In office doctor apt over a tv screen…..what???

[Eg_cruz]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?

[ThirdOfFive]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?
Never heard of that before.

But I have heard of Premier. In fact, I used them when we first moved here. Dropped 'em like a bad habit after only a few months of service, for various reasons. But let's just say that because of my experience with them, I can easily see them doing what the OP described.

[Ham_and_Cheese]

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.This is crazy and I would have told them so - if I'm going to have a virtual visit, it's going to be from my home not their office.

In that case - what's the point of the office at all?
.

[MrFlorida]

I would find a new doctor.

[retiredguy123]

They do it because the insurance company will pay for it. They also schedule appointments with a physician's assistant or a nurse practitioner because insurance will pay the same amount as a personal appointment with a medical doctor. Insurance companies should not pay the same amount for these types of appointments.

[Two Bills]

Won't be long before surgeons talk you through doing your own surgery.

[SoCalGal]

I had a "virtual" appointment with a doctor just this week. I was fine with it because I was participating from the comfort of my home. I would never go to a doctor's office only to have him/her participate on a screen. That's outrageous.

[Topspinmo]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?

Eventually AI will put doctors out of work. Next will be lawyers. :shrug:

[Topspinmo]

This is crazy and I would have told them so - if I'm going to have a virtual visit, it's going to be from my home not their office.

In that case - what's the point of the office at all?
.


More $$$$$.

[Eg_cruz]

I would find a new doctor.
She is not going back

[Eg_cruz]

They do it because the insurance company will pay for it. They also schedule appointments with a physician's assistant or a nurse practitioner because insurance will pay the same amount as a personal appointment with a medical doctor. Insurance companies should not pay the same amount for these types of appointments.
She is reporting the doctor today to the insurance company and Medicare

[Two Bills]

Most of my discourse with my GP (PCD) these days is by phone.
Saves me a journey, and their time.
I only visit for tests, examination or treatment.
Works for my wife and I.

[Stu from NYC]

We had virtual ones during covid. Some value but since doc cannot listen to my heart and lungs and check blood pressure, limited value.

Very quickly asked doc how many masks can we wear so she would feel safe during a real visit. Not about to go back to virtual unless we had no choice.

[Velvet]

What the hell! Sorry, this is beyond unacceptable. If it was me I’d write up this experience in every form of media I could think of, and rate the doctor etc etc. And keep on writing it for a long time to make sure as many people as possible would be warned about this practice.

[ElDiabloJoe]

Eventually AI will put doctors out of work. Next will be lawyers. :shrug:

From your lips to God's ears.

[golfing eagles]

She is reporting the doctor today to the insurance company and Medicare

Excellent. In 40 years of practice, I never encountered anything so egregious, much less imagine it. You should check the Medicare EOB for the CPT visit code they billed. If it something other than a telemedicine visit, they are "screwed". In particular, look for new patient code 99202-99205, which have certain physical examination criteria, which are impossible to meet if the "physician" isn't in the room. At the very least this should trigger a Medicare audit in which they will look at 25 to 100 patient visits and documentation to see if it meets coding criteria. If blatantly guilty, they can be banned from participating in Medicare for 2 years. I am appalled at this scenario and embarrassed for my profession.

[ThirdOfFive]

More $$$$$.
Definitely.

Lots of stuff seems to go on in Florida that is a bit on the shady side. At my last physical the NP recited three words and said she'd aske me what they were in a few minutes. I had never had this happen before but repeated the words and didn't think much about it until for some reason I checked the printout I got from my insurance following the visit. The insurance paid something like $60 extra for that visit for a "dementia screening"!

Not bad pay for one question.

[retiredguy123]

Definitely.

Lots of stuff seems to go on in Florida that is a bit on the shady side. At my last physical the NP recited three words and said she'd aske me what they were in a few minutes. I had never had this happen before but repeated the words and didn't think much about it until for some reason I checked the printout I got from my insurance following the visit. The insurance paid something like $60 extra for that visit for a "dementia screening"!

Not bad pay for one question.
If a medical doctor has 10 patients in a nursing home, they can visit the facility every day, 7 days per week, and bill Medicare for 70 home visits every week, even though they may just stop in to ask how they are feeling. For 70 visits, they can collect about $5,600 or more even though they may only spend less than a hour in the facility. If they have 5 nursing homes on their route, they can make $28,000 per week. I have seen this happen.

