Saturday Q and A

  Dr. Ahmed writes:   Thank you very much for your posts.   How were you so successful in your Medicare Advantage practice?   You’re welcome, Ahmed.   Here’s the system that worked best for us.   We had a certified coder review every Medicare Advantage encounter.   They added the codes that passed muster to an excel spreadsheet.   They submitted that spreadsheet to our insurer every quarter—and they submitted it to CMS.  ...

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Saturday Q and A

    Dr. Allen writes: Tom, Thanks for all the tips. What’s the best way to save money on patient care costs with Medicare Advantage besides just saying “no”?   Allen, you’re welcome for the help,   Just saying “no” pushes care costs into the future—and doing so ensures you will pay far more money in care costs then than you will now because your patients will be sicker.   But you can’t really control...

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Saturday Q and A

      Dr. Sara B. asks,  “Thank you for your tip last week about addenda, they seem like a powerful tool. But how do you best use them?”     Sara, as I review the laboratory and test results, I’m on the lookout for a dozen so conditions that commonly pop up. I cover them in my success codes blog series and in my upcoming book.     Class 1 diastolic dysfunction, atherosclerosis of...

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Saturday Q and A

      How can you use addendums to capture diagnostic codes identified after the fact?   Here’s what you need to know.   Follow our LInkedIn business page for the latest free, actionable tactics for your Medicare Advantage success.

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Saturday Q and A

    Dr. Bpb asks?   What is the biggest difference in taking care of Medicare Advantage patients in the nursing home rather than in the office?     In the office you have to worry about coding.     In the nursing home you just have to care for your patients, the nursing home will submit your codes for you.     Code your patients once upon admission, accurately so that you appropriately reflect...

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Saturday Q and A

  Shallam askes   How do I deal with patients who leave my Medicare Advantage panel?   The question’s a bit ambiguous but here’s what I do.   I’m familiar enough with my panel that I know the ones I want to stay and who I don’t want back.   The ones I don’t want back are either too time intensive, non-compliant, or simply a pain to deal with.   The ones I want to...

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Saturday Q and A

    Dr. Holly asks   The only patients who sign up on my Medicare Advantage panel are the sickest ones. What should I do?   Prosper.   The sicker the patient, the more value your expertise will generate.   Every sick patient is an opportunity to ply your trade.   The difference is, under Traditional Medicare, the sick patient just means more work.   With Medicare Advantage, it means more pay.    

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Saturday Q. and A.

    Dr. Greta asks: Do insurance companies allow nurse practitioners to be PCPs for their Medicare Advantage plans?   Not yet.   But it’s coming.   Your best bet is to find an independent practice with a thriving MA population and speak to the physician about working with them. Make sure you check about their non-competes. Most aren’t expecting you to compete with them, so it shouldn’t be a problem.   Learn all you...

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Saturday Q and A

Dr. Barbara asks: What’s the optimal patient panel size under a 50/50 risk-share split under a Medicare Advantage Contract? Fewer than 200 patients will leave you with a level of volatility in your performance that will be distracting and cause you unnecessary anxiety. The upper level is up to you. Once you reach it, you can scale it by adding APNs With that tactic, there is no upper limit.    

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