Title: Message
I agree -- no bill is the same as cash in my book.
 
The opinions expressed here are my own and not necessarily the opinion of LCMH.
 
Douglas M. Webb
Computer System Engineer
Little Company of Mary Hospital & Health Care Centers
[EMAIL PROTECTED]
 
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----- Original Message -----
Sent: Monday, February 03, 2003 11:05 AM
Subject: RE: Covered Entity or not

I think one category of CE that will stay uncovered at least for a while is employer sponsored on site medical clinics that don't bill at all.
-----Original Message-----
From: Doug Webb [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 03, 2003 11:57 AM
To: WEDI SNIP Privacy Workgroup List
Subject: Re: Covered Entity or not

Susan,
Well said.
 
Still another kink -- come October, you will have to file your Medicare claims electronically, which makes the loopholes even smaller.
 
IMHO, this makes just about anyoune who does "Health Care" a CE, except for those few providers who do a strictly cash business, and never file a claim with anyone.
 
I kind of expect that in another few years, large numbers of payors other than Medicare will be rejecting paper claims.
 
The opinions expressed here are my own and not necessarily the opinion of LCMH.
 
Douglas M. Webb
Computer System Engineer
Little Company of Mary Hospital & Health Care Centers
[EMAIL PROTECTED]
 
"This electronic message may contain information that is confidential and/or legally privileged. It is intended only for the use of the individual(s) and entity(s)  named as recipients in the message. If you are not an intended recipient of the message, please notify the sender immediately,  delete the material from any computer, do not deliver, distribute, or copy this message, and do not disclose its contents or take action in reliance on the information it contains. Thank you."
 

 
----- Original Message -----
Sent: Monday, February 03, 2003 09:19 AM
Subject: Covered Entity or not

Everyone,
We can argue all day long whether or not we are a covered entity, but I think it makes good business decision to agree that you are if you send in claims and be done with it.

Look at this situation, I don't know if many doctors or support staff realize this:  Anytime a claim is sent to Medicare, paper or electronic, it is coverted into an electronic transaction because Medicare forwards it to 2nd insurance companies.  So now you are a covered entity.  The only way to get out of sending claims to Medicare is not to treat anyone who may have Medicare.  Who can afford to refuse to treat a large portion of our society.  Another kink- Medicare requires the doctor to file the claim for the patient so don't think you can give the claim to the patient and he files it for you. 

The loop holes for not being a covered entity is so small, you almost have to practicing in the dark ages to not be a covered entity. 

I think you just have to resign yourself that if you practice and treat patient whether cash practice or not, you ARE A COVERED ENTITY.  At least that is what I am advising our clients, better safe than sorry.

Thanks,

Susan Bowes
Professional Procedures & Control
Practice Consulting Firm for the Small Practioner

Contact info:

211 Turner Drive
Reidsville, NC  27320

Phone- 336-578-7461
Fax-  336-578-7461 or 336-342-2030
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