Envision screwing doctors again!!!!

[RustedFox]

I this a joke?

Click it.
It's not at all a joke.

What *they* think of us IS a joke, though.

---

Members don't see this ad.

 

[deleted109597]

Nurses Were Promised $10K a Week to Serve in NY Hospitals. They Say It Was a “Classic Bait and Switch.”

They just sued a Kansas-based health care recruitment company.

www.motherjones.com

Thankfully the nurses appear to A) not have been paid and B) shown to be terrible people. So was the company.
You don't sign up for $10K and then say "but I only see rehab patients". That's not how this works. You want the bonus, you see the sick people.

 

[WilcoWorld]

Nurses Were Promised $10K a Week to Serve in NY Hospitals. They Say It Was a “Classic Bait and Switch.”

They just sued a Kansas-based health care recruitment company.

www.motherjones.com

Thankfully the nurses appear to A) not have been paid and B) shown to be terrible people. So was the company.
You don't sign up for $10K and then say "but I only see rehab patients". That's not how this works. You want the bonus, you see the sick people.

 

[RustedFox]

Thank you.

Guarantee that we CMG proles get screwed on this. An "infusion" of money straight into the CMG admin's pockets.
Should be criminal.

 

[deleted109597]

Guarantee that we CMG proles get screwed on this. An "infusion" of money straight into the CMG admin's pockets.
Should be criminal.

Fastest way to get fired is to ask where that goes. Preferably on some public text.

 

[RustedFox]

Fastest way to get fired is to ask where that goes. Preferably on some public text.

Sadly, you're so so so right.

 

[deleted109597]

Shhhh, it's a secret.

 

[erdoc00]

Nurses Were Promised $10K a Week to Serve in NY Hospitals. They Say It Was a “Classic Bait and Switch.”

They just sued a Kansas-based health care recruitment company.

www.motherjones.com

Thankfully the nurses appear to A) not have been paid and B) shown to be terrible people. So was the company.
You don't sign up for $10K and then say "but I only see rehab patients". That's not how this works. You want the bonus, you see the sick people.

Lol. That nursing home nurse is so salty that they recruited him at $10k/week to run critical care but then after arriving on scene he remembered the reason he became a nursing home nurse was because he couldnt cut it as a real nurse and so he instead took a job as a glorified CNA. Sounds like he should sue himself for being ****ty at his job.

(Yes maybe I'm a bit salty after numerous ridiculous telephone encounters with these same nursing home "nurses")

Also, honorable mention for the FNP who accepted a $13k/week job but then became verklempt when they expected her to know how to manage ICU patient.

Double bonus honorable mention for using fear of losing their nursing license as the excuse for being unable to perform their job duties safely

 

[DocEspana]

Nurses Were Promised $10K a Week to Serve in NY Hospitals. They Say It Was a “Classic Bait and Switch.”

They just sued a Kansas-based health care recruitment company.

www.motherjones.com

Thankfully the nurses appear to A) not have been paid and B) shown to be terrible people. So was the company.
You don't sign up for $10K and then say "but I only see rehab patients". That's not how this works. You want the bonus, you see the sick people.

Fun things about that story that no one touched on yet:

a) The *least* absurd name in that story is the person used a pseudonym. To the point where the article had to clarify the other two were using real names.

b) They got assigned to Coler. Working in four major cities since I left residency (and doing residency in NYC. so five cities total).... that is *by far* the most dysfunctional nursing home I've ever seen. Its truly a place you go to quietly have your relatives killed quickly and legally so you can get the inheritance. And I am intimately familiar with all sorts of horrible nursing homes. But that one specializes in killing people in record time by a mixture of dehydration, iatrogenic anorexia, and malignant neglect. Trying to turn that into a high functioning COVID center is a hysterical joke. Those nurses must have lost bowel continence when they witnessed that city-sponsored execution site.

 

[EctopicFetus]

I think it’s 6.2% of your annual Medicare billing that drops as a bonus, not a loan. We are in network with every insurer so don’t have to worry about the balance billing part. We did not apply for that it just dropped into the account. I’m sure Envision will pass along a rightful share to all its docs...


