My wife is a pharmacist at a 500 bed hospital. I ask her every day if it is getting crazy yet and she says not even close. The hospitals and doctors must be losing a ton and tons of money because they are not doing "elective" procedures. She says they don't have many Covid patients either and are getting similar reports from other hospitals in their system.

She has been desperately trying to get in to see her or a neurologist due to migraine headache issues and so far not much luck. She started on Aimovig injection a few months ago and now is getting terrible headaches toward the end of the monthly period of the dose. She is also in a lot of pain with her knee and needs a Gel shot for that and was told by the large ortho practice she would have to wait.

I go to my oncologist every four weeks for a shot of octreotide and follow up. Last time was March 28 and the usually busy office had only a couple patients and everyone, including those that worked at office, were screened before allowing entry. My Doctor told me that patients with low grade tumors for breast cancer were getting their lumpectomy cancelled. I can't imagine the stress that these women are going through. A lot of this "elective" stuff being cancelled does not sound so elective to me.

I really hope doctor offices and hospitals start seeing more patients soon, of course maintaining safe practices to minimize chance of virus spread.

The real question is how bad would things be without social distancing? I grew up in Bergen county NJ which is a pretty hard hit area. My parents who are in their 70’s have lost 6 friends already. My dad volunteers at a nursing home for veterans and as of last week 40 of their inpatients died from COVID.

CARES Act Provider Relief Fund: Action Required


Dear Valued Provider:

Thank you for your tireless efforts during this critical time. President Trump is providing support to healthcare providers fighting the COVID-19 pandemic. The President signed the bipartisan CARES legislation that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. Recognizing the importance of delivering funds in a fast and transparent manner, the Department of Health and Human Services (HHS) is distributing $30 billion of the relief funds immediately. These are payments to healthcare providers, not loans, and will not need to be repaid.

Who is eligible for funds from the initial $30 billion?
Billing entities who received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. Your organization qualifies and you will automatically receive payment soon.

How are payment amounts determined?
Providers will receive a portion of the initial $30 billion distribution based on their share of total Medicare FFS reimbursements in 2019. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.

How will payments be distributed?
HHS is partnering with UnitedHealth Group to deliver funds. You will receive payment within two weeks via Automated Clearing House (ACH) to the Medicare routing number and account number you have on file with HHS. The automatic payments will come via Optum Bank with “HHSPAYMENT” as the payment description. Payments to practices that are part of larger medical groups will be sent to the group’s central billing office. All relief payments are made to provider billing organizations based on their Taxpayer Identification Numbers (TINs).

What action should I take?
Within 30 days of receiving the payment, you must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. Terms and conditions can be found on hhs.gov/providerrelief. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Payment Portal will guide you through the attestation process to accept or reject the funds. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions.

Whom can I contact for more information?

quote:

Whom can I contact for more information?

You copied an entire update - is this your actual question or just part of that?

Email I got this am


What action should I take?
Within 30 days of receiving the payment, you must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. Terms and conditions can be found on hhs.gov/providerrelief. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Payment Portal will guide you through the attestation process to accept or reject the funds. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions.

Whom can I contact for more information?
For additional information, please visit hhs.gov/providerrelief or call the CARES Provider Relief line at (866) 569-3522.

Thank you for all you are doing to support and protect the American people during this difficult time.

Eric D. Hargan
Deputy Secretary
United States Department of Health and Human Services

She has been desperately trying to get in to see her or a neurologist due to migraine headache issues and so far not much luck.

I might be of help here. Neuros are working full time. I can give you some resources. List your email in your profile and I will shoot you an email. How close are you to Chicago??

Here is good friend who is seeing patients in her office. The link provides lots of good info. Telehealth is an option with some of the neuros.

https://www.mississippimigrain...ristina-treppendahl/

quote:

Email I got this am

Almost every provider who bills Medicare got an ACH deposit last Friday or this Monday. Amount was ~6% of prior year Medicare payments. No action necessary to receive it but there a very specific guidelines for what you can and cannot do if you keep it. Those are published on their portal.

You also have to attest to those actions within 30 days. Failure to attest to them, but still keeping the money, means you effectively DID attest to them.

Portal link and more info here.

Thanks for adding the info. for me.

So, Doctor let me ask this. Does your office have a vestibule that can trap emitted breath vapors, coughs, or sneezes? Do you have the door from the vestibule to the Outside (preferred) or waiting area blocked open? Are you avoiding ANY use of the waiting area? Are you providing a mask for every patient walking into your office? Do you have someone monitoring every single patient and wiping down any surface touched by a patient immediately? If you have to answer NO to any of these questions your office is NOT safe for any patient with a high risk profile.
^^^^^^
I do not work in an acute setting seeing patients so that is not the issue for me. All of that screening IS available everywhere if you want it. Read what Dusty wrote. He is an ER doc. Telehealth is available as well. Medicare pays 100 percent of your tab. No excuse man. Doctors office probably safer than the grocery store or pharmacy. I am learning Telehealth. Not easy setting up all that stuff with no technical ability. You can see a top specialist if needed.

quote:

Originally posted by ZSMICHAEL:
She has been desperately trying to get in to see her or a neurologist due to migraine headache issues and so far not much luck.

I might be of help here. Neuros are working full time. I can give you some resources. List your email in your profile and I will shoot you an email. How close are you to Chicago??

