quietmedic Posted September 13, 2016 Share Posted September 13, 2016 A doc I know is recruiting PAs for a house-call sort of practice. The doc is someone respected and a good guy, and I don't consider anything nefarious. Just wondering, are there any pitfalls/things I have to watch out for in terms of joining this sort of service, in terms of medical, legal, things to watch out for in terms of my license? Anyone else out there every do this sort of work? Thanks all... Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted September 13, 2016 Share Posted September 13, 2016 Is this Medicare based or cash based? Many private insurance companies won't cover house calls. Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 13, 2016 Moderator Share Posted September 13, 2016 I had my own house call practice can be very rewarding pitfalls - MUST be billed under your PIN Doc must sign all VNA and hospice orders VNA and Hospice might require some education on how to get orders for your patients - you give them, as the agent for the Doc, but the doc signs them MUST do a trip fee of $40-100 per trip - this is the way you make ends meet - and I got very little (basically none) push back - this is waived for patients in an assisted living facility MUST bill for chronic care coordination, Annual wellness and care plan oversight - these add up to a nice little chunk of change The hardest part is scheduling your day - travel time sucks and is totally unreimbursed (hence trip fee) and clustering all the patients together on a give day is important DON'T open with too big a geographic area - it is heck to try to shrink it and the travel time kills you You lifeline is the local assisted living places - getting into 1-2 of those and you are golden.... Link to comment Share on other sites More sharing options...
CAAdmission Posted September 13, 2016 Share Posted September 13, 2016 Watch out for your safety, too. Go in the wrong house and next thing you know you are in one of those pits with the "Put the lotion in the basket!" guy. Link to comment Share on other sites More sharing options...
Katera Posted September 13, 2016 Share Posted September 13, 2016 Watch out for your safety, too. Go in the wrong house and next thing you know you are in one of those pits with the "Put the lotion in the basket!" guy. lol buffalo bill! Link to comment Share on other sites More sharing options...
quietmedic Posted September 14, 2016 Author Share Posted September 14, 2016 @Gordon, yes, medicare based @ventana, I think they will have a billing person, with that person know to do this (perhaps there wont be a billing person)? Also, they said even if I go to the house, and send the patient to the hospital, we still bill for a base level visit....is that what you mean by trip fee? Thanks Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 14, 2016 Moderator Share Posted September 14, 2016 @Gordon, yes, medicare based @ventana, I think they will have a billing person, with that person know to do this (perhaps there wont be a billing person)? Also, they said even if I go to the house, and send the patient to the hospital, we still bill for a base level visit....is that what you mean by trip fee? Thanks a billing person will just submit the bill - you need to code it - and therefor you need to know what you can bill if you see the patient - you need to bill -even if send to ER Trip fee is the fee they have to pay just to get you there - medicare has said it is okay - non covered so Have to get and ABN They MUST pay this at time of visit.... otherwise they will screw you out of it almost 100%of time.. Link to comment Share on other sites More sharing options...
TWR Posted September 14, 2016 Share Posted September 14, 2016 Ventana, How did you medico legally protect yourself entering a home with a female patient alone? Did you have an MA with you? Link to comment Share on other sites More sharing options...
quietmedic Posted September 22, 2016 Author Share Posted September 22, 2016 Thanks for the replies. I will have to inquire further about the billing. Are there any heads up in terms of medico-legal issues that can arise, i.e. avoiding suing, things beyond usual office practice and typical CYA activities? Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 22, 2016 Moderator Share Posted September 22, 2016 I never had an MA with me I would not do breast or pelvic exams - and Geri homebound patients rarely need these I have only heard of two providers EVER getting sued 1) for not going on a house call when they should have 2) for gross sexual misconduct JOIN AAHCM!!!!! Link to comment Share on other sites More sharing options...
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