Insurance questions for future IMP

[Guest guest]

Hello again- I have been "lurking" for a few months and enjoying all of the emails and posts (I still have about 2000 to get through though). Anyway, I plan to open my IMP in 9/10 (I know it's a long way off but the thought of it helps me go to work everyday at my busy inner-city community health center and everyday I get closer to finishing my NHSC committment), and need some advice. 1) For those of you practicing in Colorado, can you share with me what the typical reimbursement is for a 99213-99214? 2) Would it be feasible to opt out of all insurance off the bat? My situation is that I will be moving back to Denver when I finish my National Health Service Corps committment in Nashville in 2010. I did my residency in Denver and therefore have some connections there but I won't have a patient panel that I will be starting with. Other facts about my dream practice: I am also a

Registered Dietitian and will be doing nutrition/wellness as part of my practice and as another potential revenue source. I am just scared to take insurance given the state of things in this country but scared not to given I will be starting from scratch. Maybe we will be on our way to "national health care" by that time but if they base it on the current insurance model that would be even worse. Thanks for any input you can provide. I appreciate all of the sage wisdom I have gatered from this group! Meyer, D.O, M.S., R.D. Family Physician and Registered Dietitian

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

[Guest guest]

I don't think we can be specific about reimbursements on this service, it could

be considered collusion and price fixing, even though we are very far apart. I

am closer to Denver and in a rural health shortage area, but I am not a rural

health clinc due to the ridiculous governmental issues and hoops to jump

through.

I do not take medicaid for the same reason.

The best I can tell you is that for a 99214 Medicare pays 65.65- public

information. I have no idea how Meagan gets that much for medicare, since it

should be the same throughout the state, Although I believe the difference is my

participation. Will secondaries I do get about 87/99214.

My approximate reimbursement for commercial is about $116-120. I wont be more

specific or name companies.

________________________________

From: on behalf of

Sent: Thu 2/28/2008 8:57 PM

To:

Subject: Re: Insurance questions for future IMP

,

Welcome. I would be happy to share with you the average reimbursement, but only

if you come to Durango to open your IMP. It is not that far from Denver. Okay,

there ARE a couple of mountain passes, okay LARGE mountain passes between

Durango and Denver, but with a good four wheel drive and a tail wind, It would

not take you long to visit Denver!

Just kidding (although not about the invitation to Durango).

My average here in SW Colorado is $120 for a 99214, with Medicare being our

lowest payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps and

Locke may have some different numbers and are all SLIGHTLY closer to

Denver.

I am contemplating either a direct to consumer practice (like Marty Schulman)

with a reasonable membership fee or a Robin Hood practice here in Durango,

possibly as early as Jan 2009.

Right now I take about 25 insurances, including Medicare (as a

" nonparticipating " provider-may opt out entirely depending on what happens in

June this year), but I dropped Medicaid 2 years ago. It is almost impossible to

collect the lousy payments they offer in the first place, and I was bleeding to

death quickly from nonpayment for my vaccinations. They also have a 90 day

filing time frame, so even if THEY messed up paying you, if it has been over 90

days since the date of service, they will not/have never paid me. I lost over

$5K in the 1.5 years I took Colorado Medicaid in my IMP. Never again will I

take Colorado Medicaid, which is unfortunate.

I would be happy to answer questions, either on the list serve or off if you

prefer.

Good luck.

Durango, CO

griffonlewis@...

www.mountainviewmd.com <http://www.mountainviewmd.com/>

IMP started 6/2005

One 4/5 time receptionist and husband biller/office manager and ME.

On Thu, Feb 28, 2008 at 1:01 PM, Meyer <meyer.shelley@...

> wrote:

Hello again-

I have been " lurking " for a few months and enjoying all of the emails and posts

(I still have about 2000 to get through though). Anyway, I plan to open my IMP

in 9/10 (I know it's a long way off but the thought of it helps me go to work

everyday at my busy inner-city community health center and everyday I get closer

to finishing my NHSC committment), and need some advice.

1) For those of you practicing in Colorado, can you share with me what the

typical reimbursement is for a 99213-99214?

2) Would it be feasible to opt out of all insurance off the bat? My situation

is that I will be moving back to Denver when I finish my National Health Service

Corps committment in Nashville in 2010. I did my residency in Denver and

therefore have some connections there but I won't have a patient panel that I

will be starting with. Other facts about my dream practice: I am also a

Registered Dietitian and will be doing nutrition/wellness as part of my practice

and as another potential revenue source.

I am just scared to take insurance given the state of things in this country

but scared not to given I will be starting from scratch. Maybe we will be on

our way to " national health care " by that time but if they base it on the

current insurance model that would be even worse.

Thanks for any input you can provide. I appreciate all of the sage wisdom I

have gatered from this group!

Meyer, D.O, M.S., R.D.

Family Physician and Registered Dietitian

________________________________

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

<http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/categ\

ory.php?category=shopping>

--

Durango, CO

[Guest guest]

We can not collude on things we can not control. These are the insurance

companies reimbursements not our fees. Discuss away.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

Re: Insurance questions for future IMP

,

Welcome. I would be happy to share with you the average reimbursement, but

only if you come to Durango to open your IMP. It is not that far from

Denver. Okay, there ARE a couple of mountain passes, okay LARGE mountain

passes between Durango and Denver, but with a good four wheel drive and a

tail wind, It would not take you long to visit Denver!