[Pugchief]

Excellent. In 40 years of practice, I never encountered anything so egregious, much less imagine it. You should check the Medicare EOB for the CPT visit code they billed. If it something other than a telemedicine visit, they are "screwed". In particular, look for new patient code 99202-99205, which have certain physical examination criteria, which are impossible to meet if the "physician" isn't in the room. At the very least this should trigger a Medicare audit in which they will look at 25 to 100 patient visits and documentation to see if it meets coding criteria. If blatantly guilty, they can be banned from participating in Medicare for 2 years. I am appalled at this scenario and embarrassed for my profession.

Shady for sure. Can you comment on ACA, HIPAA, and EMR causing a deterioration of the doctor-patient relationship?

[Stu from NYC]

Definitely.

Lots of stuff seems to go on in Florida that is a bit on the shady side. At my last physical the NP recited three words and said she'd aske me what they were in a few minutes. I had never had this happen before but repeated the words and didn't think much about it until for some reason I checked the printout I got from my insurance following the visit. The insurance paid something like $60 extra for that visit for a "dementia screening"!

Not bad pay for one question.

My first thought was medicare wellness exam but lots more question go into that. Fraud for sure

[blueash]

Per the rules (https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-telehealth/telehealth-faqs.html/1000#welcome): An annual wellness visit is ok using telehealth. A Welcome to Medicare is not


14. Can I provide the Welcome to Medicare and Annual Wellness Visit (AWV) via telehealth?

The Medicare AWV codes (HCPCS codes G0438 and G0439) are on the list of approved Medicare telemedicine services. CMS states that self-reported vitals may be used when a beneficiary is at home and has access to the types of equipment they would need to self-report vitals. The visit must also meet all other requirements.

The Welcome to Medicare visit (code G0402, “Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment”) is not on the list of approved Medicare telemedicine services.

[Eg_cruz]

Most of my discourse with my GP (PCD) these days is by phone.
Saves me a journey, and their time.
I only visit for tests, examination or treatment.
Works for my wife and I.
That’s all good, I too do most of mine by phone. BUT I don’t travel to the doctor sit in the lobby for over a hour to talk to the doctor on a screen. I sit in my home and I know my apt is a phone call.

[Eg_cruz]

Excellent. In 40 years of practice, I never encountered anything so egregious, much less imagine it. You should check the Medicare EOB for the CPT visit code they billed. If it something other than a telemedicine visit, they are "screwed". In particular, look for new patient code 99202-99205, which have certain physical examination criteria, which are impossible to meet if the "physician" isn't in the room. At the very least this should trigger a Medicare audit in which they will look at 25 to 100 patient visits and documentation to see if it meets coding criteria. If blatantly guilty, they can be banned from participating in Medicare for 2 years. I am appalled at this scenario and embarrassed for my profession.
Thank you for your feedback, will pass the info to her.
I was very taken back.

[golfing eagles]

Thank you for your feedback, will pass the info to her.
I was very taken back.

Also pass along the info from Blueash re: wellness and welcome to Medicare coding.

[Girlcopper]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?
I find this kind of odd. I’ve had in person visits and video visits many times and always knew in advance what was going on. I’ve never showed up in person for a visit and been put in front of a video screen I have never had to go to a drs office for a video visit just so the insurance would pay for it. They’ve paid after a home video visit every time. Did the dr get sick at the last minute and they couldn’t reach all patients to cancel in time? Was the patient told in advance that it would be a video visit and they didn’t have a computer or access to one or didnt know how to connect? Was there some other unexpected issue? This sounds more like a miscommunication than an intentional action by the dr.

[Ignatz]

If a medical doctor has 10 patients in a nursing home, they can visit the facility every day, 7 days per week, and bill Medicare for 70 home visits every week, even though they may just stop in to ask how they are feeling. For 70 visits, they can collect about $5,600 or more even though they may only spend less than a hour in the facility. If they have 5 nursing homes on their route, they can make $28,000 per week. I have seen this happen.

Once again, I sure picked the wrong career!!! 😝

[Nana2Teddy]

Google Premier Medical Associates in The Villages. They’ve been fined $750K more than once for Medicare fraud, so I’m not sure how they’re still in business. Most personal experience reviews I’ve read about them in a FB group for Villages Medical/Dental recommendations have been really bad, but wow your friend’s experience is appalling.

