Hooking up w/ those naughty docs who have opted-out ; )

[CTGPAC]

 Anybody working with a fee-for service opt-out concierge like House Calls practice?  Im talking with a doc to partner as an IC who has a fee-for service only practice but is considering medicare now as a part of a Direct Home Primary Care service. 

 

Question - what if the pt is a medicare eligible but not enrolled and  wants to do fee-for service with me with this practice? 

 

AAPA confirmed that I CANNOT see any medicare patient as a fee-for-service patient - even if they want to pay fee-for-service….So if I work for a concierge service as an IC they must bill Medicare under my NPI...or i must opt out and no way Jose I'm doing that! (I'm not doing a 2-yr commit)  Too scarey...though i see how it is tempting 

 

So, i guess I can see the under 65 year olds and charge fee for service, too? I'm confused...   Ahhh! the wonderful world of Medicare! 

 

[ventana]

medicare is making it almost impossible to continue this model

 

they are making everyone sign up for some part of it in order to be able to order anything, ie DME, O2, or VNA

 

if you don't take medicare, you can't get PECOS, then you can't order anything.....

[rev ronin]

... or really, you can't order anything that medicare will pay for, right?  You can still order DME for the patient to pay cash, yes?

[Guest Paula]

But, the MD who was my SP at my former job was not enrolled in PECOS.  NO one knew how that happened as I worked at a tribal clinic.  Therefore, I did all the face to face visits for medicare DME and submitted the orders, wrote the note, he co-signed it per the (now old) rules, and the patients got their stuff.  It was legal then.......just a few months ago.  Apparently the MD didn't get re-enrolled when it was due???

 

 

No one could figure it out.  I used to work at a tribal clinic.  I figured it out. 

[ventana]

... or really, you can't order anything that medicare will pay for, right?  You can still order DME for the patient to pay cash, yes?

 

 

always can self pay, but tell that to someone trying to order a $2000 bed, or $24000 power chair.... doesn't go over well

 

Heck even a $39 mattress topper people get pissy about....