Just kidding (although not about the invitation to Durango).

My average here in SW Colorado is $120 for a 99214, with Medicare being our

lowest payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps

and Locke may have some different numbers and are all SLIGHTLY closer

to Denver.

I am contemplating either a direct to consumer practice (like Marty

Schulman) with a reasonable membership fee or a Robin Hood practice here in

Durango, possibly as early as Jan 2009.

Right now I take about 25 insurances, including Medicare (as a

" nonparticipating " provider-may opt out entirely depending on what happens

in June this year), but I dropped Medicaid 2 years ago. It is almost

impossible to collect the lousy payments they offer in the first place, and

I was bleeding to death quickly from nonpayment for my vaccinations. They

also have a 90 day filing time frame, so even if THEY messed up paying you,

if it has been over 90 days since the date of service, they will not/have

never paid me. I lost over $5K in the 1.5 years I took Colorado Medicaid in

my IMP. Never again will I take Colorado Medicaid, which is unfortunate.

I would be happy to answer questions, either on the list serve or off if you

prefer.

Good luck.

Durango, CO

griffonlewis@...

www.mountainviewmd.com <http://www.mountainviewmd.com/>

IMP started 6/2005

One 4/5 time receptionist and husband biller/office manager and ME.

On Thu, Feb 28, 2008 at 1:01 PM, Meyer <meyer.shelley@...

> wrote:

Hello again-

I have been " lurking " for a few months and enjoying all of the

emails and posts (I still have about 2000 to get through though). Anyway, I

plan to open my IMP in 9/10 (I know it's a long way off but the thought of

it helps me go to work everyday at my busy inner-city community health

center and everyday I get closer to finishing my NHSC committment), and need

some advice.

1) For those of you practicing in Colorado, can you share with me

what the typical reimbursement is for a 99213-99214?

2) Would it be feasible to opt out of all insurance off the bat? My

situation is that I will be moving back to Denver when I finish my National

Health Service Corps committment in Nashville in 2010. I did my residency

in Denver and therefore have some connections there but I won't have a

patient panel that I will be starting with. Other facts about my dream

practice: I am also a Registered Dietitian and will be doing

nutrition/wellness as part of my practice and as another potential revenue

source.

I am just scared to take insurance given the state of things in

this country but scared not to given I will be starting from scratch. Maybe

we will be on our way to " national health care " by that time but if they

base it on the current insurance model that would be even worse.

Thanks for any input you can provide. I appreciate all of the sage

wisdom I have gatered from this group!

Meyer, D.O, M.S., R.D.

Family Physician and Registered Dietitian

________________________________

Looking for last minute shopping deals? Find them fast with Yahoo!

Search.

<http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/c

ategory.php?category=shopping>

--

Durango, CO

[Guest guest]

Welcome, .

I started my IMP in 2003, and recently (a

month ago) stopped accepting insurance to work only for my patients. If

you start off that way, w/o an established practice, it will take longer for

your practice to grow (probably 2 years instead of 1 being a female). You

may consider having a ‘part time’ job (like moonlighting, or using

your RD) to cover you until you get up and running and making money. My

avg 99214 (from 2007 contract rates w United, PacifiCare, and Kaiser) was $102.

I’m happy to talk with you anytime.

My cell is .

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On

Behalf Of Meyer

Sent: Thursday, February 28, 2008

1:02 PM

To:

practiceimprovement1

Subject:

Insurance questions for future IMP

Hello again-

I have been " lurking " for a few months and enjoying all of

the emails and posts (I still have about 2000 to get through though).

Anyway, I plan to open my IMP in 9/10 (I know it's a long way off but the

thought of it helps me go to work everyday at my busy inner-city community

health center and everyday I get closer to finishing my NHSC committment),

and need some advice.

1) For those of you practicing in Colorado, can you share with me

what the typical reimbursement is for a 99213-99214?

2) Would it be feasible to opt out of all insurance off the bat? My

situation is that I will be moving back to Denver

when I finish my National Health Service Corps committment in Nashville in 2010. I did my residency

in Denver and

therefore have some connections there but I won't have a patient panel

that I will be starting with. Other facts about my dream practice: I am

also a Registered Dietitian and will be doing nutrition/wellness as part of my

practice and as another potential revenue source.

I am just scared to take insurance given the state of

things in this country but scared not to given I will be starting from

scratch. Maybe we will be on our way to " national health care "

by that time but if they base it on the current insurance model that would be

even worse.

Thanks for any input you can provide. I appreciate all of the

sage wisdom I have gatered from this group!

Meyer, D.O, M.S., R.D.

Family Physician and Registered Dietitian

Looking for last minute shopping deals? Find

them fast with Yahoo! Search.

