Posts

UC Followup

Before I post some real goodies this afternoon or tomorrow (it’s coming, Bonnie!), I thought I’d unload some of my thoughts from the Users’ Conference. This was perhaps the most overwhelming of the UCs I’ve done. I was in more classes than usual, so it meant much less downtime and no time to check out …

Verden Quarterly Report Released

The Verden Quarterly Report (Q2 2008) has been released! This is an amazing resource and the little comments about each ranking (in the blue box, off to the side of each page) are quite enlightening. And the price is right. Note that Oxford gets a most improved award, a distinct example of what I call …

Medicare Veto Results

If you missed it (and I suspect many pediatricians did), Congress surprised many and actually overrode Bush’s veto of the Medicare fix. Without launching into a never-ending note about how things really should be done here, at least, is a good summary of what the effects will be on the pediatric world: Yesterday, both the …

Quick Insurance Termination Letter Samples

After the third request for these this week, I figured I’d post them to the blog. They’re text instead of PDF for easy cut-n-paste action, imagine that. The supposition here is that this is to an insurance company you really don’t want to get rid of if they’d only treat you properly. And these are …

The AMA’s “Cure For Claims” (Wow!)

I don’t know how I missed this announcement (thanks, Bob @ PhysAll), but the AMA has embarked on an advocacy campaign specifically targeting the baloney that goes on during the insurance claim submission process. Now this is the kind of work I want to see the AMA doing (instead of restricting the rights of its …

Insurance Negotiation Story #175

I’ve ranted about how “getting big” is not an automatic recipe for success when negotiating with insurance companies. It’s rare, in my experience, that the cost of merging offices is outweighed on the contract end. Here’s an email I got just before the weekend. This isn’t a 15-20-40-80 doctor practice. This isn’t the only pediatric …

After-Hours Codes And Other Scheduling-Based Codes (99050, 99051, 99053, 99058)

In 2008, the CPT definition of the classic “after-hours” codes changed. Gone is all the rigmarole about whether your hours are “posted” or whether your patients know you are open on weekends and all the other commentary that used to convince our clients not to use these important codes. The bottom line: if you see …

Final 96110 and More Personalized Medicine

I have some fascinating data about the after hours, etc., codes (9905x) coming, but I wanted to share these two followup tidbits before I forget: The Developmental Screening Toolkit For Primary Care Providers looks like an excellent site to add to the list I posted the other day. In particular, here’s a great comparison chart …

“We will not sacrifice profitability for membership.”

They usually write themselves. Reason #1156 to pay attention to Susanne Madden and the Verden Group – the AMA itself has turned to her for an analysis of the exodus of patients from many of the large, national plans. Apparently – based on the quote above, from Wellpoint’s CEO – the insurance companies are more …

Medical Economics and Concierge Medicine

I’ve got a stack of things to post, but I want to get this one out before I wake up the kids and start a new Monday. Here is an excellent piece about concierge medicine from Medical Economics. I don’t call it excellent because it supports some of my previous comments, but because it offers …