July 20, 2006 #2, 635 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2006- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Giacalone Part of New NYC Diabetic Center

In Cabrini Medical Center’s diabetes center, Dr. Vincent F. Giacalone inspected the battered feet of Louis Squire one day last week. Giacolone is part of a new diabetes center created by Dr. Peter Sheehan, a noted endocrinologist, to create a new diabetes center, complete with services like podiatry and nutrition counseling.

Dr. Vincent F. Giacalone

Diabetes centers generally lose money, and many have closed in recent years. But Cabrini has gambled that a center focusing on treating diabetes complications of the feet and legs like those suffered by Mr. Squire, 67, a former bus driver, could prevent many amputations and pay for itself. “Eighty percent of the cost in diabetes is in 20 percent of the patients, and we’re focusing on that 20 percent,” Dr. Sheehan said.

Source: Richard Pérez-Peña, Ozier Muhammad (photo) New York Times [7/18/06]

Medicare Premiums to Rise in 2007

Medicare beneficiaries will pay higher Part B premiums in 2007, potentially driving more enrollees into Medicare Advantage plans. CMS blamed the expected 11% increase, to $98.40 per month, on rapid utilization increases. The estimated 2007 premium for Medicare Part B — which covers physician, outpatient hospital, home health and other services — assumes that physicians will get a 4.7% payment reduction in 2007. If Congress freezes that slated pay cut, the premium increase could be greater.

Source: Managed Care Week [7/18/06]

WA Podiatrist Recognized By State Board

Dr. Charles R. Chu has been recognized for nearly a decade of dedicated and outstanding service to the citizens of Washington State by working to assure the public’s health as a member of the Washington State Board of Health. Charles R. Chu, D.P.M. was first appointed to the Board in September 1997 by Governor Gary Locke, then reappointed twice.

Dr. Chu chaired the Committee on Children’s Health and Well-Being, which has made numerous contributions to children’s health, including developing community partnerships to advance policies that promote good nutrition and physical activity, and exploring public-private partnerships for social marketing.

Source: WA State Board of Health

Query: Interdigital Infection

I have a 27 year old male patient who was unfortunately involved as a victim of hurricane Katrina. He was walking in the water there for 4 days before being rescued. He has had a problem with an interdigital infection in both feet with itching but no signs of acute infection. Before seeing me he was treated with erythromycin gel, Keflex, gentian violet and soaks as well as OTC antifungal creams and Naftin. Nothing has helped. His physical exam was normal and he takes no medication. His web spaces were significantly macerated with multiple fissures and hyperkeratosis. No plantar or dorsal involvement. Bright yellow /green fluorescence under UV light.

I cultured the web spaces and started him on Cipro 500 bid for 10 days and Gris-peg for 4 weeks. His culture grew Pseudomonas aeruginosa –heavy - resistant to Cipro and Levaquin and all other oral agents, serratia marcescens- moderate--sensitive to Cipro, Enterococcus faecalis-heavy growth sensitive to ampicillin. Fungal KOH was negative. Needless to say he has had only slight improvement and has not responded to dilute acetic acid soaking. He has thrown out shoes, changes socks etc. I recently started him on gentamicin cream and I am getting an ID consult. Any other suggestions?

Mike Tritto, DPM, Rockville, MD, tritto@erols.com

RE: DMERC A Problems/Solutions
From: Paul Kesselman, DPM

With the transition from Health Now, the DMERC carrier prior to July 1 2006, to National Heritage Insurance Company (NHIC), there have been several problems, including:

1) Validation files contain errors. Validation files are files your staff downloads to check to see if the claims went through or were rejected upon submission. If you find any errors in the validation files, you should have someone contact NHIC or try downloading a new validation file. NHIC has posted corrections on its electronic bulletin boards, from where your office staff normally downloads them. The validation file system is now operational and the initial errors have been resolved.

2) Claims electronically submitted on some days were processed incorrectly. This is particularly true for claims submitted prior to July 7. You may now start seeing some rejections for unknown reasons. NHIC has performed an in house audit on all claims processed since July 1, and has reprocessed all these claims which initially may have been
incorrectly processed. There is no need for you or your staff to reprocess any claims you have already sent.

3) Correct Electronic Address Code. Be sure that your system is using the correct lectronic code for NHIC. Errors # 1 and #2 are assuming you are using the correct electronic address for NHIC. If you did not make a change to your electronic transmission system or you are not sure you are using the correct electronic address, contact your software vendor. They can verify whether or not your system is up to date.

4) Medicare Secondary Payer (MSP) Medicare secondary claims going to NHIC have on some occasions been incorrectly processed and the checks have gone to the patients. NHIC is working to correct this problem and this should be resolved this week. Most important are for those primary claims you must submit by paper other insurance companies and for which there is no electronic explanation of benefits (EOB). In these circumstances where NHIC is the MSP, I would suggest holding these claims for another week until the MSP problem is resolved. This is particularly true if you are going to submit it to NHIC electronically.

5) No paper EOB’s and/or no Electronic EOB’s. In the first week of July some paper checks were received without EOB's and without the ability to electronically download an EOB from
NHIC. This has been corrected.

It is important to remember that ALL Medicare carriers have discontinued mailing EOB's with paper checks, if your computer system has the ability to electronically download an EOB from Medicare. Please contact your software vendor if you have questions about electronic downloading of EOB's or if you have any issues with downloading EOB's.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.com

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

MEDICAL EQUIPMENT FOR SALE- PENNSYLVANIA

4 Micromac 300 "Podo spray" Nail Buzzers-- ($1500- retail) $100 each. 1 X-ray processor- Good condition- $500 each. 3 X-ray View boxes-Fair condition- $50 each. As Is. Shipping will be added. Questions or Interest, Email: barb@martinfootandankle.com

ASSOCIATE POSITION – TEXAS

Full time associate position for a PSR-24 podiatrist to join established dynamic medical and surgical practice in Central Texas. Looking for a personable, motivated, ethical, hardworking individual to join our board certified group. Please send resumes or CV to centexfootdoc1@aol.com

WEEKLY SPECIAL - One week of ads (6x) for only $75

PM Classified Ads Reach over 8,000 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most- effective way of reaching over 8,000 DPM's. Write bblock@podiatrym.com for details. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.