Query: Insurance Coverage for Interpreters?
I have been paying out of my own pocket for language interpreters. A colleague mentioned that some insurance companies pay for this. Is it true?
Name Withheld
Query: Moving and Insurance Companies
I am moving my office to a new location, and will have to inform all insurance companies of this new place of service. I would like to avoid any disruption in reimbursement and would like to hear from those who have gone through this process and have perhaps learned the “hard way” what they should have done or should not have done. Is there advice anyone can provide me with so I could hopefully avoid this potential problem?
Name Withheld
Query: Bookkeeping Under the New Sunshine Act
Now that the new Sunshine Act is in effect, how do I keep track of the costs of a dinner at Ruth's Chris steakhouse? Must I now ask for a menu and tabulate the cost and divide by the numbers of attendees? How can one do this if they are serving family style? Or should I ask the drug rep for a copy of his bill. Should I also ask the drug rep who comes to my office to give me a bill for the note pads, pens, etc.?
Paul Kesselman, DPM, Woodside, NY
Editor's comment: PM News does not provide legal advice. According to a recent Medscape article, "Physicians have no legal duty to keep a tally of industry payments and gifts, but they may want to anyway. The Sunshine Act allows them to contest the dollar amounts that drug and device makers submit to CMS, especially if they think the numbers are inflated."
Query: Treating Homeless Patients
A patient presented with a history of having lost a toe to diabetes and peripheral vascular disease, and wanted me to check out a problem on the opposite foot. He would not give me his address or phone number. Thinking that the patient was just being uncooperative, I asked "where do you live when you are not in a doctor's office?" He pointed to the hall, and there was a shopping cart filled with his belongings. The patient is homeless. He also admitted that he is virtually penniless and his diabetes is poorly managed by emergency room physicians.
I realized that this patient would be added to my list of pro-bono patients, but I have a greater concern about how to reach this patient if in the event of an emergency, or to discuss test results. Does treating a homeless patient present medical-legal risks? What if you do a procedure on such a patient? There is no way of reaching this person for follow-up should he decide to skip town. How have some of you handled such cases?
Elliot Udell, DPM, Hicksville, NY
RE: Responsibility for New Patient "No Show"
From: Chuck Ross, DPM
What is my (our) responsibility if a NEW (not yet seen) patient does not show for an appointment? Is there any legal obligation since we have not yet had an encounter? I can understand the necessity for a patient once seen, but I am uncertain as to how to proceed. I do have several no-shows who are predominantly covered under the welfare system. They are of greater risk of NOT keeping a new patient appointment than any other group that I have encountered in 40 years of practice.
Chuck Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com
Editor's comment: PM News does not provide legal advice. A doctor-patient relationship is not started until you actually examine the patient. Therefore, you have no legal responsibilities to someone who makes an appointment and fails to show.
Query: Malpractice Options
What are some other malpractice insurance options besides PICA and Podiatry Plus?
Name Withheld (TN)
Query: Scope of Practice
I work for a large multispecialty clinic. We have recently implemented our EMR system. This system was built for family practice/internal medicine and has been revised for the specialties. In this system, there is a “best practices” section that comes up if a patient is not at ideal BMI. Is it out of scope of practice for a podiatrist to ask questions about BMI, and then provide counseling?
Theresa Hughes, DPM, Galesburg, IL
