Getting reimbursed for MyChart messages

[gap55u]

De-prescribing can be hard- getting buy in, etc. oftentimes I get to it by discussing adjusting meds (add or subtract) as I start something new. (Hey...

[gap55u]

https://gomerblog.com/author/naan-derthaal/
This orthopod talks to his bro’s and lady-bro’s. I’m a pcp but say hey lady-bro to someone at...

[gap55u]

One of my regrets is believing my now-fired advisor who said I was overweighted in brkb so I adjusted my portfolio. At least I didn’t eliminate the...

[gap55u]

This happened to me a long time ago. Don’t reply or engage- but it is very reasonable to solicit positive reviews. Particularly if you are new /still...

[gap55u]

Lagavulin, ardbeg 17 (wish I could get more!) ardbeg corryvreckan, an oa, port Charlotte. Recently finished a speyside independent bottling. Woodford...

[gap55u]

I do a lot of 99214.999’s - addressing multiple chronic problems adjusting mult meds. One way to see more patients is to say hey I saw you for your...

[gap55u]

I can envision (but would not enjoy) 5 patients per hour 99214. Suspicious if you do no 99213’s as an FP. I would be very interested to know how many...

[gap55u]

I’m glad that works for you. There is no way I would allow 2000+ patients to have access to my cell phone, even if it was a Google voice #!...

[gap55u]

Every day, patients waste some of their visit time with me (Pcp) complaining about how specialists don’t reply to calls or mychart messages. I guess...

[gap55u]

I did a combination of TLH to offset gains, donating undesired legacy holdings to charity, biting the bullet and selling a portion at a gain and paying...

[gap55u]

I supervise two very experienced NP’s who were nurses for a long time before doing a brick and mortar program, and who have been practicing for years....

[gap55u]

Star trek doc - agree re panel management but frustratingly my value based pay is trivial. Still good for patient care, though.

The lawyers...

[gap55u]

One of my concerns about billable mycharts is that it could add a lot of time wasting low value care — patients won’t care if their nickel and time...

[gap55u]

Thank the law that mandates immediate results release - I have had patients see their HIV status and lung mass, to cite two examples, before I did. ...

[gap55u]

Tiny sample size but I have one elderly guy who came completely off opioids with a topical CBD off Amazon. I will occasionally recommend that (with caveats)...

[gap55u]

I agree with others that carrying the minimum needed for umbrella to kick in, beefing up umbrella and ensuring disability insurance is the way to go....

[gap55u]

My parents saw a concierge doc and got unnecessary labs and a bunch of tests that weren’t indicated (annual carotid screening, annual bone density by...

[gap55u]

Just looked up the wrvu. Was curious.
99213- 0.97. 99214- 1.5
virtual check in (phone) - 5-10 0.25. 11-20 0.5; 21+ 0.75

mychart...

[gap55u]

The minimum to count for an “asynchronous visit” is 5 minutes I think, over 7 days, and there is at least one longer time category. The issue is,...

[gap55u]

We used to have contracts that specified no one would make in excess of 90% of mgma for our specialty - like someone else said, I wonder if that is their...

[gap55u]

I agree with others who are driven crazy by having to call a number, to give a long case number to someone with a GED. Who asks a ton of stuff they already...

[gap55u]

PCP here, on EPIC. We are considering starting a standard process to bill for mychart messages more broadly (until now, it's been a case-by-case process....

[gap55u]

PCP here. Clinics recently dropped mask mandates- now optional. I stopped wearing a mask and promptly got my first URI in 2 years. . We are seeing an...

[gap55u]

This is likely very state specific. My state law is that the patient must be physically located within my state for me to do a telehealth visit.
...

[gap55u]

John Smith#1 picked up John Smith#2’s Percocet at the VA I used to work at (accidentally dispensed to the wrong John smith). Walked a block and was...

[gap55u]

My billing/revenue coders were seemingly shocked, but BCBS paid for a physical exam 99395 + 99214. We'll see how much that a) boosts my wrvu and b)...

[gap55u]

I want to go back to all the primary care doc's out there. For commercial insurance (BCBS etc), NOT medicare, NOT tricare, NOT medicaid-- tell me if...

[gap55u]

Not interested, never call again, add to do not call list. I wish I’d remembered what company/drug....

[gap55u]

One drug company found a frickin awesome way to get through to me: Dr Smith called asking for me. Patched through. Was Dr. Smith from India to tell me...

[gap55u]

If and only if value based care and population health starts to matter — then docs will show value compared to mid levels. A specialist friend goes...

[gap55u]

- i no longer refer to the cardiologist who asks that I monitor for amiodarone toxicity as a stock part of his notes.
- ditto a select few other...

[gap55u]

TT previously. CPA $450, needed some specific tax planning not just a return

[gap55u]

Re separate billing: 9939X -25 modifier.
9921X (for their uncontrolled DM / new back pain/ whatever)
As I mentioned before, our coding/compliance...

