October 6, 2001
Dollars and sense
When you treat patients in the emergency room or your office and then provide services while admitting them to a hospital, Medicare doesn't seem to notice. You get paid for only one type of care. This situation applies to you and your associates with the same billing number.
The AAFP Congress of Delegates tackled this and other frustrating reimbursement problems in its meeting this week. Regarding this particular problem, delegates asked the Academy to try to fix it by seeking changes in CPT coding.
MENTAL HEALTH SERVICES
The AAFP will work with public and private insurers to make sure FPs receive fair reimbursement for providing mental health services. In addition, the Academy will continue to promote collaborative rather than "carve-out" relationships between FPs and mental health specialists. Delegates also called on the Board of Directors to consider ways to bring the issues to the attention of the U.S. Congress, as well as ways to enlist AMA support in addressing these concerns.
It's time the Academy stepped up the pressure on this topic, said delegate Mitchell Miller, M.D., of Virginia Beach, Va., in Tuesday's reference committee hearing. He noted that for years, FPs have been put in the unenviable position of having to write "creative" diagnoses for their patients with mental health problems in order to receive reimbursement. "We've brought this up before," he noted. "Yet we're still sitting in our offices writing up the wrong diagnoses."
INTERPRETERS' SERVICES
The U.S. Office for Civil Rights requires language assistance programs, and the Academy will continue to seek solutions for appropriate reimbursement of these services.
Alternate delegate Paul Van Gorp, M.D., of Long Prairie, Minn., mentioned that an interpreter may charge from $20 to $75 per hour, far more than the physician is likely to receive for patient services.
"We have allies in internal medicine and emergency physicians on this issue," said alternate delegate Kim Bullock, M.D., of Silver Spring, Md. "Many people who don't find a physician with an interpreter end up coming to the ER for care instead."
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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