swampwitch
Joined: 16 May 2006
Posts: 8
Location: Louisiana
PostPosted: Tue May 16, 2006 6:44 pm Post subject: how often should the neph. come to the dialysis unit
Hi FRN,
Wow! I just found this site after my husband was an dialysis for 3 years. What a gold mine!
So many questions answered already.
Heres a question I need an answer to. How often should the neph. visit the unit & how often should there be a one on one with the pt.? The neph. comes every few month and sends his PA every couple of months and theres never been a one on one. Is this standard procedure? He never returns calls and I would like to ask someone some question & have no one to ask. Thanks, I,m trying to be a good cregiver with limited info & its difficult at best.
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dialysis pt
Guest
PostPosted: Wed May 17, 2006 5:31 am Post subject: neph to unit
Most of them come to the unit 3-4 times per month since they get the highest reimbursement from Medicare for that.
Now a visit of the entire unit might only take 5 minutes and a quick you need anything while standing in ear shot of 8 patients but I guess that counts as a visit for Medicare purposes.
Look on your medicare Summary Notice ESRD realated svs 4+ mo statement you should see a line ESRD realaded svs2-3($700.62) mo or 4+ ($841.48). I don't know if a PA counts for this medicare billing or not.
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swampwitch
Joined: 16 May 2006
Posts: 8
Location: Louisiana
PostPosted: Wed May 17, 2006 4:03 pm Post subject:
thanks for your prompt reply.
medicare summary says 1 ESRD related svs 4+mo 20+yrs (G0317) $ 1,300
and then say what medicare approved , what they paid and what we may be billed(which his supplement has to pay).
If medicare is paying for 4 visits per month theyre getting ripped off big time! maybe a fraud case? hmmmmm? or does that mean they are paying for 1 visit every 4 months, in which case the neph is making out like a bandit. multiply that figure by the number of pts. seen in each 10 min. visit wow I should have a job like that! hey how ya doin have a nice day Bam 200 bucks from 8 maybe 10 pts not a bad deal.
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watching
Guest
PostPosted: Sat May 20, 2006 4:49 am Post subject: paying
IT means they are paying for a visit to the unit 4 or more times in a month. Apparanly a visit does not need to mean any interaction just walkby. Jot down for a month what days a doctor was in the unit see if there are at least 4 days in a month. Pretty interesting since most months amount to 12 treatments roughly and they claim they are 'visitin' 4 or more times - Right - and they are biling this to each and every patient in the unit. for 3-4 visits they bill $841.48 for 2-3 visits$700.62(someone messed up that month forgot to take a very profitable walk.
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swampwitch
Joined: 16 May 2006
Posts: 8
Location: Louisiana
PostPosted: Sat May 20, 2006 5:40 pm Post subject: paying the neph for... what?!
been counting for a while. comes every few months for sure & some times sends PA. unless he's counting reading monthly labs in his office on the monts he dosn't come. Definately a great way to make a living. (note to self...become a neph its eady $$$) maybe I should ask someone in the medicare fraud office hmmmmm? will surely not let this go til I have a satisfactory answer. I'm stubborn that way Thanks watching
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leadsag
Joined: 31 Oct 2002
Posts: 263
PostPosted: Mon May 22, 2006 3:18 am Post subject: fraud
I agree. We should all do that, when we get the medicare statement and see that charge we should send it to the fraud office. We should ask the Nephrologist billing for documentation of what dates they saw us in the unit. Then compare that to the dares we wrote down. If a difference - send to the fraud office!!!
I have spoken to a high ranking person at Medicare and he refers to this as "Drive-by doctoring." I took this to mean they are aware of this problem but they need some of us to complain and suggest we document that there is fraus.
So I guess the answer to the initial question of how often is depends on how much money they want to make.
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swampwitch
Joined: 16 May 2006
Posts: 8
Location: Louisiana
PostPosted: Mon May 22, 2006 5:24 pm Post subject:
thanks leadsag,
Drive by doctoring???!! what the... kinda garbage is that! My taxes pay for that?? Bull.....! My hubby is letting me know when the Neph or his PA come. That stuff has to stop. Its peoples lives they're playing with. It's bad enough that half the techs dont't hav half a clue what they'e doing and some of the nurses dont care but this is too much. Im now officially at war. This is a declaration! more to come.
