Wednesday, December 03, 2008
Amish photo question
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We are getting a retinal camera soon. Our practice sees a fair number of Amish patients. I wonder if they will have any objection to having a photograph taken of their fundus. Has anyone encountered a problem with this subject?
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Tuesday, December 02, 2008
Healthcare reform
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As always, I am sure the American Optometric Association is not involved or looking out for optometrists interests' in the formulation of any universal healthcare proposals.
This is a great opportunity for the influence of Wal-Mart to benefit optometrists. I hope officials from Wal-Mart's Health and Wellness division are getting involved in the debate of universal healthcare!
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Monday, December 01, 2008
instrument disinfection
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Can anyone suggest a simple regimen to disinfect and store an Alger brush and foreign body spud after each use? I do not have an autoclave and am wondering what other doctors are doing with their hand held instruments.
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Wal-Mart supplied exam forms
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Anyone else having difficulty understanding how to fill out the updated "patient examination forms"? How much do we actually need to write under: meds; ocular ROS. What's the difference b/n chief complaint and HPI. Any insight will be greatly appreciated.
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Sunday, November 30, 2008
diabetes
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I take fundus photos on all my diabetics even ones without retinopathy, i just do it as a courtesy to the ones who dont have retinopathy. I only bill insurances when there is diabetic retinopathy. Do any of you bill insurances for your diabetics without retinopathy? if so what diagnosis do you use? thanks KI
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Tonopen
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What brand of tonopen is good?
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Saturday, November 29, 2008
RTA 5 is the single best piece of equipment a Wal-Mart OD can aquire
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It is better than the time domain OCT, more affordable than the fourier domain OCT, more versatile than a GDx or HRT.
Have at it. Tell me why I am wrong.
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Medical Billing Help
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I've been reading some comments on medical billing and have read the article by Dr. Rumpakis but am still a little confused. If we bill BCBS ppo for examle and we find a medical complaint, do we bill stictly 99xxx codes or can we bill 92xxx codes as well? Now if we bill 92xxx codes do we put the medical DX with the 92xxx procedure and can we use S codes for this example and how? I guess we can S codes to justify different price points for the same code, is that correct? Also when we say we should always bill Refraction 92015 seperately, do we charge the patient for this in each case, as in Medicare or BCBS? How about EYEMED? They don't pay for the refraction and we don't charge for it. Why the differences in refraction and how do we keep it the same accross the board. Please help. We don't want to be doing these the wrong way. Thanks
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Friday, November 28, 2008
Visual Field Billing?
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How do you bill an insurance for running a visual field if on the exam day there are high fixation errors on two complete bilateral fields and as a result you need to bring the patient back for repeat fields on another day? Do you bill once(for day one) or twice(for day one and two)? Thanks in advance. Vernon
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Thursday, November 27, 2008
Superbill ?
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When we fill out the superbill, does the patient get a copy? The last time I was at my podiatrist, dentist, general physician, chiropractor, and for my mother's cataract surgery evaluation at the ophth. I did not receive a superbill from any of those specialties. I received a fee slip for my out of pocket copay, but nothing regarding what the insurance company will be billed. At the end of the exams I perform, I have too little time to go through everything on the superbill and calculate what I am going to be billing the insurance co. and counting up all the exam components to determine the exact code. I at least come up with what the copay and other noncovered costs - is that enough to give the patient? Thanks in advance.
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Fill-in doctor rent ?
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I know the topic of fill-in doctor rent has resulted in some inflamed discussions in the past and it is not my intention to resurrect those previous issues. Here is the dilemma that I am facing: I am going to be replacing my fill-in doctor next month because he is moving out of the area. When he began working as a fill-in, I did not own any advanced instrumentation nor did I have any employees that worked on days he was in the office. I have charged him the customary fill-in doctor rent and there were no problems with that percentage on either side. When I figure out my daily advanced instrumentation expenses, payroll costs for the technicians that I will be providing the fill-in doctor when he is working in the office and the amount of revenue potential that the second doctor could achieve using the equipment I am financing; I come out in the red if I maintain the current rent percentage. I do not like the set fee approach as it does not give the fill-in doctor an incentive to work more. I have considered the guaranteed pay plus a percentage for fees over a set amount, but the numbers don?t work out very well either, especially with how much the local area doctors expect for the guaranteed portion. I was thinking today that an alternative approach would be to keep the customary percentage rent for the fill in doctor when calculating exam fees but then for the procedure codes that allow for a technical and professional components, I could separate those two fees and that would assist with covering payroll and advanced instrumentation expenses on the days the fill in is working. Also, I would only generate more for my payroll/costs if the advanced instrumentation was used by the fill in. So, my question is: Can I separate the Technical and Professional component on visual fields, ext. ocular photography, fundus photography and scanning laser(GDx) within my own office where the fill in bills for the professional fee and I bill for the technical fee because I own the equipment? Sorry so long.
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Wednesday, November 26, 2008
Trade my Volk Super 66D lens for your 20D
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I have a Vok Super 66D Fundus lens in perfect condition that I want to trade for a 20D Biomicroscopy lens.
Volk double aspheric HI/LD (high index... low dispersion) Lanthanum glass. Better resolution than your 78D, and wider field of view than your 60 diopter. The Super 66 Stereo Fundus Lens delivers 3-D virtual image for the dection of macular edema or detailed evaluation of the cup-to-disc ratio and optic nerve head contour in glaucomatous patients.
email me at nspeer55@gmail.com
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