Guest guest Posted January 6, 2012 Report Share Posted January 6, 2012 Hi, Odilia - Thank you for bringing up this cogent issue! Your address doesn't show which state you are in, so I'd ask " Are you required to have a 'prescription' to perform a wheelchair evaluation in your state? " You have a patient who requests your professional service, and you are competent to perform the evaluation. If you are in a state which permits PT evaluation without referral, just make arrangements for payment and do it. Dick Hillyer, DPT Dr. Hillyer Hillyer Consulting Cape Coral, FL 33914 DickHillyer.com _____ From: PTManager [mailto:PTManager ] On Behalf Of odiliahome Sent: Friday, January 06, 2012 5:23 PM To: PTManager Subject: referral issue Hi group, I had an issue come up today that I need some advice on. I had a patient call me stating they were working with a DME company on getting a wheelchair. The DME company requested that a PT perform a wheelchair evaluation. I do these on a regular basis, and the patient called me to request that I get a prescription from the MD to perform this. I send the request to the physician. They called me today and stated they will not refer out their own hospital system. I called the patient and asked him to call the doctor and discuss free choice of providers and that he really wanted me to do the eval. He called the physician, but the physician is adamant that she will not refer outside her own hospital system for PT, and that she will be glad to give him a prescription for PT within the system. The patient is wanting to pursue reporting this illegal behavior. How does he go about doing this. Anything I should be doing about this. I have always known about physicians doing this, just never heard of anybody doing this when the patient is requesting a specific PT and never heard a doctors office just coming out and blatantly stating that they are doing this. Thank you for your advice. Odilia Egbers, PT Rehab Enterprises Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2012 Report Share Posted January 6, 2012 Hi Dick, I am in missouri and our practice act requires we get a prescription. Odilia > Hi Dick, > > I am in missouri and we do need a prescription. > > Odilia > > >> ** >> >> >> Hi, Odilia - >> >> Thank you for bringing up this cogent issue! Your address doesn't show >> which state you are in, so I'd ask " Are you required to have a >> 'prescription' to perform a wheelchair evaluation in your state? " You have >> a patient who requests your professional service, and you are competent to >> perform the evaluation. If you are in a state which permits PT evaluation >> without referral, just make arrangements for payment and do it. >> >> Dick Hillyer, DPT >> >> Dr. Hillyer >> Hillyer Consulting >> Cape Coral, FL 33914 >> DickHillyer.com >> >> >> _____ >> >> From: PTManager [mailto:PTManager ] On >> Behalf >> Of odiliahome >> Sent: Friday, January 06, 2012 5:23 PM >> To: PTManager >> Subject: referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2012 Report Share Posted January 6, 2012 Hi, I guess I would ask then why wouldn't you refer the patient to another physician, one that would refer to you? Is there a reason why you couldn't do this? This physician doesn't sound like one that would refer to your clinic anyway so there shouldn't be a concern about losing a referral source. Unless the patient's insurance is dictating the physician, the best way to send a message is for the patient to fire the physician, establish with a better physician, then tell all her friends and family to follow her there. This is just business and there is nothing unethical to you recommending this to the patient as long. First, though, we need to know is there is a reason that the patient could not do this. M.Howell, P.T., M.P.T. IPTA Payment Specialist Meridian, Idaho thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. From: PTManager [mailto:PTManager ] On Behalf Of Odilia Egbers Sent: Friday, January 06, 2012 4:35 PM To: PTManager Subject: RE: referral issue Hi Dick, I am in missouri and our practice act requires we get a prescription. Odilia On Jan 6, 2012 5:32 PM, " Odilia Egbers " <odilia1973@... <mailto:odilia1973%40gmail.com> > wrote: > Hi Dick, > > I am in missouri and we do need a prescription. > > Odilia > On Jan 6, 2012 5:31 PM, " Dick Hillyer " <RHillyer@... <mailto:RHillyer%40comcast.net> > wrote: > >> ** >> >> >> Hi, Odilia - >> >> Thank you for bringing up this cogent issue! Your address doesn't show >> which state you are in, so I'd ask " Are you required to have a >> 'prescription' to perform a wheelchair evaluation in your state? " You have >> a patient who requests your professional service, and you are competent to >> perform the evaluation. If you are in a state which permits PT evaluation >> without referral, just make arrangements for payment and do it. >> >> Dick Hillyer, DPT >> >> Dr. Hillyer >> Hillyer Consulting >> Cape Coral, FL 33914 >> DickHillyer.com >> >> >> _____ >> >> From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On >> Behalf >> Of odiliahome >> Sent: Friday, January 06, 2012 5:23 PM >> To: PTManager <mailto:PTManager%40yahoogroups.com> >> Subject: referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2012 Report Share Posted January 6, 2012 Hi, I guess I would ask then why wouldn't you refer the patient to another physician, one that would refer to you? Is there a reason why you couldn't do this? This physician doesn't sound like one that would refer to your clinic anyway so there shouldn't be a concern about losing a referral source. Unless the patient's insurance is dictating the physician, the best way to send a message is for the patient to fire the physician, establish with a better physician, then tell all her friends and family to follow her there. This is just business and there is nothing unethical to you recommending this to the patient as long. First, though, we need to know is there is a reason that the patient could not do