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wilso2ar

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About wilso2ar

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  1. Over on Reddit someone just posted that they are bringing this to the floor to vote. They say because it was a tie and 27 did not vote. Maybe it's not dead yet!
  2. Working in pain I have inherited some absolute train wrecks of medication lists. I address my concerns with the dosages/medications and try to get them to see the danger as I'm sure you do. It's easier to change when it's their idea. I've figured out over the years that most don't realize that they are on dangerous drugs. They see them as safe since their caring physician/PA/NP had them on it for years. They are now seeing this new yahoo that wants to change their meds. I come up with alternatives, most of which are not medications (in my specialty) and come up with a plan to wean/change
  3. I think it's great that they are making it easier to treat these patients with MAT, but unless they make it more lucrative no one will want to do it. Unfortunately, most of the people that need help are on Medicaid or no insurance. I guess if they are already in to see a PCP and he she wants to do it then great.
  4. That's ironic. My son who is 23 and a new paramedic just told me yesterday that he is going to start his pre-reqs for ASN this fall. Continue the paramedic work until he gets his BSN than consider CRNA school. He was thinking about flight nurse type stuff, but doesn't think that he wants to stay in pre-hospital medicine.
  5. It appears that the first part that passed is a good thing. Independence after 10,000 hours of supervised work. I'm not so sure that I agree with the mental health bill, but maybe this is an improvement in the current situation in Utah.
  6. I see what you mean as far as not following up to make sure the patient had been seen soon enough. I don't know how one would be expected to follow up on every referral that is made to make sure that it happens. Ideas that come to mind are. making follow ups with that patient in a week or a few days. Then you would see the patient, read your note and ask where he/she is in the referral process. Then you could document the urgency of the referral as well as the insurance denial of the referral. That puts it back on them. Something I always do in a urgent referral is make sure the pati
  7. 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.
  8. 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
  9. 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
  10. 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
  11. 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.
  12. 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
  13. 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.
  14. 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.
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