[Guest guest]

Thanks , and Jim for your help with this, and thanks to everyone in the group for the advice and help that is found daily on this listserve. I will have to crunch some numbers and figure out what will be best, but I guess I have plenty of time to do that. I would love to come to Durango, , if only I could transplant all of my support structure in Denver. Maybe they could all be convinced to move..... Thanks again! Eads wrote: Welcome, . I started my IMP in 2003, and recently (a month ago) stopped accepting insurance to work only for my patients. If you start off that way, w/o an established practice, it will take longer for your practice to grow (probably 2 years instead of 1 being a female). You may consider having a ‘part time’ job (like moonlighting, or using your RD) to cover you until you get up and running and making money. My avg 99214 (from 2007

contract rates w United, PacifiCare, and Kaiser) was $102. I’m happy to talk with you anytime. My cell is . A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of MeyerSent: Thursday, February 28, 2008 1:02 PMTo: practiceimprovement1 Subject:

Insurance questions for future IMP Hello again- I have been "lurking" for a few months and enjoying all of the emails and posts (I still have about 2000 to get through though). Anyway, I plan to open my IMP in 9/10 (I know it's a long way off but the thought of it helps me go to work everyday at my busy inner-city community health center and everyday I get closer to finishing my NHSC

committment), and need some advice. 1) For those of you practicing in Colorado, can you share with me what the typical reimbursement is for a 99213-99214? 2) Would it be feasible to opt out of all insurance off the bat? My situation is that I will be moving back to Denver when I finish my National Health Service Corps committment in Nashville in 2010. I did my residency in Denver and therefore have some connections there but I won't have a patient panel that I will be starting with. Other facts about my dream practice: I am also a Registered Dietitian and will be doing nutrition/wellness as part of my practice and

as another potential revenue source. I am just scared to take insurance given the state of things in this country but scared not to given I will be starting from scratch. Maybe we will be on our way to "national health care" by that time but if they base it on the current insurance model that would be even worse. Thanks for any input you can provide. I appreciate all of the sage wisdom I have gatered from this group! Meyer, D.O, M.S., R.D. Family Physician and Registered Dietitian Looking for last minute shopping deals? Find them fast with Yahoo!

Search.

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

[Guest guest]

I doubt stating what an insurer pays is collusion or price fixing.It might be

proprietary info that we are not suppose to discuss because of small print in our

contracts. But if we don't state which insurer pays what, then I can't see any

logic in that argument.Collusion and price fixing takes a lot more effort than

that.So I suggest we just don't mention which insurer pays a certain amount

that is reported.That said... I can't be an expert witness if you are

taken before the insurance inquisitors!! ;-)Tim > On Fri, February 29, 2008 11:02 am EST,

Jim.Kennedy@... wrote:> > > I don't think we can be specific about reimbursements on this service, it

could be> considered collusion and price fixing, even though we are very

far apart. I am> closer to Denver and in a rural health shortage area, but

I am not a rural health> clinc due to the ridiculous governmental issues

and hoops to jump through.> I do not take medicaid for the same reason.> The best I can tell you is that for a 99214 Medicare pays 65.65- public

information.> I have no idea how Meagan gets that much for medicare, since

it should be the same> throughout the state, Although I believe the

difference is my participation. Will> secondaries I do get about

87/99214.> My approximate reimbursement for commercial is about $116-120. I

wont be more> specific or name companies.> >

________________________________> > From:

on behalf of > Sent: Thu

2/28/2008 8:57 PM> To: >

Subject: Re: Insurance questions for future IMP> > > > ,> Welcome. I would be happy to share

with you the average reimbursement, but only if> you come to Durango to

open your IMP. It is not that far from Denver. Okay, there> ARE a couple

of mountain passes, okay LARGE mountain passes between Durango and> Denver,

but with a good four wheel drive and a tail wind, It would not take you long> to visit Denver! :)> > Just kidding (although not

about the invitation to Durango).> > My average here in SW

Colorado is $120 for a 99214, with Medicare being our lowest> payor at

$99.25 for a 99214. Jim Kennedy, Eads, the Sharps and Locke> may have some different numbers and are all SLIGHTLY closer to Denver.> > I am contemplating either a direct to consumer practice (like

Marty Schulman) with a> reasonable membership fee or a Robin Hood practice

here in Durango, possibly as> early as Jan 2009.> > Right

now I take about 25 insurances, including Medicare (as a

" nonparticipating " > provider-may opt out entirely depending on

what happens in June this year), but I> dropped Medicaid 2 years ago. It

is almost impossible to collect the lousy payments> they offer in the first

place, and I was bleeding to death quickly from nonpayment> for my

vaccinations. They also have a 90 day filing time frame, so even if THEY>

messed up paying you, if it has been over 90 days since the date of service, they> will not/have never paid me. I lost over $5K in the 1.5 years I took

