Wow, so they give the nurse triage service the credit card # and then they process the call for the office? What fee do you pay the service? Thanks Brenda Roderick Office Manager Kids Creek Children's Clinic ----- Original Message ----- From: "Susan Teaford" <> To: <> Sent: Monday, August 09, 2004 1:14 PM Subject: RE: PedTalk Digest V1 #1037 > Re: Charging for telephone calls > > In our small community the overall trend has been to hand over the phone > calls to a fee-for-service nurse triage service. Patients call the 800 > number, charge $30 to their credit card, and get all the advice they need. > We have a written up protocol for meds the nurses may call in, ie nystatin, > auralgan, phenergan. If necessary, the nurse calls the doc on call. On > average, we get called maybe once or twice a week; no charge but we don't > mind because it's so infrequent. The charge also makes parents think twice > about calling, thus eliminating those calls about > routine-for-the-office-hours issues. Because this is a fairly new concept, > the insurance companies didn't have an issue with it. > Life is much quieter; we used to get up to 8-10 phone calls an hour! > > Susan Teaford, MD > San Luis Obispo CA > > -----Original Message----- > From: [mailto:] > Sent: Sunday, August 08, 2004 9:26 PM > To: > Subject: PedTalk Digest V1 #1037 > > > > PedTalk Digest Monday, August 9 2004 Volume 01 : Number 1037 > > > > In this issue: > > RE: BCBS not paying for ADHD > Charging for Telephone Calls > Re: Charging for Telephone Calls > Re: BCBS not paying for ADHD > Re: BCBS not paying for ADHD > Insurers and selective imm. coverage > Re: BCBS not paying for ADHD > L.A. Times Editorial - "Safer Vaccines for Children" > > See the end of the digest for information about PedTalk-digest. > > ---------------------------------------------------------------------- > > Date: Wed, 4 Aug 2004 09:34:34 -0700 (PDT) > From: Dave Hoffman <> > Subject: RE: BCBS not paying for ADHD > > I think billing for "something else" is dangerous territory. When I was in > med school we had lousy student insurance that didn't cover well visits. At > the time I appreciated my daughter's doc coding a 99213 for "Diaper Rash" > (which she barely had) on some well visits. But now I feel we should bill > for what we do (no more, no less), and leave it up to the parents to gripe > to their employer about the inadequate insurance. > > The flip side of this issue is why insurers will pay "mental health > providers," and not primary care providers, for identical services. I was > trained in residency to diagnose and treat ADHD, I'm board certified and > licensed, and I'm on the provider panel of the insurer. They don't say I > can't treat otitis media because I'm not an ENT! > > Dave Hoffman > Howell, MI > > ------------------------------ > > Date: Wed, 4 Aug 2004 13:48:49 -0400 (EDT) > From: Karen Cookson <> > Subject: Charging for Telephone Calls > > Hi, > I am interested to know if any other practices are charging for phone > calls > made to patients after office hours? If so, can I ask what you are charging? > Do any insurance plans currently cover these charges? Thanks for the info. > Karen > > ------------------------------ > > Date: Wed, 4 Aug 2004 14:29:35 -0400 > From: "Brenda Roderick" <> > Subject: Re: Charging for Telephone Calls > > Such a fresh subject in our minds. > > We approached one of our HMO's about this and they said NO WAY. We debated > on charging and have implemented some other "policies" in our office > regarding phone calls that we're going to try before we implement charges. > This is what we're planning on charging: > > 99371 (Phone call, level 1) $25.00 (See CPT description) > 99372 (Phone call, level 2) $50.00 > Forms Fee $3.00 (we charge this currently) for any camp, sports, daycare or > other forms that are not brought to the appointment with them. > $25.00 per medical record (we currently charge this) to patient > $45.00 per medical record to "other agencies" > $15.00 prescription refill because it was lost or medicine was lost > $14.00 per call for After Hours calls (this is what we're charged by our > nurse triage service, we anticipate charging $15.00 per call) > > > > - ----- Original Message ----- > From: "Karen Cookson" <> > To: <> > Sent: Wednesday, August 04, 2004 1:48 PM > Subject: Charging for Telephone Calls > > > > Hi, > > I am interested to know if any other practices are charging for phone > calls > > made to patients after office hours? If so, can I ask what you are > charging? > > Do any insurance plans currently cover these charges? Thanks for the > info. > > Karen > > > group. > > > > > > ------------------------------ > > Date: Wed, 4 Aug 2004 15:16:39 EDT > From: > Subject: Re: BCBS not paying for ADHD > > In a message dated 8/4/04 11:41:02, writes: > > << I'm wondering if there would be any usefulness in trying to get ADHD > reclassified as a Nervous condition rather than a Mental Health issue in > the next revision of the ICD codes. I've heard there's a ICD-10 due soon.