Random Questions

Getting paid for telemedicine has been eased under the present crisis, so the insurance companies are not requiring providers to first complete several hours of training, and currently although strongly advised, they stopped short of requiring HIPAA compliant technology (eg FaceTime and Skype are not HIPAA compliant), and for some services telephone calls are not covered by insurance, and you have to use the right billing codes and right modifiers (which sometimes vary by insurer) and patients are supposed to sign a specific telehealth consent form, so hopefully the companies will cover these services. There are a lot of hoops to jump through.

First off soap, is soap is soap no matter what type or form. It’s the surfactant that cleans. So dishwashing fluid vs bar soap just go for 20 seconds or longer and rub a bit. But as stated make sure you moisturize your skin.

So the doctors medical record systems, most have video conferencing capabilities but usually at an extra costs. Dr’s fees are so cut-down its usually not worth it and was something done in just a few states and some insurance companies just came on board to pay for it the last few years. It was something getting some traction but for like… Next year to check out. Well… That got ramped up this week. Unless your on a very large hospital system don’t expect your doctor to magically be able to do it. Hipaa is still an issue but… . https://doxy.me/ is a free program that you can show your doctors and it’s Hipaa compliant. But… Once they start using it and especially in the future then you will be billed for it. Why should doctors be expected to give away their time for free? People won’t want to come into the office etc.

Also… Doctors can’t just bill if you don’t show up. So no patients equals money to pay staff, insurance, bills, rent, their mortgage, their 2 kids in college etc… It’s just a small business like everyone else. These dentist that are closing for 2 weeks means no income for them. If it goes longer you will see many people including doctors going bankrupt or closing especially older ones… So…pay your bills. Paying $30.00 /month on a $300 balance won’t be allowed anymore. Why people think they can do that always intrigues me. My mechanic wouldn’t give me my car back if I didn’t pay my full bill…
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I believe doctors (and dentists) have insurance against loss of income.

One of my docs codes everything, so phone lab results can accrue time. That one has called some of those as office visits or some type/level of consult, then further explained in notes.

I just doubt docs will go bankrupt over a 2 week loss. But I also doubt we’ll see this done with only a 2 week pause.

What kind of insurance do we have against loss of income? Thats news to me!

And some services may have a code that provides for a telephone consult. In my field there is no code to cover a telephone call to a patient. There is a code for having a teleconference with other providers, but its typically not covered by insurance companies. So even though there is a procedure code for it, its not a billable service for most insurance companies.

Professional athletes get insurance on themselves in case of injury resulted in loss of income

@Nhatrang -There is disability insurance, sure. Had both “executive professional” and “your occupation” coverage. But its expensive and has a waiting period . There is office overhead insurance that helps pay overhead costs in case of illness, disability, etc. Not sure any would cover this situation. They are typically for disabling injury or illness, and again, have a waiting period and have to be an accepted claim by the insurer. And lots of paperwork. Even if a Dr. tests positive, the waiting period would likely be shorter than the length of the illness. Money doesn’t just fall from the sky if the practice has to close for a while.

Not so much a random question as a random thought…I never realized how often I touch my face until all the CV-19 business started. I’ve now realized that I’ve never thought about how much TP I use–have discovered I can easily use less, lol!

The public assumes these things like all doctors are millionaires… There is insurance with loss income in the business insurance policies for my office but not sure about a pandemic. Usually these types of things are excluded but guess what? Gonna call tomorrow. Usually for if the building is on fire and I have to shut down to rebuild or something. But if a doctor is an employee of a hospital but can’t work due to x. They might not have something like that. Athletes have this since they make $30 million a year (not all but you get my point). So besides Business insurance, disability,malpractice, life insurance etc. No sure if there is a pandemic loss of income

And the disability insurance on athletes is typically taken out by their employer (the team or the league) not by the player. Its expensive!

