I recently read a blog post by Jennifer Dennard discussing an interesting electronic service for doctors and patients called Patient Point. Apparently, it’s a service with strength in HIPAA-compliant doctor-patient communications. On one hand, I think this is a great idea. The concept of having electronic access to your doctor works well for most modern-day computer aficionados. On the other hand, how does the doctor get reimbursed properly for time spent in this type of work? If we’re talking about eliminating an office visit, but the work to be accomplished is basically an electronic office visit equivalent, then the payment to the doctor should remain the same. How does this system allow the doctor to bill appropriately for potentially a lot of money? Without such a clearly ironed-out rubber-meets-the-road provision, I think most private doctors will pass on this opportunity, which would then just be equivalent to an uncompensated time sink.
To further illustrate my point, about six months or so ago, I was excited to find CPT billing codes for telephone consultations, based on time spent providing healthcare by phone. We tried billing this, for services rendered, to several patients’ insurance companies , including Blue Cross Blue Shield, Aetna, Cigna, and Medicare. Every single one of these claims – each for about $10-$15 — were denied without exception, despite completely reasonable services rendered. These phone conversations dealt with issues such as managing medication side effects, changes in current prescription medications, new prescription medications, and evaluating and managing new symptoms. When we called in inquire with each insurance company as to the reason for denial, all said that while these codes existed for “some plans”, the specific patient that we were treating “unfortunately” didn’t have this plan feature. All I can say is, yeah right. I’m sure this is some type of loophole that makes the insurance company look good in some sense without actually providing any service to patients.
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at firstname.lastname@example.org.