>> > > I think the dichotomy between mental/emotional diseases and physical > diseases > is totally false. However, the insurance companies know that they have a > good > thing going. > > Dan Nussbaum > > ------------------------------ > > Date: Wed, 4 Aug 2004 14:03:38 -0700 > From: > Subject: Re: BCBS not paying for ADHD > > So true. The head IS connected to the body. Also, not everything that > looks > like ADHD is ADHD. Other medical conditions have to be ruled out. > > Vicki > > > > I think the dichotomy between mental/emotional diseases and physical > > diseases is totally false. However, the insurance companies know > > that they have a good thing going. > > > > Dan Nussbaum > > > > ------------------------------ > > Date: Wed, 4 Aug 2004 16:20:16 -0700 (PDT) > From: kohlrussk <> > Subject: Insurers and selective imm. coverage > > While we are on the insurance coverage issue...how about the insurer we just > came across that does not include Prevnar in their immunization benefit for > employees because it is not required for school and they ONLY cover those > that are required? > > Or, how about the insurer that we cannot yet seem to convince that > Hemophilus Influenza B shot is NOT a flu shot (causing us to repeatedly > submit claims)? > > I sense that we will soon be reporting them to the insurance commissioner as > we did another company who was telling us they only reimbursed for separate > Hep. and separate HIB. and that we should bill the combination this way. We > wrote the commissioner and reported them. After notification from the > insurance commissioner (who "instructed" them to change their system within > 30 days or else...) they did! One office CAN make a difference on a large > scale:) > > Karen Kohlruss RN BSN > Holland Pediatrics > > ------------------------------ > > Date: Wed, 4 Aug 2004 22:15:21 -0400 > From: Harry Gewanter <> > Subject: Re: BCBS not paying for ADHD > > We are paid for the E&M charges in Virginia for all those codes as long > as we don't use the mental health codes. These are legitimate > diagnostic codes and their usage is not based upon one's specialty. > > Harry Gewanter, MD > Richmond, VA > > ------------------------------ > > Date: Sun, 08 Aug 2004 21:15:55 -0700 > From: Michael Sachs <> > Subject: L.A. Times Editorial - "Safer Vaccines for Children" > > http://www.latimes.com/news/printedition/opinion/la-ed-vaccine7aug07,1,19043 > 52.story > > EDITORIAL > Safer Vaccines for Children > > August 7, 2004 > > Newborns with parents who conscientiously follow their doctors' advice > become virtual pincushions. Babies get pricked and jabbed with needles > nearly two dozen times in the first 18 months of life to protect them > against once-devastating diseases like measles, tetanus and hepatitis. > Added to the list is a new recommendation for toddlers and pregnant women: > flu shots. But few parents are likely to be aware that along with the flu > vaccine, their kids might be getting injected with potentially dangerous > amounts of mercury. > > Drug makers have long added mercury-laced thimerosal to some vaccines to > prevent bacterial growth. Mercury can cause neurological damage and > learning problems, and many scientists worry about growing environmental > exposures to it. There is a sharp and unresolved scientific debate over > whether thimerosal in vaccines has contributed to a steep rise in reported > autism cases. > > Thimerosal is often added when vaccines are packaged in multi-dose > containers because repeatedly piercing the vial's rubber stopper with a > needle can introduce bacteria. Until five years ago, kids getting a full > range of injections were often exposed to mercury levels well above > Environmental Protection Agency guidelines. > > But beginning in 1999, after requests from federal health officials and the > Academy of Pediatrics, pharmaceutical manufacturers voluntarily switched to > single-dose vials, which have only trace amounts of thimerosal, for most > children's vaccines. > > The problem arises again because of flu shots. The only maker of influenza > vaccine for toddlers, Adventis Pasteur Inc., already markets its product in > both single-dose, thimerosal-free vials as well as multi-dose packages that > contain the preservative. > > Assemblywoman Fran Pavley (D-Agoura Hills) has responded with a bill that > would ban more than trace amounts of thimerosal in vaccines for children > younger than 3 and pregnant women. Adventis opposes the bill, hinting that > it might lead to vaccine shortages. To address this concern, Pavley amended > her bill to allow thimerosal-containing vaccines to be used in the event of > a public health emergency. > > Iowa has passed a ban on thimerosal, and similar measures are pending in > other states and Congress. AB 2943 passed the Assembly in May and could > come before the full Senate by mid-August. Common sense and prudence argue > for its passage. > > If you want other stories on this topic, search the Archives at > latimes.com/archives. > > Copyright 2004 Los Angeles Times > > ------------------------------ > > End of PedTalk Digest V1 #1037 > ****************************** > > group. > To unsubscribe: mail "" with with > "unsubscribe" > group. > >