical issue or anything doc" I need anti- bitter pills today. Re: MacFriendly EMRs, Vaccine ?s Welcome, Chrissie I had the same vaccine plan when I started last year(!), but ran into a couple of

issues. Since essentially all pediatric vaccines in North Carolina are covered only under the state program, patients cannot get them paid for through the pharmacy. They have to go to the health department for that, and lots of people don't like that. The pharmacy can't bill insurance for some vaccines, so patients will end up paying out of pocket if they get them directly from the pharmacy. I have a pharmacy that will store vaccines and dole them out to me one-by-one at their cost. They bill me and I bill the patient's insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and Zostavax (non-Medicare) this way. Zostavax is complicated since paid through Medicare Part D. It means that the pharmacy can do the billing, but keeping it frozen until it can get to me for administration is tricky. I've spent a lot of time trying to make vaccines manageable for patients. But I'm still managing to avoid the

costs of keeping them in-house. Haresch > I am also struggling with vaccine choices. Considering > rx for vaccine to be picked up at pharmacy and > administered in office, avoiding the purchasing piece. > Has anyone tried that? What else are folks doing, > especially in Oregon?

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The vast majority of my patients pay by credit cards.  I

photocopy the card when  they first come in, along with their Driver’s

License and Insurance Card.  They sign a release that authorizes  me to bill

their credit card for their co-pays and for anything their insurance company

says they owe me, after the claim has been adjudicated.  Every 2 weeks, we run

our statements, and my wife sits down at her computer and enters the charges on

their credit cards.  We never send bills.

We contracted the credit card processing through Costco, use an

add-on to Quick Books to record things, and have never used the USB card reader

we paid $80.00 for because we just enter the numbers on the keyboard.  We pay a

higher percent on the keyed-in charges than we would if we swiped the cards

while the patient was there, but getting paid right away and not paying postage

more than compensates for this.   Besides, though my patients are willing to

let me copy their credit cards and sign the authorization statement, I don’t

think they would be willing to just give me the card itself to keep.

For those rare patients who do not have credit cards, we allow

them to bring in a check at the next visit to pay in full, but those are less

than 2% of my patients.

dts

From:

[mailto: ] On Behalf Of Jean

Antonucci

Sent: Wednesday, January 02, 2008 9:10 AM

To: 'Kathy Saradarian '; ' '

Subject: credit card payment

I feel back to square 1 here

Naureen mohammed posted a link to a place that must have been just a one

time special offer for her that electmer.com I think it was. wants 600.00

to get a credit card terminal That is too big an expense for me thoguh I

have not yet looked on ebay for a cheap used one.

I get under 10 requetss a year for credit cards but it seemed like I was

starting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out

ofmy pocket every month for something i would useonly occaisionally. I was

hoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.

paypal will let you invoice by email then the patietn pays by credit card

but what good is that if they don't pay me I ams till chasing them down

yes?

Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22

a month and thent his is 500 a year and that is 125 a year

for pete's sake

But everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc "

I need anti- bitter pills today.

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

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if you don't get one transaction a month, just use your own credit card

and charge yourself $5 then pay yourself back.

GOD YOU FOLKS ARES LSICK!! WHY DIDN'T I THINK OF THAT???

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Don,

Could you share the form you have your pts sign to authorize you to bill their credit card?

The vast majority of my patients pay by credit cards. I photocopy the card when they first come in, along with their Driver's License and Insurance Card. They sign a release that authorizes me to bill their credit card for their co-pays and for anything their insurance company says they owe me, after the claim has been adjudicated. Every 2 weeks, we run our statements, and my wife sits down at her computer and enters the charges on their credit cards. We never send bills.

We contracted the credit card processing through Costco, use an add-on to Quick Books to record things, and have never used the USB card reader we paid $80.00 for because we just enter the numbers on the keyboard. We pay a higher percent on the keyed-in charges than we would if we swiped the cards while the patient was there, but getting paid right away and not paying postage more than compensates for this. Besides, though my patients are willing to let me copy their credit cards and sign the authorization statement, I don't think they would be willing to just give me the card itself to keep.

