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NeoTrion

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Everything posted by NeoTrion

  1. Last year the APP staff became aware of some billing irregularities related to incident to billing and how things were showing up on our fee tickets. After pulling up Medicare guidelines we found that our SP was not seeing Medicare patients for their initial visit. This was brought to our office manager in an open meeting to which she stated "there is a loop hole for this." I should note that our office manager / COO styles herself as a billing expert, and we were told that she has vast experience in billing and was certified as a coder and biller. After two months it was finally decided t
  2. Thank you for the responses and I am currently working on this as I have presented it a number of times. She has finally admitted that they are going to change and have the SP see all new Medicare patients. This was after insisting that everything. By doing research I noted that some BCBS do not even recognize indecent to billing. She states ours in Texas does allow this, but is mum on the details. I have reached out to the specific rep to get more details on this since I would think if you are going to pay full price you would want the SP involved and documented. Should I find an issue
  3. I wanted to ask some of you billing gurus on a subject. So up until recently we were billing incident to and I did bring up the fact that we should not be doing this. On a number of occasions, they were billing this even when the physician was not in the building. Upon further reading it also appears that in order to bill incident to that the MD must see the patient for the initial visit. Our practice is a single MD and he does not see new patients except for a rare occasion (10 a year). I brought this up to our practice manager with an article from CMS stating this and she stated that th
  4. Rev Ronin, that is what I was thinking as well. The closest I can find to a "no that it can't be done" is a recommendation for a committee. Thus far I have not been able to get anyone to call me back on this that is on these committees or on the various medical boards. In fairness COVID may be causing some of this communication difficulty.
  5. Thank you for the comments. Unfortunately Appriss is the one that keeps track of our inquiries and I have found that they do not always log the inquiry. We have showed them proof of this and initially they blew me off. After about two weeks the reopened the ticket I initially opened (that they closed the same day) and stated there was a "known issue." Naturally if I am in pain management and I relying on them to cover my butt with the state, this does make a me a little nervous when relying on them to log my inquiries. I also like to have the actual report scanned into the EMR to prove wh
  6. I was hoping to get some wisdom from some of you in different states. In Texas we are required to check the PDMP before prescribing any narcotics. I currently work in pain management and this is an issue, but has been seen as a necessary step. We have been trying to work with our EMR on seeing if we can save the PDMP into the EMR. The reason why we are doing this is that we have caught the database not updating/logging our searches. As you know if it is not documented it did not happen. We were advised by our professional society to make sure a copy is in the EMR to prove we did pull the
  7. I graduated from Lynchburg and felt the curriculum was great. Without seeing the other side of the coin (ATSU) I cannot really compare.
  8. Ventana you were exactly right in my case. Mercer was about 1/3rd from that of CM&F for the coverage I was interested in. Anyone have any other places they like?
  9. I was hoping to connect with someone on the legislative team for the West Virginia Association of Physician Assistants. I had some questions concerning the recent change in the collaborative agreement from supervisory agreement that was made recently. I would appreciate if someone could post or send me a pm so I could pick there brain.
  10. I graduated earlier this year and felt that the workload was appropriate. I did have to set aside specific time away from the family or from work to get things done. If you are disciplined enough to do that then you shouldn't have a problem.
  11. I did not like my eko. To much ambient noise. I still use my Littmann that I got 5+ years ago. It is showing its age and is missing a few buttons but works great. Not impressed with eko and only use it as a last resort when my electronic Littmann or cardiology STC can't be found.
  12. I would just pick up the phone and say "By the way did you see this?" I have done that in multiple specialties and it usually ends up with a pause on the phone. It doesn't matter to me if they think I am an arse. There have been times when I have called them and they put the blame on someone else and it was probable. I would want to know if I missed something but probably an issue of just trying to move on to the next patient and refer out.
  13. Arthropathy that is the stance I have taken and have pushed them to the SP. Neither myself or the other APPs I work with do not mind letting them see these patients as we have a full load of patients without them. I am just looking for someone that can point me to the law in Texas on this one. I remember learning about this in school years ago but wanted to ask the brain trust here if they can point me to it in writing. Personally I do not want to see them if trust cannot be built in the first place. I can always remember that you rarely get sued by friends and those that trust your judge
  14. So lately we have had some patient's request to see the MD only. That is honestly no skin off my back and I am happy to let the MD see these people. As I recall there is a law in Texas that says the patient has the right to see a MD if they request. Does anyone know where I can find the text to that law?
  15. Sounds like splash damage and you were hit by it. I would think more could be said, but perhaps they used the old "you can resign or we can fire you" bit. If you find out more it would be interesting to share. It would help others in the future that come against the same situation.
  16. We had the same problem at a hospital here in Texas. We had to get our state chapter involved and claim the restriction of trade. They were making this decision based on a nursing position statement that the Board of Nursing posted on the website. The admin, that was made up of all nurses with the exception of the legal counsel and the CMO, stated: "we have to protect our nurses." Our state chapter reached out to the medical board and basically pointed out that the nurses are deciding who can practice medicine in our state. That caused a meeting between the medical board and the nursing b
  17. So TAPA has had two bills come out of committee so far. HB 2250 schedule II and HB4066 are up for consideration on the house calendar committee but has not been scheduled to be heard. Time is starting to run short. So Texas PAs help is needed to put pressure on the calendar committee. Members are posted below. If you live in their areas it would be good to send a letter and put some pressure on them. Time is growing short to get these bills on the calendar. Rep. Four Price Vice Chair: Rep. Joe Moody Members: Rep. Joe Deshotel
  18. I know this has been a topic with some members here, but I just received an email from TAPA looking for applications for committee members and committee chairs. I know some people have not made it in before, but you can't win if you don't play. I am on two committees but will be giving up a place in one, but I am trying to hang on to my place in another. It may not happen, but I would like someone from this forum to get my seat if it does. I would like to work with some of my respected peers from this forum as well. We have a large amount of experience on this forum to draw from, and our
  19. Can't make it in May, but I am definitely interested in meeting everyone in person at another event.
  20. I am in Texas. This is actually a hot topic for us, and many of us want to see some headway made.
  21. Asking mainly because I am working on my doctorate, working, and on two different committees in TAPA. I have been a member of PAFT since I was a student and wanted to see if I could take more of a leadership role. My employer is not the best with taking time off and is stingy with CME money. The meetings with TAPA have all been on my dime, so there is the financial aspect as well. I do that because I can contribute in areas that I do well in, and I was challenged to "put up or shut up" by former mentors. I am trying to see if I can fit something else in rather than commit and then reconsi
  22. Any chance you might consider sending your latest draft to me? I am working on something similar in my state and we are looking for some language to guide us and get the ball rolling.
  23. What kind of time commitment are we looking at here?
  24. CAdams, I just discussed this on a post with our legislative committee. This person kept saying we need our physician "partners" to gain traction with our agenda. I did state that's why this is important it is also important that there is mutual respect between the two parties to be "partners." If there were respect I think they would allow an independent PA board, but they keep thumbing their nose at our board in different ways.
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