[gap55u]

Do your payors actually pay for that? Ours universally reject the E&M code. It's a racket on their part....

[gap55u]

Primary care here. I am increasingly parsimonious with labs (otherwise my inbasket is ridiculous and you chase a lot of BS). Like lordosis I follow uspstf...

[gap55u]

Other threads here also outlined using a living trust. I set up a living trust and bought i-bonds a that way. An aside: I used a NOLO library book &...

[gap55u]

My academic medical institution is pretty hypocritical: vigorously goes after departing docs over basically nonenforceable noncompetes, but drags out...

[gap55u]

I am currently renting based on a recent divorce. Pretty worried about what I’ll be able to buy with our current marker - awful for buyers (cash only...

[gap55u]

I have my beneficiary for ira (and POD and 401k) the gap55u living trust. It does create minor child trusts on my death. There’s a benefit to having...

[gap55u]

That is 100% absurd. I’m not sure that our new primary care docs make much more than that salary guarantee for the first two years, and certainly expect...

[gap55u]

500k exemption is split. If you lived in the house less than 2 years the 500k is proportionally reduced (x days / 730 days)*500k is the exemption. You...

[gap55u]

My state allows 529 for k-12 and offers tax advantages for contributions — so here, 529 clearly the best....

[gap55u]

I would cut back as burnout prevention & to tend to a relationship regardless of net worth. I ended up divorced and not as present for kids when they...

[gap55u]

I'd get rid of those shares. Don’t forget charitable contribution instead of selling, as well, if you already give to charity. This can be DAF or...

[gap55u]

I’ve done two reviews for a defense firm and felt standard of care was not met. I’m not sure they will contact me again. But it was my considered...

[gap55u]

In 50:50 custody, is it possible to have both households as head of household? Eg 2 kids, dad is head of household with 1 dependent and mom is HOH with...

[gap55u]

Followup question: I can TLH about 1K in VTI. I saw that ITOT - ishares Core S&P Total Index - is really substantially the same so a good TLH partner....

[gap55u]

Honestly I don’t like a business to be in your face about politics either way, to be accurate....

[gap55u]

I used to own a lot more brkb than I do now. Unfortunately my prior financial advisor convinced me that my portfolio was too concentrated with >5%...

[gap55u]

My biggest stupid tax was paid at the end of residency when a neighbor got me in to what was basically a Ponzi scheme. She didn’t lose all her money,...

[gap55u]

2 haircuts ago: Great Clips, 100% mask use.
Last haircut: independent shop, I was only one wearing a mask, OAN was on TV. I would have left if I'd...

[gap55u]

My understanding is that you want a trust after death for minor children. I created a Revocable Living Trust that once I pass becomes irrevocable and...

[gap55u]

I do want to consider my ex, certainly for the duration of spousal support, but she will be able to support herself (though not with physician salary)...

[gap55u]

Life insurance is very expensive due to health conditions. Current policies total 12k for 3.5M tailing to 4K-ish ending in a little longer than 20 years...

[gap55u]

I have life insurance, amount determined before divorce. Once divorced, the situation changes - I need to plan for kids, not kids/spouse. I don't want...

[gap55u]

Lordosis — the CDC put out their very confusing exit isolation at day 5 if no fever for 24 hours no antipyretic and all symptoms improving. But wear...

[gap55u]

As a family physician sending patients to specialties, man, I've absolutely seen poor decision-making. There are also some really good APP's. We've...

[gap55u]

I do AWV at the same time as chronic follow ups in a double slot. 20 minutes would be fine for most but I have 15 & 30 as options. One doc here looks...

[gap55u]

So I’m going through a divorce now. A few tips I learned
- regardless of what you choose re pre-nup, KEEP SEPARATE PREMARITAL ACCOUNTS. I did...

[gap55u]

Cubicle & Random1 -- I do suggest appointments or asynchronous for more detailed things. A few of my colleagues get page-long mycharts and end up...

[gap55u]

Must be nice! My organization is very rigidly in compliance with the federal law that says results must be released immediately. I routinely get mychart...

[gap55u]

Doc in my clinic (who speaks only English) has several Vietnamese patients who come to see him. The translation requirements really slow things down a...

[gap55u]

what about getting enough side gig income to roll into a solo 401K, then you have increased flexibility?...

[gap55u]

It’s even worse when patients find out about their new major findings via immediate release of results ( HIV, lung mass, unexpected renal failure among...

[gap55u]

primary care at the VA I worked at sucked — tons of phone/message based work, tons of narcotics, dysfunctional system, chronic follow ups only with...

[gap55u]

Mychart was marketed as “text your doctor any random question that pops in your head” it feels like. Some docs are absolutely overwhelmed some less...

[gap55u]

Don’t forget charitable giving for your most appreciated shares. As others said, you can fire your advisor now, but don’t have to simultaneously move...

[gap55u]

I recently talked to a patient about Covid vaccine. “I’m not getting those vaccines because they contain aborted fetal cells” <debunk this>...