Here is good friend who is seeing patients in her office. The link provides lots of good info. Telehealth is an option with some of the neuros.

https://www.mississippimigrain...ristina-treppendahl/

Thanks for the offer, very generous. Good news is Northwest Neurology got back to her this morning and prescribed some meds including prednisilone, same as last time, that worked well to deal with her "rebound" headaches.

^^^
Good to hear.

quote:

Originally posted by ZSMICHAEL:
So, Doctor let me ask this. Does your office have a vestibule that can trap emitted breath vapors, coughs, or sneezes? Do you have the door from the vestibule to the Outside (preferred) or waiting area blocked open? Are you avoiding ANY use of the waiting area? Are you providing a mask for every patient walking into your office? Do you have someone monitoring every single patient and wiping down any surface touched by a patient immediately? If you have to answer NO to any of these questions your office is NOT safe for any patient with a high risk profile.
^^^^^^
I do not work in an acute setting seeing patients so that is not the issue for me. All of that screening IS available everywhere if you want it. Read what Dusty wrote. He is an ER doc. Telehealth is available as well. Medicare pays 100 percent of your tab. No excuse man. Doctors office probably safer than the grocery store or pharmacy. I am learning Telehealth. Not easy setting up all that stuff with no technical ability. You can see a top specialist if needed.

It’s a trap.

quote:

It’s a trap.

What's a trap?

I am 82 with Type 2 Diabetes and wearing a pacemaker for AFIB. I believe that puts me in the category of serious risk. I am overdue to have bloodwork done and have been reluctant to visit my doctor to have that done because I don't want to encounter the waiting area. I am presently asymptomatic and want to stay that way.

flashguy

Blood work is now done by appointment in my area. I would suggest calling your doctor.

For the patients- call your local hospital. They will help you thru this crisis. If you watch the news, and your weather person or newscaster is broadcasting from home- that is what a telemedicine visit is like. Remote communication- has to be secure, has to be private.
For the providers- Spruce is a very easy app to allow a telemedicine visit. Secure, HIPPA compliant and meets criteria for billing.
COVID is no joke. It is a non discriminatory virus. New York has 600-700 deaths per day.
Obstetrics cannot stop- patients need to be seen in the office and hospital. Non emergency visits can be handeled with telemedicine. I used to worry about blood splatter. Now I worry about aerolization from patients pushing during labor.

On a different note- it was range day. Ringing the gong at 200 with 6.5 Creedmoor.

From Medscape:
There has been a massive decline in outpatient office visits as patients have stayed home — likely deferring needed care — because of COVID-19, new research shows.

The number of visits to ambulatory practices dropped by a whopping 60% in mid-March, and continues to be down by at least 50% since early February, according to new data compiled and analyzed by Harvard University and Phreesia, a healthcare technology company.

Phreesia — which helps medical practices with patient registration, insurance verification, and payments — has data on 50,000 providers in all 50 states; in a typical year, Phreesia tracks 50 million outpatient visits.

The report was published online April 23 by The Commonwealth Fund.

The company captured data on visits from February 1 through April 16. The decline was greatest in New England and the Mid-Atlantic states, where, at the steepest end of the decline in late March, visits were down 66%.

They have rebounded slightly since then but are still down 64%. Practices in the mountain states had the smallest decline, but visits were down by 45% as of April 16.

Many practices have attempted to reach out to patients through telemedicine. As of April 16, about 30% of all visits tracked by Phreesia were provided via telemedicine — by phone or through video. That's a monumental increase from mid-February, when zero visits were conducted virtually.

However, the Harvard researchers found that telemedicine visits barely made up for the huge decline in office visits.

Decline by Specialty
Not surprisingly, declining visits have been steeper in procedure-oriented specialties.

Overall visits — including telemedicine — to ophthalmologists and otolaryngologists had declined by 79% and 75%, respectively, as of the week of April 5. Dermatology saw a 73% decline. Surgery, pulmonology, urology, orthopedics, cardiology, and gastroenterology all experienced declines ranging from 61% to 66%.

Primary care offices, oncology, endocrinology, and obstetrics/gynecology all fared slightly better, with visits down by half. Behavioral health experienced the lowest rate of decline (30%).

School-aged children were skipping care most often. The study showed a 71% drop in visits in 7- to 17-year-olds, and a 59% decline in visits by neonates, infants, and toddlers (up to age 6). Overall, pediatric practices experienced a 62% drop-off in visits.

Nearly two thirds of Americans over age 65 also stayed away from their doctors. Only half of those aged 18 to 64 reduced their physician visits.

OK, I called my doc and got an appointment for last Thursday. Arrived and they gave me a mask. Sat in the waiting room about 20 minutes--only one other person there, about 10 feet away. Had the vital signs checks and a first check by my doctor. Blood got drawn. Second bit with the doctor and then had a couple of tests made--bone density and visual balance assessment. Bone density OK but minor issues with my spine. Got some exercises to use at home for balance improvement. Doctor said he'd had 2 patients check positive for COBID. He only tests patients with some other symptoms (and I don't have any).

flashguy

My dr is not seeing patients for most things.
You are screened over the phone and they tell you if you can come in.

My son in law is a Dr. and works for a firm that services 5 hospitals, he is very busy, though he is a specialist.0

I saw mine this morning. Very quiet in the waitng room. Most specialists, neurology, ENT and cardiology are working and seeing patients in the office. Elective surgeries are back on. Now is a good time to go if you have issues or need labs. The general public has been scared to death.