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leadsag
Joined: 31 Oct 2002
Posts: 263
PostPosted: Tue May 23, 2006 3:22 am Post subject: count me in
Count me in on the battle - Most of the patients at the unit worship the doctor ....he is such a great man.....and they don't care to hear that he/she is just making big bucks off us and ripping off the gov't in the process
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ask for proof
Guest
PostPosted: Wed May 24, 2006 1:47 pm Post subject: Proof of dates seen for non-dialysis charges
I asked the billing dept today for proof of dates seen and got the resopnse it was in March - asked again - I want dates Got some sheet eventually with a date adn dr.'s scribble looks like running at XXX/ML/Min.... hard to tell if he was ther or ot - keeping my own log sounds like a good idea
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jented
Guest
PostPosted: Thu May 25, 2006 1:02 pm Post subject: Re: Proof of dates seen for non-dialysis charges
[quote:2e0e016611="ask for proof"]I asked the billing dept today for proof of dates seen and got the resopnse it was in March - asked again - I want dates Got some sheet eventually with a date adn dr.'s scribble looks like running at XXX/ML/Min.... hard to tell if he was ther or ot - keeping my own log sounds like a good idea[/quote:2e0e016611]
This is my first posting. I have been reading through all the postings and have learned alot. I know that we are not alone as many of our problems have been discussed.
My husband has been back on dialysis patient for 4 yrs now since his transplant failed in 2002. The dialysis unit is at a satelite unit 80 miles from the hospital that it is out of. And the nephr comes from there. Due to the rural community we live in, we travel 35 miles one way from home to reach this unit.
I was pleased to see the explanation of the 20 yrs + 4 mo. I have been looking for this info and have asked the billing dept many times for explanations of different abreviations with no answers. I was informed by the nurse manager that we see the dr. once a month. If that is so, why should he bill Medicare for 4 mo? There was a four month spell were the dr. never showed at all. The bills do not reflect that. It was 4 mo as usual.
We were also told that Medicare will only pay for 15 hours per week for a Renal Social Worker. There are 54 patients (9 stations/3 shift/TTS/MWF). I haven't seen the Soc Wkr in the unit in four weeks.
All the short cuts that are taken in patient care are excused by "that's all Medicare will pay for". It sickens me to see the lack of quality in patients' healthcare because of the holy dollar.
I agree this has become a WAR. We all need to speak out that this is unacceptible.
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swampwitch
Joined: 16 May 2006
Posts: 8
Location: Louisiana
PostPosted: Sat May 27, 2006 6:01 pm Post subject:
welcome to the war!!! I'm tracking visits & then will try to find out about the billing. But get this.... I tried to get hold of the neph by phone & was told the unit couldn't give out his phone #. How do ya reach the guy in an emergency if the unit is closed. He's not in the phone book either. I think I know who he's in partnership with. Will try to find out. What a racket.
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leadsag
Joined: 31 Oct 2002
Posts: 263
PostPosted: Sun May 28, 2006 2:15 am Post subject: Non-medical Unit
Just a reminder.....Unless the dialysis unit
you are at is in a hospital, you are dialyzing in a non-medical facility so not all the rules that you would think apply.
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Guest
PostPosted: Mon Jun 05, 2006 10:11 pm Post subject: Help, Being denied Diaylsis at Clinics
To Whom It May Concern:
I am an African-American who is HIV positive, who has been doing Hemo-diaylsis for about eight months. My problem is that I?m being deprived of services of a clinic or facility, because I?m not liked, or my personality is sturdy. However, I don?t think it?s aggressive, I think my personality is assertive. Meaning that I will not be allowed to be treated with contempt or stereotypical biases. I was kicked out of Davita in Thornton, for taking the bandages off my needles, in which I just thought I was helping out, but I was automatically rejected from the facility, and I begged for forgiveness, and asked for another chance and they said no, I would no longer be allowed to dialysis at the clinic. Not knowing what to do I looked on the internet and found Fresenius. Meanwhile, I was receiving my dialysis through the emergency room, at sanatorium such as, St. Josephs, Presbyterian St. Lukes and Rose. In all these hospitals, they all went by the Potassium level in order to get me dialyzed, meaning if it was low, the hospital would not give you dialysis for that day, resulting in you coming back, sicker, due to the hospital?s protocol. Plus, I have to wait five to six hours in order to get dialyzed, but you have to get a room so the hospital will get paid. I personally think this is ridiculous. If I come to a facility every week to get dialyzed you would think that they find a way or a clinic for me to attend to, but that is not the case instead they give me a lecture about how I need to find a treatment center and when I explain I?ve been listed as a ?trouble maker? and way to opinionated. So clinics will not take me, as a result, I get dialysis from the hospitals, if a clinic would take me and treat me ?well? I?ll be more than glad to attend a clinic, but most clinics are way to aggressive and just plain have no compassion for clients as well as employees. Plus, if you have a grievance with a unit it will and can be used against you, how do you think I got the label trouble maker?