@Knowsstuff , I guess not. Unless you own an airline company, the government will back you up “100%”

/end sarcasm

Doctor offices, like many other small businesses, will get hurt. My sister has 2 optometry offices, she closed them after the shelter in place thingy, she is in the Bay Area. The rent is what going to hurt her. And it won’t be just 2 weeks pause

@Nhatrang… Yep. Solo doctors here and the public might not understand. Jan - March no one wants to see their doctors due to high deductibles. Some patients have like $8,000-10,000 Deductibles. Then add this on top of it. I have my own OR and had surgery this morning but stock is hard to get now. If I get sick or if my Anesthesia person today gets it and was with me today then I have to shut down completely. At least my wife can keep the practice going. But rent /bills still need to be paid. Colleges still like their tuition.

https://www.cnn.com/2020/03/18/politics/coronavirus-congress-relief-senate-house/index.html

Well this is fun… So where does this money come from? I see lots of people claiming to not feeling well soon. At least I don’t have any staff with small kids. At one time they all did and would have to close if they all stayed home once their kids schools closed

DH is a retired dentist and has said he’s not sure how he would’ve fared through a prolonged shutdown. As others have said, there is overhead insurance, but it may not apply under these circumstances. He would probably have paid his staff through the shutdown out of compassion and to ensure he’d have staff returning when he re-opened.

^^^this… Luckily I have part timers that really don’t rely on this income but could. My daughter a student barista was told she was payed off but temporarily and to claim unemployment for the time being…

Last time this happened my 2 main people with me for 21/23 years. One husband lost his job we advanced bonuses, sick time (but gave more to cover, gave her more hours and just didn’t look at the clock per se. Think we paid some bills for her. But I didn’t have 2 kids in college then either.

If we get sick and have to shut down then we would just tell them to not come in and resume when we come back. Think they would be ok with this. But others will lose their jobs and suffer. There won’t be a shortage of people that need to work but who wants to start training people when you have great employees…!!!

Good friend of ours a doctor had employees for years just quit do to stupid issues (doctor to demanding), they are calling back asking for their job back… Grass is always greener…

Business overhead insurance doesn’t cover a pandemic.

I shut my office Monday. I’ll pay my employees for 2 weeks, then partially, just depends how long this goes. Current state unemployment rules only apply if the employee left work due to illness, care for sick person, children home from school. I think that will change fairly soon. I’ll be okay because I’ve been at this a long time: no debt on anything, office cash reserves.

Employees have to be careful about state unemployment rules and continued health insurance. Under today’s guidelines, the waiver for temporary unemployment extends 45 days. The plan I offer would end when employee files. (I do think that will change.) Oregon mandated a shutdown of non-essential care for 3 months today. This includes dentists. Many offices will be in trouble.

Just made the call to State Farm and waiting for my insurance dude to call me back Think we have interruption insurance or overhead .

My receptionist voluntarily took off last week due to not feeling well. Not sure what happens if she needs to take off another week?

Friend is a dentist. Has no clue past next week if he can pay employees. People in general public just don’t get this. He is applying for loans to keep going
. People pay your medical bills! It’s how we put food on our table and kids in college.

We just applied for SBA emergency loans. My wife said the process was fast actually
Not sure what happens now. Not sure if we will actually get/take it. Not sure how long this will go on. We don’t need it today but 3 months from now we might. Too many unknowns for all businesses right now. I always try to buy local and support local small businesses. I am being thanked almost daily now for doing that.

Unfortunately, even in normal times, people often have difficulty paying medical bills (one of the most common sources of personal bankruptcy in the US). Payment could also be slow when billing or insurance reimbursement has something incorrect that the patient, provider, and insurance company need to figure out how to fix. COVID-19 and the associated effects (people losing jobs and investments, as well as overburdened health care) will make it worse.

Of course, this could eventually lead to the closure of many small medical and dental practices, increasing the consolidation of providers into larger practices.

Just received notice that Michigan’s governor signed an executive order that “temporarily postpones all non-essential or elective dental procedures”. No end date listed. True emergencies only. We will be shut for awhile.

Violation of the order includes ethics violation, loss of license and/or criminal charges.

Is there a way to turn of one click purchasing on Amazon Prime? Especially on digital kindle purchases? I share my account with my daughter and we both want to buy kindle books and be able to control if a gift card is used (or not).

I did figure out how to change which credit card is charged but not how to avoid using a gift card on the one click purchases.

So, I just want to turn off the one click.