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Re: more guideline stuff From: art fougner, md (evsono@pipeline.com) Sun Jan 10 10:04:08 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Malcolm Griffiths: "Re: Vaginal breech less safe; new Swedish study" Previous message: John Robertson M.D.: "Re: diabetes mother - dystroph child" In reply to: charlie chambers: "Re: more guideline stuff" Next in thread: J': "Re: Vaginal breech less safe; new Swedish study" Reply: J': "Re: Vaginal breech less safe; new Swedish study" in our lab, we have experienced an interesting loophole - a precert does NOT insure reimbursement for the test. we are currently embroiled in some distressing issues with several payors with regards to this problem. has anyone else experienced this, and more importantly, how was this resolved? art At Sun, 10 Jan 1999, charlie chambers wrote: > >I think the way you describe handling your precerts is quite reasonable. I >noticed the emphasis for using guidelines as guidelines, not as law. My >primary annoyance with pre-certs are the occassions where I am forced to >speak with probably an MA or LPN who is holding the "guidelines" in hand and >cannot understand that some flexibility is useful especially a situation >where a patient has a couple of "soft" indications for hysterectomy, has >been offerred/tried other options, but remains a treatment failure. However, >in total, pre-certs have not been a significant factor in my practice to >date. > >-- >############################################################################ > >Charlie Chambers, MD "No matter where you go... >Owatonna Clinic-Mayo Health Systems there you are." >cchamber@mnic.net >chambers.charles@mayo.edu Dr. Buckaroo Banzai > >############################################################################ > >> I think in the long run, those docs that do legit surgery will be least >> affected by this program and encounter the least "infringement" on their >> management. But I will not be sad if those docs who do must too many >> hysts that aren't medically necessary feel very put upon and >> "micromanaged." Putting the brakes on those docs will only result in >> better patient care. >> -- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com Next message: Malcolm Griffiths: "Re: Vaginal breech less safe; new Swedish study" Previous message: John Robertson M.D.: "Re: diabetes mother - dystroph child" In reply to: charlie chambers: "Re: more guideline stuff" Next in thread: J': "Re: Vaginal breech less safe; new Swedish study" Reply: J': "Re: Vaginal breech less safe; new Swedish study"

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