Fresenius was a nice facility, but the employees were to busy singing and dancing to really be concerned with the patients. Plus, the Program Manager, Linda was always insidious when dealing with me. If I asked her to wash her hands she would, become cynical and explain she did wash her hands, yet I see a blue ink mark on her hand and she became red in the face. Also, she decided one day she was going to put the needles in my arm, so of course in a clinic I had no choice and I allowed her to put the needles in my arm. Well, as a result of Linda not paying attention and laughing with her fellow employee?s she infiltrated my arm. So as a result, I couldn?t dialysis that day or for the next coming week. So of course I made a grievance, because I felt that it was done on purpose and not done in a professional manner. After, making the complaint against the program manager I was labeled a trouble maker. Everyday I came to dialysis I was given new regulations and new obligations which if I think about it, that were small irrelevant rules, just to put her at ease, I abided to this simplistic request. However, it just seemed the more I followed this rules, the more she disrespected me or even worst give me a lecture, on my personality, that I was ?angry? and I would constantly explain I wasn?t angry. However, I think because I listened to rap music, I was considered to be ?angry?. So I would be asked every visit to talk to Linda in the facility to be talked to about my persona. Plus, she told me I could do three hours and I would be fine, then after all the rules she gave me she said ?legally? she can not allow me to do three hours, which at the same time I was signing a release form explaining that I was aware I was doing three hours. So as a result, of the strain I left the facility, thinking I rather go through the hospital then go through this facility. So I left and not thinking I would return. Yet, I get a call two days after the episode and the social worker is trying to persuade me back into the facility. What?s interesting is that now, I wanted to return back to the facility, thinking I?m willing to compromise if the company is willing to meet me half way, but I was told that they didn?t want me back, or rather I couldn?t come back to the facility.
At present, I go through the emergency of the hospital in order to get dialysis, I realize it?s expensive and time consuming and more than 91% of African-Americans who dialysis supposedly go through the emergency of the hospital to get dialyzed. In which I think is another racist form to oppress Black Americans. So in going to hospital they as well give me a hard time, they want me to get a chronic unit, but the problem is, no unit will take me, so my options with treatment is limited. Yet, the control, or the illusion is the control is in the chronic units, yet these units are unsanitary, the technicians are abrasive, rude, rough, Kurt, confrontational. What?s even more fascinating is I?m the man who is HIV positive dealing with E.S.R.D. (Kidney Failure). There is no compassion or empathy for us as clients, and I?m most definitely not the only one who has problems with units in Colorado. Many others have ?major? problems with facilities, but don?t say anything, because it most definitely will be used against you, in either treatment, or how that technician treats you. Even the way the doctor treats you. So one who is a patient must be ?passive? and silent and to express that the needles in your arm hurt in anyway makes the technician feel scared or makes them nervous. Also, many of the technicians ill inform patients, resulting in confusion on the patient?s part. Also, the discrimination in units is rapid and swift although African-Americans make up a large percentage of Kidney failure, you rarely see any African-Americans if one in a chronic unit.
For Instance, as stated before I go through the hospital?s emergency room to get dialysis. Anyway, I met a young African-American women, whom was a patient at Davita in Littleton, they kicked her out as well with no warning no write up no protocol what?s so ever, and as a result for six months she?s been going through the emergency three times a week. Although, she said she didn?t mind, I really felt her pain, due to the fact I was in the same position, and her doctor is Mrs. Susan , who is nice but really doesn?t have any pull to get an individual into a clinic. She?s just a primary doctor who writes out prescriptions to patients, but to have her wait six months for a unit means Mrs. Susan can?t really do anything if a unit decides they will or won?t allow you to get treatment. Finally, when I go the hospital?s they sometimes will not dialysis me because me blood work is good. For example, if my potassium is 6 or above they will dialysis me, even if my creatinine level is high and my BUN is high they still will not dialysis me. I think that is so ?dumb? if I?ve been coming to the hospital every week with the same diagnose then I should be able to get dialysis without lecture or confrontation. Plus, for the hospital to get paid with dialysis I have to get a room so the hospital will get paid this is, foolish to me because as soon as I get dialysis I feel good, and I don?t need a room, I only ?need? a room when I?m sick, really sick. Lastly, the hospital can be o.k. without the lectures of trying to get another unit, when no unit in Colorado will take me, for I?m non-compliant which means I?m too much of a trouble maker, to much into the details.
Signed,
Disenchanted Patient
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Arlene
Site Admin
Joined: 02 Feb 2003
Posts: 48
PostPosted: Tue Jun 06, 2006 7:38 am Post subject: Please call me! I am pasting this on the discussion board Reply with quote
under a new topic. Please call me at *********.Arlene
