Good Faith Estimate, 11 months later

[sighchiatry]

Now that the Good Faith Estimate requirement from the No Surprises Act has been out for some time, I am curious to see how others in private practice have handled it.

The APA still recommends following the No Surprises Act to the letter: Psychiatry.org - No Surprises Act Implementation

I have essentially ignored it all, hoping that it will go away. Now that we are approaching the one year anniversary, I feel like it's time to implement.

---

Members don't see this ad.

 

[TexasPhysician]

Now that the Good Faith Estimate requirement from the No Surprises Act has been out for some time, I am curious to see how others in private practice have handled it.

The APA still recommends following the No Surprises Act to the letter: Psychiatry.org - No Surprises Act Implementation

I have essentially ignored it all, hoping that it will go away. Now that we are approaching the one year anniversary, I feel like it's time to implement.

My attorney says it doesn’t apply. Who knows?

 

[sighchiatry]

My attorney says it doesn’t apply. Who knows?

I like your attorney. This is dumb.

I sometimes consider sending estimates to the effect of:
"I charge $X per hour.
If you are seen for one hour every 3 months, your estimate is 4X per year.
If you are seen for one hour every month, your estimate is 12X per year.
If you are seen one hour every week, your estimate is 52X per year.
Please contact me with any questions."

 

[Sushirolls]

I've seen one hospital post on their website their entire spreadsheet of all charges, AND what each insurance reimburses for all CPT codes!!
Quite helpful when considering that locale for when I moved my office.

I do what I did before and make sure cash patients know upfront what to expect, and leave it to be patient question prompted. If they ask, we do our best to answer. Basically, I didn't change anything. Perhaps I'm in the wrong? At this point, I'm probably in the wrong with a bunch of other things and illegal on other things. It's impossible to stay abreast of all rules, all laws.

At some point I dropped my OCPD fears, said eff it, and am just doing the best I can and reflect if it's what I'd want for my own family, and treat my one employee with respect, that's about as good as it can get. Anything else, I'll ask for forgiveness.

 

[Merovinge]

I've seen one hospital post on their website their entire spreadsheet of all charges, AND what each insurance reimburses for all CPT codes!!
Quite helpful when considering that locale for when I moved my office.

I do what I did before and make sure cash patients know upfront what to expect, and leave it to be patient question prompted. If they ask, we do our best to answer. Basically, I didn't change anything. Perhaps I'm in the wrong? At this point, I'm probably in the wrong with a bunch of other things and illegal on other things. It's impossible to stay abreast of all rules, all laws.

At some point I dropped my OCPD fears, said eff it, and am just doing the best I can and reflect if it's what I'd want for my own family, and treat my one employee with respect, that's about as good as it can get. Anything else, I'll ask for forgiveness.

Of course the system was designed this way to centralize power among large PE firms or corporations and away from physicians. Definitely a feature not a bug.

 

[Sushirolls]

Of course the system was designed this way to centralize power among large PE firms or corporations and away from physicians. Definitely a feature not a bug.

So true. Only they can hire the lawyers and admin to monitor all these things...

[Insert my long winded conservative, Fox News angle rant here]

 

[Geraltofrivia]

Of course the system was designed this way to centralize power among large PE firms or corporations and away from physicians. Definitely a feature not a bug.

I've noticed PE firms entering healthcare. I didn't know this was possible. What is allowing this to happen? What law? I am scared as a young person to grow old in this country seeing how they're (PE companies) running otherwise good practices into the ground

 

[Sushirolls]

Free country. Why can't they?

Doesn't help that academic medicine is not teaching, and not selecting for pro business, pro independent students.
Instead they are pushing team mantras and latest kool-aid flavor, is focusing on DEI as more important to the future of healthcare.

Why stop PE impacts with physician run organizations or encouraging the small independent (or solo) physicians, when you can watch these run amok, and use as political evidence to say, "See! Look, Look! Free market economy is bad, we need to socialize everything!"

The only thing I'm aware of is Nebraska [<--fact check that] passed a law saying pharmacies had to be owned by pharmacists. So there, only through legislation, does the old school pharmacist own business thrive. The rest succumbed to the pressures of Big Box Shops. There may be some minor examples elsewhere for physician ownership. But when you have STARK laws, they practically go towards gutting that as a possibility - and if memory serves me - thank Senator Grassley for that one [<--may need fact checking].

In theory you could do a push at national or state levels, to say all healthcare entities delivery direct patient care must be owned by a physician or group of physicians only. A hospital would be exempt as they don't deliver the care, perse, but they couldn't own the physician medical groups anymore. Lot of kinks to work out on that legislation to make it fly. But the thing is... doctors don't want it. See above. The bulk of physicians are now sheeple who want to be told what to do, and someone else running everything for them, and have a socialized healthcare overlord dictating everything.

 

[Merovinge]

I've noticed PE firms entering healthcare. I didn't know this was possible. What is allowing this to happen? What law? I am scared as a young person to grow old in this country seeing how they're (PE companies) running otherwise good practices into the ground

It's been happening for some time now. The majority of large group specialty practices are targets and there is a huge rush to snap up all the practices that are profitable. Optho, ENT, Derm, EM, Urology, etc are all seeing this across the entire country.

Even psychiatry, where group practices are not typically profitable or scalable enough to warrant attention from PE, has entered in with RTC/PHP/IOP. Eating recovery Center started as a Denver practice with local psychiatrists, bought by PE who made a quick 400% increase then exited to another PE. Same with Newport Academy, although this was only recently sold last year.

 

[smalltownpsych]

It's been happening for some time now. The majority of large group specialty practices are targets and there is a huge rush to snap up all the practices that are profitable. Optho, ENT, Derm, EM, Urology, etc are all seeing this across the entire country.

Even psychiatry, where group practices are not typically profitable or scalable enough to warrant attention from PE, has entered in with RTC/PHP/IOP. Eating recovery Center started as a Denver practice with local psychiatrists, bought by PE who made a quick 400% increase then exited to another PE. Same with Newport Academy, although this was only recently sold last year.

Residential program I worked at was bought by PE. It’s why I left and started my own business. Apparently insurance is covering the short term hospitalizations again so there is money to be made. I still believe there is room for private pay so I’ll stay focused on that. Wish me luck.

 

[Merovinge]

Residential program I worked at was bought by PE. It’s why I left and started my own business. Apparently insurance is covering the short term hospitalizations again so there is money to be made. I still believe there is room for private pay so I’ll stay focused on that. Wish me luck.

I hope you are right, definitely wish you luck as it sounds like you are doing great/important work from your comments on other posts.

 

[dl2dp2]

I think good faith estimator is exactly this: give patients the most accurate, good faith estimate of the cost of treatment. That's the spirit of the law. Exactly what you should do is context-dependent, unless you are run by the system, in which case the system dictates the standard operating procedure.

Whatever way you decide, I would give the estimate in writing.

 

[smalltownpsych]

I hope you are right, definitely wish you luck as it sounds like you are doing great/important work from your comments on other posts.

Thank you for your kind words. We are doing some good things and I am excited about it although this month it looks like we’re only going to break even. Damn holiday! I did tell one of my employees that this holiday means people will be spending more time with their families and next month even more stress so we are going to be real busy real soon. 😁

 

[FlowRate]

Eating recovery Center started as a Denver practice with local psychiatrists, bought by PE who made a quick 400% increase then exited to another PE.

What you're describing sounds a little like it could be a leveraged buyout, unless they leaned it out to high profitability and the other PE bought expecting consistent returns (vs stupidly bought a LBO)?