For those rare patients who do not have credit cards, we allow them to bring in a check at the next visit to pay in full, but those are less than 2% of my patients.

dts

From: [mailto:

] On Behalf Of Sent: Wednesday, January 02, 2008 9:10 AMTo: 'Kathy Saradarian '; '

'Subject: credit card payment

I feel back to square 1 hereNaureen mohammed posted a link to a place that must have been just a onetime special offer for her that electmer.com I think it was. wants 600.00to get a credit card terminal That is too big an expense for me thoguh Ihave not yet looked on ebay for a cheap used one.I get under 10 requetss a year for credit cards but it seemed like I wasstarting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 outofmy pocket every month for something i would useonly occaisionally. I washoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.paypal will let you invoice by email then the patietn pays by credit cardbut what good is that if they don't pay me I ams till chasing them downyes?Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22a month and thent his is 500 a year and that is 125 a year for pete's sakeBut everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc " I need anti- bitter pills today. RE: Vaccine ?sChrissie and ,I have the misfortune of not having any pharmacies that will order

vaccines so must get them for the patient myself. I will only order thereally expensive vaccines if requested like Zostavax and Gardisil. Ibuy things like MMR from other doctors as I have no need for 10 of them.

I buy Menactra, Adacel, Td, Pneumovax and Influenza for myself, as wellas Hep B and Hep A. I had to buy 10 doses of pediatric Hep A which isunfortunate as not much need but adult Hep A can be on a dose by dose

basis.Although the VFC program is to supply vaccines for all " uninsured " children (even those with insurance that doesn't cover routinevaccination), I don't participate as not a strong need and a lot of

paperwork and waste. I tried to send some adolescents to the publichealth clinic only to find out they charge full price for vaccine andfor some reason are not getting them through the VFC program. I amstill at a loss about what to do about this as I don't want to take on

the extra burden of the VFC myself.Medicare Zostavax I am having them pay for before I order.Word of note, Medicare Part B will no longer be paying theadministration for Zostavax (G0034? Or something like that) and that

will now be " billed " to Part D too, adding to the confusion.Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90Practice Partner 5/03Low staffingFrom:

[mailto: ] On Behalf Of HareschSent: Wednesday, January 02, 2008 10:10 AMTo:

Subject: Re: MacFriendly EMRs, Vaccine ?sWelcome, ChrissieI had the same vaccine plan when I started last year(!), but ran intoa couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot getthem paid for through the pharmacy. They have to go to the healthdepartment for that, and lots of people don't like that.The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from thepharmacy. I have a pharmacy that will store vaccines and dole them outto me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, andZostavax (non-Medicare) this way.Zostavax is complicated since paid through Medicare Part D. It meansthat the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.I've spent a lot of time trying to make vaccines manageable forpatients. But I'm still managing to avoid the costs of keeping themin-house. Haresch

> I am also struggling with vaccine choices. Considering> rx for vaccine to be picked up at pharmacy and> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,> especially in Oregon?

-- A. Eads, M.D

..Pinnacle Family Medicine, PLLC phone faxP.O. Box 7275Woodland Park, CO 80863www.PinnacleFamilyMedicine.com

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The form is on my letterhead, but is nothing special:

I authorize Sammamish Diabetes and Lipid Clinic to charge my

credit card with last 4 numbers: ­­­_____________ for unpaid co-pays or

patient responsibility determined by my insurance company.

______________________________________

Print Name:

_______________________________________

Signature Date

b

From:

[mailto: ] On Behalf Of Eads

Sent: Thursday, January 03, 2008 3:52 PM

To:

Subject: Re: credit card payment

Don,

Could you share the form you have your pts sign to authorize

you to bill their credit card?

The

vast majority of my patients pay by credit cards. I photocopy the card

when they first come in, along with their Driver's License and Insurance

Card. They sign a release that authorizes me to bill their credit

card for their co-pays and for anything their insurance company says they owe

me, after the claim has been adjudicated. Every 2 weeks, we run our

statements, and my wife sits down at her computer and enters the charges on

their credit cards. We never send bills.

We

contracted the credit card processing through Costco, use an add-on to Quick

Books to record things, and have never used the USB card reader we paid $80.00

for because we just enter the numbers on the keyboard. We pay a higher

percent on the keyed-in charges than we would if we swiped the cards while the

patient was there, but getting paid right away and not paying postage more than

compensates for this. Besides, though my patients are willing to

let me copy their credit cards and sign the authorization statement, I don't

think they would be willing to just give me the card itself to keep.