[gap55u]

Our derm much prefers oral minoxidil to topical, which surprised me. Agree that you don’t get much, and certainly temporary with propecia...

[gap55u]

Opinion question: I have the cash, should I bother - Citi has a new checking account offer https://banking.citi.com/cbol/priori...er/default.htm that...

[gap55u]

I was medically retired (cue expensive life insurance, and I can't get disability insurance - shoulda met WCI sooner). The annual amount is inflation...

[gap55u]

It failed to link one of 4 accounts at Schwab, which was irritating. They are researching it. Slowly. It's fine - I just manually track that one ac...

[gap55u]

Part of me views the 21K in inflation-adjusted AF/VA pension as a bond equivalent -- it's 500K I don't have to save to get that 21K (500K * 0.04 = 21K)....

[gap55u]

Update 6 weeks later --
Post-divorce net worth will be around 1.5M. Health Insurance is covered for life. 21K in military/VA pension. Current...

[gap55u]

I should clarify my original post. Prescribe for the dual indication of off-label for weight, and for alcohol, but only tell the pharmacy & health...

[gap55u]

You could also prescribe naltrexone off label for weight loss, and indicate that was the reason on the sig line and diagnosis. I would document the weight...

[gap55u]

As posted in women’s issues, I’m guessing OP is a woman. In my area (a little more casual, most men do not wear ties, but still dress shirts) —...

[gap55u]

I fired my financial advisor -- who had me in a reasonable, though unnecessarily complex portfolio, when I realized they did not have my best interests...

[gap55u]

Correct. 10K Dr Lordosis, 10K Mrs. Lordosis, 10K Trust of Dr Lordosis, 10K Trust of Mrs. Lordosis, 5K from refund of overpayment of taxes. It's pretty...

[gap55u]

PCP here. Unless you are in a specific group you aren’t at high risk for hep B and don’t need it as an adult. You are making a false equivalence argument...

[gap55u]

I have some ibonds purchased in '99-'02 or so - yielding 7%. I wish I'd bought more back then. For my situation now, I'm thinking ibonds are a good idea...

[gap55u]

Edit: I was all screwed up on rate. Rate was a still-good 2.2 20 year VA from NASB....

[gap55u]

Thanks for the feedback.
The 529 is 75k far less than it should be. We had a spending problem. Putting in just $500/mo currently until I get used...

[gap55u]

Thanks to all. I do have a good lawyer and accountant in my corner. I'm in the 45-55 age range. About 10 years until youngest graduates high school. Post-divorce...

[gap55u]

I know a few on the forum have gone through divorce -- I'm in the process. In the interest of quasi-anonymity, I have kids and face "more than 5...

[gap55u]

Has anyone here used physician wealth advisors (ryan Inman from money meets medicine). Thanks! Strongly considering, their plan is 6k/yr and includes...

[gap55u]

I had a nurse practitioner patient mychart me asking about treatments for her mom since her cardiologists didn’t know what to do, what you you think...

[gap55u]

We use an app called "seek" for everything - bugs, animals, plants, etc etc. Great, and links to wikipedia. I'm not sure if it would work for...

[gap55u]

Re vaccination — I’m outpatient primary care and really not face-to-face with Covid a lot — but have had lots of patients with unnecessary disease...

[gap55u]

Several DO’s interested in ongoing OMT went to my FM residency. OMT isn’t 100% paying the bills but it tilts their mix as a FM sports doc sees a different...

[gap55u]

I have never been asked for a mask exemption form. Because our governor in his vast stupidity has said that parents can simply sign a form exempting their...

[gap55u]

Latest prior auth fun: Ordered an MRI. Denied. Told to call for peer to peer. After I called (as the primary care doc calling, ya know) I'm told by some...

[gap55u]

I completely do not understand how that patient was not dismissed after episode #1. After episode #2, absolutely!! Simply awful management. And the gall...

[gap55u]

Immunocompromised patients and vaccine boosters: I am checking titers for select patients. Kidney transplant, j&j was what he could get first - negative...

[gap55u]

We are upgrading from regular toothbrushes to electrics the adults have sonicares and we've been happy with that. For kids, any brand or model recommendation?...

[gap55u]

I have taken to having scripts as “x may substitute y” on my preference list because I don’t want the callback. If the emr integrated reliably...

[gap55u]

I mentioned my patient was Republican as he said it not me. His political bent meant he was hearing more anti-science, anti-vaccine media (Fox News and...

[gap55u]

I convinced a very skeptical, anti-government, anti-science, mistrustful (Republican) patient to get vaccinated today. I was respectful and offered information...

[gap55u]

I had an experience where an expensive rheum drug was approved to tune of >6k/mo. And an appeal for rhinocort (before it was otc) was required for...

[gap55u]

Others will correct me if I’m wrong, but you can put in 500 monthly to tIRA and wait a day and convert to rIRA. (Or any combination). At the end of...