Moderator ventana Posted February 17, 2016 Moderator Share Posted February 17, 2016 Yet another night of dictating and working for free (AHHHHHH I hate working at night....) Billing company just advised me that I can not bill for the 99497 for reviewing the MOLST form for anywhere but the office. As I do house calls this is just insane. just beyond belief that Primary care makes you jump through so many stupid hoops. Heck there is less paperwork for the orthos to get paid for a surgery then for me to get a lousy $80 for spending a 1/2 hour with a frail HOH elderly slightly demented patient to discuss hugely important issues..... this system is broke.... vent done..... climbing off my soap box to go to bed..... Link to comment Share on other sites More sharing options...
NLRP3 Posted February 17, 2016 Share Posted February 17, 2016 Why is it that people don't want to go into primary care again? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 17, 2016 Moderator Share Posted February 17, 2016 yup. I refuse to chart outside of work. that is working for me. If I'm charting I'm on the clock... Link to comment Share on other sites More sharing options...
Acebecker Posted February 18, 2016 Share Posted February 18, 2016 I cannot tolerate the idea that you have to spend 30 minutes face-to-face in order to bill for advanced directives. It is never going to happen. Friggin' insane. I can see two patients in the time it takes me to discuss the POLST (that's what we call it). And I can usually discuss the POLST in much less time. I think the way around this is to do a counseling dominated established visit for 25 minutes and bill a 99214 instead. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 18, 2016 Author Moderator Share Posted February 18, 2016 I cannot tolerate the idea that you have to spend 30 minutes face-to-face in order to bill for advanced directives. It is never going to happen. Friggin' insane. I can see two patients in the time it takes me to discuss the POLST (that's what we call it). And I can usually discuss the POLST in much less time. I think the way around this is to do a counseling dominated established visit for 25 minutes and bill a 99214 instead. You don't have it right, their is two codes 99497 is for < 30 min 99498? I think - is for > 30 min I usually take about 10-20 min to review, and Bill a 99497 today I got an email from AAHCM - American Academy Home Care Medicine - stating it specially should be paid in house calls..... Yet another way to screw the PCP.... Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 18, 2016 Share Posted February 18, 2016 My recent battle involved Qvar - my least favorite inhaled steroid. It is actually sampled for some reason. My partner gave a patient a sample. He failed. His symptoms are not improved. He needs a LABA with steroid. I sent in the pre-auth. The morons will NOT COUNT A SAMPLE as a trial. It has to be a written and supposedly paid for prescription before they will consider it a real trial. So, I saved them money and tried the stupid drug on the patient and they don't recognize that effort. Meanwhile, guy is doing great on the dual inhaler samples I gave him and his daily function is improved and his symptoms are abated. So, let me get this straight..... I am supposed to take him off a proven med that is working - let him suffer - risk his health and safety -- and give him an inferior drug that he has to frigging pay for ---- and then show his failure and then they MIGHT pay for a combo inhaler. Somewhere, someone has died doing this - I have no doubt. Do you suppose the person at the insurance company was held responsible????? Not a chance. Common Sense is dead and buried and likely never to return to the practice of medicine in the US. Link to comment Share on other sites More sharing options...
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