Colorado> Medicaid in my IMP. Never again will I take Colorado Medicaid,

which is> unfortunate.> > I would be happy to answer

questions, either on the list serve or off if you prefer.> > Good

luck.> > > Durango, CO>

griffonlewis@...> www.mountainviewmd.com> IMP started

6/2005> One 4/5 time receptionist and husband biller/office manager and

ME.> > > > > > > Hello again-> > I have been " lurking " for a few months and enjoying all of the

emails and posts (I> still have about 2000 to get through though). Anyway,

I plan to open my IMP in> 9/10 (I know it's a long way off but the thought

of it helps me go to work everyday> at my busy inner-city community health

center and everyday I get closer to> finishing my NHSC committment), and

need some advice.> 1) For those of you practicing in Colorado, can you

share with me what the typical> reimbursement is for a 99213-99214?> 2) Would it be feasible to opt out of all insurance off the bat? My

situation is> that I will be moving back to Denver when I finish my

National Health Service Corps> committment in Nashville in 2010. I did my

residency in Denver and therefore have> some connections there but I won't

have a patient panel that I will be starting> with. Other facts about my

dream practice: I am also a Registered Dietitian and> will be doing

nutrition/wellness as part of my practice and as another potential> revenue

source.> I am just scared to take insurance given the state of things

in this country but> scared not to given I will be starting from scratch. Maybe we will be on our> way to " national health care " by that

time but if they base it on the current> insurance model that would be even

worse.> > Thanks for any input you can provide. I appreciate all

of the sage wisdom I have> gatered from this group!> >

Meyer, D.O, M.S., R.D.> Family Physician and Registered

Dietitian> > > ________________________________>

> Looking for last minute shopping deals? Find them fast with Yahoo!

Search.> > > > > > >

> > > > > > > > --> > Durango, CO> > > > > >

[Guest guest]

Medicare rates are open source -- you can share those reimbursement rates

Matt in Western Pa

RE: Insurance questions for future IMP

I don't think we can be specific about reimbursements on this service, it could be considered collusion and price fixing, even though we are very far apart. I am closer to Denver and in a rural health shortage area, but I am not a rural health clinc due to the ridiculous governmental issues and hoops to jump through.I do not take medicaid for the same reason.The best I can tell you is that for a 99214 Medicare pays 65.65- public information. I have no idea how Meagan gets that much for medicare, since it should be the same throughout the state, Although I believe the difference is my participation. Will secondaries I do get about 87/99214.My approximate reimbursement for commercial is about $116-120. I wont be more specific or name companies.________________________________From: on behalf of Sent: Thu 2/28/2008 8:57 PMTo: Subject: Re: Insurance questions for future IMP,Welcome. I would be happy to share with you the average reimbursement, but only if you come to Durango to open your IMP. It is not that far from Denver. Okay, there ARE a couple of mountain passes, okay LARGE mountain passes between Durango and Denver, but with a good four wheel drive and a tail wind, It would not take you long to visit Denver! :)Just kidding (although not about the invitation to Durango).My average here in SW Colorado is $120 for a 99214, with Medicare being our lowest payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps and Locke may have some different numbers and are all SLIGHTLY closer to Denver.I am contemplating either a direct to consumer practice (like Marty Schulman) with a reasonable membership fee or a Robin Hood practice here in Durango, possibly as early as Jan 2009. Right now I take about 25 insurances, including Medicare (as a "nonparticipating" provider-may opt out entirely depending on what happens in June this year), but I dropped Medicaid 2 years ago. It is almost impossible to collect the lousy payments they offer in the first place, and I was bleeding to death quickly from nonpayment for my vaccinations. They also have a 90 day filing time frame, so even if THEY messed up paying you, if it has been over 90 days since the date of service, they will not/have never paid me. I lost over $5K in the 1.5 years I took Colorado Medicaid in my IMP. Never again will I take Colorado Medicaid, which is unfortunate. I would be happy to answer questions, either on the list serve or off if you prefer.Good luck. Durango, COgriffonlewisgmail <mailto:griffonlewisgmail> www.mountainviewmd.com <http://www.mountainviewmd.com/> IMP started 6/2005One 4/5 time receptionist and husband biller/office manager and ME.On Thu, Feb 28, 2008 at 1:01 PM, Meyer <meyer.shelley <mailto:meyer.shelley> > wrote:Hello again-I have been "lurking" for a few months and enjoying all of the emails and posts (I still have about 2000 to get through though). Anyway, I plan to open my IMP in 9/10 (I know it's a long way off but the thought of it helps me go to work everyday at my busy inner-city community health center and everyday I get closer to finishing my NHSC committment), and need some advice.1) For those of you practicing in Colorado, can you share with me what the typical reimbursement is for a 99213-99214?2) Would it be feasible to opt out of all insurance off the bat? My situation is that I will be moving back to Denver when I finish my National Health Service Corps committment in Nashville in 2010. I did my residency in Denver and therefore have some connections there but I won't have a patient panel that I will be starting with. Other facts about my dream practice: I am also a Registered Dietitian and will be doing nutrition/wellness as part of my practice and as another potential revenue source. I am just scared to take insurance given the state of things in this country but scared not to given I will be starting from scratch. Maybe we will be on our way to "national health care" by that time but if they base it on the current insurance model that would be even worse.Thanks for any input you can provide. I appreciate all of the sage wisdom I have gatered from this group! Meyer, D.O, M.S., R.D.Family Physician and Registered Dietitian________________________________Looking for last minute shopping deals? Find them fast with Yahoo! Search. <http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/category.php?category=shopping> -- Durango, CO

[Guest guest]

Jim,

I think your posting was the Medicare amount for the 99213. Your 99214 should be a minimum of 89.00 according to the still incorrect Noridain CMS fee schedule. (With the 0.5% update, we should be getting more money than last year, but unfortunately, the fee schedule still represents a 1% pay cut that no one has been able to explain.)

