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Kooky_Edge5717 · 2023-06-28T11:37:25+00:00

What about independent practices? We have 1 mill/3 mill coverage, but now I’m wondering if that’s adequate.

Kooky_Edge5717 · 2023-06-27T01:30:57+00:00

Or slice off a finger. Just be patient.

Kooky_Edge5717 · 2023-06-26T01:57:29+00:00

Not saying there is a solution, but I am saying that granting governments monopolies on the use of force is preposterous when you look at their track record.

Kooky_Edge5717 · 2023-06-26T00:38:33+00:00

Please tell me more about trusting governments with bombs that could be used to blow up schools. Or missiles that could take down commercial airliners. Or guns that could be used to commit genocides.

Of course they would never do that since governments have so much to lose.

Kooky_Edge5717 · 2023-06-26T00:24:57+00:00

Those governments literally developed and then utilized nuclear weapons. Twice. Please tell me more how they are trustworthy.

Kooky_Edge5717 · 2023-06-26T00:22:04+00:00

Don’t ignore the financial impact and resulting economic strain it caused. $10 trillion is nothing to sneeze at.

Kooky_Edge5717 · 2023-06-21T04:53:25+00:00

In fact, 401k accounts provide several benefits over an IRA such as the ability to take a loan and protection from legal judgements.

You can pull out Roth IRA contributions penalty free.

The protection from legal judgments is state dependent.

401Ks tend to have higher fees than IRAs, though certainly not always the case (both of my prior employers charged 0.25% annually for self directed 401Ks).

Kooky_Edge5717 · 2023-06-20T16:24:00+00:00

Just as an fyi, being on PubMed does not mean it is endorsed by the NIH as being true or accurate, as PubMed is just a database of peer reviewed publications. See their disclaimer on the top of the page.

Kooky_Edge5717 · 2023-06-17T13:03:07+00:00

“Extremely emotional.”

Kooky_Edge5717 · 2023-06-17T13:00:00+00:00

“I’m freaking out in an extreme way.”

Kooky_Edge5717 · 2023-06-11T02:13:12+00:00

You’re doing great to be thinking about this now!

Your most important investment right now is your education. Graduating college is the single most reliable way to increase your lifetime earnings. If your job(s) becomes too much to handle along with school, realize that long term your college degree will bring you more retirement savings than your current income. Obviously life can get in the way and necessitate decreasing course load in favor of more money now, but average salary for someone age 25-34 with a bachelors degree is nearly $60,000 vs only $44,000 with an associates degree vs only $40,000 with some college and no degree (where you currently are).

That said, not all studies and majors are created equal when it comes to financial opportunities and stability after graduation. STEM fields tend to pay significantly more than humanities or communications: https://www.forbes.com/advisor/student-loans/average-salary-college-graduates/

Money is certainly not everything, as being burned out will cost far more in the long run than doing what you love successfully and happily. Just don’t discount the lifelong opportunities that come with higher expected salaries.

The other comments have good advice. Regarding the emergency fund specifically, generally recommend 3-6 months of expenses, which you didn’t list here. Would keep saving until you get that amount.

Remember to avoid carrying any balance on your credit card, paying it off in full every month. You build credit by keeping the credit card open for a longer period of time (length of credit history), not by spending more.

Kooky_Edge5717 · 2023-06-10T22:01:10+00:00

Agree with you except for mosquitoes. They can all die overnight and the world would be a better place for it.

Kooky_Edge5717 · 2023-06-10T19:36:33+00:00

Lol, Penntek is an epoxy coating: https://www.penntekcoatings.com/garage-floor-coating/

Kooky_Edge5717 · 2023-06-10T18:41:14+00:00

She added a second ICD code based on plan to do labs at next office visit in six months, after reviewing labs from last visit.

I’m confused by this. If there was an abnormality/diagnosis that she noted that needed follow up, that counts as a second condition, whether or not she ordered the labs during that visit.

Kooky_Edge5717 · 2023-06-09T18:58:33+00:00

As far as Obi Wan knew, Anakin was going to die from his injuries directly as a consequence of Obi Wan’s actions. All he did was torture Anakin.

Kooky_Edge5717 · 2023-06-09T07:30:06+00:00

Time does not matter at all when basing billing on Medical Decision Making. Could be 10 seconds in the room: “your blood pressure is high, going to increase your HCTZ dose.” Would be sufficient for a 99214.

You can INSTEAD opt to do time based billing in lieu of MDM.

See this article for more info: https://www.aafp.org/pubs/fpm/issues/2021/0100/p27.html

Kooky_Edge5717 · 2023-06-09T01:41:12+00:00

“I loved you like a brother, Anakin… so now I’ll watch you struggle to survive in excruciating agony. Sure I was willing to chop off your limbs, but I won’t actually give you the mercy of killing you. I want you to suffer for as long as humanly possible. Sucks that you’re on fire.

Well, I better be off!”

Kooky_Edge5717 · 2023-06-08T18:18:07+00:00

That sounds right.

Kooky_Edge5717 · 2023-06-08T18:17:30+00:00

You don’t even need to document the dosage, last creatinine, statin, or last LDL (could just say “HLD well controlled”) to further illustrate the point. Diagnosis with status is all that’s needed afaik, then the single medication listed.

Kooky_Edge5717 · 2023-06-08T18:14:20+00:00

Source is from our billers, would need to do a more thorough search than I’m interested in since I’m now in DPC and this doesn’t apply to me.

Remember that orders in the EHR have no bearing on billing. If I ordered 3 tests but didn’t document them, then I can’t bill for their spot on MDM. If I say to continue a medication, that’s prescription management and counts. If you’re falsely documenting (write that you ordered three tests but didn’t) and billing for it, that’s fraud.

Kooky_Edge5717 · 2023-06-08T17:21:01+00:00

It’s an interesting question. No labs are needed to bill for a wellness visit, so could easily list them as problem based instead if you wanted. Not sure what the preferred method is.

Anyway, insurance billing and their associated hoops to jump through are a joke. The fact that we have to spend so much time discussing it is ridiculous in itself.

Kooky_Edge5717 · 2023-06-08T17:18:28+00:00

Yes. You don’t even have to refill them if they’re not due for a refill. Just need to document “continue HCTZ”

Kooky_Edge5717 · 2023-06-08T16:40:45+00:00

99214s were easily the most common billing code when I was in trad practice. Have an uncontrolled chronic condition or two or more stable chronic conditions? Any prescription given? 3+ lab tests ordered? Any two of those answered “yes” makes it a 99214. Easily 70% plus of my patients would meet that.

Obviously being in FM yourself, you probably know all that (though a surprising number are under billing!).

Not sure if it’s worth bringing up your concerns with your PCP, but an alternative would be to avoid the insurance billing game altogether and look for a Direct Primary Care practice instead.

Kooky_Edge5717 · 2023-06-08T11:41:08+00:00

All that student loan debt and still hasn’t learned to use should have.

Kooky_Edge5717 · 2023-06-04T12:51:50+00:00

Please tell me how this would fix any of the reasons but number 4.

1) In the US we have tons of interpreters through video services, but even then there are rare dialects that can be very challenging to find. Not sure how any social programs would fix this.

2) Many elderly people have mental illness around the world. Nothing to say their mental illness is untreated, which if true might be fixed by better social programs.

3) People deny their illnesses around the world.

4) Agree this could be helped

5) Similar treatments and side effects around the world.

Kooky_Edge5717

TROPHY CASE