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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The Nice Thing About Working For Yourself

    One of the nice things about working for yourself instead of working for an employer is that you quickly get a sense of who you’re working for and how much.   How much time are you spending to pay your taxes, to pay for your personal upkeep, to pay to keep your licensure up to date?   How much time are you spending to pay your “future self” in the form of savings?  ...

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The One Question You Must Ask Perspective Employers—Pushback Edition

  Yep, I sure did get a lot of pushback about last week’s post from the organization leaders who read this blog     You’re misleading your readers . .   Retention bonus can be an effective tool in work force management. . .   It is an industry standard to use them to retain top talent. . .   Retention bonuses allow us the flexibility to keep ahead of a changing labor market. ....

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Sunday Q and A

  Dr. Anna S. asks   How do I keep my patients out of the emergency room?   Make sure they have your home phone number. “The government pays me to be your personal clinician. Use me. Contact me before you consider any medical care outside this office.”     Fortunately most ERs are paid by Medicare Advantage Organizations on a bundled basis—one payment for everything (though the payments are tiered somewhat based on the...

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Dramatically Increase Your Medicare Advantage Patient Panel Size

  Take note of your Medicare Advantage panel size.   Call the three largest insurance agencies in your community   Set up a meeting with their leader.   They will love to see you.   Tell them you’re interested in increasing your panel size.   Ask them if they have any questions about the practical aspects of the program.   Ask the about their challenges. Ask them how you can help.   Tell them you’ll...

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Beware Extra Benefits

  For the first time this year, you’re going to be hit with people trying to sell you Medicare Advantage plans by telling you they’re going to cover in home personal care and housecleaning.   They will, but only under very limited and restricted circumstances.   And you won’t have control over who is going to be offering those services to you.   Be very careful when evaluating these new benefits.   Questions to ask:...

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Do You Understand Your Contract?

      The most surprising thing in my 25 years of working with docs and organizations under Medicare Advantage?   How few understand the nuts and bolts of their Medicare Advantage contracts.   Do you understand how the dollars flow through your contract?   Can you identify at least key three pressure points?   Then contact me.   With greater understanding will come much greater performance.      

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Saturday Q and A

Dr. Beth asks:   When is it appropriate to do testing to find risk codes? My boss is asking me to do routine Cxrs to find atherosclerosis of the Aorta.   Beth It’s never appropriate to do testing to find risk codes. Ever. If you can, find a new employer.  Yours is going to get you into trouble. No telling what other corners they’re going to cut.

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How to Deal With Your Telemedicine Partner’s Clinical Limitations

Every telemedicine provider has a set of things they don’t want their doctors to do.     No lifestyle drugs. No anti-depressants. No tick bites.     I even have one that won’t let you manage a sunburn with blisters.     These “never treats” are usually in response to a bad outcome or a lawsuit—and there are not very many.     Keep a mental note of them—if you violate them and there’s a...

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Saturday Q and A

Dr. Hakim asks:   What are the diagnostic risk codes my patient probably has and I’m missing?   Atherosclerosis of the Aorta (review past imaging, it may be an incidental finding) Stage 1 diastolic CHF (review past echos) Renovascular hypertension (HTN + atherosclerosis of the renal artery on a past imaging study) Emphysema (review past chest x-rays) Peripheral Neuropathy (perform sensory testing on their feet)     These are the most common. There are more—check...

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