Re: Work Comp

[Guest guest]

Chirag,

Workmen’s comp is a lot of work.  So you would have to

find out how many patients the factories average in WC cases.  You should also

find out what roll you would play.  When you treat a patient with a WC injury,

you should be the patient’s advocate and work on getting the patient better. 

Very often, if you work for the employer, you become someone who’s job is

to reduce cost to the company.  It is very short sighted too, they don’t

ever look at the best in the long run, always the short run.  If the company

will let you advocate for the injured worker, it could be very rewarding.  It

would definitely be easier with an EMR.  Anything you do or order needs to be preapproved

by the “case manager”.  Copies of all notes with dx and plan of

action, etc must be sent to the insurer.  Often, you try to get the patient

back to light duty and are told,  “there is no light duty, it’s

full duty or nothing”.   There have been many studies showing that

getting the worker back to work is key to recovery, even if they just sit at a

desk doing nothing but many employers just don’t make accommodations or understand

the long term picture.  They act like every employee is trying to rip them off

..  It can be frustrating.

I am only involved with WC when one of my patients is injured. 

Usually I am seeing them for their Primary Care issues and hear of the WC

issues as an aside.  It is usually horrible.  But if you think you could

develop a good working relationship being the patient’s advocate and

getting them back to work then go for it.  Just be aware of the records

sending, phone calling work that comes with it. 

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 Chirag Patel

Sent: Wednesday, January 02, 2008 12:18 PM

To: ; 'Kathy Saradarian '

Subject: Work Comp

I'm a new family med graduate-just opened my new solo clinic last

month. I have tons of small factories around me and some other clinics

that are not too far away from me that do work comp. Is this a good

way to get patient flow? I would then have set up drug testing, etc. for

the clinic, correct? Currently, my only staff member is me, and not sure

how much extra work this would be. Any advice?

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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[Guest guest]

RE Workman's comp

Must correct something here.

If you are WC doc, and pt was injured "on the job" if there is no light duty, the company pays the pt at a reduced rate, usually.

Company does not have to find light duty OR pay if the person is not able to do job AND was not injured on the job.

May be different elsewhere but is this way in PA

Matt Western PA FP

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?

Never miss a thing. Make Yahoo your homepage.

[Guest guest]

Matt,

Clarification. I didn’t say that the company had to,

I am saying it is in the best interests of the company to do so. All

studies have indicated that the quicker the person returns to the job, the

better they do. Keeping them out until they are 100% is detrimental to

the patient and more than likely they never return 100% because when they do

return, they are so deconditioned that they get hurt again. Since we are

talking Workmen’s Comp I am only talking about people hurt on the job.

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 Dr Levin

Sent: Thursday, January 03, 2008 8:32 PM

To:

Subject: Re: Work Comp

RE

Workman's comp

Must

correct something here.

If

you are WC doc, and pt was injured " on the job " if there is no light

duty, the company pays the pt at a reduced rate, usually.

Company

does not have to find light duty OR pay if the person is not able to do job AND

was not injured on the job.

May

be different elsewhere but is this way in PA

Matt

Western PA FP

-----

Original Message -----

From: Kathy Saradarian

To:

Sent: Thursday, January

03, 2008 8:52 AM

Subject: RE:

Work Comp

Chirag,

Workmen’s comp is a lot of

work. So you would have to find out how many patients the factories

average in WC cases. You should also find out what roll you would

play. When you treat a patient with a WC injury, you should be the

patient’s advocate and work on getting the patient better. Very

often, if you work for the employer, you become someone who’s job is to

reduce cost to the company. It is very short sighted too, they

don’t ever look at the best in the long run, always the short run.

If the company will let you advocate for the injured worker, it could be very

rewarding. It would definitely be easier with an EMR. Anything you

do or order needs to be preapproved by the “case manager”.

Copies of all notes with dx and plan of action, etc must be sent to the

insurer. Often, you try to get the patient back to light duty and are

told, “there is no light duty, it’s full duty or

nothing”. There have been many studies showing that getting

the worker back to work is key to recovery, even if they just sit at a desk

doing nothing but many employers just don’t make accommodations or

understand the long term picture. They act like every employee is trying

to rip them off . It can be frustrating.

I am only involved with WC when one of

my patients is injured. Usually I am seeing them for their Primary Care

issues and hear of the WC issues as an aside. It is usually

horrible. But if you think you could develop a good working relationship

being the patient’s advocate and getting them back to work then go for

it. Just be aware of the records sending, phone calling work that comes

with it.

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 Chirag Patel

Sent: Wednesday, January 02, 2008 12:18 PM

To: ; 'Kathy Saradarian '

Subject: Work Comp

I'm a new family med graduate-just opened my new solo clinic last

month. I have tons of small factories around me and some other clinics

that are not too far away from me that do work comp. Is this a good

way to get patient flow? I would then have set up drug testing, etc. for

the clinic, correct? Currently, my only staff member is me, and not sure

how much extra work this would be. Any advice?

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?

Never

miss a thing. Make Yahoo

your homepage.