Re: GEN: Billing/Insurance
From: Jay Kulkin (jkulkin@mindspring.com)
Fri Jun 27 19:08:29 2003
Employers pay for the plan to "administer" the program. Thye pay a fee for
this service. This is called ASOministratrive Services Only. All the
plans use bundling software so this is where the argument has to be made.
Jay
--
Jay M. Kulkin MD MBA FACOG
Women's Institute For Health PC
975 Johnson Ferry Road
Suite 460
Atlanta, GA. 30342
ph: 404-832-0300
fax: 404-832-0070
http://www.wifh.com
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>----- Original Message -----
From: "art fougner, md" <evsono@pipeline.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
Sent: Friday, June 27, 2003 6:26 PM
Subject: Re: GEN: Billing/Insurance
> looks as though this is a bundling issue - why not begin to bill
> patients for the balance after notifying both them and their insurance
> carrier what you are planning to do. this is going on long enuff - if
> combined surgery is indicated, then propose it. if payment cannot be
> assured do NOT perform any component. involve the patient in this issue
> - have the patient notify the employer who pays good money for this sham
> of coverage.
>
> just my opinion ... i could be wrong.
>
> art
>
> At Fri, 27 Jun 2003, D. Ashley Hill, MD wrote:
> >
> >At Thu, 26 Jun 2003, Garry E. Siegel, M.D. wrote:
> >>
> >>While I'm sure that my staff will sort this out, the fact that this
> >>happened, and that will need to appeal it, galls me.
> >>
> >>A patient was referred from a colon rectal surgeon for LAVH-BSO, as she
> >>was having to undergo a sphincter repair, and wanted/needed a
> >>hysterectomy (not the subject of this post). As it turns out, she also
> >>needed an anti-incontinence operation.
> >
> >snip
> >
> >One of the largest urology groups in town announced a few weeks ago that
> >they no longer will perform combined urologic procedures along with, for
> >example, gynecologic procedures. For example, if a patient needs a
> >vaginal hysterectomy and enterocele repair along with a sling, they
> >advise that we perform the gynecologic procedures first, then, at a
> >later date, they will perform the sling or tape procedure. This is in
> >response to the local insurer's denial of payments for "secondary"
> >procedures.
> >
> >Ashley
> >
> >--
> >D. Ashley Hill, MD
> >Associate Director
> >Department of Obstetrics and Gynecology
> >Florida Hospital Family Practice Residency
> >Orlando, Florida
> >
>
> --
> art fougner, md
> ich bin ein New Yorker
