Posted on 07/08/2020 6:48:34 PM PDT by Viking2002
*sigh* OK. On Friday, 6/26, I underwent an upper GI endoscopic exam for my Hemo/oncology specialist, to check for varices, bleeders, portal hypertension, etc. After I came out of the fog, they unhooked all with wires, tubes, etc., and allowed me to dress. The endo doc came by and said, with the exception of some 'changes' due to GERD (which has been treated for years), nothing was amiss. In the midst of shaking the fuzz out of my ears, they mentioned that I'd have a follow-up for it. Here's where it gets good: They called me this afternoon to confirm the follow-up, and informed me that I didn't necessarily have to come to the hospital for it, it could be conducted by the doctor over the phone. BUT - because I live on one side of the state line (AL), I mean literally five minutes away, I would still have to be present on the GA side of the state line in order for them to do it, meaning I'd have to drive across the bridge to be in a GA zip code. FURTHER: they want me to be in front of a place where I can readily give them a street address to confirm my location.
I have never heard of this.
The only thing I can think of is if you are a Medicare patient they have strange requirements for getting reimbursement. In the Radiology end of things, and they have a thing called “Place of Read” so if a Radiologist is reading an exam from home, you have to tell Medicare where they were actually sitting when they interpreted the exam because they reimburse different amounts depending on where the “service” took place.
It might well be that if the “service” performed on you was over the phone, and it was out of state, there might be some bizarre infraction of Medicare regulations and guidelines.
With that in mind, any time you hear about “Medicare Fraud” and see some hospital getting dinged and having to return money to Medicare, keep in mind that most “fraud” isn’t “fraud” at all, it is an honest mistake where the facility simply wasn’t adhering to some guideline in the byzantine myriad of reams and reams of wonderful government regulations.
Kind of like what government does to us by legislating to death, and making so many laws that any one of us could be prosecuted at any time as a criminal because we were unknowingly in violation of two or three laws.
There was a big hospital in Boston some years back that the SCUM SEIU people went after because the hospital didn’t want to unionize, so the head of SEIU at the time said they were going to destroy the relationships between the physicians and their patients.
They parked a billboard truck across the street from the main entrance of the hospital for weeks, and the billboard said “X Hospital was implicated in Medicare Fraud and had to return X amount of dollars to Medicare”
Most people who have ever worked in medical billing know that health care providers have to refund money to Medicare all the time. Sometimes Medicare pays out more money to the health care provider.
Usually it is because, after the fact or in the course of some billing inquiry of some kind, the hospital sees they did something wrong, and contact Medicare and Medicare says “send us this much more money and fix the problem so it doesn’t happen again.
You always want to find the issue and report it to Medicare. You NEVER want to have Medicare find an issue and bring it to YOUR attention, though I believe it happens.
So when the SEIU aholes put that board out in front of that hospital...I doubt it was real fraud, because the hospital has a good reputation for quality. More like SEIU scum lying through their teeth being the Leftist turds they are.
You found out what you needed to know. Don’t let them steal more money from you with senseless follow-ups that are simply there to line their pockets.
When they call again, confirm the follow-up then, the day before the appointment, call and cancel. After that, every time they want to reschedule, tell them that day doesn’t work for you. Eventually, they’ll lose interest.
Unless you cut the cord, these guys will schedule endless follow-up visits so they can collect their co-pays and tell you the same bs you already know.
The system is rigged to vacuum as much money from you as possible. You have to take control and cut them off like drunks at a bar. At least, that’s my free advice.
Right. The doctor in GA has to be credentialed with insurance providers in Alabama. I think most hospitals get credentialing on physicians set up for all bordering states, or states that are close enough where they get significant numbers of patients from.
sounds like just some routine bureaucracy, However bring guns, ammo and tasers just in case, it also sounds suspect.
Didn’t t the CARES act essentially federalize medical licenses. I think we can now practice across state lines. I know lots of critical care units said licensing not an issue any more because they are good in alll states.
I haven’t had an endoscopy for a couple of years now. I’m due because I have GERD and Barrett’s esophagus. My doctor will do endoscopy and colonoscopy at the same time, even though he only gets paid for one procedure. Normally he stops by my bedside while I’m recovering to talk to me about his findings, and gives me the pictures he took during the endoscopy. I can’t see him making any changes to that. The Gastroenterology group he belongs to has their own building in which all procedures are done. It beats having to go sit at the hospital anymore. I live in Central New York State.
At my checkup last month my doctor asked me if I had any anxiety. I told him, “Every time I put this damn mask on.” He was still laughing when he left the room.
I have been in and out of the hospital since May with liver failure. I have been given the covid test six times, which were all negative. I was even told I would be registered with the CDC. It was really upsetting but there was nothing I could do about it.
Sounds like the doctor is licensed in Georgia and doesn’t want to get accused of unlawful practice in Alabama. Probably motivated by his insurer or by a warning that came out after some legal issue.
That’s... Odd.
Honestly, Google (or whatever search engine you prefer) an address and call, then tell them the address and describe the building (map street view) if they ask.
I’ve had phone consultations with Mayo in MN, and I live in Chicago. The whole thing sounds ridiculous.
Or, just call and say you won’t put up with the request unless they give you a REALLY good reason; like a legal one. If you’re five minutes out, drive five minutes and treat yourself to something in the area if there’s a pressing need for you to cross state lines.
It might be a rule specific to the state of GA. It must be a liability thing on the doc’s part if it is.
They will get reimbursed more if you are in GA? That’s my first guess. Has nothing to do with covid, but your insurance.
It’s an insurance thing. Go ahead and do it, bro. Insurance does not cross state lines.
It has to do with COVID because of the nonsense that we can’t have real exam visits.
So he’s forced into televisit.
I hate all this garbage. Just had a rear scope (delayed for 3 mos) and HAD to get COVID testing just days prior. All fine except, what if I get COVID in the days between? What was the point?
Never mind all the hesitation to even call a doctor, when we non-COVID problems have to wait at the back of the bus!
More likely, no reimbursement UNLESS in GA.
Hah. See #35.
My guess is that the rigamarole is due to their medical licensing not being valid for services delivered across state lines. You can drive and get a procedure done out of your state, but they cannot deliver services out of state, which, arguably, is what happens when they call their patient at his out of state residence. If this seems idiotic, it is.
It doesn't say he couldn't have a "real exam visit".
So can you do telemedicine for patients in other states now? Prescriptions?
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