Guest guest Posted July 16, 2008 Report Share Posted July 16, 2008 Hi Cassie, It all indicates that the treatment is not working properly for you. This could be for any of these reasons and others: 1 - Your dose is far too low. If so your GP needs to raise it and get your blood tested every 6 weeks to monitor what is going on. 2 - Your body is not absorbing the medication properly 3 - Your body is not converting the T4 to T3, so you are not getting any benefit from it. I would expect your T4 levels to be higher if that were the case. 4 - Some other medication is interfering with the levothyroxine. Some antidepressants (eg-seroxat) can do this. It is very scarey to continue to feel ill when you are taking the medication. At least your current results confirm that you are no longer borderline, you are definitely hypothyroid and the GP needs to treat you properly. You ought to have an official diagnosis now (free prescriptions). If the GP doesn't understand how to treat you he needs to refer you to an endocrinologist who can and as soon as possible. Good luck Tracey > > I had Glandular Fever at the age of 13 which was misdiagnosed so many > times that I was ill for nearly 2 years. I have spent the rest of my > life being diagnosed as depressed...to the point of suicide several > times. 4 years ago I was diagnosed as borderline hypo and put on 50m > of levo increased last year to 75m. My doctor failed to tell me i > needed another blood test 6 months ago...in the meantime I have seen > him with everything from 'depression' to aching joints. Now I get > these latest test results and guess what? Through the roof! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2008 Report Share Posted July 17, 2008 HI Cassie I would write to your GP listing ALL your symptoms and your signs. Check what you are suffering from our website www.tpa-uk.org.uk and click on Hypothyroidiosm in the Menu. In the drop down Menu you will see 'Signs and Symptoms' click on that so you can check. If you have a thermometer, take your temperature before you get out of bed in a morning for 4 to 5 days and write these down with your list of symptoms and signs. Write down whether you have other members of your family with an autoimmune or thyroid problem. Tell your GP that because you are tired of not being giving the right dose of thyroid hormone replacement your body requires, that you would now like to be referred to a specialist at your local hospital who specialises in thyroid disease. Write to him that you are feeling so ill you can barely continue to work, and you need to do this to earn your money and that you need all the help and support to regain your normal health. Ask him to write back to you (put in a stamped addressed envelope to show him how serious you are) and send a copy to the Practice Nurse or Manager. This way, your letter has to go into your medical notes, and if they ignore your request, they will need a good reason. Everybody is entitlted to a second opinion, especially when a GP is just that, a GP - and he does not specialise in thyroid problems. I know you must feel like poo, and we will do everything we can to help you. You are probably getting aching joints because you are not getting enough thyroid hormone replacement. The 'inactive' T4 needs to convert to the active hormone T3. If your cells are not getting sufficient T3, this is the reason you could be getting the aches and pains. Do the adrenal questionnaire in our FILES Cassie, because if they are not functioning properly, no amount of thyroid hormone replacement is going to work. You can boost these with adrenal supplements such as Nutri Adrenal Extra if you have a problem here. Luv - Sheila So, and do excuse me for not using the big words or abbreviations andnot having the money for private tests or treatments, I am **appingmyself because I cannot afford to stay off work any longer..eventhough I feel like poo...and I don't find it funny.Bye bye.No virus found in this incoming message. Checked by AVG - http://www.avg.com Version: 8.0.138 / Virus Database: 270.5.0/1555 - Release Date: 16/07/2008 06:43 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2008 Report Share Posted July 22, 2008 Hi Cassie, Glandular fever is a very serious disease. It took my daughter 5 years to recover. Despite diagnosis she was offered no treatment as she laid on the sofa for 6 weeks hardly able to move. It is not unusual for thyroid disease to appear after a serious illness or other trauma. You should be going back to you doc every 6 weeks until TSh has reached 'normal' then visits longer apart to fine tune. I think that you must insist on this in view of docs poor performance. Subject: FYI I had Glandular Fever at the age of 13 which was misdiagnosed so many times that I was ill for nearly 2 years. I have spent the rest of my life being diagnosed as depressed...to the point of suicide several times. 4 years ago I was diagnosed as borderline hypo and put on 50m of levo increased last year to 75m. My doctor failed to tell me i needed another blood test 6 months ago...in the meantime I have seen him with everything from 'depression' to aching joints. Now I get these latest test results and guess what? Through the roof! Bye bye. ------------------------------------ Messages are not a substitute for professional medical advice. Always consult with a suitably qualified practitioner before changing medication. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2009 Report Share Posted January 12, 2009 The legal issue is bigger than hyperbarics. Using codes to bill for other than the condition that the code is established for is crazy. It is irresponsible and gives hyperbarics a bad rap. Other than this bad error of judgement on billing, she did nothing wrong. It is sad that a number of people won't be getting treatments now because she made a bad decision. Sent from my Verizon Wireless BlackBerry [ ] FYI http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html Just a note on knowing the legalities of running hyperbaric centers and billing insurance companies. Wayne McHowell, RN, BSN, ONC, CHRNA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 Well, yes, other than alleged insurance fraud, she did nothing wrong. Other than break a federal law, allegedly, she did nothing wrong. If she did commit insurance fraud, that was SOMETHING very seriously wrong, don't kid yourself. Regardless of her intentions, which some of us might believe could possibly be in the best interest of certain patients--I don't know, because the story was not forthcoming on what conditions the patients did have--the law will not be interested in " good intentions. " It will be interested in whether she did, or did not, bill fraudulently for conditions which did not match the patients' diagnoses. It's a very unfortunate situation; I don't have that I have much sympathy for this individual, because allegedly her actions were illegal, and if so, showed terrible judgment--it was almost a given that fraud would eventually come to light--and it reflects poorly on the community of hyperbaric medicine. > From: szymonski@... <szymonski@...> > Subject: Re: [ ] FYI > medicaid > Date: Monday, January 12, 2009, 9:10 PM > The legal issue is bigger than hyperbarics. Using codes to > bill for other than the condition that the code is > established for is crazy. > It is irresponsible and gives hyperbarics a bad rap. > Other than this bad error of judgement on billing, she did > nothing wrong. It is sad that a number of people won't > be getting treatments now because she made a bad decision. > Sent from my Verizon Wireless BlackBerry > > [ ] FYI > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 That is what I said, . Sent from my Verizon Wireless BlackBerry [ ] FYI > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 In response to the people who do not?no the facts, I am responding not only to you but to my patients that were treated and very pleased.? I am accused of a scheme to defraud Medicare and or insurance companies.? There is a discrepancy in the code that was used which is not definitively enough to state that a physician have to put a patient in the chamber.? We have had nurses and hyperbaric technicians trained to implement the procedure with physician awareness and supervision.??The staff ?have spent 80% of administrative time fighting with the insurance companies.The staff??did everything they requested of my facility to get hyperbarics approved, meaning they requested the patients records, lab reports, diagnostic reports and gave us authorization numbers to perform the treatments.??Many insurance companies stated that no?authorization for the cpt code we provided to them were needed for the?hyperbaric treatments.? We have lost thousands of dollars in which?we had to write off and consider charity.? I have a daughter who have 8 doctors and has been diagnosed with Aspers(austism), she has been in and out of the hospital for the last 6 years, last year alone she was admitted 3 times?to ICU, out of the 3 times she was in ICU she was put on a ventilator and at that time was given a grim report, to God be the glory the report did not come to pass because of? my fasting and praying and the support of my church, family, and friends prayers,she has been diagnosed with type one diabetes, in which her leg became ulcerated from something as simple as poison Ivy. ?She has a seizure disorder in which she has almost drowned on 3 occasions, her doctors are all puzzled because of the complications of all of her conditions.? You tell me as a single parent, when and how do I have time to defraud anybody especially the insurance companies who have brought so much headache over the years to the point I only excepted medicare for 8 months out of the 9 years I've been in business because of the constant back and forth and requesting payments back.? I have a very good attorney and?God will prevail.? In the meantime, I am not going to buy into your personal beliefs and accusations because I know what has happened over the 9 years I've been in business.? My daughter has received Hyperbarics in which she did not have to face amputation of her ulcerated leg,?the physicians and nurses?have treated autistic children that I have witnessed not speaking and flapping like a seal.?After a course of 20+ treatments, they began to say words and were calm and the flapping stopped, and they began to communicate on a higher level with their parents.? I have seen great? progress with my daughter alone.? So, I will not stop the work that has been divinely assigned to me. [ ] FYI > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 lets not judge this horse yet. None of us no the facts in this cituation. She may very well have dont things correctly. There are people out there that do way more worse things than this like Freedom of information request when they have the information all along. Altering portables and no one I mean no one stands up and jumps on the bandwagaon on them. Â So to cbsheena you hold your held up. You no what happened. There bashing you and jumping your but for somethign when they no other people out here have done far worse and they never say anythign to them. Â Lets see , Tom, e and many more have done far more dispicable things than this and yet many on here defend them to no end. Let her trial take place and then make your judgements. Â Darin > From: szymonski (DOT) com <szymonski (DOT) com> > Subject: Re: [ ] FYI > medicaid > Date: Monday, January 12, 2009, 9:10 PM > The legal issue is bigger than hyperbarics. Using codes to > bill for other than the condition that the code is > established for is crazy. > It is irresponsible and gives hyperbarics a bad rap. > Other than this bad error of judgement on billing, she did > nothing wrong. It is sad that a number of people won't > be getting treatments now because she made a bad decision. > Sent from my Verizon Wireless BlackBerry > > [ ] FYI > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 You know what the real crime is