I tried calling Noridian just now, but only got their answering machine that does not take messages ans stated they were all in customer service training.

Indeed my higher Medicare reimbursement numbers are from the limiting charge fees that nonparticipating providers charge.-- Durango, CO

I don't think we can be specific about reimbursements on this service, it could be considered collusion and price fixing, even though we are very far apart. I am closer to Denver and in a rural health shortage area, but I am not a rural health clinc due to the ridiculous governmental issues and hoops to jump through.

I do not take medicaid for the same reason.The best I can tell you is that for a 99214 Medicare pays 65.65- public information. I have no idea how Meagan gets that much for medicare, since it should be the same throughout the state, Although I believe the difference is my participation. Will secondaries I do get about 87/99214.

My approximate reimbursement for commercial is about $116-120. I wont be more specific or name companies.________________________________From: on behalf of

Sent: Thu 2/28/2008 8:57 PMTo: Subject: Re: Insurance questions for future IMP ,Welcome. I would be happy to share with you the average reimbursement, but only if you come to Durango to open your IMP. It is not that far from Denver. Okay, there ARE a couple of mountain passes, okay LARGE mountain passes between Durango and Denver, but with a good four wheel drive and a tail wind, It would not take you long to visit Denver! :)

Just kidding (although not about the invitation to Durango).My average here in SW Colorado is $120 for a 99214, with Medicare being our lowest payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps and Locke may have some different numbers and are all SLIGHTLY closer to Denver.

I am contemplating either a direct to consumer practice (like Marty Schulman) with a reasonable membership fee or a Robin Hood practice here in Durango, possibly as early as Jan 2009. Right now I take about 25 insurances, including Medicare (as a " nonparticipating " provider-may opt out entirely depending on what happens in June this year), but I dropped Medicaid 2 years ago. It is almost impossible to collect the lousy payments they offer in the first place, and I was bleeding to death quickly from nonpayment for my vaccinations. They also have a 90 day filing time frame, so even if THEY messed up paying you, if it has been over 90 days since the date of service, they will not/have never paid me. I lost over $5K in the 1.5 years I took Colorado Medicaid in my IMP. Never again will I take Colorado Medicaid, which is unfortunate.

I would be happy to answer questions, either on the list serve or off if you prefer.Good luck. Durango, COgriffonlewis@...

www.mountainviewmd.com <http://www.mountainviewmd.com/>

IMP started 6/2005One 4/5 time receptionist and husband biller/office manager and ME.

On Thu, Feb 28, 2008 at 1:01 PM, Meyer > wrote:

Hello again-I have been " lurking " for a few months and enjoying all of the emails and posts (I still have about 2000 to get through though). Anyway, I plan to open my IMP in 9/10 (I know it's a long way off but the thought of it helps me go to work everyday at my busy inner-city community health center and everyday I get closer to finishing my NHSC committment), and need some advice.

1) For those of you practicing in Colorado, can you share with me what the typical reimbursement is for a 99213-99214?2) Would it be feasible to opt out of all insurance off the bat? My situation is that I will be moving back to Denver when I finish my National Health Service Corps committment in Nashville in 2010. I did my residency in Denver and therefore have some connections there but I won't have a patient panel that I will be starting with. Other facts about my dream practice: I am also a Registered Dietitian and will be doing nutrition/wellness as part of my practice and as another potential revenue source.

I am just scared to take insurance given the state of things in this country but scared not to given I will be starting from scratch. Maybe we will be on our way to " national health care " by that time but if they base it on the current insurance model that would be even worse.

Thanks for any input you can provide. I appreciate all of the sage wisdom I have gatered from this group! Meyer, D.O, M.S., R.D.Family Physician and Registered Dietitian________________________________

Looking for last minute shopping deals? Find them fast with Yahoo! Search. <http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/category.php?category=shopping>

-- Durango, CO

-- Durango, CO

[Guest guest]

i am in denver and my 99214 is $ 108 !!!

claudia

endocrineimp

--- wrote:

> Jim,

> I think your posting was the Medicare amount for the

> 99213. Your 99214

> should be a minimum of 89.00 according to the still

> incorrect Noridain CMS

> fee schedule. (With the 0.5% update, we should be

> getting more money than

> last year, but unfortunately, the fee schedule still

> represents a 1% pay cut

> that no one has been able to explain.)

>

> I tried calling Noridian just now, but only got

> their answering machine that

> does not take messages ans stated they were all in

> customer service

> training.

>

> Indeed my higher Medicare reimbursement numbers are

> from the limiting charge

> fees that nonparticipating providers charge.

>

> --

>

> Durango, CO

>

>

> On Fri, Feb 29, 2008 at 9:02 AM,

> wrote:

>

> > I don't think we can be specific about

> reimbursements on this service,

> > it could be considered collusion and price fixing,

> even though we are very

> > far apart. I am closer to Denver and in a rural

> health shortage area, but I

> > am not a rural health clinc due to the ridiculous

> governmental issues and

> > hoops to jump through.

> > I do not take medicaid for the same reason.

> > The best I can tell you is that for a 99214

> Medicare pays 65.65- public

> > information. I have no idea how Meagan gets that

> much for medicare, since it

> > should be the same throughout the state, Although

> I believe the difference

> > is my participation. Will secondaries I do get

> about 87/99214.