CARES Act Provider Relief Fund
President Trump is providing support to healthcare providers fighting the COVID-19 pandemic. On March 27, 2020, the President signed the bipartisan CARES Act that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19.
Immediate infusion of $30 billion into healthcare system
Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately – with payments arriving via direct deposit beginning April 10, 2020 – to eligible providers throughout the American healthcare system. These are payments, not loans, to healthcare providers, and will not need to be repaid.
Who is eligible for initial $30 billion

• All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
• Payments to practices that are part of larger medical groups will be sent to the group's central billing office.
  • All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).
• As a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
• This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.
• If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

How are payment distributions determined

• Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
• A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization's revenue management system.
• As an example: A community hospital billed Medicare FFS $121 million in 2019. To determine how much they would receive, use this equation:
  • $121,000,000/$484,000,000,000 x $30,000,000,000 = $7,500,000

What to do if you are an eligible provider

• HHS has partnered with UnitedHealth Group (UHG) to provide rapid payment to providers eligible for the distribution of the initial $30 billion in funds.
• Providers will be paid via Automated Clearing House account information on file with UHG or the Centers for Medicare & Medicaid Services (CMS).
  • The automatic payments will come to providers via Optum Bank with "HHSPAYMENT" as the payment description.
  • Providers who normally receive a paper check for reimbursement from CMS, will receive a paper check in the mail for this payment as well, within the next few weeks.
• Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13, 2020, and will be linked on this page.
• HHS' payment of this initial tranche of funds is conditioned on the healthcare provider's acceptance of the Terms and Conditions - PDF, which acceptance must occur within 30 days of receipt of payment. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions. If a provider receives payment and does not wish to comply with these Terms and Conditions, the provider must do the following: contact HHS within 30 days of receipt of payment and then remit the full payment to HHS as instructed. Appropriate contact information will be provided soon.

Is this different than the CMS Accelerated and Advance Payment Program?
Yes. The CMS Accelerated and Advance Payment Program has delivered billions of dollars to healthcare providers to help ensure providers and suppliers have the resources needed to combat the pandemic. The CMS accelerated and advance payments are a loan that providers must pay back. Read more information from CMS.

Seems unliekly you are in netwrok with everyone.. its never quite that simple. If you are not in a place with Kaiser around, are you in network with them? Doubtful. My group sees over 200k visits we probably have 20-30 insurers from people traveling out of state we are OON with since no one wants to contract with you if you arent gonna see their patients.. Just food for thought.

 

[EctopicFetus]

Are you saying we get paid more to work in desirable areas? Or that CMGs use hospitals in good payor mix areas to keep their margins high? I think it's the second - if anything it seems the more desirable the area ( usually indicating a better the payor mix, though not always ) the LESS you get paid.

If you are an SDG yes. If you work for a CMG they just profit more there. Does that somehow make you feel happier? CMGs run a simple business. Pay as little as possible. Maximize profit both short and long term.

Some idiots think CMGs take on crap ass contracts out of the goodness of their hearts. That idiotic. They look at each contract and decide what they want. They dont hold money losing contracts. A single hospital might be a money loser but the 4 other hospitals in that contract make more than enough for them to have a hefty profit.

 

[Dr Mantis Toboggan]

Seems unliekly you are in netwrok with everyone.. its never quite that simple. If you are not in a place with Kaiser around, are you in network with them? Doubtful. My group sees over 200k visits we probably have 20-30 insurers from people traveling out of state we are OON with since no one wants to contract with you if you arent gonna see their patients.. Just food for thought.

Fair enough. I believe we joined some type of coalition of independent groups such that functionally it works out that way. But you are right. There is no formal contract with Kaiser etc. Not exactly sure how the out of state piece works, we don’t have a ton of tourists. I imagine we just take whatever we can get.

 

[RustedFox]

Yeah; this whole "network" thing is bogus. A clever ploy by the greedy toads to dicker-down payments.
Are you an American? Maybe spending time in a different state?
You should be in network.

I fly to Tennessee to enjoy some historical sites and good BBQ.
I get appendicitis.
Somehow, this magically costs me more than it would if I stayed in Florida?

I didn't get appendicitis, by the way.

 

[TooMuchResearch]

As we all know, the insurance system is effed.

Yeah; this whole "network" thing is bogus. A clever ploy by the greedy toads to dicker-down payments.
Are you an American? Maybe spending time in a different state?
You should be in network.

I fly to Tennessee to enjoy some historical sites and good BBQ.
I get appendicitis.
Somehow, this magically costs me more than it would if I stayed in Florida?

I didn't get appendicitis, by the way.

 

[CliveStaples]

Has anybody specifically heard of Envision cutting pay to Emergency Physicians? I don't mean by cutting hours to account for lower volumes - I mean actually paying a lower rate per hour, cutting some type of benefit, cutting some kind of bonus, etc.

 

[Emdocinabox]

What CMG’s are NOT cutting pay? I’ve heard Team, Envision and Alteon have. Mine has been awesome so far, but time will tell

 

[deleted109597]

Yeah; this whole "network" thing is bogus. A clever ploy by the greedy toads to dicker-down payments.
Are you an American? Maybe spending time in a different state?
You should be in network.