here? Insurance companies taking people's money every month, and when these people need treatments, the insurance companies deny them coverage. If the government wants to go after her, maybe they should investigate the insurance companies as well! Sent from my Verizon Wireless BlackBerry [ ] FYI > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 Oh I agree with you totally. Im about to go back into a training class for work I can't go into it. But I agree. the a holes take billions of dollars a year and then want to complain about someone figureing out a way to get some of it back. Get a life. I have no smpathy for the insurance industry. > From: szymonski (DOT) com <szymonski (DOT) com> > Subject: Re: [ ] FYI > medicaid > Date: Monday, January 12, 2009, 9:10 PM > The legal issue is bigger than hyperbarics. Using codes to > bill for other than the condition that the code is > established for is crazy. > It is irresponsible and gives hyperbarics a bad rap. > Other than this bad error of judgement on billing, she did > nothing wrong. It is sad that a number of people won't > be getting treatments now because she made a bad decision. > Sent from my Verizon Wireless BlackBerry > > [ ] FYI > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 I will you in later on a personal screwing I got ($30,000 worth), and it doesn't even include hyperbarics. Sent from my Verizon Wireless BlackBerry [ ] FYI > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 Oh I can't even tell you on a daily basis how much insurance compaines screw people over I have a case Im helping a family with right now where they approved the procedure had prior authorization and then they denied the claim. DONT EVEN GET ME STARTED > From: szymonski (DOT) com <szymonski (DOT) com> > Subject: Re: [ ] FYI > medicaid > Date: Monday, January 12, 2009, 9:10 PM > The legal issue is bigger than hyperbarics. Using codes to > bill for other than the condition that the code is > established for is crazy. > It is irresponsible and gives hyperbarics a bad rap. > Other than this bad error of judgement on billing, she did > nothing wrong. It is sad that a number of people won't > be getting treatments now because she made a bad decision. > Sent from my Verizon Wireless BlackBerry > > [ ] FYI > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > > Just a note on knowing the legalities of running hyperbaric > centers and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 I agree Darin, in our system, everyone is innocent until proven guilty. The facts of the matter are murky; there is no point to a trial by public opinion based on half-baked information and misinformation. I certainly would not want the job of trying to figure out Medicare and Medicaid's CFP codes or whatever they're called. They've made medical care twice as expensive as it would otherwise be with their exasperating complicated coding system which almost no one can understand--as a practicing physician, it used to drive me crazy trying to figure out what to code, as I had to do at one place where I practiced. I'm sure that most of the time--and this was ten or 15 years ago--because I was wasn't trained to understand their billing and coding system, I ended up getting far less re-imbursement than I might have if I really knew what to do. I used to be on call every fourth night and every fourth week-end, and that wasn't reimbursed at all. Patient encounters were, but with hospitalized patients, I spent hours that I didn't even know how to document, that therefore, was time not billed for. Yes, I would document the history and physical, and the notes when I rounded, but often, especially with critically ill patients, I'd of course spend far more time, following their response to treatment, following lab results I ordered, and so forth, that were the part that didn't get documented or reimbursed. Medical billing and coding is so specialized, hospitals have people who do nothing else, and go over charts after a patient is discharged, with a fine tooth comb, looking for evidence of procedures or time spent, which would support a billing code, just because those of us who were doing the medical practice were so poorly trained to know how to do it. And this was not to gouge the patient. It was to get adequate reimbursement. Most of us knows that Medicare when it does reimburse for a given medical code, does so at a fraction of the billing cost. I've been amazed at how little my physicians get reimbursed for some of my care, now that my place in medicine is as a patient. I shouldn't have jumped to any conclusions based on the newspaper story, which was very vague, at best. I think our friend with the Blackberry just gets me irritated with remarks like he or she made about not doing anything wrong except treating with the wrong billing code. That is not a minor thing. It was the statement that suggested, " oh, well, it's no big deal, " that set me off. I apologize for being irritable and sounding so critical. Note that I did carefully use " allegedly " because again, these are at this point, just that--allegations. Definitely, not for any of us to decide. It looks, unfortunately, as though this has come to be a matter for the legal system to decide, and that is certainly not a perfect system, either. I will try to avoid responding to these things--I'm sorry--I think I just made a difficult situation for this individual that much worse. > > > From: szymonski (DOT) com <szymonski (DOT) > com> > > Subject: Re: [ ] FYI > > medicaid > > Date: Monday, January 12, 2009, 9:10 PM > > The legal issue is bigger than hyperbarics. Using > codes to > > bill for other than the condition that the code is > > established for is crazy. > > It is irresponsible and gives hyperbarics a bad rap. > > Other than this bad error of judgement on billing, she > did > > nothing wrong. It is sad that a number of people > won't > > be getting treatments now because she made a bad > decision. > > Sent from my Verizon Wireless BlackBerry > > > > [ ] FYI > > > > > > http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html > > > > Just a note on knowing the legalities of running > hyperbaric > > centers and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2009 Report Share Posted January 13, 2009 , You really need to stop jumping to conclusions. I was not making light of any of the fraud accusations. What I was talking about is the comment in the article about her not having a medical license. I thought I made it clear enough what my feelings are on fraud. Also, to make it clear, so you don't jump to any more conclusions, I do think she is innocent until proven otherwise. Brett Sent from my Verizon Wireless BlackBerry [ ] FYI > > > > > > http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html > > > > Just a note on knowing the legalities of running > hyperbaric > > centers and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2009 Report Share Posted January 14, 2009 To All, This seems to be a bunch of bureaucratic BS done to stop HBOT and punish someone for doing what is right. Look, so this is well understood, after I first opened the Sacramento HBOT clinic, we had Dr as the Medical Director, and who is the Med Dir of Chico HBOT a long established clinic. He/we had some Medicare billing questions, and had a conference call with two top Regional Medicare Bureaucrats to get the correct answer. They bickered on the phone call about what was correct and what was wrong and had n agreement on the situation. At the end of the call, we asked them what we should do, and they said do what you feel is right. " But, what if we are wrong? You two can't agree. " They answered, " well, you will be committing Medicare Fraud which is a Felony. " " How do we find out what is right? " " You do the billing, and if you are right, nothing happens. If you are wrong, your committing fraud. that's how the system works. " So, if anyone is ever accused of committing insurance fraud, or anything else, I pay absolutely no attention. The system IS BROKEN. Not the providers. This is not a debate. This is fact. Yeah, there is Medicare or Insurance Fraud going on. but, those cases are fake billings for services NOT rendered; or recently, in LA they closed down a shop that paid patients to get procedures they did not need and billed for it. IT is obvious that this is a billing code debate, which IS NOT fraud. The only person that can accuse someone of fraud in regards to a billing debate is someone who really has no idea of how the system is constructed and how broken it is. The fact is, you can find ANYONE to argue ANYTHING regarding billing codes. And, that is on both sides of the insurance fence. I have experienced all kinds of false complaints like that. All by people who " didn't like " HBOT. I will not bore everyone with the details. But, this is a pro-con HBOT issue, and not a legal or ethical issue as far as I can see. Blessings, Ed On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > Just a note on knowing the legalities of running hyperbaric centers > and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2009 Report Share Posted January 14, 2009 I re-reviewed the article: There is one charge in the article that is possibly damaging. / " Beckwith, who does not hold any type of medical license, provided hyperbaric oxygen therapy to patients in her clinic/ ..... AND / " Beckwith submitted $1.58 million in claims to insurance companies and Medicare " / I don't know any of the arrangements Beckwith had in establishing her clinic. But, Medicare can only specifically pay physicians, or other licensed professionals for those approved services. Definitely, HBOT will not fall under that category. However, I doubt there is anyway Beckwith could get Medicare Approved to accept payments directly. They need a Physician Federal Drug # for that. But, if Medicare did make a mistake, Beckwith will pay the price. Like I said in my previous email, regardless of the mistake Medicare makes, they claim the individual is committing billing fraud. RE: insurance reimbursement, similar issues. Here in CA (I assume its the same other paces) you need a physicians # to submit. This should not prevent patients from submitting billings to their payers, and getting reimbursed for their payments, as far as I can tell. So, then it should come down to providing HBOT / Medical services without a medical license (assume 40% of any article is 100% incorrect in its assertions, minimally!) So that will solely depend on the state's laws. Here in CA, there is no licensing for HBOT. But, HBOT is a prescription drug. So, it is entirely unclear whether in CA a physicians license is required. But, this clinic was est. with a physician, in compliance with CA requirements, which are far more strict and highly defined than anyplace else. The final truth is, the state can grind anyone down to the bone, by spending thousands of hours of manpower to chase people down, until they simply have no more financial resources to fight... thus automatically lose. Anyhow, the Medical License issue could be a game changer, but I still have a hard time with the fraudulent billing issues. That is more like giving a patient a band aid, and billing for a body cast. Again, I find is almost impossible for Medicare billings to have gone through without a physician. The entire bureaucracy had to miss the missing physcian #. Those are my thoughts from what little i read in the article. Blessings On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > Just a note on knowing the legalities of running hyperbaric centers > and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2009 Report Share Posted January 14, 2009 Ed, A clinic can get a number, even if it isn't owned by a doctor or other qualified licensed person(nurse practitioner for example), as long as a licensed person is on staff. I am sure you know this, but I just wanted to clarify so people understand. This does not mean that a person needs a federal number to administer HBOT, but to submit to insurance it is