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Insurance (long)From: Garry E. Siegel, M.D. (garrys@mindspring.com)Sat Sep 1 09:34:39 2007
FWIW, here's what we TRY to do. When patients call for an appointment, sometimes they will say to the receptionist/scheduler: "I need my pap and I'm having X problem (pain, AUB, menopausal symptoms, etc.)." At this point, they are told to make two appointments--usually the problem one soon, and the pap later. It usually goes over fine, as we say that insurance doesn't allow us to do 2 things at one visit. We don't get any more detailed than that. When they come in, sometimes they'll ask the medical assistant and/or me--"Can't we just do it all today?" Sometimes, there are circumstances that make that best (they live a long way away, they are self-pay, there are compelling medical reasons, or they just complain too much and too loudly), but usually it is accepted. I tell them directly--"When you go to the grocery store and buy bread and milk, you pay for both. Your annual examination is bread, and your menopausal symptoms are milk, and many insurers won't pay for both on one day, and we can't call every insurer for every patient. We're sorry but we need to get paid for what we do and keep the lights on." Most accept it. Another scenario is when people come in for an annual, and, by the way, I have AUB or I want my IUD out. I generally tell them the same story, and they generally are accepting of it. I know that the CPT rules allow various modifiers to allow two services on one visit, but our experience is that we aren't paid uniformly, have to appeal, get denied, etc. Maybe we are doing it incorrectly, but this solution is pretty simple and seems to work for us. Of course, we realize that it is NOT convenient for the patients, but my partner and I feel we have no choice but to maximize our reimbursement given today's climate. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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