[Robojo]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?

I would walk out immediately and not pay a dime.

[waterflower]

Doctors only PRACTICE medicine. They will be replaced with energy healing machines.
Lawyers are going to be replaced with "Common Law' practitioners- B.A.R.-british accredited registry-"Maritime Law"
Nov 7 (Reuters) - Law graduates will be able to become licensed in Oregon without taking the bar exam, starting in May 2024.
Changes are coming. Be patient

[msilagy]

I went to Premier to see my Endocrinologist - same thing they took me to a room and didn't even tell me I was to see him on a screen. Bad, very bad.

[Stu from NYC]

Once again, I sure picked the wrong career!!! 😝

Never to late. 75 is the new 40.

[kendi]

This is crazy and I would have told them so - if I'm going to have a virtual visit, it's going to be from my home not their office.

In that case - what's the point of the office at all?
.

They can charge more??

[blueash]

If a medical doctor has 10 patients in a nursing home, they can visit the facility every day, 7 days per week, and bill Medicare for 70 home visits every week, even though they may just stop in to ask how they are feeling. For 70 visits, they can collect about $5,600 or more even though they may only spend less than a hour in the facility. If they have 5 nursing homes on their route, they can make $28,000 per week. I have seen this happen.

You are making that up and have no idea what time is required and what Medicare pays. Firstly a simple visit as you described to a nursing home/ long term care facility in 2024 pays the doctor a huge $39.64. This would include reviewing the nursing notes since the previous visit, writing a visit note, reviewing any labs. It would not include a complete physical exam of the patient, if that were required the visit would be billed at a higher code.

I can assure you that no doctor is able to do the work on a single patient including those services in 6 minutes. You've seen how long it takes a doctor to enter a note in an electronic medical record. Figure 10 minutes, then go to the next patient, start over. You do 6 patients an hour and are paid about 240 dollars. I just paid more than that for a plumber for an hour of work. And nobody was going to die if he got something wrong.

If taking care of nursing home patients made doctors rich there wouldn't be a shortage of doctors willing to take on their care. They often have complex illnesses, on multiple medications, cannot clearly define their own needs and symptoms, are cared for by staff that may not be excellent at either documentation or provision of care, etc. It ain't easy and it doesn't pay well compared to almost any other field of medicine.

[kamal]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?

I go there also and the TV screen is just for checking in like a receptionist. They always have doctors or nurse practitioner to see you if you go there with an appointment. Or in the same building around the corner you can walk in to their “Urgent Care” with no appointment. And a doctor will see you. They also do lot of in-house routine blood tests there.

[golfing eagles]

If a medical doctor has 10 patients in a nursing home, they can visit the facility every day, 7 days per week, and bill Medicare for 70 home visits every week, even though they may just stop in to ask how they are feeling. For 70 visits, they can collect about $5,600 or more even though they may only spend less than a hour in the facility. If they have 5 nursing homes on their route, they can make $28,000 per week. I have seen this happen.

You are making that up and have no idea what time is required and what Medicare pays. Firstly a simple visit as you described to a nursing home/ long term care facility in 2024 pays the doctor a huge $39.64. This would include reviewing the nursing notes since the previous visit, writing a visit note, reviewing any labs. It would not include a complete physical exam of the patient, if that were required the visit would be billed at a higher code.

I can assure you that no doctor is able to do the work on a single patient including those services in 6 minutes. You've seen how long it takes a doctor to enter a note in an electronic medical record. Figure 10 minutes, then go to the next patient, start over. You do 6 patients an hour and are paid about 240 dollars. I just paid more than that for a plumber for an hour of work. And nobody was going to die if he got something wrong.

If taking care of nursing home patients made doctors rich there wouldn't be a shortage of doctors willing to take on their care. They often have complex illnesses, on multiple medications, cannot clearly define their own needs and symptoms, are cared for by staff that may not be excellent at either documentation or provision of care, etc. It ain't easy and it doesn't pay well compared to almost any other field of medicine.

