What to do with patient?

[bedrock]

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I don’t officially do any chronic medication management, but I did put 3 patients on butrans because nobody else would help them/I knew COT wasn’t the answer.

For one of those patients, I did a stimulator and a unilateral MBB and RFA 2 years ago. The patient lost their job at the end of the 2023, but still never paid their amount for the stimulator and RFA from two years ago. They owe our practice over $12,000.

Patient is only on 10mcg of butrans. I assume they could just stop it without any ill effects?

I’m debating requiring them to pay cash in advance for an office visit this week and also reducing butrans to 5mcg x 1 month supply, and then that is our final visit unless they make monthly significant payments on their balance.

Thoughts?

 

[Agast]

The patch isn’t 100% empty after a week. They could wear it another 4-5 days and there’s your taper

 

[bedrock]

The patch isn’t 100% empty after a week. They could wear it another 4-5 days and there’s your taper

Thank you. Good idea.

 

[powermd]

I don’t officially do any chronic medication management, but I did put 3 patients on butrans because nobody else would help them/I knew COT wasn’t the answer.

For one of those patients, I did a stimulator and a unilateral MBB and RFA 2 years ago. The patient lost their job at the end of the 2023, but still never paid their amount for the stimulator and RFA from two years ago. They owe our practice over $12,000.

Patient is only on 10mcg of butrans. I assume they could just stop it without any ill effects?

I’m debating requiring them to pay cash in advance for an office visit this week and also reducing butrans to 5mcg x 1 month supply, and then that is our final visit unless they make monthly significant payments on their balance.

Thoughts?

The procedures were all cash, no insurance? Trying to figure out how you get to a $12k balance on two procedures. Maybe I'm doing something wrong.

 

[bedrock]

The procedures were all cash, no insurance? Trying to figure out how you get to a $12k balance on two procedures. Maybe I'm doing something wrong.

I’m a partner so the total cost included the ASC facility fees. Stim trial and implant certainly exceed 12K.

 

[Agast]

Your ASC should be collecting the patient portion before they allow the surgery to proceed

 

[PinchandBurn]

Your ASC should be collecting the patient portion before they allow the surgery to proceed

That's hard to. The patient will freak. Agreed it's better. But we r like bedrock.

Bedrock. Maybe try to collect half. Then write of rest as hardship

 

[Agast]

That's hard to. The patient will freak. Agreed it's better. But we r like bedrock.

Bedrock. Maybe try to collect half. Then write of rest as hardship

If they don’t have money for an elective surgery they can elect to do it later. Sometimes the ASC will work out a payment plan where they pay half first and then make installments. But collecting nothing on big cases is a great way to run your business into the ground. ASC doesn’t operate on hopes and dreams. At any rate, once he owed the balance on one procedure he should not have been allowed to book a second one.

 

[Ducttape]

I would instruct your office cannot see any longer due to financial limitations, including med management. Can just have them keep 10 on for 10-12 days or finish 10 mcg then 1 month 5 mcg if they say it really helps. (Most pharmacies will not allow you to give only 1 patch as they come in boxes of 4).

That gives person time to find someone else and you won't be accused of abandonment.

 

[RoloTomassi]

I would instruct your office cannot see any longer due to financial limitations, including med management. Can just have them keep 10 on for 10-12 days or finish 10 mcg then 1 month 5 mcg if they say it really helps. (Most pharmacies will not allow you to give only 1 patch as they come in boxes of 4).

That gives person time to find someone else and you won't be accused of abandonment.

Yes, our new patient paperwork office policy that they sign states that carrying an outstanding balance for x number of days is ground for termination of physician patient relationship

 

[lobelsteve]

Payment plan, collections?
Butrans non issue.