Oxford Shenanigans

A few weeks ago, Dr. Stoller sent me this (and I have just been too swamped to keep up): “OXFORD:  ALERT! Recoupment Requests Based on Extrapolation Some members have received letters from Oxford requesting that they pay large alleged overpayments based on extrapolation. Members are urged to alert their office staff to be aware of …

Fighting For Pediatric Stimulus

I had an interesting conversation the other day with the sales head of one of the big EHR/PM systems (you’ve heard of them) who bragged to me about their lobbyists down in Washington DC and implied how he, as a result, is more aware of what’s “really” going on down there than the rest of …

Red Alert – Changes to First Data Bank AWP!

An eagle-eyed resource sent me this today: We received information from First DataBank that it was no longer going to include the FET in its AWP calculation. We monitor the pricing publications and noted that the First DataBank AWP for June reflects that the excise tax is no longer included. For those of you who …

A Real Live Insurance Fee Schedule Analysis

A few weeks ago, over on PedTalk, I promised I’d make a public walk-through of an insurance fee schedule offering so folks can see the math that I like to do.  We’re opening Pandora’s Box here and I don’t want this entry to be 10 pages long, so we’re ignoring some important aspects of this …

2004 Sick-to-Well Analysis

The other day, I posted our new Sick:Well visit benchmarks that take into account the -25 modifier usage.  I remarked that there appeared to be an interesting dip in the benchmark in 2004 and asked if anyone had an explanation. Turns out that Chipsblog Super Fan (my label) Dr. Suzanne Berman did a little research …

Anne Francis, M.D. for AAP President-Elect

Within the AAP, there are some fairly strict/arcane/goofy rules about campaigning for AAP President-Elect.  Most AAP members here are aware of how it works. I, however, am not an AAP member!  So, I can campaign for whomever I wish without breaking any rules. There has been a positive shift in the AAP’s work with private …

Why I Like My Job (Patient Recall 101)

While I was at Skytop lecturing last week, I ran into JR Vought – actually, he literally ran into me on purpose – who proceeded to do what he usually does in my classes, which is ask me questions which are somewhere between really good and yanking my chain. JR pays attention, you see, and …

Pediatric Benchmark: Sick-to-Well Visit Ratio

A long time ago, PCC came up with the concept of an important pediatric clinical measurement, the Sick-to-Well Visit ratio.  The concept was straightforward: how could we encapsulate, in a single number, a practice’s focus on providing preventive care? The ratio and another (intentional) use – it’s a really good indicator of the financial health …

Pediatric Concierge Medicine Powow

First, I just got back from a great weekend at Skytop Lodge, where I spoke for the Goryeb Children’s Hospital.  Had an excellent time, hung out with some old friends, learned a lot.  This may be the best pediatric conference to which to bring a family anywhere in the country.  Well, that and our AAP …