Again, absolutely correct. Before I dropped out of taking care of patients at our nursing home, I had about 60. Using RG's math, I would have made $168,000/ week or $8.7 million/year on that alone. In reality, I made about $14,000/ year----before overhead and taxes. It is not a desirable facet of practicing medicine---because you're right, the patients often have complex medical problems, many have severe dementia and mobility issues leading to decubiti and intercurrent infection all in a facility that is not usually staffed by the best nurses and others. Also, the families of these patients, while well meaning, tend to be a PITA. It's not just the ever-increasing time it takes for a visit and documentation, there are the endless phone calls, usually pretty stupid, day and night. Then, at least in NY, the state health department watches these places like a hawk, ready to pounce on any lack of documentation with draconian penalties. One of my partners was fined $15,000 for "failing" to do a breast examination on a 99-year-old woman.

Anyone who thinks that nursing home care is a desirable aspect of practicing medicine, or plans to "get rich" doing it, needs to switch from geriatrics to psychiatry.

But to dispute one aspect of that post, I suppose a plumber could cause a massive leak to the ceiling of a watertight home and create a life and death scenario

[nn0wheremann]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?
Premier has some outstanding doctors, but the support staff seems to be hired from special ed and reform schools, and their billing practices are outrageous.

[retiredguy123]

You are making that up and have no idea what time is required and what Medicare pays. Firstly a simple visit as you described to a nursing home/ long term care facility in 2024 pays the doctor a huge $39.64. This would include reviewing the nursing notes since the previous visit, writing a visit note, reviewing any labs. It would not include a complete physical exam of the patient, if that were required the visit would be billed at a higher code.

I can assure you that no doctor is able to do the work on a single patient including those services in 6 minutes. You've seen how long it takes a doctor to enter a note in an electronic medical record. Figure 10 minutes, then go to the next patient, start over. You do 6 patients an hour and are paid about 240 dollars. I just paid more than that for a plumber for an hour of work. And nobody was going to die if he got something wrong.

If taking care of nursing home patients made doctors rich there wouldn't be a shortage of doctors willing to take on their care. They often have complex illnesses, on multiple medications, cannot clearly define their own needs and symptoms, are cared for by staff that may not be excellent at either documentation or provision of care, etc. It ain't easy and it doesn't pay well compared to almost any other field of medicine.
I am not making it up. My mother was seen by a private practice doctor, who she never hired, in the hospital. The doctor followed her to every rehab nursing home she was sent to (5 facilities and the hospital). The doctor billed Medicare for every day for 4 months, 7 days per week. Medicare paid the doctor $80 per visit. For some visits, the doctor had to shake my mother to wake her up, and spent less than a minute in the room. It was months later that I received all of the Medicare receipts. I assume that the doctor got my mother's Medicare number from her chart or from my mother and just started billing it. We assumed that the doctor worked for the hospital because my mother never hired her. The doctor never treated my mother for anything or prescribed any medication. All she ever did was to ask how she was feeling.

[Djean1981]

My insurance offers teledoc service (in home on your own computer). If I use it, I save my copay. However, I would not use it for something serious...

[golfing eagles]

I am not making it up. My mother was seen by a private practice doctor, who she never hired, in the hospital. The doctor followed her to every rehab nursing home she was sent to (5 facilities and the hospital). The doctor billed Medicare for every day for 4 months, 7 days per week. Medicare paid the doctor $80 per visit. For some visits, the doctor had to shake my mother to wake her up, and spent less than a minute in the room. It was months later that I received all of the Medicare receipts. I assume that the doctor got my mother's Medicare number from her chart or from my mother and just started billing it. We assumed that the doctor worked for the hospital because my mother never hired her. The doctor never treated my mother for anything or prescribed any medication. All she ever did was to ask how she was feeling.

There is a difference between rehab and nursing home. Both the physician and the facility are paid differently.

[dpmers]

Do some research on Dr Khanna and will learn what you are dealing with.
We had an attorney drive all the way from south Florida only to find out he has no malpractice insurance

[retiredguy123]

There is a difference between rehab and nursing home. Both the physician and the facility are paid differently.
When my mother was released from the hospital, which happaned at least 6 times before she died, they would always send her to a nursing home for rehab, where she would stay for a few weeks and then go back to the hospital. The rehab stays were always paid by Medicare. The doctor who followed her around, showed up every day and she had multiple patients in each nursing home. The Medicare statement said that the doctor was paid $80 for every visit. This doctor did not work for the hospital or for any nursing home. She had a private practice. One problem with Medicare is that my mother never hired this doctor to do anything, and Medicare never verified that the doctor had ever been hired. Another problem is that when you are in the hospital, you never know who works for the hospital and who doesn't and who is going to bill you when you leave. Because my mother had Medicare Part B and a supplement, she never received a bill. The Medicare statement didn't arrive until after she had died. I checked the statement and determined that the doctor had billed for a visit every day for 4 consecutive months. I am not making this up.

