Journeys of Don, Angie & Cookie
http://blog.donself.com
Journeys of Don, Angie & Cookie
MAR 5 - Not Many Reading Don's Latest News
In January, I started a LATEST NEWS addition to my main website to be able to update folks every couple of days to issues that affect many in the medical reimbursement business. I was advised that this may help folks, so I let it run for 2 months and on March 1st, I started a survey to see who was actually reading the LATEST NEWS. The article on the 1st offered a free gift to those reading the article if they took the 3 minute survey to tell me how often they read the LATEST NEWS and how often they visit the website. The free gifts were a choice of my mailing them a free E&M Documentation Sliderule that I normally sell for $12.00 on my website or the Excel file for their own specialty showing the bell curve data from Medicare in graphical format. Ok - the results were a little surprising to me. After running that LATEST NEWS and survey from the 1st through the 5th of March, I only had 9 people do the survey and take advantage of the free gift. Interestingly, one of the 9 said it was their first time to visit the website. So - due to a lack of interest in the LATEST NEWS section, I am discontinuing it. I guess enough folks get their data from my monthly subscription newsletter that I send out each month or my free email listserv.
ok - so now I'm going to do the same thing for 1 day for the readers of the BLOG to determine if folks are reading this or I'm wasting my time on the blog. So - if you will - please take the 3 minute survey and you also get a free gift at the end.
Thank you - Don
MAR 1, 2012 - CREATIONISM
A CREATION STATEMENT EVERYONE AGREES WITH
A CREATION STATEMENT EVERYONE AGREES WITH
It doesn't matter if you believe in Creation or if you believe in the theory of Evolution. Everyone enjoys this one. Click on the powerpoint link here and enjoy it. I would love to hear what you think by emailing me.
CREATION POWERPOINT TO MAKE YOU SMILE
FEB 21 - 2 SURVEYS TO HELP DON
As you may have noticed, I'm curious why some practices have not reported on PQRI and also - why many offices are so confused about the Annual Wellness Visits that they pass up the $14,000 a month that is easily made from these - if they typically see at least 8 Medicare patients a day.
For this reason, I have created 2 Surveys for folks to spend about 3 minutes on that will not only educate the person taking it - but will help me understand and perhaps help me develop a new template for either to help these doctors, managers and billers. If you don't mind - please click on each of the 2 links below and take these surveys to help me.
AWV SURVEY
and
PQRI 2011 SURVEY
FEB 18 - ELEVEN DAYS TO REPORT PQRI
Many people have not reported PQRI for 2011. I honestly believe that alot of doctors think their staff has done it - when in fact - they haven't - and that is ridiculous. Some are waiting on EHR - and I have NO IDEA why they would want to. If it were their OWN money, there is no way that many of the managers would not take advantage of it. If Medicare came out with a bonus for medical office managers that the manager could take the check home and use it to pay bills, I can almost guarantee that every MOM in the country would take the 2 or 3 hours to do what it takes to get the $2,000 to $4,000 - so why is every single one not doing it for the doctors?
You have until March 1st to do so and get your doctors the check this year and the fact that you're doing E-RX or doing Meaningful Use has NOTHING TO DO with reporting PQRI for last year - so do it. Here are two websites you can use (use either one - it's your choice as they both have deadlines for March 1st).
1st Accent is $279 before the discount and $229 after. Use DonSelf as the code (capital D and capital S) and it takes $50 off the registration and that adds up if you have quite a few doctors! 1stAscentPQRS
or you can use:
PQRWIZARD.COM and use DONSELF2011 as the coupon. - PQRI Wizard is $299 before the discount and $249 after.
OCCUPY GOLF!
I am not a very good golfer, although I do enjoy it. I haven't spent the hundreds to thousands of hours practicing. I spent my money on wasteful things like movies, entertainment, the latest cell phones, Christmas decorations, etc... instead of on greens fees, lessons, tutors, etc... I also did not have the skills to be the very best.
Now, though, I feel that I should be paid by the successful professional golfers for trying. I did try and I do play every couple of years or so. It just isn't fair that those that worked harder, studied the game, have better skills and spent tens of thousands to develop their game should make more and have more money than I. I know they give $ to charities - but they get to write that off taxes - so it doesn't help me.
