Outpatient follow ups worth it?

[a gray man]

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Hey there, currently deciding between inpatient 1099 positions and I was toying with the idea of seeing my own follow up appointments say one afternoon per week. I already have the office set up for other patients I see another morning per week. Can anyone comment on reimbursement and whether it’s worth it to see your own follow ups?

 

[RangerBob]

I don't see outpatients, so I can only respond in general terms.

I think whether it's worth it or not depends on a few things.

From a personal standpoint, you may find it fulfilling to see your patients down the road and see them doing better.

From a financial standpoint, it's unlikely you'll make as much per unit of time worked compared to inpatient, unless you're doing botox or other procedures. If you weren't going to be working that afternoon anyway, then you'll make more than you would have otherwise. On the other hand, if you have the chance to just see more inpatients/do consults, you'd likely make more doing that instead.

Since you already have a clinic day, you likely already understand the stresses/hassles of the inbox.

 

[Momentum70]

I used to do combination and found that I made more money and had more free time if I stopped seeing follow ups and just increased census or work load. I do a lot of consults now on the acute side. See if you can get on with the hospitals that send you the most patients to do PMR consults. Hospital I worked out was a little apprehensive but I only consulted on the managed medicare or ones that had denials from IPR. Once they saw my success rate getting them out and doing peer to peers was much better than the random surgeon/IM/PA/NP doing it the consult service exploded and there was no reason to go back to clinic again. Now at another location that already learned that lesson and my partners and I take turns running the consult service.

Another bonus about consults as opposed to clinic is you see them on your schedule and no office staff to manage. They may be out of room for procedure but no random no shows throughout the day that come 2-3 hours late and demand to be seen.

 

[j4pac]

Regarding job satisfaction 100% beneficial. Financially would depend. If you are doing well on inpatient maybe not. But botulinum toxin injections can be very lucrative, so that is one follow-up likely worth it. I work in academics and outpatient neuro is a big part of my practice, and I love those patients

 

[a gray man]

Now that I’m a month or two into inpatient services, I am revisiting this. I always find myself concerned about the well-being of patients after they discharge and fear, even despite setting them up with follow on appointments that their care may fall through the cracks.Not only would it be beneficial to the patients, but it sure seems that I could bill TCM codes for transitional care which would make the time and effort more worth it. I have some concerns with getting set up to accept private insurance in addition to Medicare and all the billing headaches as the rest of my outpatient care is cash pay but just curious is anyone billing TCM codes?

 

[piviti]

I do know someone who does follow ups on all patients discharged from his inpatient rehab and I think bills TCM codes. On his weekend on call he sees everyone in the hospital then refers them to his outpatient clinic which he does via telehealth. Not sure if this telehealth will continue to be covered this year though.

 

[a gray man]

I do know someone who does follow ups on all patients discharged from his inpatient rehab and I think bills TCM codes. On his weekend on call he sees everyone in the hospital then refers them to his outpatient clinic which he does via telehealth. Not sure if this telehealth will continue to be covered this year though.

What do you mean you're not sure if it will be continued to be covered this year?

 

[piviti]

The Telehealth coverage expansion for Medicare is supposed to expire end of next month for nonrural locations. Unless it’s extended by congress.