[Red Rose]

Plus, this was her very first visit to this doctor, so I don’t think a telehealth visit would apply here.

[Pugchief]

Law graduates will be able to become licensed in Oregon without taking the bar exam, starting in May 2024.

You know this will turn out well bc it's Oregon....

[Michael G.]

I would find a new doctor.

Yeah, and wait another 8 months to see another. :shrug:

[Stu from NYC]

My insurance offers teledoc service (in home on your own computer). If I use it, I save my copay. However, I would not use it for something serious...

At our age things can start happening that we are not aware of and a telehealth visit will not catch.

At each appt want doctor to listen to my heart and lungs and discuss things that I might not be aware of. If we would have to pay a copay to do this, so be it.

[TommyT]

I left them years ago..... after a few visits and VERY glad I did..

[bmcgowan13]

I would walk out immediately and not pay a dime.

Send them a video of your check for payment....

[Notsocrates]

They do it because the insurance company will pay for it. They also schedule appointments with a physician's assistant or a nurse practitioner because insurance will pay the same amount as a personal appointment with a medical doctor. Insurance companies should not pay the same amount for these types of appointments.

Are you impying that you get inferior. care from a PA so it is worth less?

[retiredguy123]

Are you impying that you get inferior. care from a PA so it is worth less?
Yes, I am. Why would you expect to get the same level of care from a physician's assistant than from a medical doctor who has more education, a lifetime commitment to the practice of medicine, and backed up by medical malpractice insurance? The physician's assistant is hired to assist the physican, not to be a physican. To me, it is a no brainer.

[Eg_cruz]

I find this kind of odd. I’ve had in person visits and video visits many times and always knew in advance what was going on. I’ve never showed up in person for a visit and been put in front of a video screen I have never had to go to a drs office for a video visit just so the insurance would pay for it. They’ve paid after a home video visit every time. Did the dr get sick at the last minute and they couldn’t reach all patients to cancel in time? Was the patient told in advance that it would be a video visit and they didn’t have a computer or access to one or didnt know how to connect? Was there some other unexpected issue? This sounds more like a miscommunication than an intentional action by the dr.
No miscommunication. She went there to SEE the doctor in person. No one in the office told her when she arrived that the doctor was sick so her apt would be on screen. This was a complete disregard of her.

[Eg_cruz]

I went to Premier to see my Endocrinologist - same thing they took me to a room and didn't even tell me I was to see him on a screen. Bad, very bad.
Yup the same doctor. Did they tell you why? Did they bill for an in person apt? Did you report they to Medicare and you insurance company?

[Eg_cruz]

I go there also and the TV screen is just for checking in like a receptionist. They always have doctors or nurse practitioner to see you if you go there with an appointment. Or in the same building around the corner you can walk in to their “Urgent Care” with no appointment. And a doctor will see you. They also do lot of in-house routine blood tests there.
The apt was held over the screen not for check in. She was taken to a room after waiting for over a hour. She NEVER saw the doctor in person.

[Eg_cruz]

Premier has some outstanding doctors, but the support staff seems to be hired from special ed and reform schools, and their billing practices are outrageous.
Well this doctor was not “outstanding “ in any fashion. This is ridiculous and you can’t blame the staff. This is on the doctor. And if you read the you’ll see that she is not the only one this has happened to.

