by Caroline Fife, M.D. | Jan 22, 2021 | Healthcare Payment Policy, The Patient's Voice
It’s happening more and more often. Patients have such high co-pays and deductibles that the basic things needed for wound management are becoming unaffordable. I am seeing this with private pay insurance and with Medicare Advantage plans (see more about this in...
by Caroline Fife, M.D. | Jan 12, 2021 | Healthcare Payment Policy, Tales of the Medicare Disadvantaged, The Patient's Voice
Here’s another story from Patricia Han about her Medicare “Disadvantage” plan: –Caroline I started looking for a Medicare Advantage (MA) plan in 2013. I studied every plan in detail. As I have mentioned, I am a nurse and have worked in the insurance industry and...
by Caroline Fife, M.D. | Jan 11, 2021 | Healthcare Payment Policy, Tales of the Medicare Disadvantaged, The Patient's Voice
If your practice is like mine, an increasing percentage of your patients have Medicare Advantage (MA), rather than traditional Medicare fee for service (FFS). If you are like me, you have been frustrated with the inability to get their Medicare “Advantage” plan to pay...
by Caroline Fife, M.D. | Jan 8, 2021 | Healthcare Payment Policy
The G2211 code (the inherently complex add-on code for evaluation and management — EM) has been deferred to 2024. Instead CMS increased the RVU value to $34.8931, which is 3.75% global pay increase for physicians. CMS has produced NO other regulatory guidance,...
by Caroline Fife, M.D. | Jan 6, 2021 | Healthcare Payment Policy
Effective January 1, 2021, Texas Health and Safety Code, §§481.0755 requires that prescriptions for controlled substances to be issued electronically unless a waiver has been granted by the appropriate agency. I have been using electronic prescribing for several...
by Caroline Fife, M.D. | Jan 5, 2021 | Healthcare Payment Policy
Dr. Helen Gelly sent me the statement below from Blue Cross Blue Shield of Alabama (BCBSAL) as it pertains to considerations regarding Hyperbaric Oxygen Therapy: Menstruation: There is a great risk for decompression illness in the early phase of the menstrual cycle....
by Caroline Fife, M.D. | Dec 16, 2020 | Healthcare Payment Policy
It’s time to revisit the issue of the relationship of the physician to the hospital-based outpatient department (HOPD), the “site of service” for many wound care programs. The issue is confusing, I agree. More and more wound management is being done in doctor’s...
by Caroline Fife, M.D. | Dec 10, 2020 | Healthcare Payment Policy, Quality Payment Program
Here are links to information regarding the Physicians Fee Schedule final rule: Final Rule Physician Fee Schedule Final Rule fact sheet Quality Payment Program Final Rule fact sheet and FAQs Here are the Physician Fee Schedule files:...
by Caroline Fife, M.D. | Dec 9, 2020 | Healthcare Payment Policy, Quality Payment Program
CMS is conducting Webinars on the Final Rules of the Quality Payment Program and the Physician Schedule – starting today! 1. Register for the December 9 Overview of the 2021 Quality Payment Program Final Rule Webinar 2:00 – 3:30 pm eastern The Centers for...
by Caroline Fife, M.D. | Dec 8, 2020 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Healthcare Payment Policy
I understand why companies develop products for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs), even though those are NOT the most common wound problems. It’s because the clinical trials needed to satisfy the Food and Drug Administration (FDA) are well...