For

those rare patients who do not have credit cards, we allow them to bring in a

check at the next visit to pay in full, but those are less than 2% of my

patients.

dts

From: [mailto:

] On Behalf Of

Sent: Wednesday, January 02, 2008 9:10 AM

To: 'Kathy Saradarian '; '

'

Subject: credit card payment

I feel back to square 1 here

Naureen mohammed posted a link to a place that must have been just a one

time special offer for her that electmer.com

I think it was. wants 600.00

to get a credit card terminal That is too big an expense for me thoguh I

have not yet looked on ebay for a cheap used one.

I get under 10 requetss a year for credit cards but it seemed like I was

starting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out

ofmy pocket every month for something i would useonly occaisionally. I was

hoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.

paypal will let you invoice by email then the patietn pays by credit card

but what good is that if they don't pay me I ams till chasing them down

yes?

Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22

a month and thent his is 500 a year and that is 125 a year

for pete's sake

But everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc "

I need anti- bitter pills today.

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

--

A. Eads, M.D .

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

www.PinnacleFamilyMedicine.com

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Not getting even one charge per month, that won't happen. Once folks

know you take credit, they will charge everything, and your FSH

floweill be better too.

Sent from my iPhone

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well I dunno about my follicle stimulating hormone Naureenlet's keep our

hormones out of this.

:)

They said that since LInda used your name -this company- you were gonna get

50.00 And i since I used she will get 50.00 SOMEONE please sign up

and use my name!!

Re: credit card payment

Not getting even one charge per month, that won't happen. Once folks

know you take credit, they will charge everything, and your FSH

floweill be better too.

Sent from my iPhone

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Thank you !!! Naureen did you get your $50.00? If not, give them a call because I gave them your name as a referral!

Lee

Re: credit card paymentNot getting even one charge per month, that won't happen. Once folks know you take credit, they will charge everything, and your FSH floweill be better too.Sent from my iPhone

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OK, really basic question.  I am working on making the jump to

take credit cards.  I am looking at the Verifone OMNI 3730, but find my self

wondering how does verify or get approvals?  Does it connect to a PC and then

clear the charges via the internet, or do you have to plug the thing into a

phone or fax line directly?    It always costs a fortune to have the phone

people do anything, so I much prefer something that will plug into a USB and

work over my DSL connection….

Anybody even understand what I am trying to ask?

Annie

From:

[mailto: ] On Behalf Of T.

, MD

Sent: Friday, January 04, 2008 11:30 PM

To:

Subject: RE: credit card payment

The form is on my letterhead, but is

nothing special:

I

authorize Sammamish Diabetes and Lipid Clinic to charge my credit card with

last 4 numbers: ­­­_____________ for unpaid co-pays or

patient responsibility determined by my insurance company.

______________________________________

Print

Name:

_______________________________________

Signature

Date

b

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, January 03, 2008 3:52 PM

To:

Subject: Re: credit card payment

Don,

Could

you share the form you have your pts sign to authorize you to bill their credit

card?

On

Jan 2, 2008 10:13 PM, T. , MD wrote:

The

vast majority of my patients pay by credit cards. I photocopy the card

when they first come in, along with their Driver's License and Insurance

Card. They sign a release that authorizes me to bill their credit

card for their co-pays and for anything their insurance company says they owe

me, after the claim has been adjudicated. Every 2 weeks, we run our

statements, and my wife sits down at her computer and enters the charges on

their credit cards. We never send bills.

We

contracted the credit card processing through Costco, use an add-on to Quick

Books to record things, and have never used the USB card reader we paid $80.00

for because we just enter the numbers on the keyboard. We pay a higher

percent on the keyed-in charges than we would if we swiped the cards while the

patient was there, but getting paid right away and not paying postage more than

compensates for this. Besides, though my patients are willing to

let me copy their credit cards and sign the authorization statement, I don't

think they would be willing to just give me the card itself to keep.

For those

rare patients who do not have credit cards, we allow them to bring in a check

at the next visit to pay in full, but those are less than 2% of my patients.

dts

From: [mailto:

] On Behalf Of

Sent: Wednesday, January 02, 2008 9:10 AM

To: 'Kathy Saradarian '; '

'

Subject: credit card payment

I feel back to square 1 here

Naureen mohammed posted a link to a place that must have been just a one

time special offer for her that electmer.com

I think it was. wants 600.00

to get a credit card terminal That is too big an expense for me thoguh I

have not yet looked on ebay for a cheap used one.