[Eg_cruz]

I am not making it up. My mother was seen by a private practice doctor, who she never hired, in the hospital. The doctor followed her to every rehab nursing home she was sent to (5 facilities and the hospital). The doctor billed Medicare for every day for 4 months, 7 days per week. Medicare paid the doctor $80 per visit. For some visits, the doctor had to shake my mother to wake her up, and spent less than a minute in the room. It was months later that I received all of the Medicare receipts. I assume that the doctor got my mother's Medicare number from her chart or from my mother and just started billing it. We assumed that the doctor worked for the hospital because my mother never hired her. The doctor never treated my mother for anything or prescribed any medication. All she ever did was to ask how she was feeling.
I hope you reported her,

[ThirdOfFive]

Yes, I am. Why would you expect to get the same level of care from a physician's assistant than from a medical doctor who has more education, a lifetime commitment to the practice of medicine, and backed up by medical malpractice insurance? The physician's assistant is hired to assist the physican, not to be a physican. To me, it is a no brainer.
Unlike some others, I don't particularly have a problem being seen by a P.A. or APRN for routine doctor visits. This is the trend in many (most?) other areas of the country. In my experience they're quite capable of handling the routine stuff such as annual physicals, annoying rashes, the occasional bug, etc. They're supervised by MDs so it is a safe assumption that they'll be consulting with their supervisor if anything well out of the ordinary pops up.

Kudos to the APRN who sees me. She picked up on some symptoms as part of my annual physical, ordered some follow-up tests that confirmed a mass in my bladder, then pulled some strings to get me in to an excellent urologist w/minimal wait time for the appointment. Cancer was confirmed and subsequently removed. Due to her efforts it was caught and removed very early and right now the outlook is excellent. I doubt that things would have gone as well had I been seen by the MD who supervises her.

[Velvet]

If the doctor is sick, then either they should be part of a team of doctors who can help out. Or it should be made clear to the patient so she can cancel her appointment. This attempt did not go over well.

[Stu from NYC]

Unlike some others, I don't particularly have a problem being seen by a P.A. or APRN for routine doctor visits. This is the trend in many (most?) other areas of the country. In my experience they're quite capable of handling the routine stuff such as annual physicals, annoying rashes, the occasional bug, etc. They're supervised by MDs so it is a safe assumption that they'll be consulting with their supervisor if anything well out of the ordinary pops up.

Kudos to the APRN who sees me. She picked up on some symptoms as part of my annual physical, ordered some follow-up tests that confirmed a mass in my bladder, then pulled some strings to get me in to an excellent urologist w/minimal wait time for the appointment. Cancer was confirmed and subsequently removed. Due to her efforts it was caught and removed very early and right now the outlook is excellent. I doubt that things would have gone as well had I been seen by the MD who supervises her.

Excellent care

[retiredguy123]

Unlike some others, I don't particularly have a problem being seen by a P.A. or APRN for routine doctor visits. This is the trend in many (most?) other areas of the country. In my experience they're quite capable of handling the routine stuff such as annual physicals, annoying rashes, the occasional bug, etc. They're supervised by MDs so it is a safe assumption that they'll be consulting with their supervisor if anything well out of the ordinary pops up.

Kudos to the APRN who sees me. She picked up on some symptoms as part of my annual physical, ordered some follow-up tests that confirmed a mass in my bladder, then pulled some strings to get me in to an excellent urologist w/minimal wait time for the appointment. Cancer was confirmed and subsequently removed. Due to her efforts it was caught and removed very early and right now the outlook is excellent. I doubt that things would have gone as well had I been seen by the MD who supervises her.
I don't have a problem with PAs and nurses, but the insurance payment should be less than for a physician.

[TomSpasm]

I've gone thru a 6 month hassle trying to get an appointment with an endocrinologist at Premier Medical at the Santa Barbara location. Their entire support staff is seemingly in India, and you get a different person every time you call. That would be ok except they never seem able to receive referral faxes and you get your phone calls with them cut off about 30% of the time. When I got exasperated last week and decided to just go into the office to try to make the referral happen, I was pointed to a computer screen, where I had a conversation with a woman who appeared to be in her kitchen in Islamabad or Chennai. I asked her if they had received a referral for me, and it took her 5 minutes to figure out that they had not. The whole experience was surreal.

When they finally got the referral the following week (on the 6th try), it was time to make the appointment, the first available is October 31st!!!!!! And now I learn here that may be over Skype too!

[Michael 61]

I've gone thru a 6 month hassle trying to get an appointment with an endocrinologist at Premier Medical at the Santa Barbara location. Their entire support staff is seemingly in India, and you get a different person every time you call. That would be ok except they never seem able to receive referral faxes and you get your phone calls with them cut off about 30% of the time. When I got exasperated last week and decided to just go into the office to try to make the referral happen, I was pointed to a computer screen, where I had a conversation with a woman who appeared to be in her kitchen in Islamabad or Chennai. I asked her if they had received a referral for me, and it took her 5 minutes to figure out that they had not. The whole experience was surreal.

