Medicare Debra Phares Murphy RRS firstname.lastname@example.org
I am in total agreement with putting the criminals (white collar, blue collar, what ever collar) in prison for the consistent neglect they continue to "knowingly" do. I have doctors offices refusing to send their patients my our way anymore because if there is something they send over that does not go by the guidelines, I call them and advise them we cannot see their patient until this matter is resolved. That I need medical necessity documentation before any of our clinicians can see their patients. Boy do they get up set. And when I go to the seminars, what we started along time ago doing, they are just now hearing about it in the seminars? When doctors offices don't even know what Medicare will allow or not, and we (the little people-not physicians) have to tell them? What is this world coming to? And then we have the patients calling us, we advise them what Medicares guidelines are and that we cannot see them because of ........ and boy do they get upset. They say they'll just go somewhere else. So who is at fault also here? If the patient has been advised that what they are wanting to do is not Medicare's guidelines, and Medicare even advises them, and they are still going to search out someone who will help them, and they are the ones turning us in? What gives. Medicare has a hotline and a 1-800 to call for questions any time. I have always found them to be very helpful. But we are still blasted by the physician and the patient for "not" going against the grain! I don't much care. If it's not allowed, it's not going to be done in "our" facility. I have the say so at least in that area. And no matter what, I feel good about getting everything in order and trying our best to be part of the solution. But to be honest, all the other people I talk to in other offices just don't seem to have the concern or understand the importance in this matter. If we don't do something now, there will be no healthcare system when those of us will need it. And that scares me. We will accept any insurance that will pay us (in-network) and even go out of our way to make payment arrangements with patients in a financial crunch. Whatever it takes to get them the treatment they need. And our highest reimbursement from Medicare is approximately $50.00 a visit. We accept assignment and most of our carriers are managed care. And the ones we have a contract with on a per visit rate is usually only $20.00 per visit. And we have not changed our prices in a few years. We are also well below the national average and have been so since we've been in business. We are not out just for the bucks, even though money is the only thing which will keep our doors open. Instead, we have added alternative programs to our services. These are not insurance billed, they are cash pay and are not considered physical therapy visits. Now adays, instead of finding ways to cheat the government, look for alternative solutions. This is what we have come up with. This way, we make the money to keep our doors open without having to put the burden on our patients or on the carriers. I'm not saying we are perfect in every way, put we try to be and we "make" the time to learn all we can about the guidelines, changes, new concepts, alternative ideas, continuous educational & training meetings "every month". But the stress is still there because you are still fighting a battle every day whether it be a misgruntled patient or physician. It just seems no winning either way. If they would just catch the ones who don't give a damn, it would make things alot easier. I believe the patients themselves also need to be made aware of the severity of their decisions as well when they know what they are doing is not what Medicare says is allowed. We hear it everyday and they are not one bit afraid to let us know. And some of the ones giveing us all this heck, are probably some of the ones who started this stuff in the first place. I guess there will always be stress in this field and all a person can do is try their best. But I have definitely learned the severity of all this. And I take it very seriously now. Especially since I've heard some of the fraudulent stories that Medicare has put out. These people are either down right stupid or is looking to go to jail to get out of some other debt they are in. Stop It! My future is somewhere in this mess! Don't complain about it if you aren't going to take it serious or do the right thing. Cause if you continue to do the things you "knowingly" are not right, than "you" are part of this mess as well. I just don't see much of a future for myself and I don't like that. Maybe we should just let the government do whatever they must, and we need to concentrate on what we are doing (or not doing). OK stress is out now. Thanks for listening. Your comments are very appreciated and I have learned more from them. Thank you.
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