required. Brett Sent from my Verizon Wireless BlackBerry Re: [ ] FYI I re-reviewed the article: There is one charge in the article that is possibly damaging. / " Beckwith, who does not hold any type of medical license, provided hyperbaric oxygen therapy to patients in her clinic/ ..... AND / " Beckwith submitted $1.58 million in claims to insurance companies and Medicare " / I don't know any of the arrangements Beckwith had in establishing her clinic. But, Medicare can only specifically pay physicians, or other licensed professionals for those approved services. Definitely, HBOT will not fall under that category. However, I doubt there is anyway Beckwith could get Medicare Approved to accept payments directly. They need a Physician Federal Drug # for that. But, if Medicare did make a mistake, Beckwith will pay the price. Like I said in my previous email, regardless of the mistake Medicare makes, they claim the individual is committing billing fraud. RE: insurance reimbursement, similar issues. Here in CA (I assume its the same other paces) you need a physicians # to submit. This should not prevent patients from submitting billings to their payers, and getting reimbursed for their payments, as far as I can tell. So, then it should come down to providing HBOT / Medical services without a medical license (assume 40% of any article is 100% incorrect in its assertions, minimally!) So that will solely depend on the state's laws. Here in CA, there is no licensing for HBOT. But, HBOT is a prescription drug. So, it is entirely unclear whether in CA a physicians license is required. But, this clinic was est. with a physician, in compliance with CA requirements, which are far more strict and highly defined than anyplace else. The final truth is, the state can grind anyone down to the bone, by spending thousands of hours of manpower to chase people down, until they simply have no more financial resources to fight... thus automatically lose. Anyhow, the Medical License issue could be a game changer, but I still have a hard time with the fraudulent billing issues. That is more like giving a patient a band aid, and billing for a body cast. Again, I find is almost impossible for Medicare billings to have gone through without a physician. The entire bureaucracy had to miss the missing physcian #. Those are my thoughts from what little i read in the article. Blessings On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > Just a note on knowing the legalities of running hyperbaric centers > and billing insurance companies. > > Wayne McHowell, RN, BSN, ONC, CHRNA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2009 Report Share Posted January 14, 2009 Hi Brett, Our applications to medicare required a physician's #. They kicked it back when it was mistakingly left off. Further, Medicare HBOT billing requires a physician to be present during the ascent and within 5 minutes for the rest of the treatment. This is because Medicare will only pay Freestanding Clinics for the Physician billings. A PS, or someone like that can be available instead of the physician. THanks, Ed On 1/14/2009 2:01 PM, szymonski@... wrote: > > Ed, > > A clinic can get a number, even if it isn't owned by a doctor or other > qualified licensed person(nurse practitioner for example), as long as > a licensed person is on staff. > I am sure you know this, but I just wanted to clarify so people > understand. > This does not mean that a person needs a federal number to administer > HBOT, but to submit to insurance it is required. > > Brett > Sent from my Verizon Wireless BlackBerry > > Re: [ ] FYI > > > I re-reviewed the article: > > There is one charge in the article that is possibly damaging. > > / " Beckwith, who does not hold any type of medical license, provided > hyperbaric oxygen therapy to patients in her clinic/ ..... > > AND > > / " Beckwith submitted $1.58 million in claims to insurance companies and > Medicare " / > > I don't know any of the arrangements Beckwith had in establishing her > clinic. But, Medicare can only specifically pay physicians, or other > licensed professionals for those approved services. > > Definitely, HBOT will not fall under that category. > > However, I doubt there is anyway Beckwith could get Medicare Approved to > accept payments directly. They need a Physician Federal Drug # for that. > > But, if Medicare did make a mistake, Beckwith will pay the price. Like > I said in my previous email, regardless of the mistake Medicare makes, > they claim the individual is committing billing fraud. > > RE: insurance reimbursement, similar issues. Here in CA (I assume its > the same other paces) you need a physicians # to submit. > > This should not prevent patients from submitting billings to their > payers, and getting reimbursed for their payments, as far as I can tell. > > So, then it should come down to providing HBOT / Medical services > without a medical license (assume 40% of any article is 100% incorrect > in its assertions, minimally!) > > So that will solely depend on the state's laws. > > Here in CA, there is no licensing for HBOT. But, HBOT is a prescription > drug. So, it is entirely unclear whether in CA a physicians license is > required. But, this clinic was est. with a physician, in compliance > with CA requirements, which are far more strict and highly defined than > anyplace else. > > The final truth is, the state can grind anyone down to the bone, by > spending thousands of hours of manpower to chase people down, until they > simply have no more financial resources to fight... thus automatically > lose. > > Anyhow, the Medical License issue could be a game changer, but I still > have a hard time with the fraudulent billing issues. That is more like > giving a patient a band aid, and billing for a body cast. > > Again, I find is almost impossible for Medicare billings to have gone > through without a physician. The entire bureaucracy had to miss the > missing physcian #. > > Those are my thoughts from what little i read in the article. > > Blessings > > > > > > > > On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html>> > > > > Just a note on knowing the legalities of running hyperbaric centers > > and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2009 Report Share Posted January 14, 2009 What I meant was the physician doesn't need to be the owner of the clinic. We have a couple of clinics here that are owned by people that are not physicians, but the physicians are on all insurance paperwork. You are correct, the medicare/medicaid number must be on claims. Also, my wife (who is a nurse practitioner) has to supply her number on Medicaid/Medicare claims. (She does not work in hyperbarics, but in pediatrics.) However, here in SD, she only gets reimbursed 90% of what a physician gets. Regardless of what happened in the case in the news, and I think it might all be BS, I think this is good conversation for us to all share. Sent from my Verizon Wireless BlackBerry Re: [ ] FYI > > > I re-reviewed the article: > > There is one charge in the article that is possibly damaging. > > / " Beckwith, who does not hold any type of medical license, provided > hyperbaric oxygen therapy to patients in her clinic/ ..... > > AND > > / " Beckwith submitted $1.58 million in claims to insurance companies and > Medicare " / > > I don't know any of the arrangements Beckwith had in establishing her > clinic. But, Medicare can only specifically pay physicians, or other > licensed professionals for those approved services. > > Definitely, HBOT will not fall under that category. > > However, I doubt there is anyway Beckwith could get Medicare Approved to > accept payments directly. They need a Physician Federal Drug # for that. > > But, if Medicare did make a mistake, Beckwith will pay the price. Like > I said in my previous email, regardless of the mistake Medicare makes, > they claim the individual is committing billing fraud. > > RE: insurance reimbursement, similar issues. Here in CA (I assume its > the same other paces) you need a physicians # to submit. > > This should not prevent patients from submitting billings to their > payers, and getting reimbursed for their payments, as far as I can tell. > > So, then it should come down to providing HBOT / Medical services > without a medical license (assume 40% of any article is 100% incorrect > in its assertions, minimally!) > > So that will solely depend on the state's laws. > > Here in CA, there is no licensing for HBOT. But, HBOT is a prescription > drug. So, it is entirely unclear whether in CA a physicians license is > required. But, this clinic was est. with a physician, in compliance > with CA requirements, which are far more strict and highly defined than > anyplace else. > > The final truth is, the state can grind anyone down to the bone, by > spending thousands of hours of manpower to chase people down, until they > simply have no more financial resources to fight... thus automatically > lose. > > Anyhow, the Medical License issue could be a game changer, but I still > have a hard time with the fraudulent billing issues. That is more like > giving a patient a band aid, and billing for a body cast. > > Again, I find is almost impossible for Medicare billings to have gone > through without a physician. The entire bureaucracy had to miss the > missing physcian #. > > Those are my thoughts from what little i read in the article. > > Blessings > > > > > > > > On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html>> > > > > Just a note on knowing the legalities of running hyperbaric centers > > and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2009 Report Share Posted January 15, 2009 Ed: Unless the rules have changed, It is my understanding that for a freestanding facility to bill Medicare for HBOT, (which I do) the physician must be on the premesis the entire treatment and it also must be a MD or DO.....nothing less. Re: [ ] FYI > > > I re-reviewed the article: > > There is one charge in the article that is possibly damaging. > > / " Beckwith, who does not hold any type of medical license, provided > hyperbaric oxygen therapy to patients in her clinic/ ..... > > AND > > / " Beckwith submitted $1.58 million in claims to insurance companies and > Medicare " / > > I don't know any of the arrangements Beckwith had in establishing her > clinic. But, Medicare can only specifically pay physicians, or other > licensed professionals for those approved services. > > Definitely, HBOT will not fall under that category. > > However, I doubt there is anyway Beckwith could get Medicare Approved to > accept payments directly. They need a Physician Federal Drug # for that. > > But, if Medicare did make a mistake, Beckwith will pay the price. Like > I said in my previous email, regardless of the mistake Medicare makes, > they claim the individual is committing billing fraud. > > RE: insurance reimbursement, similar issues. Here in CA (I assume its > the same other paces) you need a physicians # to submit. > > This should not prevent patients from submitting billings to their > payers, and getting reimbursed for their payments, as far as I can tell. > > So, then it should come down to providing HBOT / Medical services > without a medical license (assume 40% of any article is 100% incorrect > in its assertions, minimally!) > > So that will solely depend on the state's laws. > > Here in CA, there is no licensing for HBOT. But, HBOT is a prescription > drug. So, it is entirely unclear whether in CA a physicians license is > required. But, this clinic was est. with a physician, in compliance > with CA requirements, which are far more strict and highly defined than > anyplace else. > > The final truth is, the state can grind anyone down to the bone, by > spending thousands of hours of manpower to chase people down, until they > simply have no more financial resources to fight... thus automatically > lose. > > Anyhow, the Medical License issue could be a game changer, but I still > have a hard time with the fraudulent billing issues. That is more like > giving a patient a band aid, and billing for a body cast. > > Again, I find is almost impossible for Medicare billings to have gone > through without a physician. The entire bureaucracy had to miss the > missing physcian #. > > Those are my thoughts from what little i read in the article. > > Blessings > > > > > > > > On 1/12/2009 6:57 PM, Wayne McHowell wrote: > > > > http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html> > > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html > <http://www.bizjournals.com/atlanta/stories/2009/01/05/daily84.html>> > > > > Just a note on knowing the legalities of running hyperbaric centers > > and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2009 Report Share Posted January 16, 2009 That is the biggest problem, no one knows the rules, including those that run the system. I don't understand why a nurse practitioner can do (at least here) nearly anything a physician can do, but in HBOT it is different. Doesn't make a bit of sense.  Does anyone have any ideas on how we can move together to get this covered by insurance for everyone? I know it is a long battle to fight, but to this point there has been too much bickering amongst the hyperbaric community, and not enough working together to do something about this problem. I know some states are passing bills, maybe we take this on state by state.  It is absolutely ridiculous that you can show all the benefits of HBOT through the many people that have improved, but yet cannot get insurance coverage.  > > > > http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > <http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html> > > <http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html > <http://www.bizjourn als.com/atlanta/ stories/2009/ 01/05/daily84. html>> > > > > Just a note on knowing the legalities of running hyperbaric centers > > and billing insurance companies. > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2009 Report Share Posted January 16, 2009 Brett, I believe it was in the last congress that HR7299 was introduced which would make HBOT standard of care for TBI. I don't know whether it has been reintroduced in this congress, but I have written to both my US Congressman and Senator (we only have one at the moment for Minnesota, though that will change eventually). I am sure it is going to happen eventually, with the results of the studies now being done on Iraq war veterans, and there will be more money pouring in regarding vets and TBI with the new administration, I believe. I would encourage everyone to write or if they have the where with all, to visit their representatives in Congress and keep making the case. So many people have been treated with positive results at this point, and of course I support the use of HBOT for autism, and anoxic brain injuries other than TBI. Of course Grace's story is unusual because her brain mitochondrial disorder is so rare, but she wouldn't be alive today without HBOT. These decisions should be in the hands of doctors, not insurance companies, whether Medicare, Tricare or the Blues. They are essentially practicing medicine by deciding what care a patient can or cannot be reimbursed for. I like the approach in Texas where the legislation, as I understand it, requires insurance to cover any treatment for a neurologic condition prescribed by a physician. That avoids the necessity for making a case by case point to a bureaucracy. The bean counters are not the ones who should be making these decisions. Don't even get me started on this, because I am so incensed at the way Medicare gives stroke victims a month to get better, or whatever--they have their criteria, then wave a magic wand and declare they've met " maximum medical improvement " at a point much earlier than neurologically that is possible, and shove them out the door. I'm preaching to the choir, I know, but what's wrong with this picture is that physicians, who have the training and should be making these decisions, have been left out of the decison making. I've had the experience when I was practicing of someone from insurance billing contact me to tell me my patient was ready for discharge because insurance would no longer pay. That's just wrong. I even had one overly ambitious insurance agent who directly phoned a woman, the day after she delivered a baby, and tell her that if she stayed another day, her insurance wouldn't pay! She had a horrific headache from a CSF leak from having spinal anesthesia. I came in to find her in tears, telling me what this insurance agent had said. I restarted her IV, got anesthesia to come to to give her a blood patch to stop the CSF leak, and the insurance people backed down and covered her bill. But that's what's making it so difficult to practice good medicine these days. As one physician put it to me, " too many people coming over the hill from behind, shooting you in the back. " Too much friendly fire. I was once told I would be fined, by the hospital which employed me, for referring a patient " out of system, " which I believed was the best choice for his problem. I said, " fine, " and referred him anyway. Maybe we're going to need to do a more aggressive job of educating physicians and getting them on board. Too few physicians in primary care or even in the specialties which you would think would need to know, such as neurology, have ever been exposed to hyperbaric oxygen treatment. I talked about it to a local physician in Dululth who practiced a great deal of alternative medicine, and I was shocked when he merely responded, " well, oxygen can be toxic too. " I was shocked that he was unwilling to look into it, and just resorted to giving me a dismissive answer like that. Water can be toxic in too large quantities. Of course oxygen can be toxic if given continuously at high levels. That doesn't make it dangerous the way it is used in treatment of TBi, and protocol that I got, 100 percent oxygen by hood at 1.5 ATM twice a day, has been well tested and proven to be safe. I think