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Once Upon an Urgent Care Visit... - Keyboard Dancer


Posted: Sep 09, 2013

I went to Urgent Care with my fiance last week as he was not feeling well.  They got us right in.  A medical assistant took his vitals immediately. The doctor was in within 5 minutes.  (There was only one person in the waiting room ahead of us and, incidentally, no one yet after us.)  Everyone was very nice, personable, and efficient.  The doctor started asking my fiance questions about his health, as he sat in front of a laptop computer and entered all the information himself.  He would ask a question, my fiance would answer, and he would spend minutes at a time typing in the laptop.  There was also a quick physical examination.  I, as an MT, finally asked him if he had to input all his own info.  He said he did, that the company had spent ‘A Billion Dollars’ for their new system in which they input their own information on the patient visits.  HE said because of it he was not able to spend as much time actually examining patients as was done in the past, instead had to spend this time entering data.  We explained I was a medical transcriptionist, and he remarked that he WISHED he could have a medical transcriptionist, that this was not what he went to medical school for, and he was not a very good typist.  I appreciated his frankness, and when the visit was over we left, sad to see what has become of, at least in this setting, what used to be an honored, appreciated profession, but which is becoming virtually extinct.  The End.

Life moves on - cant dwell on the past - sm

[ In Reply To ..]
Gone are my days of making $16 an hour as MT. Now some days I make $9 other days I make $3.17.

Used to dwell on the past of oh how it was great this or that or this is not what I went through MT school for. Since all of it is not here anymore there is no reason to dwell on it. Times are changes.

To quote Paul Harvey - "And that is the rest of the story".

16 an hour? - sm

[ In Reply To ..]
At one point, in the late 1990s, I was making 30-32 an hour. Maybe that's why my hands are completely shredded. Ahhh...the glory days!

yes, easily without trying hard I was making - 25 to 30 an hour

[ In Reply To ..]
Those were the days!

$16/hr? That was a very slow day's pay. - Allie

[ In Reply To ..]
.

Reply to all 3 that responded about my 16 an hour - sm

[ In Reply To ..]
You all must have started long before I came on board. I thought 16 was great! :-) Was very happy with my wages. If I was making 32 I would have never quit. LOL. Now most days I'm making between $3.50 to 5.00 an hour. Just don't know what I'm going to do. Going through my savings to pay bills and it will eventually run out. I don't dwell in the past or do the I wish I could have because I could go all the way back to high school on the "I wish" list. But got to start thinking about how I'm going to survive and what I'm going to do.

I have heard the exact same sentiment..... - Mom22dogs

[ In Reply To ..]
.....from doctors that I know. Unfortunately, it doesn't seem to matter what even THEY think about it!

Sad part is we still get charged the full hour rate for 5 min of doc time! n/m - ???

[ In Reply To ..]
x

That type of service is not charged by the hour - Coder

[ In Reply To ..]
Office visits like that are not charged an hourly rate. They are paid on the basis of the complexity of the medical decision making, IF there is enough documentation to support it. This is standard throughout the US. The charge includes the face-to-face time with the patient, reviewing records and labs, and doing the documentation regardless of when or how it is done.

That doctor was not being entirely truthful. He is not required to type while he sees the patient. He should be typing after he sees him. He somehow managed to remember everything long enough to dictate it after the visit; he can darn well remember it long enough to type it or dictste it in Dragon after the visit.

Even if that particular system requires input during the visit, it should not interfere with the patient's time. That is because past visits would have been, say 15 minutes with the patient and 5 minutes documenting. He still has only 5 minutes of documentation to do. The patient is just in the room 5 minutes longer.

The problem there is the doctor.



What doctor charges a per hour rate? - ??

[ In Reply To ..]
Maybe you need to find another physician? I've never heard of a Dr. charging a per hour visit... it's always been based on the service/treatment given.

What I meant was... - ???

[ In Reply To ..]
What I should've said was that, yes I know doctors charge per codes and all that, but just from my experience with my own doctors, that the standard codes they use do have a time period associated with them, like a new patient exam, lab draw, etc. I used to work in a doctor's office and they did use different codes depending on the patient and the time set for the appt. So my basis for what I said earlier was that even though the doctor only spoke to or actually touched the patient may have been only 5 minutes, the billing code he uses may be for a 15 min, 30 min, 60 min visit time. If that makes sense. Meaning that the insurance company will still get charged "full" rate of that code no matter how long the doc was actually in with the patient. If that makes sense.

I was just commenting on the OP because that makes me angry that no matter how long the doc sees a patient, they still charge/get paid the set amount no matter what. I'm one of the those patients that asks alot of questions and takes up my whole hour (or whatever time slot I have) b/c I'm paying what insurance doesn't and I want my money's "worth."

So Yes I do know that they do not charge by the hour so to speak.
Sorry, that is still incorrect - Coder
[ In Reply To ..]
The office where you worked misunderstood the purpose of the "time" the CPT book lists for E&M codes. Those are not time-based codes.

It is an estimate provided to help you understand the code. It is not a literal definition of how long the service should take. You are not supposed to determine the code based on that time.

The codes are based on the complexity of the problem. A minor problem can be addressed quickly. It may warrant a low-level code. The charge is therefore lower. The coding is based on the fact that the problem is minor. It warrants only, say, 99212 because it requires little decision making. The listed time on that code says 5 or 10 minutes only because that is how long it usually takes. It can take less or more time.

If your doctor spent 5 minutes with you, it was because the problem required only that long.

Sorry, but your beliefs on this are just incorrect. A large part of your upset about this is due to your own misconception and erroneous beliefs.
Again, let me "explain" what I meant (jeez!) - ???
[ In Reply To ..]
Okay, so now to avoid this back and forth nonsense with Coder, I may be incorrect in what you stated. That said, my original response to the OP was just a passing observation out of my mouth like I was thinking back to old school doctors and "charging by the hour" quote unquote so to speak. Anyway, thanks for telling me that I am wrong in what I believe (um?) and don't wanna do this "arguing" on MTstars. Really? Basically, I was just making a "stupid" or whatever you want to call it statement about being in a doctor's office for 2 seconds and still getting charged their rate, however it is coded. I didn't think I was going to get a "talking to" on here by simply stating a blank generalized statement like "yeah and you still get charged by the hour" as in ha ha, like that kind of thing. Somebody is incorrect in their belief at what they obviously misconstrued what I meant. I'm done!

Know the Feeling - Patient

[ In Reply To ..]
Recently, I spent an extra 30 minutes in a doctor's office while a PA asked me my history, etc. and hunted and pecked her way through the laptop with my answers. Fortunately, I have no real medical history and only take multivitamins. I'd hate to be someone who takes 30 different meds and has a complicated medical history.


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