I get under 10 requetss a year for credit cards but it seemed like I was

starting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out

ofmy pocket every month for something i would useonly occaisionally. I was

hoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.

paypal will let you invoice by email then the patietn pays by credit card

but what good is that if they don't pay me I ams till chasing them down

yes?

Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22

a month and thent his is 500 a year and that is 125 a year

for pete's sake

But everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc "

I need anti- bitter pills today.

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

--

A. Eads, M.D .

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

www.PinnacleFamilyMedicine.com

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Share on other sites

Annie

I think I have a Omni 3730 here in NZ.

I connect it to a phone line which I share with my fax line.

I just swipe cards and if there's no problem it just goes thru.

I believe some can be used over the internet and mine does have an

ethernet port.

However, so far only a few devices have been approved by our network

for use over the internet.

> OK, really basic question. I am working on making the jump to take credit

> cards. I am looking at the Verifone OMNI 3730, but find my self wondering

> how does verify or get approvals? Does it connect to a PC and then clear

> the charges via the internet, or do you have to plug the thing into a phone

> or fax line directly? It always costs a fortune to have the phone people

> do anything, so I much prefer something that will plug into a USB and work

> over my DSL connection….

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

Link to comment
Share on other sites

Suppose it would be a tax deductible business expense for me to come to NZ

and learn how you do it?? <g>

You never did tell me exactly what you mean by " 9 months of winter " and I'm

still wondering...

But back to business: Anybody heard of " merchantservicesinc " .. no

statement fee, waive statement for first 6 months...??is it too good to be

true? On ebay they say they are giving away the 3730 if you qualify for an

account.. Should I pursue this?

Annie

Re: credit card payment

Annie

I think I have a Omni 3730 here in NZ.

I connect it to a phone line which I share with my fax line.

I just swipe cards and if there's no problem it just goes thru.

I believe some can be used over the internet and mine does have an

ethernet port.

However, so far only a few devices have been approved by our network

for use over the internet.

> OK, really basic question. I am working on making the jump to take credit

> cards. I am looking at the Verifone OMNI 3730, but find my self wondering

> how does verify or get approvals? Does it connect to a PC and then clear

> the charges via the internet, or do you have to plug the thing into a

phone

> or fax line directly? It always costs a fortune to have the phone

people

> do anything, so I much prefer something that will plug into a USB and work

> over my DSL connection..

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

Link to comment
Share on other sites

Annie

This is where I live

http://www.wellington.govt.nz/aboutwgtn/glance/index.html

It says annually 2025 sunshine hours ... I'd like more!

>

>

>

>

>

>

> Suppose it would be a tax deductible business expense for me to come to NZ

> and learn how you do it?? <g>

>

Sure ... :)

> You never did tell me exactly what you mean by " 9 months of winter " and I'm

> still wondering...

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

Link to comment
Share on other sites

Today, is mid summer ... sky is all clouded over and it's raining.

Outside temperature is 12 deg. C.

Not warm enough for me either!

On Jan 7, 2008 5:11 PM, Cayuga Family Medicine

wrote:

>

>

>

>

>

>

>

> oops - the warmest month is Feb and is only 17 degrees C - or 62.6 degrees

> F - not quite warm enough for me in the summer.

>

>

>

> At 11:00 PM 1/6/2008, you wrote:

>

> Annie

>

> This is where I live

>

> http://www.wellington.govt.nz/aboutwgtn/glance/index.html

>

> It says annually 2025 sunshine hours ... I'd like more!

> Messages in this topic (35) Reply (via web post) | Start a new topic

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

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Share on other sites

Although I have a plug-in card reader, I do not use it.  I just  scan

the fronts and backs of the cards and punch the orders in via the computer

keypad.  The software  verifies and approves immediately.

dts

From:

[mailto: ]

On Behalf Of Annie Skaggs

Sent: Sunday, January 06, 2008 6:13 PM

To:

Subject: RE: credit card payment

OK, really basic question. I am

working on making the jump to take credit cards. I am looking at the

Verifone OMNI 3730, but find my self wondering how does verify or get

approvals? Does it connect to a PC and then clear the charges via the

internet, or do you have to plug the thing into a phone or fax line directly?