> > My approximate reimbursement for commercial is

> about $116-120. I wont be

> > more specific or name companies.

> >

> > ________________________________

> >

> > From:

>

<%40yahoogroups.com>on

> behalf of

> > Sent: Thu 2/28/2008 8:57 PM

> > To:

>

<%40yahoogroups.com>

> > Subject: Re: Insurance

> questions for future IMP

> >

> > ,

> > Welcome. I would be happy to share with you the

> average reimbursement, but

> > only if you come to Durango to open your IMP. It

> is not that far from

> > Denver. Okay, there ARE a couple of mountain

> passes, okay LARGE mountain

> > passes between Durango and Denver, but with a good

> four wheel drive and a

> > tail wind, It would not take you long to visit

> Denver! :)

> >

> > Just kidding (although not about the invitation to

> Durango).

> >

> > My average here in SW Colorado is $120 for a

> 99214, with Medicare being

> > our lowest payor at $99.25 for a 99214. Jim

> Kennedy, Eads, the

> > Sharps and Locke may have some different

> numbers and are all SLIGHTLY

> > closer to Denver.

> >

> > I am contemplating either a direct to consumer

> practice (like Marty

> > Schulman) with a reasonable membership fee or a

> Robin Hood practice here in

> > Durango, possibly as early as Jan 2009.

> >

> > Right now I take about 25 insurances, including

> Medicare (as a

> > " nonparticipating " provider-may opt out entirely

> depending on what happens

> > in June this year), but I dropped Medicaid 2 years

> ago. It is almost

> > impossible to collect the lousy payments they

> offer in the first place, and

> > I was bleeding to death quickly from nonpayment

> for my vaccinations. They

> > also have a 90 day filing time frame, so even if

> THEY messed up paying you,

> > if it has been over 90 days since the date of

> service, they will not/have

> > never paid me. I lost over $5K in the 1.5 years I

> took Colorado Medicaid

> > in my IMP. Never again will I take Colorado

> Medicaid, which is unfortunate.

> >

> > I would be happy to answer questions, either on

> the list serve or off if

> > you prefer.

> >

> > Good luck.

> >

> >

> > Durango, CO

> > griffonlewis@... <griffonlewis%40gmail.com>

> <mailto:

> > griffonlewis@... <griffonlewis%40gmail.com>>

> > www.mountainviewmd.com

> <http://www.mountainviewmd.com/>

> > IMP started 6/2005

> > One 4/5 time receptionist and husband

> biller/office manager and ME.

> >

> > On Thu, Feb 28, 2008 at 1:01 PM, Meyer

>

<meyer.shelley@...<meyer.shelley%40yahoo.com><mailto:

> > meyer.shelley@...

> <meyer.shelley%40yahoo.com>> > wrote:

> >

> >

> > Hello again-

> >

> > I have been " lurking " for a few months and

> enjoying all of the emails and

> > posts (I still have about 2000 to get through

> though). Anyway, I plan to

> > open my IMP in 9/10 (I know it's a long way off

> but the thought of it helps

> > me go to work everyday at my busy inner-city

> community health center and

> > everyday I get closer to finishing my NHSC

> committment), and need some

> > advice.

> > 1) For those of you practicing in Colorado, can

> you share with me what the

> > typical reimbursement is for a 99213-99214?

> > 2) Would it be feasible to opt out of all

> insurance off the bat? My

> > situation is that I will be moving back to Denver

> when I finish my National

> > Health Service Corps committment in Nashville in

> 2010. I did my residency in

> > Denver and therefore have some connections there

> but I won't have a patient

> > panel that I will be starting with. Other facts

> about my dream practice: I

> > am also a Registered Dietitian and will be doing

> nutrition/wellness as part

> > of my practice and as another potential revenue

> source.

> > I am just scared to take insurance given the state

> of things in this

> > country but scared not to given I will be starting

> from scratch. Maybe we

> > will be on our way to " national health care " by

> that time but if they base

> > it on the current insurance model that would be

> even worse.

> >

> > Thanks for any input you can provide. I appreciate

> all of the sage wisdom

> > I have gatered from this group!

> >

> > Meyer, D.O, M.S., R.D.

> > Family Physician and Registered Dietitian

> >

> >

> > ________________________________

> >

> > Looking for last minute shopping deals? Find them

> fast with Yahoo! Search.

> > <

> >

>

http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/catego\

ry.php?category=shopping>

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > --

> >

>

=== message truncated ===

________________________________________________________________________________\

____

Never miss a thing. Make Yahoo your home page.

http://www.yahoo.com/r/hs

[Guest guest]

agree, but i get it through MDC and secondary since I participate. So the fee

to MDC looks like 65

________________________________

From: on behalf of

Sent: Fri 2/29/2008 2:41 PM

To:

Subject: Re: Insurance questions for future IMP

Jim,

I think your posting was the Medicare amount for the 99213. Your 99214 should

be a minimum of 89.00 according to the still incorrect Noridain CMS fee

schedule. (With the 0.5% update, we should be getting more money than last year,

but unfortunately, the fee schedule still represents a 1% pay cut that no one

has been able to explain.)

