Illinois retina associates locations10/4/2023 ![]() ![]() Q: Do you have routine call-backs or follow-up visits after injections?Ī: After a patient's first injection, we bring them back 1 week later. Every physician has slight variations in how he preps the patient, how he gives the injection and the follow-up instructions, and we accommodate all of the variations.īecause we have two or three physicians rotating through an office, we have procedure cards for each physician so the clinical staff knows how to set up the injection for the doctor. Most of our physicians prefer to perform injections throughout the course of the day, not grouped together. With 11 physicians, how does your practice manage those different approaches?Ī: The way injections are given is purely up to the physician there is no practice-wide policy, although the physicians often compare notes on how each other are performing injections or other procedures. ![]() Q: Every physician has his own preferred way to give injections. But we have increased the use of some rooms that were previously underutilized. We have not made any physical changes or added space. Q: Have you adjusted your physical plant to accommodate an increased demand for injections?Ī: Not really. Although this has not been a major issue for us in the past, it may become one as we go forward.įortunately, the drug companies have charitable foundations (eg, Genentech's Access to Care Foundation) that can assist patients, if they meet the criteria both medically and financially, with their lack of coverage or copay. With the advent of Medicare Advantage plans, however, we are seeing patients who are not covered for the 20% deductible on the drug, and this can create a hardship for the patient. Most of our patients are covered by Medicare, with secondary coverage through BlueCross BlueShield or another good carrier, and as a result we have not had problems with collections. The software works for primary insurance only, not the secondary, but this new automation will help streamline the process.Ī: The insurance market in Chicago has been very traditional. A few days in advance of the patient's visit, the software automatically sends an electronic message to the insurance company, and we receive an electronic response as to the nature of coverage. We have just purchased software capable of certifying that patients have coverage with their primary insurance. Once benefits have been verified, the patient is merged back into the physician's patient flow to receive the injection.įor established patients coming back for an injection, we call their insurance in advance. Some companies have special considerations for Part B injectables, such as higher deductibles or only providing a percentage of coverage. We then call the insurance company and certify that there is coverage, specifically coverage for Part B injectables. Once the physician has seen the patient and determined that an injection is necessary, the patient goes back to the front desk. Q: How do you handle insurance precertification?Ī: When a patient is new to the practice and needs an injection for the first time, our physicians like to do the injection on the same day. We use the same spreadsheet to track insurance payments from the primary and secondary insurance, and any third party if applicable. The record for each visit contains the name of the patient, the physician providing the service, the date of service, and the agent that was injected. This helps us to keep track of inventories. ![]() At the end of the day, the clinical person compares notes with the front desk to make sure the records and charges accurately reflect what quantities of what drugs were used that day.Įntries are also made in a spreadsheet program that is shared by all the offices. With multiple locations, how does your practice handle inventories to avoid loss?Ī: We have one person responsible for keeping track of the use of injectables each day at each practice location.
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