When they finally got the referral the following week (on the 6th try), it was time to make the appointment, the first available is October 31st!!!!!! And now I learn here that may be over Skype too!

I’d switch medical facilities. Sounds horrible. I had a referral to a specialist a year ago up in the Spanish Springs area - i too was placed in front of a TV Screen. The doctor was on screen in his sweatpants from his living room in a high rise apartment in Detroit. The doctor was previously retired and in his late 70s. I guess he thought he could do this easy gig and make some extra cash while retired. I was deceived, and never told ahead of time my appointment would be a teleconference- was my first and last visit with that practice. Now I ask.

[asiebel]

I go to Premier Medical and have not had this happen!

[asiebel]

I go to Premier Medical and have never had this happen!

[Stu from NYC]

I go to Premier Medical and have never had this happen!

It does seem to happen to others

[PootleK]

... If blatantly guilty, they can be banned from participating in Medicare for 2 years. I am appalled at this scenario and embarrassed for my profession.

No wonder the doctors try it on if the only punishment for fraud is to be banned from taking money from Medicare for only 2 years. :ohdear:

[golfing eagles]

No wonder the doctors try it on if the only punishment for fraud is to be banned from taking money from Medicare for only 2 years. :ohdear:

That "punishment" is HUGE. Especially in Florida with an elderly population

Plus you have to pay back any disallowed charges and pay a fine

[Eg_cruz]

I’d switch medical facilities. Sounds horrible. I had a referral to a specialist a year ago up in the Spanish Springs area - i too was placed in front of a TV Screen. The doctor was on screen in his sweatpants from his living room in a high rise apartment in Detroit. The doctor was previously retired and in his late 70s. I guess he thought he could do this easy gig and make some extra cash while retired. I was deceived, and never told ahead of time my appointment would be a teleconference- was my first and last visit with that practice. Now I ask.
Wow

[Velvet]

My only teleconference experience was in Yellowstone Park in 2010. My husband and I were traveling across the United States on a luxury touring motorcycle for 62 days in a row. Nothing to live out of except saddle bags. Many days we were riding 10 hours straight (stopping only to eat). Somewhere along the trip I caught a cold which was quickly turning into bronchitis. At the park near the entrance was a pharmacy. They asked me if I wanted to teleconference with a doctor. I said yes. He came on the monitor and talked to me for about 10 minutes. He then wrote a prescription which the pharmacy filled. Total cost of conference $50, prescription $22. I took it that night, within 18 hours I was well enough to continue our trip. On the back of the bike, in full sun, in August, on the highway etc. Now that guy, was worth every penny!

[tophcfa]

I don’t mind virtual medical appointment if it’s all that is necessary for a particular appointment, it’s disclosed up front, and I can do it from our home. But it’s totally unacceptable to go to a doctor’s office, wait an hour, and then have it jammed down your throat without any upfront disclosure. As far as PA’s go, based on our experience, I have absolutely no problem seeing one. The PA’s that work for our orthopedic practice are all great. We have never seen our listed primary care physician, only the PA that works directly with her. She is both incredibly knowledgeable and thorough and seems to spend more time with us than a physician typically would. I’m sorry the OP’s friend had to go through that experience, I would run away from that practice.

[KatieRN]

Yesterday a friend went to Premier Medical at Santa Barbara Blvd. This was her first appointment with the doctor, she traveled from Ocala on a referral. She waiting in the lobby for over an hour. She was brought back into the examination room and put in front of a screen where the doctor pops up.

Yes her appointment at his office was over a computer screen. I have never heard of this it blew my mind.

Are we really at this point that you travel to see a in person doctor wait in his lobby for over an hour to talk to him on a tv screen. The big problem was his accent was very heavy and he spoke very fast so she walked out of there without knowing what was spoken about (part was she was so taken back) She couldn’t tell you what the doctor said it was beyond sad.

I found this way to operate your practice is shameful. Really what the point of traveling to the office to talk to a screen.

Has anyone had this happen to you? Do other doctors do this as well?

That needs to be reported to Medicare as Medicare fraud.

[JMintzer]

That needs to be reported to Medicare as Medicare fraud.

It's only fraud if they bill for a face to face visit, rather than a tele-visit...

That has yet to be determined...