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sas5814 last won the day on September 17

sas5814 had the most liked content!

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About sas5814

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    Advanced Member


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    Physician Assistant

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  1. Myself. Good picks. Forward thinkers who see what needs to be done. It will be interesting to see what comes out of it.
  2. Next year at the AAPA HOD the information will be presented from the title change study. Some decision will likely be made at that point. Assuming a title is recommended and passed by the HOD then each state has to do the work to make the title change. In a sense it would be a simple thing. A simple amendment to the existing statute that says everywhere physician assistant appears it should be amended to read >name<. It is a simple thing and nobody should care what we choose to call ourselves but in politics...who knows. Now...arguably..... we could simply say "from now on we are called >name<" without changing the language in each state's enabling legislation but I don't think that will get much traction.
  3. I suspect it will happen. It is just going to be a slow process like most things this big.
  4. sas5814

    Down-Code Billing issue

    Yea I'm with you. I have been doing the same since we took on a "strategic partner" and there has been change after change after change none of them good for the employees. After losing 50% of our APP staff in the UC they just keep making bad changes. I'm casually looking. They pay me very well but there is always a breaking point.
  5. sas5814

    Down-Code Billing issue

    Good grief..... If you are on RVUs and they are downcoding your visits without your knowledge they are just screwing you. The reply was, in my opinion, intentionally threatening. Rock the boat and it can come back and bite you......
  6. sas5814

    Down-Code Billing issue

    As a matter of law nobody can set the visit level but the provider who performed the service. The billing folks CANNOT change the visit level. They can ask you to do it. The insurance company can refuse the payment at the level you set and pay at a lower level but what your billing people are doing is really inappropriate. What they are doing could be construed as fraud. Downcoding, at least with CMS, can get you in as much trouble as upcoding. The expectation is coding be accurate and not manipulated after the visit. This is in CMS codes and regulations somewhere and CMS generally sets the rules and other follow . Do some research and you'll find it.
  7. The magic sauce is everyone working at the top of their game. That, however doesn't mean fantastic and possibly dangerous encroachments into areas you aren't qualified for. Do pharmacists know more about pharmacology than most PAs? I certainly hope so. Does that qualify them to prescribe? No no no no. I served for several years on the BOD of a hospital district and chaired the board credentials committee...the last stop of the credentials process. The number of times I had to get into arguments over who could do what, usually provoked by one physician group trying to protect their financial interests, I can't even count. My questions were simple. Are the measurably, properly trained and qualified? Can they do it to a high degree of excellence? Is there a system to ensure ongoing competence? An example was the ortho docs not wanting the pods to operate on the ankle. That argument went on for months until I applied the above questions. The answers were yes, yes, and yes. Problem solved.
  8. (3) as a volunteer for a charitable organization or at a public or private event, including a religious event, sporting event, community event, or health fair.
  9. sas5814

    Concierge Medicine

    Not even in my happiest dreams....
  10. sas5814

    Is it worth it?

    Agree. A friend once said...when I'm in my own head I'm my own worst enemy. I work in a giant organization that is going to do what it does and doesn't give a tiny damn about what I think about anything. Once I finally wrapped my head around that and let it all go I was a much happier man.
  11. sas5814

    Is it worth it?

    The "calling" is a great thing if you find it but it has never been that way for me. I work for a Catholic organization and they talk about "the calling" when they meant work for free, donate some of your money back to their charities, don't take your PTO so you lose it all in the name of "the calling." This is a job. I trade my time and talent for money and benefits. I enjoy my work for the most part. I enjoy all the people I work with but this is a transactional relationship and all the clabber about "the calling"is an attempt to use guilt to take money from people who earned it.
  12. A BILL TO BE ENTITLED AN ACT relating to physician assistant services performed as volunteer care. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 204.2045, Occupations Code, is amended to read as follows: Sec. 204.2045. VOLUNTEER CARE AND SERVICES PERFORMED DURING DISASTER. (a) The supervision and delegation requirements of this chapter and Subtitle B do not apply to medical tasks performed by a physician assistant: (1) during a disaster under the state emergency management plan adopted under Section 418.042, Government Code; (2) during [, or] a disaster declared by the governor or United States government; or (3) as a volunteer for a charitable organization or at a public or private event, including a religious event, sporting event, community event, or health fair. (a-1) This section does not apply to medical tasks performed by a physician assistant for compensation or other remuneration. (b) A physician assistant performing medical tasks under this section: (1) is entitled to the immunity from liability provided by Section 74.151, Civil Practice and Remedies Code; and (2) is acting within the scope of the physician assistant's license for purposes of immunity under Section 84.004(c), Civil Practice and Remedies Code. (c) A physician assistant may perform tasks described by this section: (1) under the supervision of any physician who is also performing volunteer work in the disaster, for the charitable organization, or at the public or private event; or (2) without the supervision of a physician, if a physician is not available to provide supervision. (d) A physician assistant employed by the United States government or licensed in another state may perform medical tasks in this state in circumstances described by Subsection (a) without holding a license in this state. SECTION 2. Section 204.2045, Occupations Code, as amended by this Act, applies only to services performed on or after the effective date of this Act. Services performed before that date are governed by the law in effect on the date the services were performed, and the former law is continued in effect for that purpose. SECTION 3. This Act takes effect September 1, 2017.
  13. I'd be happy to pitch in. My experience is less data driven and formal but lord knows I have made every mistake in the world. A wise man learns from his mistakes....a genius from someone elses'.
  14. State laws vary. Many allow PAs to volunteer without a SP. Check yours. At the risk of sounding paranoid never assume the problems are so simple they can't come back to bite you. See if the people you are volunteering with extend some kind of liability protection to volunteers. I have volunteered at events where people suddenly dropped dead of a thunderclap MI. Stuff happens. Let me add that if something bad happens you can't suddenly decide you aren't a PA. You have an obligation to act. Failure to do so can put you in a jackpot as fast as acting and having a bad outcome.

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