It always costs a fortune to have the phone people do anything, so I much

prefer something that will plug into a USB and work over my DSL connection….

Anybody even understand what I am trying

to ask?

Annie

From:

[mailto: ]

On Behalf Of T. , MD

Sent: Friday, January 04, 2008 11:30 PM

To:

Subject: RE: credit card payment

The form is on my letterhead, but is

nothing special:

I

authorize Sammamish Diabetes and Lipid Clinic to charge my credit card with

last 4 numbers: ­­­_____________ for unpaid co-pays or

patient responsibility determined by my insurance company.

______________________________________

Print

Name:

_______________________________________

Signature

Date

b

From:

[mailto: ]

On Behalf Of Eads

Sent: Thursday, January 03, 2008 3:52 PM

To:

Subject: Re: credit card payment

Don,

Could

you share the form you have your pts sign to authorize you to bill their credit

card?

On

Jan 2, 2008 10:13 PM, T. , MD wrote:

The

vast majority of my patients pay by credit cards. I photocopy the card

when they first come in, along with their Driver's License and Insurance

Card. They sign a release that authorizes me to bill their credit

card for their co-pays and for anything their insurance company says they owe

me, after the claim has been adjudicated. Every 2 weeks, we run our

statements, and my wife sits down at her computer and enters the charges on

their credit cards. We never send bills.

We

contracted the credit card processing through Costco, use an add-on to Quick

Books to record things, and have never used the USB card reader we paid $80.00

for because we just enter the numbers on the keyboard. We pay a higher

percent on the keyed-in charges than we would if we swiped the cards while the

patient was there, but getting paid right away and not paying postage more than

compensates for this. Besides, though my patients are willing to

let me copy their credit cards and sign the authorization statement, I don't

think they would be willing to just give me the card itself to keep.

For

those rare patients who do not have credit cards, we allow them to bring in a

check at the next visit to pay in full, but those are less than 2% of my

patients.

dts

From: [mailto:

] On Behalf Of

Sent: Wednesday, January 02, 2008 9:10 AM

To: 'Kathy Saradarian '; '

'

Subject: credit card payment

I feel back to square 1 here

Naureen mohammed posted a link to a place that must have been just a one

time special offer for her that electmer.com

I think it was. wants 600.00

to get a credit card terminal That is too big an expense for me thoguh I

have not yet looked on ebay for a cheap used one.

I get under 10 requetss a year for credit cards but it seemed like I was

starting to get enough i would look into it

So then I call Paypal and they want 30.00 a month . TO me that is 30.00 out

ofmy pocket every month for something i would useonly occaisionally. I was

hoping to have say a high transacation fee or a set up fee then pay as i go.

no deal.

paypal will let you invoice by email then the patietn pays by credit card

but what good is that if they don't pay me I ams till chasing them down

yes?

Pretty frustating to be a small business

One product is 50.00 amonth and thenext is 10 a month and thefollowing is 22

a month and thent his is 500 a year and that is 125 a year

for pete's sake

But everyone want me to just call in prescriptions " becasue it isn;'t like

it is a medical issue or anything doc "

I need anti- bitter pills today.

Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

--

A. Eads, M.D .

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

www.PinnacleFamilyMedicine.com

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Share on other sites

Annie,

I use the Veriphone Omni 3750. Most places seem to not tell you this,

but it actually comes with either a 2MB or 4MB flash ROM built in. If

you want to use it via DSL, instead of a fax/phone line, you will want

the larger memory version (4MB) to hold the Internet firmware. A

reputable dealer on eBAY (e.g., one who sells a lot of them) will know

which is which.

In our area about 90% of patients pay copays, etc. with credit cards (as

opposed to checks or cash), so for us it's a must!

Warm regards,

Cyrus

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Grahm,

If you have a moment, I’d like to hear more about the payor

system in NZ. If we’re going to discuss the optimal type of payor

system we want here in the US, I think we need to look at the various options

used by other health care systems?

Straz

Re:

credit card payment

Today, is mid summer ... sky is all clouded over and

it's raining.

Outside temperature is 12 deg. C.

Not warm enough for me either!

On Jan 7, 2008 5:11 PM, Cayuga Family Medicine

<CFMchoiceonemail>

wrote:

>

>

>

>

>

>

>

> oops - the warmest month is Feb and is only 17 degrees C - or 62.6 degrees

> F - not quite warm enough for me in the summer.

