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About wilso2ar

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    Physician Assistant

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  1. Blue Cross in Michigan you can bill under the physician billing numbers ( therefore getting 100% reimbursement ) if you discuss the case either before or after the visit with the physician on the same day. You have to document this discussion in the note. i.e. you see the patient, you treat the patient, you discuss the treatment at some point during the same day with physician, you document said conversation, the patient gets billed under the physician billing numbers.
  2. You can get a few through AAPA, but only about 12-15 category 1 with the JAAPA tests. They are only good for a year so you can only go back as far as February 2020 and they come out once per month. You can likely buy some through AAPA or another source. You only need 50 hours of category 1 and the remainder can be category 1 or 2. Do you have CPR certification, ACLS etc. all those count. Trying to not be negative, but I assume you have been certified for at least two years if your CME is due. You just realized you need this? Your license is the single most important thing to c
  3. I've been doing nothing put pain management for 12+ years. Honestly I love it most of the time, but I have been very fortunate to work for two different practices that are legitimate clinics. Think of it as non-operative orthopedics with some neurology and psych thrown in. In my experience it is not near as bad as what most people think. I might just be lucky due to my geographical location though. Rev made some great points. I do manage opioids, but It's obviously not right for everyone. We follow all state laws as well as good practice like UDS, state PDMP, keep doses low, frequen
  4. I'm curious what everyone's thoughts are on the new guidelines when using medical decision making when deciding E/M codes. Personally I love it and am using MDM to determine levels of all my E/M codes now. I find that I write a lot under the diagnosis anyway both to help me remember at their next visit as well as to make it more clear my thought process to anyone reading the note. I am also finding that almost all of my office visits are 99214s now. Now if we can find a way to get the useless "patient centered medical home" info out of the notes from the PCP. I hate sifting through 15
  5. We did this in my old practice. The Physician saw all the new patients and then I saw them in follow up. It met incident too most times as he was in the office most of the time, but then the patient comes in for their back and they say "My shoulder is killing me" then bam, does not meet incident too. It was a pain in the A** to try and keep track of. I have since left that job and now we bill direct for everything and it makes it much simpler. And much lower risk of committing fraud.
  6. I got my first Pfizer dose yesterday. All I have is a very slight sore arm today. One of my MAs is out today with fever and body aches after getting hers yesterday. I agree the roll out is very uncoordinated in my neck of the woods. The Nurse giving me my dose said that she had to turn people away because they did not have proof that they should be in phase one. She then had to throw a partial bottle away because there was no one to give it to. It's interesting what England is doing. They are stretching out the vaccination schedule to be able to give the first dose to more peopl
  7. Check out Jon Jacobson's fundamentals of musculoskeletal ultrasound book. I found it very helpful as I was getting started. Actual injection courses are very expensive. Reading the book and a good mentor is how I learned.
  8. Congratulations Rev! Interventional spine/pain is such a great specialty to work in. Although I do not perform spinal intervention, I do almost every other procedure we offer. It has served me well in the past 12 years. It's an interesting blend of neurology and MSK medicine as well as the psychosocial issues that go along with chronic pain.
  9. That's perfect size. Plenty big where you don't see any patients in your day to day life. Likely lower cost of living compared to big city. Get to work in a smaller system that maybe you are not just a number. I live in a community of 30,000 and would not want to work anywhere else. Good money and low COL.
  10. Define small town. If they have a dedicated GI specialist that needs a PA and a hospital that supports them, it can't be that small. Great training is a big plus.
  11. Why would you need to get around the requirement? If you are doing telemedicine with a practice, the requirements would be the same if it was telemedicine or in office.
  12. In Michigan we used to have our "delegates" the MAs print and save the PDMP to the chart before every visit. Then I would look at it. I think they would scan it into the chart without printing. Like you pointed out this takes a lot of labor. I am not aware of any law that forbids you from entering this in the chart, but I never looked to see if it's legal either. About a year ago our EMR vendor now has a button I click on that automatically brings up the PDMP. We use E-clinical works. I no longer save it in the chart. I have logged in through the state and it does log my inquiry. Ou
  13. I'm going for lawn care independent contractor. Buy a nice zero turn mower and ride around all day with headphones on.
  14. Disclose it. I had a stupid thing my friends and I did while we were in high school. We fulfilled all of the requirements from the judge. I disclosed it to NCCPA and for state licensing. No one has ever contacted my about it.
  15. If I could go back to where I was just out of high school I would go pre-med then med school. I was basically pre-med in undergrad, but did not start until I was 25. I already had a wife and a child at that time, so I thought med school would have been impossible. I lived in a town that had a PA program. Once I became a physician I would work the same amount of time I am now except make twice as much money.
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