I fly to Tennessee to enjoy some historical sites and good BBQ.
I get appendicitis.
Somehow, this magically costs me more than it would if I stayed in Florida?

I didn't get appendicitis, by the way.

I might, just might allow this if you had said "Memphis" instead of Tennessee.
Memphis BBQ still sucks, but it's better than anything else in the state.
And I went to high school, college, and medical school there.
The order is NC>SC>TX>everywhere else.

 

[Torsion]

The order is NC>SC>TX>everywhere else.

I can confirm this order. I will put a plug in for KC BBQ, though. Went to Kansas City for a conference last year. I was skeptical as an NC native used to the whole hog pig pickin' barbeque format, but the KC beef briskett and burnt ends were outstanding. It would almost be worth going back to Kansas City to eat those again.

 

[nimbus]

OMG. I just realized - I haven’t seen a child in the ER in at least three weeks either. How bizarre.

And yes about the specialists. And they’re NICE. I had one of the usually harsh orthopedists today literally apologize to ME (the lowly PA) for the fact that his patient came to the ER for some postoperative bleeding. “So sorry... you shouldn’t have to deal with that... thanks so much for taking care of him... have a great day... stay well... mmm hmm, you have a really great day... thank you so much, bye.” It is unreal.

Time off relaxing at home has been good for him.

 

[bougiecric]

From EMDocs:

"ANONYMOUS POST:
Envision just announced something insane to its medical directors: they have made hours cuts on everyone....docs and apps during the covid pandemic. now they are saying that because of contract issues they have to give the APPs ALL of their hours back...but not the docs. in fact, because of this, the docs will take further cuts. so they are asking that we teach the APPs procedures and expand their scope "during this time" but that it "isn't a ploy to replace docs".
What the hell is going on here???!!!"

 

[Dr Mantis Toboggan]

From EMDocs:

"ANONYMOUS POST:
Envision just announced something insane to its medical directors: they have made hours cuts on everyone....docs and apps during the covid pandemic. now they are saying that because of contract issues they have to give the APPs ALL of their hours back...but not the docs. in fact, because of this, the docs will take further cuts. so they are asking that we teach the APPs procedures and expand their scope "during this time" but that it "isn't a ploy to replace docs".
What the hell is going on here???!!!"

If true we will know soon enough. Hopefully it is not.

 

[erdoc111]

Do not teach them... during this time.

 

[deleted941485]

From EMDocs:

"ANONYMOUS POST:
Envision just announced something insane to its medical directors: they have made hours cuts on everyone....docs and apps during the covid pandemic. now they are saying that because of contract issues they have to give the APPs ALL of their hours back...but not the docs. in fact, because of this, the docs will take further cuts. so they are asking that we teach the APPs procedures and expand their scope "during this time" but that it "isn't a ploy to replace docs".
What the hell is going on here???!!!"

Envision is dying and they cannot access small bussiness relief through the feds because they are owned by a PE firm. If this is true they are really grasping at straws here.

What exactly are the APPs gonna do? Cases aren’t happening

 

[RustedFox]

Do not teach them... during this time.

Yeah, I would do no such thing.

 

[turkeyjerky]

We need a nationwide physician paperwork strike. Now's the time, with the wide-ranging protections against med-mal.

Show up and keep working. Just don't document. No more billing, no more corporate profits.

Our demands are simple--immediate cancellation of all CMG contracts by hospitals.

 

[alpinism]

This is exactly what I tell friends every time I hear about their plans for a "nationwide physician strike."

You don't need to stop working shifts just stop charting patients so they stop making any profits.

 

[Birdstrike]

but the KC beef briskett and burnt ends were outstanding. It would almost be worth going back to Kansas City to eat those again.

Dude. I just bought a Green Mountain (Daniel Boone) smoker and just made some of this last weekend. 14 hours on the smoker with pure hickory wood. It was just outrageous. It was so damn good I tried a little without sauce and some with, and sauce made it worse. Imagine that. This damn smoker I got makes it so easy. Plug and play, all digitial, temps monitored via phone. Get a pellet smoker. Smoked brisket and burnt ends are without your reach. Pork shoulder is even easier. With cherry wood. Em-em-good!

Back to going on strike ...

 

[Birdstrike]

I might, just might allow this if you had said "Memphis" instead of Tennessee.
Memphis BBQ still sucks, but it's better than anything else in the state.
And I went to high school, college, and medical school there.
The order is NC>SC>TX>everywhere else.

