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Please give specifics, as I feel like you're not telling us everything we need to know in order to give you our best recommendations.
The doctor maybe right in this case, sadly.
As for the billing, there could be bills the doctor charges for doing work that doesn't require seeing the patient, such as paperwork, or calls to get medical information if you use an outside source.
Happened in my case. I got my COVID booster not from the facility, but from the pharmacy of my hospital. The facility NP sent a bill to insurance, for time getting this information to add to the medical record. I did not see the NP.
Regarding the billing from other entities, that is not the case in this situation. The doctor billed it as an 'extensive and complicated 45 minute' visit to the patient in the nursing home - a visit for which the nursing home has no documentation. Would you not question this?
Simply google "Can a doctor terminate a patient relationship".
You have no right to ask any doctor for patient's records unless you are POA for an incompetent patient.
Maybe I didn't word it correctly. If this doctor has an exclusive contract with the nursing home to provide medical care onsite and he terminates that relationship, he is violating the contract with the nursing home. If the nursing home cannot provide another doctor to provide medical services on site, then the nursing home is not only breaking federal law, but they are violating their contract with my brother's insurance (the insurance plan pays for onsite physical services). Hope that clarifies it for you.
Because of his TBI, I have POA with the nursing home....so yes, I have every right to ask the nursing home and doctor for his records.
And in the past you've stated that he's a difficult patient.
Are you certain the doctor hasn't paid visits to him,? Are there records, outside of brothers recollections,?
Forget about hiring an attorney to fight a hopeless cause. This doctor can drop ALL of his patients if he so desires. My suggestion to you is to find out which doctors do visit this nursing home regularly and nicely ask one of them to take your brother on as a patient. And don't do to THEM what you did to the last doctor who dropped your brother as a patient!
Good luck to you.
- You seem to be overlooking the fact the nursing home must, by federal law, provide physician care on site and not force patients to go outside of the facility for basic care.
- I already stated I am pursuing a list of other doctors that service this facility. And, as has happened in the past, I am being stone-walled in getting this documentation.
- Even difficult or bipolar patients need and have a right to medical care - TBI, bipolar, or not. That's one reason I go every day to make sure things are running smoothly, to help out the staff where needed, but also to make sure he is receiving the care he needs.
When such patients don't get proper care - as often happens in our society - they end up on the street homeless. There's too much prejudice and lack of understanding on this subject in our society. It's heart-braking for the families and the patients. I am attempting to make sure my brother does not become a 'statistic'.
My husband is a doctor and in 26 years of private practice, he has only terminated a relationship with 1 patient. He also spoke with his lawyer before doing it to be assured there would be no blowback. He had a good bit of documentation to back him up.
The staff at this facility are some of the most uncaring and antagonistic nurses and CNAs I have ever interacted with. Since I have been going there nearly every day for a long time, I have become acquainted with other patients and they have made the same observations. The company that owns this facility was even sued by the state for staffing shortages. This facility is overall rated a "1" on most internet sites - mostly because of the staff but also for poor food quality, lack of cleanliness, lack of maintenance, poor communication, lack of records, etc.
It is sad to see people commenting with such negativity toward what posted. Doctors may have the 'legal' right in a situation like the one I share, but it doesn't make it morally right to put patients in this position. Patients who have 'issues' deserve proper medical care as much as the rest of us.
"Morally" right doesn't mean much these days. When I had neck surgery in 2008 and contacted my insurance co about the $250K bill for 1 night at the hospital, they laughed at me, saying that was standard pricing. Meanwhile, the insurance co ASKED that we report what we felt to be outrageous charges.
From personal experience that has been the case at the facility. The last time I saw one of the NH Drs and the one that is assigned to me, was on Father's Day. His NP handles most of the medical issues, and yes he charged insurance for this visit even though it was short.
Our doctor has a terrific service that employs two nurses who call us once a month. They chat about our health, falls, med changes, upcoming medical needs. This is billed to Medicare as some sort of visit under the doctor's name, although we haven't "seen" the doctor. This is not fraud.
It's kept us healthier, especially my husband. The nurses know better than he does when he needs a new script.
When I questioned why they were seeing him 3 or 4 times a week they went straight out defense. I know that is because they would be at the facility daily, wound care patient, literally pop my dad's door open, ask, "How are you today?" My dad would answer fine and you? Then Medicare would be billed for an extensive visit. Fraud!! No two ways about it. I know this because I was in the room multiple times this happened and I handled all the paperwork.
I filed complaints with every governing agencies and Medicare, this is taxpayers money being stolen. The end result in my dad's situation, he moved, the facility was closed by the state and the "medical group" disappeared completely from the city. I have no doubt they think they can run and hide but, Medicare is federal and they will be found, if they haven't been already.
Being a jerk, hard to deal with or mentally ill is no justification for robbing the tax payers as sooooo many believe nowadays is acceptable.
Good luck finding a doctor to treat your brother.
- To 'IsThisReallyReal'. I agree. Too many people just accept what these organizations are doing. Someone needs to stand up and stop the fraud - IF that's what is truly going on.
- To 'Cover9339'. I have taken my brother to see outside specialists when it was necessary but that's not usually the type of care this doctor has provided. He (mostly his PAs) address every-day, non-critical issues, i.e., writing orders for weekly labs, ordering tests, and renews prescriptions every two weeks. It's really not that difficult nor do I believe it is asking too much even if my brother asks too many questions, which, BTW, is pretty difficult to do when the doctor rarely goes into his room to see him. I personally think he is going off the deep end and his male ego is hurt because I asked for a reconciliation.....OR there really is fraud taking place.
- I have contacted multiple facilities in this area. NONE have open LT Medicaid beds and none would take my name on a waitlist. The system is currently overwhelmed.
- The current nursing home is still stone-walling me and has not provided a list of any other doctors that could attend to his care at this facility.
Thanks again! This is a large NH? I ask, usually the person assigned to the facility have their own office there, so they can go to resident's rooms if necessary. I hope fraud is not happening in your brother's case, and that this whole situation can be worked out.
We used to have a Nurse Representative from his Medicaid insurance provider. But after she quit, no one replaced her. I've requested a replacement several times and got - crickets!
Asking verbally can be blown off, your word against theirs type of bs. In writing, sent via a Federal agency with proof of receipt is a different story all together and will get people's attention, either the Doctor and NH or the governing agencies when you file complaints.
Make the requested information very clear, explain that you are concerned about the bills and require the records for an audit but, DO NOT make any allegations of wrong doing.
My bet is they are up to no good, whether it's fraudulent billings or abominable record keeping or....something is amiss, otherwise they could have and would have printed the records for you.
I've engaged the local Ombudsman several times on this one issue and she's not been able to accomplish anything. Just recently I was informed that all Ombudsmans are volunteers with no enforcement capability. Guess it's time to file a complaint - at least on this issue!
Maybe this doctor feels that your brother is out of his realm of expertise. I really find it weird that the NH only has one doctor with privileges overseeing the patients. And the DON should know who these drs are. Drs who except Medicaid are not prevalent. Medicaid is a lousy payer. I also don't think just any doctor can enter a facility to see a resident. The doctors must be given privileges. So a doctor has a right to say that you must come to him if u want to continue with him.
All I can say is keep trying to get brother into another facility. Unless you have a lot of money and a good lawyer you are not going to win this one. If you have not called Medicare, do it and talk to their fraud dept. Let them figure it out.