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Re: [CRN-L] advice needed on how to refute wrong info given to docs by drug/p...

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  • HPMSI@aol.com
    Reminds me of the time I watched a demo for a practice management system for a client......when I asked the rep to show me how his system distinguishes
    Message 1 of 3 , Jun 1, 2007
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      Reminds me of the time I watched a demo for a practice management system for
      a client......when I asked the rep to show me how his system distinguishes
      between assignment of benefits and accept assignment, he said the system didn't
      - it would put "YES" in both areas of the claim.........there was no way to
      say "accept assignment - No" and have the money come to the physician.

      Can you imagine how many practices bought a system like this? It would make
      *every* claim go out of your system as accepting a discount, whether you
      were contracted or not.

      SCARY.


      Karen Hurley, CMM, CPC, LE
      President, HPMSI
      P.O. Box 159
      Waldorf, MD 20604-0159
      Tel: (301) 651-4767
      Fax: (240) 368-0059
      Web: _www.hpmsi.com_ (http://www.hpmsi.com/)



      In a message dated 5/31/2007 10:18:11 P.M. Eastern Daylight Time,
      donself@... writes:

      This is an ongoing constant problem. In fact, one of the seminars I teach
      (which I happen to be teaching on Friday morning in Destin to the
      Mississippi osteopathic medical association, lists some of the incorrect
      advice that reps are giving to the docs in attempts to sell them and also I
      happen to be listing some of the OIG investigations going on with different
      devices/sales companies and even listing some of the CEOs of those companies
      that are now in federal jail. It takes awareness. It takes getting the
      physician's attention. It takes doing what you've done and get the facts.

      I take personal pleasure at these conventions at addressing these issues
      with the sales reps, while in front of the physician attendees. In fact,
      today, I spent some time with a PSS rep at this convention talking about the
      NCV company investigation by the OIG and the problems their reps are
      causing. It turns out that the PSS reps sell this product. It was fun and
      educational to the rep and he seemed to appreciate it.


      Don
      Don Self & Associates, Inc
      305 Senter Ave, Whitehouse, TX 75791
      903 839-7045 fax 839-7069
      donself@... www.donself.com

      Confidentiality. This email is not confidential and there is no copyright,
      fine or penalty for reading it, copying it, forwarding it or memorizing it.
      In fact, I feel honored that you have read it. Enjoy it.



      _____

      From: CRN-L@yahoogroups.com [mailto:CRN-L@yahoogroups.com] On Behalf Of Zia
      Clarkson
      Sent: Thursday, May 31, 2007 8:32 AM
      To: CRN-L@yahoogroups.com
      Subject: Re: [CRN-L] advice needed on how to refute wrong info given to docs
      by drug/product reps



      I have dealt with it like this :

      We call up the reps, have them come back, and give them the evidence with a
      "WTF????" and see what they have to say. Usually they leave with their tail
      between their legs and return with some 'substantiation' of why their advice
      was correct which usually is centered around the fact that their
      billing/coding advice is to reflect national policies and not necessarily
      that of a specific region, but advising to go with the guidelines that we
      had presented.

      One incident in particular that I can think of where this one drug company
      rep, who had been our local rep for some years and was promoted to national
      was giving us advice on Medicare guidelines that were for New Jersey, not my
      area here in area 2 of New York. I informed her of that immediately and she
      retracted her statement and has never been back.

      We've educated more than one rep on more than one drug in this office. It
      would be good if they could get their own education, wouldn't it ?

      This is a topic I could stand on a soap box about for a few hours.

      Fortunately once I hit one company really hard, my senior partner trusted my
      advice and opinions implicitly and now I don't have to jump the credibility
      hurdle anymore. I hope that is your case as well.

      My advice : Do your research, confirm it with payers and then stand up and
      speak your mind. Hopefully you will only be faced with skepticism once.
      After all, you are the head coder. This is your chance to show that you
      aren't just a girl that puts the bills in the computer and sends them to the
      insurance company. Go for it. We stand by you :)

      ----- Original Message ----
      From: "Melissa Anderson, CPC" <med_coding@yahoo.
      <mailto:med_coding%40yahoo.com> com>
      To: CRN <CRN-L@yahoogroups. <mailto:CRN-L%40yahoogroups.com> com>
      Sent: Thursday, May 31, 2007 12:21:39 AM
      Subject: [CRN-L] advice needed on how to refute wrong info given to docs by
      drug/product reps

      I had another situation today where we had a rep come
      into the office and tell the doctors incorrect ways to
      do billing for their product. I was asked to code the
      way the rep instructed even though I know it's wrong.
      After spending 2 hours online and going thru
      references, I did find proof that the rep's
      information did not follow proper coding guidelines.

      My question is how do other coders handle these
      matters? How do you get your point across to the
      doctors that you have the correct information not the
      reps, especially when the reps say they have no
      coding/billing knowledge except the trusty form their
      company gave them? I would think after being the head
      coder in the practice for 7 years that they would
      trust my knowledge before a peddler that is just
      trying to make his quota on selling his product.

      Any advice??

      Melissa

      mail to: med_coding@yahoo. com

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    • maureen murphy
      laparascopic nissen funduplication and hiatal hernia repair, reduction of gastric volvulus . I can not find CPT code for repair of hiatal hernia
      Message 2 of 3 , Jun 1, 2007
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        laparascopic
        nissen funduplication and hiatal hernia repair,
        reduction of gastric
        volvulus . I can not find CPT code for repair of
        hiatal hernia laparascopically(There is code for open
        procedure)

        Any help would be greatly appreciated ;)



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        that gives answers, not web links.
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      • maureen murphy
        It s included...thanks anyway.... ... http://mobile.yahoo.com/mobileweb/onesearch?refer=1ONXIC ...
        Message 3 of 3 , Jun 1, 2007
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          It's included...thanks anyway....




          --- maureen murphy <MURPHMA161@...> wrote:

          > laparascopic
          > nissen funduplication and hiatal hernia repair,
          > reduction of gastric
          > volvulus . I can not find CPT code for repair of
          > hiatal hernia laparascopically(There is code for
          > open
          > procedure)
          >
          > Any help would be greatly appreciated ;)
          >
          >
          >
          >
          ____________________________________________________________________________________
          > Yahoo! oneSearch: Finally, mobile search
          > that gives answers, not web links.
          >
          http://mobile.yahoo.com/mobileweb/onesearch?refer=1ONXIC
          >




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