I think money should be taken from them to be given to me because I want to be better at golf even though I'm not willing to do what it takes to be better. I want to get others together and we'll OCCUPY a golf course and demand that those who are better pay us that are not as good. Who is with me?
Feb 15 - THEY WANT EVERYTHING FOR FREE
THEY WANT IT FOR FREE
THEY WANT IT FOR FREE
Every single day we are surrounded by people wanting something for free. Patients want you to see them without them having to pay a co-pay, deductible or co-insurance. You may have employees expecting the "company" to pay for whatever holiday that Congress has created. You have patients wanting you to provide them with free drug samples so they don't have to pay for a prescription. You have the President wanting you to provide additional healthcare benefits to your employees and if you fail to do so - then you will be looking at fines in 2014 and later. I must get at least 2 calls a day - every day from doctors wanting to get free advice - but they don't want to subscribe to my newsletter, buy my book or hire me. It doesn't stop there. The kids today expect mom and dad to provide not only a high school education - but they think they are ENTITLED to a college education and perhaps it goes further that they want you to pay for a Masters or a Doctorate. Where does it stop?
We can't change what we did 20 or 30 years ago with our children in teaching them to expect everything be handed to them - which is evident by the number of people on foodstamps, public assistance, etc… but we can re-train our patients to expect to be responsible for paying for the services you provide in your office. Later this month, I'm teaching a seminar on collections and while that may help - we need to start the retraining process alot earlier than we have in the past.
It's time you start educating your patients BEFORE the doctor sees them that they will be held responsible. Responsible for the co-pay, responsible if they fail to keep the appointment, responsible for bringing in their medications with them on every visit, responsible for bringing their insurance card (and wallet) every time they show up, responsible for paying (in advance) when they want forms filled out that will take time, responsible for following the doctor's advice or they may need to find a new doctor, responsible for following office policy on HIPAA, privacy, respect, dress code, controlling their children, etc…
WAKE UP PEOPLE. It's time we (management, physicians, staff, physicians (yes - I said physicians twice as we really require their help) start holding our patients and our customers responsible for following the office policies - but until we hold the staff responsible - we will not be successful at holding the patients responsible. Before you can clean up your neighborhood, you have to clean up your own house - so I think we need to know that this is possible. It may not be easy - but it is possible. Start working on your own compliance plans first and next week we have a Credentialing seminar and the week after a collection seminar and next month we're going to start a COMPLIANCE seminar series with a couple of experts. Watch our website and our Blog for this information.
Feb 9, 2012 - BELL CURVE DATA NOW AVAILABLE
I have spent more than 120 hours over the past week and a half (Including while watching the Super Bowl) creating new tools to help you and as of this week - they are on my webshop. First - I also updated my website and added new pages to my website - plus a new design - including a page on BELL-CURVEs, a new one on the Code-Portal and one on CANS-MCI that I'm still developing.
How often do you wonder whether your physician or physician extender is coding within the normal parameters of others in your specialty? (seriously - how often?)
Have you wondered if you're over-coding or flagging audits? (I know you have!)
Have you tried to express to your doctor that they are under-coding, based on a comparison to the other doctors in the same specialty? (yes - you can do this) Have you questioned the validity of the letter you received from Aetna or Blue Cross or Anthem or whomever saying your doctor is using 99214 more often other others in his or her specialty? (you should question it as they may tell you a big fat fib!!)
You now have an availability of finding out how your doctor compares to others in their OWN specialty by using the 2010 data (most recent data released by CMS) which I found in a very large file and extrapolated the data. They say a picture is worth a thousand words? OK - now you can show your doctor a graph of how they compare and that is very effective. I've been using graphs for more than 20 years when performing a fee/code/charge analysis for practices and it gets the physician's attention much more than numbers when you show them how they compare. Check out http://www.donself.com/bell-curve.html. I believe you'll find it very helpful.
Feb 6, 2010 - Try Our Coding Portal Free for 29 DAYS
We received some requests from folks asking for an opportunity to try my Coding Portal for free, without a credit card - for up to 29 days - so we have decided to do so. The Coding Portal allows you to look up any CPT, any HCPCS, any ICD-9 or ICD-10 or Modifier or Place of Service immediately. it allows you to cross over from an ICD-9 to the appropriate ICD-10 without having to take a class on ICD-10. It gives you not only the Medicare Global Fee Period on every CPT/HCPCS code but also the Medicare allowed amount in EVERY locality in the country. You also get Don's personal coding/reimbursement advice on hundreds of codes to help you make sure you're not coding or documenting illegally to keep you out of trouble.