this. M.Howell, P.T., M.P.T. IPTA Payment Specialist Meridian, Idaho thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. From: PTManager [mailto:PTManager ] On Behalf Of Odilia Egbers Sent: Friday, January 06, 2012 4:35 PM To: PTManager Subject: RE: referral issue Hi Dick, I am in missouri and our practice act requires we get a prescription. Odilia On Jan 6, 2012 5:32 PM, " Odilia Egbers " <odilia1973@... <mailto:odilia1973%40gmail.com> > wrote: > Hi Dick, > > I am in missouri and we do need a prescription. > > Odilia > On Jan 6, 2012 5:31 PM, " Dick Hillyer " <RHillyer@... <mailto:RHillyer%40comcast.net> > wrote: > >> ** >> >> >> Hi, Odilia - >> >> Thank you for bringing up this cogent issue! Your address doesn't show >> which state you are in, so I'd ask " Are you required to have a >> 'prescription' to perform a wheelchair evaluation in your state? " You have >> a patient who requests your professional service, and you are competent to >> perform the evaluation. If you are in a state which permits PT evaluation >> without referral, just make arrangements for payment and do it. >> >> Dick Hillyer, DPT >> >> Dr. Hillyer >> Hillyer Consulting >> Cape Coral, FL 33914 >> DickHillyer.com >> >> >> _____ >> >> From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On >> Behalf >> Of odiliahome >> Sent: Friday, January 06, 2012 5:23 PM >> To: PTManager <mailto:PTManager%40yahoogroups.com> >> Subject: referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2012 Report Share Posted January 7, 2012 We've faced similar circumstances and have been seeing this more frequently in the past year. If the patient has a prescription, we accept it. It doesn't matter if another provider is listed, it is still a prescription for PT. On the rare occasion when the physicians office has refused to sign a plan of care because the patient didn't go where the MD want, we advise them that this is grounds for a state and federal ethics complaints and may also be against medicare regulations. Each time the POC has been returned quickly. We will also ask the patient if they are happy with the physician and if he/she is really looking out for their best interest. We also advise them that we can suggest a local MD with an excellent reputation and patient satisfaction. Quite a few have been considering changing and have jumped at the opportunity. In this case, everyone comes out better. The patient gets and MD that is looking out for their best interest instead of the bottom line. The MD is happy to have another patient and we don't need to deal with a difficult office. They may even learn a lesson and provide better care in the future. jeff overstreet resorative therapies inc boynton beach fl Subject: referral issue To: PTManager Date: Friday, January 6, 2012, 5:22 PM  Hi group, I had an issue come up today that I need some advice on. I had a patient call me stating they were working with a DME company on getting a wheelchair. The DME company requested that a PT perform a wheelchair evaluation. I do these on a regular basis, and the patient called me to request that I get a prescription from the MD to perform this. I send the request to the physician. They called me today and stated they will not refer out their own hospital system. I called the patient and asked him to call the doctor and discuss free choice of providers and that he really wanted me to do the eval. He called the physician, but the physician is adamant that she will not refer outside her own hospital system for PT, and that she will be glad to give him a prescription for PT within the system. The patient is wanting to pursue reporting this illegal behavior. How does he go about doing this. Anything I should be doing about this. I have always known about physicians doing this, just never heard of anybody doing this when the patient is requesting a specific PT and never heard a doctors office just coming out and blatantly stating that they are doing this. Thank you for your advice. Odilia Egbers, PT Rehab Enterprises Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2012 Report Share Posted January 7, 2012 This is a great discussion Here are my 2 cents Traditionally, it was always that we were trained and we pushed hard to have the physician be the decision maker and try to get favored status with key physicians who would then send patients to us. We were somehow - less. Traditionally, it was considered heresy to put your self as a therapist between the patient and the physician. I suggest that now is that now only NOT heresy, it is needed. There are many times when we need to put ourselves between a patient and a physician. At times, we need to be a wedge to separate the patient from their " less than desirable " physician. It is not only not heresy, it is expected and desirable- for both the patient and our practice. The first few times, it can be very uncomfortable. Our training is to be passive, step in line and comply. That is no longer the case. As Tom Howell points out - there is nothing to lose with the physician - you've already lost them. So they get mad and don't like you - they don't like you now. Big deal. We, as PTs, should have the skills and abilities to make decisions, to advise patients, and sometimes that includes helping them find a new medical resource or physician. For our practice, for the past several years, in over 70% of our patients, the patient comes to us directly and just happens to bring his or her physician along. We are not in a direct consumer access state - it does not matter. The patient can still have a choice - we just have to help them know that. We have had to learn methods to forge new relationships. Key targets for relationship-building have expanded to include adult children of aging parents, owners and operators of senior housing facilities, home health agencies, community-based senior advocates including elder law professionals and private duty personal care companies. These are all in addition to, not instead