SC>KC>NC>Everywhere else

 

[thegenius]

Dude. I just bought a Green Mountain (Daniel Boone) smoker and just made some of this last weekend. 14 hours on the smoker with pure hickory wood. It was just outrageous. It was so damn good I tried a little without sauce and some with, and sauce made it worse. Imagine that. This damn smoker I got makes it so easy. Plug and play, all digitial, temps monitored via phone. Get a pellet smoker. Smoked brisket and burnt ends are without your reach. Pork shoulder is even easier. With cherry wood. Em-em-good!

Back to going on strike ...

This thing?

Prime Grills

 

[WilcoWorld]

SC>KC>NC>Everywhere else

Pork from the half a hog I bought from my farmer neighbor cooked in my backyard>Everywhere else

 

[WilcoWorld]

Next time I'm buying the whole damn pig.

 

[Birdstrike]

My backyard>Everywhere else

Yeah. That's true. I'm in! Lol

 

[Birdstrike]

Next time I'm buying the whole damn pig.

I'm gonna do a whole packer brisket next time. 20 lbs. A whole pig would be awesome, though. There's a barbecue place a drive from me called Scott's Barbecue and they let you come in the smokehouse and see it. It's insane, multiple whole pigs on spits. So good, though.

 

[VA Hopeful Dr]

SC>KC>NC>Everywhere else

Keep in mind that North coast SC is basically NC when it comes to BBQ.

Vinegar is the best which I was always told was an Eastern NC thing originally.

 

[Birdstrike]

Keep in mind that North coast SC is basically NC when it comes to BBQ.

Vinegar is the best which I was always told was an Eastern NC thing originally.

The more I ponder this, the more I think I just like all kinds of smoked, barbecued meat, to some large degree or another. It's all really damn good, just some of it's slightly better.

 

[deleted547339]

The

The more I ponder this, the more I think I just like all kinds of smoked, barbecued meat, to some large degree or another. It's all really damn good, just some of it's slightly better.

Wet rub, dry rub, spare ribs, baby back, hot sauce, sweet sauce, tangy sauce, white sauce, brisket or pulled pork. Bring em all.

 

[thegenius]

The

The more I ponder this, the more I think I just like all kinds of smoked, barbecued meat, to some large degree or another. It's all really damn good, just some of it's slightly better.

I'm lame
I just spent 1.5 hours watching some guy on youtube, Aaron Franklin, describe how he slow-cooks brisket, ribs, pork butt, and a variety of other meats and pork products.
Looks so good

 

[Apollyon]

I'm lame
I just spent 1.5 hours watching some guy on youtube, Aaron Franklin, describe how he slow-cooks brisket, ribs, pork butt, and a variety of other meats and pork products.
Looks so good

Not lame. And, Aaron REALLY knows his stuff.

 

[Birdstrike]

This weekend, I will fulfill this prophecy. On the way home from work today, I sneak in-n-out of the grocery store like a masked Ninja and get two bone-in Pork Boston Butts (18-20 lbs total). I soak them in apple juice overnight. Tomorrow I coat them in the sickest dry rub of all time. Then, I fire up Green Mountain smoker until it's billowing out so much intoxicating hickory smoke that at least one neighbor calls the fire department in a false alarm. Then, BOOM, on the grill they go at 210. 24 hours later, like a drooling caveman, I will take my kill, smoldering as black as night, off the fire and enjoy a big hunk of Heaven on Earth, and eat. Eat. Eat. Then eat. Then sleep.


Y U M

 

[RustedFox]

This weekend, I will fulfill this prophecy. On the way home from work today, I sneak in-n-out of the grocery store like a masked Ninja and get two bone-in Pork Boston Butts (18-20 lbs total). I soak them in apple juice overnight. Tomorrow I coat them in the sickest dry rub of all time. Then, I fire up Green Mountain smoker until it's billowing out so much intoxicating hickory smoke that at least one neighbor calls the fire department in a false alarm. Then, BOOM, on the grill they go at 210. 24 hours later, like a drooling caveman, I will take my kill, smoldering as black as night, off the fire and enjoy a big hunk of Heaven on Earth, and eat. Eat. Eat. Then eat. Then sleep.


Y U M

 

[Birdstrike]

Envision may be screwing docs. COVID may have rendered me with too much time on my hands. Here's how I responded.