The one part of my Coding Portal that most people rant and rave about is the Claims Scrubber that allows you to scrub the claim to see if the payer will pay for it. We probably get more people praising us for that portion of the Portal than any other. So - now you can check it out and try it and use it without a credit card for up to 29 days before deciding to subscribe to it on a month to month or annual basis. If you compare it to all of the other programs, I believe you will find it costs you less than 25% of other ones similar to it, at $30 per month. Click on the box on the left at http://www.donself.com for DON'S CODING ADVISOR on the left menu to try it out.
FEB 1, 2012 - MAJORING ON THE MINOR
The patient was brought in on a stretcher, in critical condition and the on-call surgeon was paged to the ICU. The EMTs and nurses updated the physician that the patient had been hit and drug by a truck along the highway for at least 30 feet. The patient's left lung had collapsed, the patient was unresponsive and the head trauma looked severe. The physician spent a few minutes looking over the patient and then proceeded to pull shards of glass and bits of rock out of the patient's superficial wounds on his legs until the patient expires.
Sounds ridiculous doesn't it? It's a great thing for the patients that most physicians are so much better at medicine than they are business because if most physicians practiced medicine the way they run their business, we as patients would be in real trouble. What I am talking about is the massive urgency that so many physicians are concentrating on to achieve Meaningful Use. The main objective by almost every one of them is to qualify to get the $44,000 bonus (if they achieve it for five full years), so let's look at that for a minute or two.
$44,000 / 5 years = $8,800 a year
$8,800 / 12 months = $733.33 a month
$733.33 / 4.3 weeks = $170.54 a week
$170.54 / 5 days = $ 34.10 a day
Yep - you folks are going to alot of trouble for $34.10 a day (that's what it will average out to over 5 years, by the way)
So let's look at the maximum you can get from MU per year:
So - if you started last year, the maximum you can get in MU is $44K - but that means you get $18,000 this year, $12K next year, $8K in 2014, $4K in 2015 and your check in 2016 from meeting it in 2015 will be $2,000.
If you start this year, you can max out at $44K - just putting the checks one year later
if you don't start till 2013 - you'll max out at $39K and if you wait until 2014, then you'll only max out at $24K.
So - $18,000 this year. That sounds better. Let's look at this year.
$18,000 / 12 = $ 1500 per month
$ 1,500 / 4.3 = $ 348.83 per week
$ 348.83 / 5 = $ 69.76 a day
And if you get the Hydrostat I sell and do just one Hydrostat on a patient with GERD or abdominal pain or flatulence a day, you make a net of $73.10 per day and that takes about 4 minutes of a staff's time. If you do one Annual Wellness Visit on a Medicare patient per day and you use my test to determine cognitive level, you make $211 per day for your nurse spending about 25 minutes with a patient.
OK - My innerds are not getting real tickled about Meaningful Use yet. Forgive me.
And, if you're going after the Medicaid MU instead, you should know that the Medicaid incentives will be paid by the States, but the timing will vary according to State - and if you're in a state that has given away all of their money, like California - do you really expect them to have any money to pay MU?
Folks - don't get me wrong. You need to do it as it is money that the Congress put our grandchildren into further debt for and it's already borrowed money that we have to pay interest on, whether you take it or not (if you don't take it - they'll spend it on something else) - so you should get it because you deserve it.
JAN 30, 2012 - ARE YOU GETTING THE 1% E-RX CUT?
Many physicians did not listen last year when we pointed out that they needed to do at least 10 electronic prescriptions or they would get a 1% reduction in Medicare allowed on their payments in 2012. Now - they are getting the 1% reduction and calling me to find out how to fix it. You can't. You had a deadline last year and you have one this year too.
There is a change in the reporting requirements for 2012 and 2013 with regards to avoiding penalties for 2013 and 2014. You don't want to lose 2% in 2013, so you need to pay attention. During the first six months of 2012, you simply have to report G8553, the code that indicates you did an eRx during a visit ten times. So any time you do an eRx (for a Medicare Part B patient) during the 1st six months, you should report the G8553 code, and by doing that 10 times you will avoid the payment reduction the following year. That 2% in 2013 can add up as the 1% in 2012 already is, so you should look into doing at least 10.