of, the traditional physician relationships that we have always tried to develop. In addition to communicating how we can help physicians help their patients as we always have, we concurrently communicate to the non-physician community that they should consider us to be the Physical Therapists for their family - much like families have dentists and plumbers and physicians. This has allowed us to encourage referrals from our current patients of their friends, neighbors and families when they have issues that could benefit from our services or counsel. Repeat business and patient referrals are now driving our business - sometimes in spite of efforts by physicians and hospital system employees to direct patients away from us. It has not been quick, but it has been successful. Otherwise, we would still be somehow - less. Kovacek, PT, DPT, MSA Harper Woods, MI > > > > Hi group, > > > > I had an issue come up today that I need some advice on. I had a patient call me stating they were working with a DME company on getting a wheelchair. The DME company requested that a PT perform a wheelchair evaluation. I do these on a regular basis, and the patient called me to request that I get a prescription from the MD to perform this. > > > > I send the request to the physician. They called me today and stated they will not refer out their own hospital system. I called the patient and asked him to call the doctor and discuss free choice of providers and that he really wanted me to do the eval. He called the physician, but the physician is adamant that she will not refer outside her own hospital system for PT, and that she will be glad to give him a prescription for PT within the system. > > > > The patient is wanting to pursue reporting this illegal behavior. How does he go about doing this. Anything I should be doing about this. I have always known about physicians doing this, just never heard of anybody doing this when the patient is requesting a specific PT and never heard a doctors office just coming out and blatantly stating that they are doing this. > > > > Thank you for your advice. > > > > Odilia Egbers, PT > > Rehab Enterprises > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2012 Report Share Posted January 9, 2012 As long as the MD/DO has prescriptive privileges in the State you practice. Ron Barbato PT PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that is privileged subject to attorney-client privilege or attorney work product, confidential and/or exempt from disclosure under applicable law. If you are not the intended recipient, then please do not read it and be aware that any disclosure, copying, distribution, or use of the information contained herein (including any reliance thereon) is STRICTLY PROHIBITED. If you received this transmission in error, please immediately advise me, by reply e-mail, and delete this message and any attachments without retaining a copy in any form. Thank you. referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2012 Report Share Posted January 9, 2012 As long as the MD/DO has prescriptive privileges in the State you practice. Ron Barbato PT PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that is privileged subject to attorney-client privilege or attorney work product, confidential and/or exempt from disclosure under applicable law. If you are not the intended recipient, then please do not read it and be aware that any disclosure, copying, distribution, or use of the information contained herein (including any reliance thereon) is STRICTLY PROHIBITED. If you received this transmission in error, please immediately advise me, by reply e-mail, and delete this message and any attachments without retaining a copy in any form. Thank you. referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2012 Report Share Posted January 9, 2012 As long as the MD/DO has prescriptive privileges in the State you practice. Ron Barbato PT PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that is privileged subject to attorney-client privilege or attorney work product, confidential and/or exempt from disclosure under applicable law. If you are not the intended recipient, then please do not read it and be aware that any disclosure, copying, distribution, or use of the information contained herein (including any reliance thereon) is STRICTLY PROHIBITED. If you received this transmission in error, please immediately advise me, by reply e-mail, and delete this message and any attachments without retaining a copy in any form. Thank you. referral issue >> >> Hi group, >> >> I had an issue come up today that I need some advice on. I had a patient >> call me stating they were working with a DME company on getting a >> wheelchair. The DME company requested that a PT perform a wheelchair >> evaluation. I do these on a regular basis, and the patient called me to >> request that I get a prescription from the MD to perform this. >> >> I send the request to the physician. They called me today and stated they >> will not refer out their own hospital system. I called the patient and >> asked >> him to call the doctor and discuss free choice of providers and that he >> really wanted me to do the eval. He called the physician, but the >> physician >> is adamant that she will not refer outside her own hospital system for PT, >> and that she will be glad to give him a prescription for PT within the >> system. >> >> The patient is wanting to pursue reporting this illegal behavior. How does >> he go about doing this. Anything I should be doing about this. I have >> always >> known about physicians doing this, just never heard of anybody doing this >> when the patient is requesting a specific PT and never heard a doctors >> office just coming out and blatantly stating that they are doing this. >> >> Thank you for your advice. >> >> Odilia Egbers, PT >> Rehab Enterprises >> >> Quote Link to comment Share on other sites More sharing options...
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