My most delicious hunk of meat ever. I finally found my magic formula. 10 lb pork shoulder, soak in 3/4 apple juice, 1/4 vinegar + spices, overnight. Then, paint with Dijon mustard, followed by a criminal amount of dry rub. Then, on to the smoker with a pure hickory (or cherry) wood fire at 200-225F until meat temp about 150-160 (8 hours). Then, wrap in unlined butcher paper, put in pan and back on smoker overnight until meat temp of 205F (17 hours). Then, take off smoker and let sit wrapped 1 hour. Then, unwrap and let the magical flavor juices drip into the pan. Then, with Jimmy Buffett playing and sunshine blasting through my windows, pull off a hunk of meat, smokey bark on the outside, moist steaming-pink on the inside, confirming absolutely outrageous, taste and smell. Call kids inside, let them pull off a hunk, "Holy crap that's good." Success. F- you, COVID.

After 25 hours and 30 minutes on the smoker, a caveman's finished product:

cc: @thegenius

 

[EctopicFetus]

Envision may be screwing docs. COVID may have rendered me with too much time on my hands. Here's how I responded.

My most delicious hunk of meat ever. I finally found my magic formula. 10 lb pork shoulder, soak in 3/4 apple juice, 1/4 vinegar + spices, overnight. Then, paint with Dijon mustard, followed by a criminal amount of dry rub. Then, on to the smoker with a pure hickory (or cherry) wood fire at 200-225F until meat temp about 150-160 (8 hours). Then, wrap in unlined butcher paper, put in pan and back on smoker overnight until meat temp of 205F (17 hours). Then, take off smoker and let sit wrapped 1 hour. Then, unwrap and let the magical flavor juices drip into the pan. Then, with Jimmy Buffett playing and sunshine blasting through my windows, pull off a hunk of meat, smokey bark on the outside, moist steaming-pink on the inside, confirming absolutely outrageous, taste and smell. Call kids inside, let them pull off a hunk, "Holy crap that's good." Success. F- you, COVID.

After 25 hours and 30 minutes on the smoker, a caveman's finished product:

View attachment 302720

cc: @thegenius

Looks great. Quite the effort. Mad props.

 

[deleted109597]

I'll be right over

 

[Birdstrike]

I'll be right over

Would gladly have you all over, if I could. I need help with this 10 pounder!

 

[deleted109597]

Would gladly have you all over, if I could. I need help with this 10 pounder!

Start marking out the 6 foot distancing tape squares now.

 

[RustedFox]

When this is all over, and businesses re-open (hopefully soon), I have one word to say:

Barcade.

 

[bravotwozero]

Also, would hate to see the lineup at barbershops, lol.

 

[RustedFox]

Also, would hate to see the lineup at barbershops, lol.

Amigo...

Our CEO rolled thru the ER a few days ago and asked the limpdicked generalized/required question of:
"What can I do to help you guys ?"

I said:
"Get me some surgical caps. No; not those puffy ones, the tie-them-down-in-the-back ones. If I can't get a haircut for another 4 weeks... I'm going to be one longhaired dude. It will border on unprofessional, and the ORs aren't doing squat these days."

He replied with:
"Really? You're not so bad now. What gives?"

My hair grows like weeds if you fed them MiracleGro. I'm not a puffy/fluffy type, either where it can be stacked well and it looks okay. Longhaired greaser. @dchristismi knows this is true.

 

[GeneralVeers]

Im sure someone can come to your house.....thats what I did.

Amigo...

Our CEO rolled thru the ER a few days ago and asked the limpdicked generalized/required question of:
"What can I do to help you guys ?"

I said:
"Get me some surgical caps. No; not those puffy ones, the tie-them-down-in-the-back ones. If I can't get a haircut for another 4 weeks... I'm going to be one longhaired dude. It will border on unprofessional, and the ORs aren't doing squat these days."

He replied with:
"Really? You're not so bad now. What gives?"

My hair grows like weeds if you fed them MiracleGro. I'm not a puffy/fluffy type, either where it can be stacked well and it looks okay. Longhaired greaser. @dchristismi knows this is true.

 

[docB]

Amigo...

Our CEO rolled thru the ER a few days ago and asked the limpdicked generalized/required question of:
"What can I do to help you guys ?"

I said:
"Get me some surgical caps. No; not those puffy ones, the tie-them-down-in-the-back ones. If I can't get a haircut for another 4 weeks... I'm going to be one longhaired dude. It will border on unprofessional, and the ORs aren't doing squat these days."

He replied with:
"Really? You're not so bad now. What gives?"

My hair grows like weeds if you fed them MiracleGro. I'm not a puffy/fluffy type, either where it can be stacked well and it looks okay. Longhaired greaser. @dchristismi knows this is true.

Yes. Same. We have been formally told not to go to the OR for PPE. So I bought my own and shaved my head. Typical.