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Can't wait to see the responses to this thread although I can probably already guess how this "discussion" is gonna go down.
joyfulMD wrote: Given lower reimbursements, I imagine that many practices that accept Medicaid try to keep Medicaid patients below a certain percentage of their patient load to maintain revenues.
AnnaM wrote: A couple of problems I see with the article: The secret shoppers posed as parents calling on their own. If asked, they said they were referred by a doctor or ER. Most specialists want a direct call from another doc's office for the referral, and if I thought a kid needed a particular specialist, I could just pick up the phone myself and get the kid seen.
Some of the diagnoses they called about (broken bone, uncontrolled asthma, seizures, severe depression) sound like stuff that should be seen in the ER (and frequently is).
I have NO idea where she got the figure of 99+ bucks reimbursement for a moderate complexity problem as payment from Illinois Medicaid. That is pure fantasy. A 99213 used to pay something like 30 bucks, if memory serves.