Clearinghouse Bullying

A good friend remarked that my blog is a little “stale” these days, and she was right.  I am so caught up in putting out fires these days – ARRA, PCMH, portal design, etc. – that I forget to come back here. (And, hey, it’s a lot of work to take visiting clients out to …

Conspiracy to Defraud Pediatricians

[Note the continued updates at the end] I have avoided blogging for over a week as I tear my hair out dealing with the transition to the 2011 Immunization Administration codes for our clients. I am going to name names below and if anyone representing any of these organizations would like to correct my information, …

Brief Explanations!

Gosh, a guy makes a couple statements in a blog and now people actually want him to explain the numbers so that they make sense. There’s no satisfying the mercurial reader any more. My word isn’t good enough? Actually, my apologies for some confusing data. Let me explain yesterday’s post in more detail and, perhaps, …

Slowly Turning Tide

Vaccines may be saving the lives of children, but they are killing the docs who give them. Pediatricians have to pre-purchase tens or hundreds of thousands of dollars of vaccines, insure them while they sit in the fridge, and then are often paid at or less than what they paid for the vaccines themselves when …

Retention Rate

The most common worry I hear from practices considering dropping a plan is that they can’t afford to “lose all those patients.” The larger the portion those patients make of a practice, the scarier it gets. “BCBS/Aetna/Oxford/etc. is 25% of my practice! I can’t lose 25% of my visits!” Ultimately, it’s the greatest obstacle in …

2007 RVU Snag

The 2007 RVU changes were a bit of a mess. Read the AAP’s RVU brochure you’ll see this little tidbit: Budget Neutrality: Statutory guidelines indicate that revisions to the RVUs for physician services may not alter physician expenditures within the Medicare RBRVS physician fee schedule by more than $20 million from the principal expenditures that …

All For One! (The Myths of Merging)

I took another “We Think We Need To Merge!” call today from a thoughtful practice on the east coast. A couple small groups, aimed at getting a more fair piece of the pie. Can’t say I blame their intent. Practice mergers are like tattoos – they sound good when you and all your friends have …

Sometimes They Write Themselves

Paraphrased from a customer message on our client-only mailing list today: I was wondering what you think of Coventry Health/Health First. I guess they have replaced old Health Care Value Management. We have been noticing that since Coventry has replaced HCVM their reimbursement has been ridiculously low… I called him and complained. Someone called back …

Another Day, Another Bluff

I’m going to take some liberties with an email I received from one of our customers today. Very typical. He’s been an “honor student” lately and has increased the revenue for his practice by tens of thousands of dollars simply by asking for what they should have been getting all along. After picking off some …

Hello, World!

Let me open this blog with a summary of the phone call that inspired me to begin recording my experiences consulting with private pediatric practices around the country. A long-time customer of PCC’s called me from San Antonio two weeks ago. I’ve always enjoyed my conversations with him, as it’s delightful to work with someone …