I tried calling Noridian just now, but only got their answering machine that

does not take messages ans stated they were all in customer service training.

Indeed my higher Medicare reimbursement numbers are from the limiting charge

fees that nonparticipating providers charge.

--

Durango, CO

On Fri, Feb 29, 2008 at 9:02 AM, <Jim.Kennedy@...

> wrote:

I don't think we can be specific about reimbursements on this service, it could

be considered collusion and price fixing, even though we are very far apart. I

am closer to Denver and in a rural health shortage area, but I am not a rural

health clinc due to the ridiculous governmental issues and hoops to jump

through.

I do not take medicaid for the same reason.

The best I can tell you is that for a 99214 Medicare pays 65.65- public

information. I have no idea how Meagan gets that much for medicare, since it

should be the same throughout the state, Although I believe the difference is my

participation. Will secondaries I do get about 87/99214.

My approximate reimbursement for commercial is about $116-120. I wont be more

specific or name companies.

________________________________

From:

<mailto:%40yahoogroups.com> on behalf of

Sent: Thu 2/28/2008 8:57 PM

To:

<mailto:%40yahoogroups.com>

Subject: Re: Insurance questions for future IMP

,

Welcome. I would be happy to share with you the average reimbursement, but only

if you come to Durango to open your IMP. It is not that far from Denver. Okay,

there ARE a couple of mountain passes, okay LARGE mountain passes between

Durango and Denver, but with a good four wheel drive and a tail wind, It would

not take you long to visit Denver! :)

Just kidding (although not about the invitation to Durango).

My average here in SW Colorado is $120 for a 99214, with Medicare being our

lowest payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps and

Locke may have some different numbers and are all SLIGHTLY closer to

Denver.

I am contemplating either a direct to consumer practice (like Marty Schulman)

with a reasonable membership fee or a Robin Hood practice here in Durango,

possibly as early as Jan 2009.

Right now I take about 25 insurances, including Medicare (as a

" nonparticipating " provider-may opt out entirely depending on what happens in

June this year), but I dropped Medicaid 2 years ago. It is almost impossible to

collect the lousy payments they offer in the first place, and I was bleeding to

death quickly from nonpayment for my vaccinations. They also have a 90 day

filing time frame, so even if THEY messed up paying you, if it has been over 90

days since the date of service, they will not/have never paid me. I lost over

$5K in the 1.5 years I took Colorado Medicaid in my IMP. Never again will I take

Colorado Medicaid, which is unfortunate.

I would be happy to answer questions, either on the list serve or off if you

prefer.

Good luck.

Durango, CO

griffonlewis@... <mailto:griffonlewis%40gmail.com>

<mailto:griffonlewis@... <mailto:griffonlewis%40gmail.com> >

www.mountainviewmd.com <http://www.mountainviewmd.com/>

<http://www.mountainviewmd.com/ <http://www.mountainviewmd.com/> >

IMP started 6/2005

One 4/5 time receptionist and husband biller/office manager and ME.

On Thu, Feb 28, 2008 at 1:01 PM, Meyer <meyer.shelley@...

<mailto:meyer.shelley%40yahoo.com> <mailto:meyer.shelley@...

<mailto:meyer.shelley%40yahoo.com> > > wrote:

Hello again-

I have been " lurking " for a few months and enjoying all of the emails and posts

(I still have about 2000 to get through though). Anyway, I plan to open my IMP

in 9/10 (I know it's a long way off but the thought of it helps me go to work

everyday at my busy inner-city community health center and everyday I get closer

to finishing my NHSC committment), and need some advice.

1) For those of you practicing in Colorado, can you share with me what the

typical reimbursement is for a 99213-99214?

2) Would it be feasible to opt out of all insurance off the bat? My situation

is that I will be moving back to Denver when I finish my National Health Service

Corps committment in Nashville in 2010. I did my residency in Denver and

therefore have some connections there but I won't have a patient panel that I

will be starting with. Other facts about my dream practice: I am also a

Registered Dietitian and will be doing nutrition/wellness as part of my practice

and as another potential revenue source.

I am just scared to take insurance given the state of things in this country

but scared not to given I will be starting from scratch. Maybe we will be on our

way to " national health care " by that time but if they base it on the current

insurance model that would be even worse.

Thanks for any input you can provide. I appreciate all of the sage wisdom I

have gatered from this group!

Meyer, D.O, M.S., R.D.

Family Physician and Registered Dietitian

________________________________

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

<http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/categ\

ory.php?category=shopping

<http://us.rd.yahoo.com/evt=51734/*http://tools.search.yahoo.com/newsearch/categ\

ory.php?category=shopping> >

--

Durango, CO

--

Durango, CO

[Guest guest]

,

Do you do OMT? That's a good practice builder and generally boosts income while providing a much needed and appreciated service. It's always so much fun when someone limps in and leaps out with a smile on their face.

Tim

[Guest guest]

Tim,I'm not currently doing it because they only provide us with 15 minutes per patient at the clinic where I am working (for anything, even first OB appts, well child checks, pap smears, any type of procedure, etc...). But I would like to return to it in the future and I do plan to do it in my practice. I need to take a refresher course, though, any ideas?ThanksTim Scheffel wrote: , Do you do OMT? That's a good practice builder and generally boosts income

while providing a much needed and appreciated service. It's always so much fun when someone limps in and leaps out with a smile on their face. Tim

Never miss a thing. Make Yahoo your homepage.

