BS Fee Schedule DDS pays for CE and more!

[RNyorkiemom]

I wanted to share with everyone who is dealing with CE EXAMS!!  I was looking at NC DDS recruitment site just because I wanted to see the requirements for various positions and I am now livid.  I am unsure how to paost a copy on the site, but I have no clue how to do so.  I get why so many doctors do these assessments now.  It really pads their wallets!!!

Here is an example:

I believe this rate is exact, but Neurologist gets reimburse $135 per exam.  When I went for mine the doctor was through, but his documentation sucked.  I asked him how many visits he does for DDS. The number varried day to day, but average was 3 a day.  So in theory this doctor would make:

$ 405 per day
$ 2025 per week
$ 8100 for 4 week
$ 97000 if the Dr worked 48 weeks per year

So easy money + bread  = BS documentation of patients needs = denials of due benefits to workers who have paid in = citizens suffer financialy and emotionally!!  WTF is our government thinking???  No shocker why SSID may run out of funds in 2016. 

Only in America

[Helper]

$135 is less than he would make seeing private patients, especially if it is more than a 15 minute visit (including documentation time).

Also, typically physicians need to bill an amount at least 3x their salary each year to cover the cost of office staff, office space/utilities, equipment & supplies, malpractice insurance, health insurance, insurance on equipment & office space, etc.

So, the doctor would have to go to 4 years of college, 4 years of medical school, & complete a residency (making around $50,000/year during residency) & possibly a fellowship at low pay as well & incur over $200,000 in education costs & then perform 9 CEs per day to make $97,000 a year. 

[Helper]

Also, you can request your own doctor perform the CE.  However, they will often refuse due to the poor reimbursement!

[newdawn]

I wanted to share with everyone who is dealing with CE EXAMS!!  I was looking at NC DDS recruitment site just because I wanted to see the requirements for various positions and I am now livid.  I am unsure how to paost a copy on the site, but I have no clue how to do so.  I get why so many doctors do these assessments now.  It really pads their wallets!!!

Here is an example:

I believe this rate is exact, but Neurologist gets reimburse $135 per exam.  When I went for mine the doctor was through, but his documentation sucked.  I asked him how many visits he does for DDS. The number varried day to day, but average was 3 a day.  So in theory this doctor would make:

$ 405 per day
$ 2025 per week
$ 8100 for 4 week
$ 97000 if the Dr worked 48 weeks per year

So easy money + bread  = BS documentation of patients needs = denials of due benefits to workers who have paid in = citizens suffer financialy and emotionally!!  WTF is our government thinking???  No shocker why SSID may run out of funds in 2016.  

Only in America

I've heard that a lot of people's regular doctors won't perform CEs because the pay rate is so low. They not only have to spend time meeting with the claimant, but also generate a report. My psychiatrist charges $150 for a 20 minute session (which I find is extremely reasonable, especially considering she is a master at getting pharmacy benefit managers to cover prescriptions and faxes paperwork quickly and at no extra cost. In fact, I think she's only able to keep her rates so low because she doesn't have a full-time receptionist/scheduler and only takes self-pay, medicare, or BCBS). She charges even more for paperwork she does for me that she cannot complete during our little sessions. No way my psychiatrist would consider it lucrative to set aside time for a CE and generate a report for SSA for $135. I can see where some doctors who don't have a lot of patients for whatever reason might use CE exams to fill in the gaps, but I doubt they're getting seriously rich off of it.

Doctors have to pay a ton of overhead for malpractice insurance, office rental costs, someone to handle insurance billing, receptionist if they have one, etc.

(Helper posted much of what I had to say as I was typing.)

[Lit Love]

Not only do doctors consider them low pay, but most have zero interest in having to learn SS's requirements which are constantly being updated. 

[RNyorkiemom]

I worked in the medical field as a RN for years.  There are a few misconceptions people have on these poor doctors.  When you are set up for a CE go to the medical board website and look at the Dr training history and other information like the year they graduated.  The last CE I had for psy graduated the same year I was born. He had no SSID training llst on his continuing education. 

Yes the doctors have bills and cost associated with their practice. They can write off equipment, mileage and other cost.  They truly don't have huge over head cost since everyone was forced to go to erecoeds in 2010.  So there is no records clerk. These practice go billing from provided software and insurance companies. They out size payroll if they are a large company if not they have a payroll clerk. The staff is typical made up of CNAs or CMAs. The pay rate ranges from $10 to 15 hour. Yes they have rent, but part of that is a tax exemption.

These doctors are cheap. The majority by low end equipment. I will give you an example when I started with the surgical center I was given a pulse ox that was taped together and a 5$ stephascope.  The same day I was assigned those items I went out and bought a Litmsn Cardio 3 strohascops and a 70$ pulse ox so I had adequate supplies.  The other issue was cutting corners such as not covering endoscopes or cleaning them with expires sanitizer.  So really disgusting.

I know from people I have spoken with the medical CE last 15 to 3o min so a 15 min visit the doctor makes $135 for the $15 minute visit so the actual value of his time was $33.75 for the 15 minutes he spent with you. If it was a 30 minute visit $67.50 was cost for 30 mi ute visit and the Has nice margins on these appointments. If the doctor doesn't have a regular practice site DDS pays for the location.

If you read your CE notes from your CE.  They are poorly documented and in and not adequate. So I don't get any of the pro CME REMARKS.  IN THE STATE OF NC most of the doctors are semi retires and this is their play money. 

One other interesting rid bit is during the mints and months you are waiting through your initial application thru recon your file sits and collects dust and in all an examiner my spend a grand total of 5 to 7 days actually reviewing your file.

[Lit Love]

The Green Book link:  https://www.ssa.gov/disability/professionals/greenbook/index.htm

Adult CE Report Guidelines:  https://www.ssa.gov/disability/professionals/greenbook/ce-adult.htm

[ChugginAlong]

The psychologist who performed my CE was *much* younger than I and well regarded in the community. My therapist had shared office space with her in the past and spoke highly of her. Her write up was thorough and accurate.  I'm not sure it's fair to lump doctors who perform CE evals all in one category. 

[newdawn]

One other interesting rid bit is during the mints and months you are waiting through your initial application thru recon your file sits and collects dust and in all an examiner my spend a grand total of 5 to 7 days actually reviewing your file.

As someone who briefly worked in claims (albeit not SSA claims), I think it's normal for a file to basically sit in someone's queue while either waiting for doctors to send in requested info and/or to evaluate all of the info and make a determination. I wouldn't think it would take weeks for a competent DDS examiner to read through a person's file and make a determination. And sometimes the wrong determination is made for whatever reason but that's why there's QA, reconsideration, and appeals, some of which allow for additional evidence to be submitted.

I wish the wait times weren't as long as they are, but that seems like it could mainly be improved by employing more DDS examiners, ALJs, etc. or somehow streamlining the process further.