I had a procedure done last week. The doctor supervising told me to see my family practice doctor in a week. Of course, he wasn't accessible, so I went to one of his nurse practitioners. She came in and asked me why I was there. I told her about the procedure and that this was a follow up. She then asked what I wanted her to do. I told her to check the site and me over for any signs of internal bleeding, and take my vitals to make sure I wasn't dying. She did, and I left.


Shouldn't your practitioner know this stuff?

Around here, this is what we get for medical advice:

I’m finding that out. Two weeks ago I had a mild case of Covid, onset of less than 24 hours.

I asked the Urgent Care physician to prescribe Paxlovid and he proceeded to give me many excuses why he didn’t want to and why I should let it “run it’s course”! One reason he gave, rebound Covid was a possibility.

I brought up the facts, 72 y/o, asthma, high B.P. and cholesterol (under control) and CABG patient, reluctantly he agreed but when he left the room I made a backup call to my cardiologist, he acts as my PCP normally.

Prior to his leaving the room I asked him if he wanted to call my cardiologist to get his ok to prescribe Paxlovid. His answer was “I don’t talk to other doctors.”

Now that was a weird response. I’ve seen other doctors, specialists and ER doctors over the last 26 years and never ever gotten a response like that.

Yeah, I would find that wierd.

"What do you want me to do?"

"Whatever it is that you're supposed to do!"

Heck, I didn't go to medical school.

quote:

Originally posted by shovelhead:

“I don’t talk to other doctors.”

Totally unacceptable!

quote:

Shouldn't your practitioner know this stuff?

Thank administrative policies to maximize profit.
The MD who said I do not talk to other docs should be in another line of work.

^^^^
This doctor also said to me “Many insurance companies will not pay for Paxlovid” to which I replied “If they don’t I’ll deal with it.”

I did have to ask him for a cough suppressant as he didn’t offer one. The ironic part, my Medicare Advantage carrier, BC/BS paid for the Paxlovid with no co-pay but charged me just under eleven dollars for the suppressant.

Procedure done by MD is billed by MD and MD is responsible for any complication that occurs in the post op time frame. You can't pass the buck to the Family Practice for a post op check--in medical terminology it's called FRAUD.

quote:

Originally posted by SIGfourme:
Procedure done by MD is billed by MD and MD is responsible for any complication that occurs in the post op time frame. You can't pass the buck to the Family Practice for a post op check--in medical terminology it's called FRAUD.

BINGO!

quote:

Originally posted by SIGfourme:
Procedure done by MD is billed by MD and MD is responsible for any complication that occurs in the post op time frame. You can't pass the buck to the Family Practice for a post op check--in medical terminology it's called FRAUD.

I refer pain (injection) patients back to their PCP for follow up all the time. Our orthopedist does procedures every day and hands (in)patients off to the hospitalist every day. ER docs do procedures all day long and give patients instructions to follow up with their PCP. Are we all committing fraud?

Family practice cannot bill for a post op visit-MD who performed procedure is responsible party. Pain Patient who receives epidural injection , develops headache is managed by MD who performed the epidural. Hospitalist accepts ortho patient for inpatient pain/PT then develops fever- Orthpod is called back. ER patient has procedure done and has pain comes right back to ER.
Typically , Family practice does a pre op visit to clear a patient for surgery- not the reverse.Family practice cannot code/charge for a post op visit- that would be fraud.

You're saying that the hospitalist cannot bill for treating the post-op knee that gets infected without committing fraud, the neurosurgeon I send my epidural hematoma to cannot bill for treating it without committing fraud, and the family practice doc cannot bill for removing sutures placed in the ER without committing fraud? Sorry, but that is just a silly assertion because it happens everyday everywhere. There'd be a whole lot of providers in jail if it were illegal.

quote:

Originally posted by shovelhead:
His answer was “I don’t talk to other doctors.”

Words fail.

I've dealt with medical doctors as friends and as a patient for decades, and they all routinely talk with, consult with, and respect one another. I don't think I'd go to a doctor who said that and meant it.

This message has been edited. Last edited by: joel9507,

quote:

Originally posted by SIGfourme:
Family practice cannot bill for a post op visit-MD who performed procedure is responsible party. Pain Patient who receives epidural injection , develops headache is managed by MD who performed the epidural. Hospitalist accepts ortho patient for inpatient pain/PT then develops fever- Orthpod is called back. ER patient has procedure done and has pain comes right back to ER.
Typically , Family practice does a pre op visit to clear a patient for surgery- not the reverse.Family practice cannot code/charge for a post op visit- that would be fraud.

What is modifier -55?

Over the last ten years I have had more "procedures" done than you can shake a stick at. A few were in-hospital stays most were out-patient. I have NEVER had the surgeon tell me to have a follow up with my family doctor. They are all done at his office.

Interesting. To make it stranger, it was done at a hospital not affiliated with my doctor, they had better equipment. My intake dr was a contract "rover" out of Florida, and had no access to my records (she said.) We spoke extensively to give her the data. I was then wheeled into the procedure room where a PA and a tech did the work.


Oh well, I survived. I'll know better next time.

quote:

Originally posted by Gustofer:
You're saying that the hospitalist cannot bill for treating the post-op knee that gets infected without committing fraud, the neurosurgeon I send my epidural hematoma to cannot bill for treating it without committing fraud, and the family practice doc cannot bill for removing sutures placed in the ER without committing fraud? Sorry, but that is just a silly assertion because it happens everyday everywhere. There'd be a whole lot of providers in jail if it were illegal.

I think it depends on whether the procedure is done by order or referral. Family MD orders a epidural for my wife done by an interventional radiologist, follow-up with family dr. The interventionalist doesn't have an office to meet her in. He sent me to a neurosurgeon by referral and the neuro ordered and did the surgery. Follow-up with neuro.