[Guest guest]

The important point isnot saying which insurer. The lawyers we spoke to are

pretty specific about sharing exact charges fro specific insurers

________________________________

From: on behalf of Malia, MD

Sent: Fri 2/29/2008 12:33 PM

To: Kennedy, Jim; practiceimprovement1

Subject: RE: Insurance questions for future IMP

I doubt stating what an insurer pays is collusion or price fixing.

It might be proprietary info that we are not suppose to discuss because of small

print in our contracts. But if we don't state which insurer pays what, then I

can't see any logic in that argument.

Collusion and price fixing takes a lot more effort than that.

So I suggest we just don't mention which insurer pays a certain amount that is

reported.

That said... I can't be an expert witness if you are taken before the insurance

inquisitors!! ;-)

Tim

> On Fri, February 29, 2008 11:02 am EST, Jim.Kennedy@... wrote:

>

>

> I don't think we can be specific about reimbursements on this service, it

could be

> considered collusion and price fixing, even though we are very far apart. I am

> closer to Denver and in a rural health shortage area, but I am not a rural

health

> clinc due to the ridiculous governmental issues and hoops to jump through.

> I do not take medicaid for the same reason.

> The best I can tell you is that for a 99214 Medicare pays 65.65- public

information.

> I have no idea how Meagan gets that much for medicare, since it should be the

same

> throughout the state, Although I believe the difference is my participation.

Will

> secondaries I do get about 87/99214.

> My approximate reimbursement for commercial is about $116-120. I wont be more

> specific or name companies.

>

> ________________________________

>

> From: on behalf of

> Sent: Thu 2/28/2008 8:57 PM

> To:

> Subject: Re: Insurance questions for future IMP

>

>

>

> ,

> Welcome. I would be happy to share with you the average reimbursement, but

only if

> you come to Durango to open your IMP. It is not that far from Denver. Okay,

there

> ARE a couple of mountain passes, okay LARGE mountain passes between Durango

and

> Denver, but with a good four wheel drive and a tail wind, It would not take

you long

> to visit Denver! :)

>

> Just kidding (although not about the invitation to Durango).

>

> My average here in SW Colorado is $120 for a 99214, with Medicare being our

lowest

> payor at $99.25 for a 99214. Jim Kennedy, Eads, the Sharps and

Locke

> may have some different numbers and are all SLIGHTLY closer to Denver.

>

> I am contemplating either a direct to consumer practice (like Marty Schulman)

with a

> reasonable membership fee or a Robin Hood practice here in Durango, possibly

as

> early as Jan 2009.

>

> Right now I take about 25 insurances, including Medicare (as a

" nonparticipating "

> provider-may opt out entirely depending on what happens in June this year),

but I

> dropped Medicaid 2 years ago. It is almost impossible to collect the lousy

payments

> they offer in the first place, and I was bleeding to death quickly from

nonpayment

> for my vaccinations. They also have a 90 day filing time frame, so even if

THEY

> messed up paying you, if it has been over 90 days since the date of service,

they

> will not/have never paid me. I lost over $5K in the 1.5 years I took Colorado

> Medicaid in my IMP. Never again will I take Colorado Medicaid, which is

> unfortunate.

>

> I would be happy to answer questions, either on the list serve or off if you

prefer.

>

> Good luck.

>

>

> Durango, CO

> griffonlewis@...

> www.mountainviewmd.com

> IMP started 6/2005

> One 4/5 time receptionist and husband biller/office manager and ME.

>

>

>

>

>

>

> Hello again-

>

> I have been " lurking " for a few months and enjoying all of the emails and

posts (I

> still have about 2000 to get through though). Anyway, I plan to open my IMP in

> 9/10 (I know it's a long way off but the thought of it helps me go to work

everyday

> at my busy inner-city community health center and everyday I get closer to

> finishing my NHSC committment), and need some advice.

> 1) For those of you practicing in Colorado, can you share with me what the

typical

> reimbursement is for a 99213-99214?

> 2) Would it be feasible to opt out of all insurance off the bat? My situation

is

> that I will be moving back to Denver when I finish my National Health Service

Corps

> committment in Nashville in 2010. I did my residency in Denver and therefore

have

> some connections there but I won't have a patient panel that I will be

starting

> with. Other facts about my dream practice: I am also a Registered Dietitian

and

> will be doing nutrition/wellness as part of my practice and as another

potential

> revenue source.

> I am just scared to take insurance given the state of things in this country

but

> scared not to given I will be starting from scratch. Maybe we will be on our

> way to " national health care " by that time but if they base it on the current

> insurance model that would be even worse.

>

> Thanks for any input you can provide. I appreciate all of the sage wisdom I

have

> gatered from this group!

>

> Meyer, D.O, M.S., R.D.

> Family Physician and Registered Dietitian

>

>

> ________________________________

>

> Looking for last minute shopping deals? Find them fast with Yahoo! Search.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> --

>

> Durango, CO

>

>

>

>

>

>