one approach would be to find foundation funding to sponsor CME conferences on TBI, and the use of various modalities including HBOT, for example. Same for autism. Unless you've been to the centers where these kids are coming for treatment, it is hard to believe that we are in an epidemic--I never saw a single child with autism when I was in practice for 23 years, and when I first heard a radio report on Minnesota Public Radio about 1 in 150 children being diagnosed with autism, I simply didn't believe it because I had never seen it. Whatever the cause is--and it may be multifactorial--it is a new phenomina on this level and it is very real. I appreciate forums like this where at least we can exchange ideas and access information from what others are doing. In my usual way, I've sort of rambled about some of the problems I've seen, and some possible solutions; I'm probably not the best to make the case with the left brain damage that I have--I'm too tangential, I suspect--but it's going to be the intact parents of children with autism and TBI who have the energy and will power to take up the battle. We will win it, I just want to see it happen sooner rather than later, for the kids with autism, for my dad who has had a stroke, for other family members, as well as for me. The current denial of reimbursement is penny wise and pound foolish, when HBOT can make such a difference in recovery in so many of these conditions. best regards, > > > > > > http://www.bizjourn als.com/atlanta/ > stories/2009/ 01/05/daily84. html > > <http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html> > > > <http://www.bizjourn als.com/atlanta/ > stories/2009/ 01/05/daily84. html > > <http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html>> > > > > > > Just a note on knowing the legalities of running > hyperbaric centers > > > and billing insurance companies. > > > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2009 Report Share Posted January 16, 2009 Good points, . I am currently working on putting a conference together in Rapid City in March. I would enjoy having you here!  Another point I want to make. I have heard numerous times that " double blind clinical trials " need to be done to get insurance acceptance. I want to share with everyone a little information regarding this.  I heard the other day, from a DO, that less than half of the prescriptions in the Physicians Desk Reference have had double blind clinical trials. Yes, that is less than 50%. Therefore, this morning I have been looking through it. He is correct! Less than half have had double blind clinical trials. The question is than, why do we use them and why does insurance cover them? The answer is easy: THEY WORK. Now, I'm not the smartest guy in the world, but is that not the same with HBOT? It has been shown to work over, and over, and over. Therefore, we need to group together and do something about this. I know this sounds impossible as there are so many personal feelings involved, but this is our best chance to take this mainstream. > > > > > > http://www.bizjourn als.com/atlanta/ > stories/2009/ 01/05/daily84. html > > <http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html> > > > <http://www.bizjourn als.com/atlanta/ > stories/2009/ 01/05/daily84. html > > <http://www.bizjourn als.com/atlanta/ stories/2009/ > 01/05/daily84. html>> > > > > > > Just a note on knowing the legalities of running > hyperbaric centers > > > and billing insurance companies. > > > > > > Wayne McHowell, RN, BSN, ONC, CHRNA > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2009 Report Share Posted July 1, 2009 PRESS RELEASE > > > Dore E. Frances, M.A. > Therapeutic Consultant > Specializing in Advocacy > Educational Consulting > Horizon Family Solutions, LLC > (541) 312-4422 > Dore@... > > www.HorizonFamilySolutions.com > www.TroubledTeenHelp.com > > LA Talk Radio Every Monday at 12 noon PST > > This transmission may contain information that is privileged, confidential > and/or exempt from disclosure under applicable law. If you are not the > intended recipient, you are hereby notified 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 contact the sender and destroy > the material in its entirety, whether in electronic or hard copy format. > Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 1, 2009 Report Share Posted August 1, 2009 Military Planning For Possible H1N1 Outbreak h1n1 The U.S. military wants to establish regional teams of military personnel to assist civilian authorities in the event of a significant outbreak of the H1N1 virus this fall, according to Defense Department officials. The proposal is awaiting final approval from Defense Secretary Gates. The officials would not be identified because the proposal from U.S. Northern Command's Gen. Victor Renuart has not been approved by the secretary. The plan calls for military task forces to work in conjunction with the Federal Emergency Management Agency. There is no final decision on how the military effort would be manned, but one source said it would likely include personnel from all branches of the military. Don't Miss * U.S. students face second quarantine in China * School: No shortage of volunteers for swine flu trials It has yet to be determined how many troops would be needed and whether they would come from the active duty or the National Guard and Reserve forces. Civilian authorities would lead any relief efforts in the event of a major outbreak, the official said. The military, as they would for a natural disaster or other significant emergency situation, could provide support and fulfill any tasks that civilian authorities could not, such as air transport or testing of large numbers of viral samples from infected patients. Source This story comes to us via Homeland Security - National Terror Alert. National Terror Alert is America's trusted source for homeland security news and information. Quote Link to comment Share on other sites More sharing options...
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