>

>

>

> At 11:00 PM 1/6/2008, you wrote:

>

> Annie

>

> This is where I live

>

> http://www.wellington.govt.nz/aboutwgtn/glance/index.html

>

> It says annually 2025 sunshine hours ... I'd like more!

> Messages in this topic (35) Reply (via web post) | Start a new topic

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

Link to comment
Share on other sites

I think that was " average " temp for Feb, ie- nite and day together.

Another point said something like 20C was the average high in summer.But, the

winter temps don't look too bad... considering Rochester in winter!TimOn Sun, January 6, 2008 11:11 pm EST,

Cayuga Family Medicine wrote:

oops - the warmest month is Feb and

is only 17 degrees C - or 62.6degrees F - not quite warm enough for me in the

summer.At 11:00 PM 1/6/2008, you wrote:AnnieThis is where I livehttp://www.wellington.govt.nz/aboutwgtn/glance/index.htmlIt says

annually 2025 sunshine hours ... I'd likemore!

---------------------------------------- Malia, MDMalia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450 (phone /

fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com--

Confidentiality Notice --This email message, including all the attachments, is

for the sole use of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended recipient,

you may not use, disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email and destroy

all copies of the original message, including attachments.----------------------------------------

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this may be? what naureen mohammed has that linda lee got that I may get

elect-mer.com the web site says $600 terminal If you call and say you are

a doc no cost for the terminal 11.00 a month max rates as good as anyone.

call and talk to them

Re: credit card payment

Annie

I think I have a Omni 3730 here in NZ.

I connect it to a phone line which I share with my fax line.

I just swipe cards and if there's no problem it just goes thru.

I believe some can be used over the internet and mine does have an

ethernet port.

However, so far only a few devices have been approved by our network

for use over the internet.

On Jan 7, 2008 3:12 PM, Annie Skaggs < askaggs@fayettefami

<mailto:askaggs%40fayettefamilymed.com> lymed.com> wrote:

> OK, really basic question. I am working on making the jump to take

credit

> cards. I am looking at the Verifone OMNI 3730, but find my self

wondering

> how does verify or get approvals? Does it connect to a PC and then

clear

> the charges via the internet, or do you have to plug the thing into a

phone

> or fax line directly? It always costs a fortune to have the phone

people

> do anything, so I much prefer something that will plug into a USB and

work

> over my DSL connection..

--

Graham Chiu

http://www.synapsed <http://www.synapsedirect.com> irect.com

Synapse-EMR - innovative electronic medical records system

Link to comment
Share on other sites

I'm not too familiar with primary care so I'll give it my best shot.

Medicine is both private and socialized. Most hospitals are run by

the government and provide emergency services. There is no charge for

services.

Private hospitals are run by insurance companies or groups of owner

docs. These are primarily to provide surgical services though many

have ambulatory care services run by outside specialists. They do not

provide emergency services. These are all paid for the patient who

then claims reimbursement from their insurance companies if they have

insurance. These services are not subsidized by the government.

Sometimes the public hospitals develop too long a waiting list. They

will then contract with the private sector ( often the same docs who

work in the public hospital ) to do the surgery.

Specialists either provide outpatient services at public hospitals,

private hospitals or in private rooms. In the two latter cases, the

patient pays and claims back from the insurance company. About 40% of

the population carry private insurance.

In primary care most patients do not have insurance to cover their

expenses with the general practitioners. Some do. Others will have

only surgical cover. The indicative charges are set by the government,

but you can charge what you like. There is some type of policy where

under 5s are not supposed to be charged at all but my understanding is

that the subsidy is not that great and so some docs will charge a

small extra free.

If the general practice is part of a PHO, then they will receive extra

monies to provide for services they wish to .. eg diabetes prevention

etc. They can use this money to subsidize visits and prescription

costs ( otherwise it's $15 per item ... drops this to $3 per item ).

A practice can also capitate but I'm a bit fuzzy how that works ...

>

> Grahm,

>

>

>

> If you have a moment, I'd like to hear more about the payor system in NZ.

> If we're going to discuss the optimal type of payor system we want here in

> the US, I think we need to look at the various options used by other health

> care systems?

>

>

>

> Straz

>

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

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