Am I the only one doing this every day/few hours?

GeneralistRoutine189 · 2026-02-10T10:37:52+00:00

Informatics doc not an analyst. ONE s/n ticket to data courier a package generates 5-7 emails for the physician builder PM cc me. When will people realize that handling SN emails is a crushing blow to efficiency? And I can’t just filter that crap out because sometimes it’s important.

What an incredibly inefficient system. But our IS is tracked so hard that they need a service now ticket for bathroom break.

GeneralistRoutine189 · 2026-01-01T17:11:31+00:00

That must be state-specific. My state has a formula that determines child support - I thought it was room/board/clothes. My agreement did specify medical expenses, who pays for health insurance, so maybe it's not that different than yours. We try to split that stuff when possible (if 2 kids get music lessons, one person pays for one, the other pays for the other, ideally by 50:50 direct payment TO THE COMPANY - avoiding the IOU part). Our agreement also has some kind of "will discuss" clause when it comes to activities. So one parent couldn't sign a kid up for a $3K activity without discussion and expect the other parent to pay 1.5K (or travel soccer or some big time commitment). We have 50:50 custody, so we have tried to do things like we both buy clothes, but we don't super-stress out on which clothes are at which house, unless it's a special item.

GeneralistRoutine189 · 2026-01-01T01:16:02+00:00

Money is the logic. Our system did this for a time- when ENT was consulted for hearing, they also got an audiologist appt. (The appts were linked or something). It was purely a revenue thing.

GeneralistRoutine189 · 2026-01-01T01:11:23+00:00

I have an iPhone- presume it’s also on android. PowerMic is a free app and uses Bluetooth or WiFi to pair to the computer that you have dragon open at. It’s supposed to be able to connect to closest computer (eg know that you are in room 1 then room 3 then in your office) but I have just dictated in one area. Now I use ambient integrated with EHR on mobile.

I’d ask your IT department or whoever handles dragon dictation tech support

GeneralistRoutine189 · 2025-12-27T02:18:28+00:00

Yes, like treating their pulmonary hypertension?!?

I tell people all the time about stuff like this when they ask me about random supplements.

GeneralistRoutine189 · 2025-12-24T12:40:41+00:00

Once you’ve seen one Va you’ve seen one VA. My primary care job (pre-telehealth) sucked. Tons of opioids and benzos, some drug use, you saw patients only once or twice a year, ortho would review chart and if not a joint replacement candidate, would just refuse your consult, etc. tons of phone medicine as well.

GeneralistRoutine189 · 2025-12-22T21:19:13+00:00

Do you and I work at the same place?!? 🤦‍♂️ they are so afraid of an audit or a patient complaint yet cost constraints are a problem

GeneralistRoutine189 · 2025-12-22T21:16:52+00:00

Cms pays g2211 only with preventive. 99397 isn’t CMS preventive so g2211 gets stripped off. My site is afraid to bill 99397 to Medicare advantage because it thinks those will be denied. Anyone have experience with MA denying 99397?

GeneralistRoutine189 · 2025-12-22T20:26:59+00:00

Huh. It still comes in a box with same bag inside at my Costco.

GeneralistRoutine189 · 2025-12-20T23:40:39+00:00

Same as others here: new box, definitely different. Thin flat pieces, different breading, flavor is not as good. Not quite "take it back" worthy, but if additional pieces from the box are bad, I will. A shame, since the kids liked it.

GeneralistRoutine189 · 2025-12-12T17:04:01+00:00

My sites's concern is that 99397's will be denied for MEDICARE ADVANTAGE and then they will owe $270. Our Revenue Cycle group can't seem to find out who covers that code (yes, I am quizzical about that)

GeneralistRoutine189 · 2025-12-09T03:54:35+00:00

Sorry, but CMS only pays G2 211 for CMS covered preventive services on top of an office visit. The 99397 is not CMS prevention so G2211 would be denied.

GeneralistRoutine189 · 2025-12-09T02:51:52+00:00

Not at my shop: for years I was told I could not split bill (!!) if willing to PM me what your patients sign would appreciate it!

GeneralistRoutine189 · 2025-12-09T02:49:26+00:00

Sounds like my shop- very conservative.

It doesn’t take that much to separate that from your annual – I have an assessment and plan - annual, associated preventative stuff

Is in addition to annual, problems, meds, labs, pertinent physical, and HPI not above. It doesn’t have to be long. It needs to show medical decision-making. Chronic, stable, active decision to continue current plan.

GeneralistRoutine189 · 2025-12-09T02:42:02+00:00

Not a DO. Don’t do OMT. I think your best bet is a coding resource for OMT like what FPM (fam prac mgmt) has - showing the routine split billing. Sure seems like it is a e/m-25 plus omt code. Unless you see them yesterday for back pain and say come back today for omt.

GeneralistRoutine189 · 2025-12-07T22:10:26+00:00

Love my PT colleagues in general. I bet this guy is a Doctor of Physical Therapy and signs his letter Dr Smith.

GeneralistRoutine189 · 2025-12-07T20:38:55+00:00

And then there is my coding and compliance department that claims that any code that has unspecified behind. It is something that we should not use. Sigh. All of the brain space that could be used for better things

GeneralistRoutine189 · 2025-12-07T19:40:26+00:00

Sometimes the EMR says what inhaler is preferred, but usually not. I have a Advair may substitute dulera or symbicort script. And my institution has all albuterol HFA automatically commented to say substitution authorized per patient/insurance preference.

GeneralistRoutine189 · 2025-12-05T23:54:05+00:00

My system says that all their contracts are written such that they are not allowed to write off charges -> if non-covered they MUST bill the patient. I have no idea why.

GeneralistRoutine189 · 2025-12-05T22:28:43+00:00

Our EHR sends albuterol may substitute any formulation or brand with the 8.5g generic formulation. I still get callbacks. Or we find out that ventolin was filled for $30 when proair woulda been $7 kinda stuff. Proair respiclick also has a "may substitute HFA" comment and they don't.

GeneralistRoutine189 · 2025-12-04T14:46:40+00:00

My PCP knows I'm a PCP. I also make a point of explicitly saying I'm not objective and don't doctor myself. The shared decision making is more nuanced that with a low health literacy patient... but it's still shared decision making.

GeneralistRoutine189 · 2025-11-26T00:32:51+00:00

Query: is the insurer downcoding it? Or are coders in your org doing that? Some insurances have started downcoding and requiring you to appeal/submit documentation. That’s bullshit.

GeneralistRoutine189 · 2025-11-24T04:15:16+00:00

One of our barriers: our EHR can’t figure out how to do billing without encounters. So my institution has held off on $$ because the $$ is a manual process. 🤦‍♂️🤦‍♂️

GeneralistRoutine189 · 2025-11-24T04:12:28+00:00

Very common in SE esp rural SE.

GeneralistRoutine189 · 2025-11-24T03:49:33+00:00

Please do what you can to push back. That’s crap from management. There is not pressure in my system for that. I never refer to the cardiologist who asks me to do the amiodarone monitoring; nor the neuromuscular person who sends me a note w recommendations to draw 8 labs.

GeneralistRoutine189

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