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I know that Medicare is supposed to cover that, though it never seems specifically addressed by my parent's primary care. I typically accompany them to all appts which are for the most part routine re-checks. My mother would refuse to go if not for thinking she is in her busybody/meddler life-long role and going to make sure my father is seen LOL. They go in together and as Dad typically takes longer with communication being tedious due to his deafness (and, btw, I often wonder if he should not be entitled to a longer visit for this reason and if it is unfair to charge for a "long" visit because it is discriminatory/ADA violation??) so he uses up Mom's "visit" time and the billing results in the facility getting all their $$$. We had a wonderful MD who departed, and I have tried for a long while to warm up to this new guy...I like him enough...but at the same time I sense how rushed he is and feel his load is too full for the attention and care I/we need. I am on this road alone for the most part, and I had great comfort knowing the other MD would have been there for me in the worst of times... I learned of another MD (the original MD suggested several names to a friend of Dad's as he was also a patient), who is at a bit further of a distance, and I'd like to meet him, touch base, see what I think. But I am not the patient...unless I circumvent it all and say I am and tell him the story when I get there. Any thoughts/experience?

Is the poster and gdaughter one and the same? I am confused😊

Whatever, the question would be if she could go without Mom and Medicare pay for it. The answer is no. I asked this when they wanted Mom back to read her lab results. Moms Dementia had gotten beyond her understanding anything. The Dr. Talked to me all the time. Mom had to be with me for the Dr. to bill Medicare. Otherwise, you would probably have to pay out of pocket to discuss her care without her.

Really, I see what poster is trying to say. The visit is to discuss the Mother. I did not take it as fraud, it was an honest question. Like I said, I have questioned it too.
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gdaughter Mar 1, 2019
THANK GOD! OR GODDESS! I'd say Halejuha but I can't spell it. THANK YOU! THAT IS IT. That is as simple a question as it was meant to be. No more, no less and NO friggin attempt to commit fraud. I seriously have no energy to attempt fraud or anything else! I don't have time for it! I have toilets to scrub for crying out loud. And I still can't see how ANY sane person could think such a thing because we're talking about a 96 year old and I do not resemble 96 by any stretch. I just want to find a nice doc who can relate to all of us the way the old doc did. I don't like the answer:-) but I appreciate you knowing and sharing. Maybe the rules need updating for us good daughters!
and yes, poster and gdaughter is me and one in the same, getting older by the minute with the stress this post has caused! Thanks again JoAnn! I think next time I will not add any additional info to my question(s)!
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Oy...I can see where I caused confusion...I did NOT mean to imply I would take on my mother's identity--and how in the world could I? Do you think I LOOK 96 and demented! That doesn't even make sense to attempt to do that! I would have been better off just calling Medicare which I very well might. So to be clear, mom is a handful, has dementia, can be miserably stubborn and refuse to go; and all of this effort is because I am less than happy with the current MD who we took in hopes of him being as good as the former MD which there is no way ANYbody is ever going to be. It is about mom and dad who are the patients, but as the caregiver I want to make sure I feel comfortable with the MD and that they understand the whole picture. These MD's are in Family Medicine, and when I said something about ME being the patient, I would have been going as the patient as MYSELF, ME, under my name, with my records...just making clear I really didn't want any care at that point beyond discussing my concerns. As in bill it on my name/number for a consult or whatever. HOWEVER, I am checking with Medicare because I think there is a legitimate and honest way to do what I actually want and feel needs to be done. It may use the term "collateral" or similar...I just thought with the wide audience here someone might have had experience with it. Fraud LOL...if nothing else I am one of the most decent and honest people out there.
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Why can't you call the doc and ask for a call back? Maybe send email to his office?
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gdaughter Mar 1, 2019
Yeah...well it's at the Cleveland CLinic...and I guess would be the most simple way to go but they turn it into such a tedious undertaking...but you're right, it may be worth a try! Thanks for stating the obvious:-)
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When you take them there ask your parents if you can come in with them at the appointment. That makes it a verbal consent under HIPPA rules
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gdaughter Mar 1, 2019
I am already 1) going in with them at every appointment; they don't mind and the staff knows me and 2) the HIPPA crap is already covered, long ago in both their records. We're good on that.
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“But I am not the patient...unless I circumvent it all and say I am and tell him the story when I get there”

This is your statement. You are clearly misrepresenting yourself as someone you are not. That IS fraud.

I am not sure this is appropriate. What will you discuss with this potentially new provider? Opinions? He won’t have any medical records to refer to b/o HIPPA.

I suggest a discussion with the current PCP’s office manager about how the appt’s time is allotted. Inform them of this problem and give them an opportunity to remedy it.

Also regarding switching providers would you be able to make an appt and bring your mother? I am not sure of Medicare billing guidelines but I can’t figure out how the new provider office could bill for a consult vs hands on care initiated by a daughter with the patient not there. That is fraud. The office may bill your mother directly and payment will be out of pocket as this new PCP has never and did not treat your mother during the appt.

The new PCP will still need medical records from your mother’s current provider and your mother will need to sign the Med records release consent.

The PCP will need to meet your mother sooner rather than later so bringing her would provide an opportunity for that. Still if he/she doesn’t provide hands on care, I am unsure how the billing office would code it for reimbursement.
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gdaughter Mar 1, 2019
The point is I want to see if this is a person I feel good about them seeing (i.e. does he live up to his video). Being that the former primary passed his name along I have a good feeling...but the former primary was such a...mensch (look it up if you don't know it)...that it will be a pair of shoes hard to fill. In essence I want to hand pick the person to join our team. The real dilemma is that this person will be about 20-30 minutes away...compared to 5-10 for the current one. And as the POA's are in place, it will no doubt be fine if Dad or I sign off on the release...plus it may not be at all necessary being that all these MD's are in the same system. My point is there may be something in the Medicare rules that DOES allow for this sort of thing. Whether the patient HAS to be present or not, at this point I don't know. I will investigate further. AND again, I AM NOT DOING ANYTHING FRAUDULENT. YOU HAVE MISUNDERSTOOD MY WORDS. If I contributed to that, my apologies...sometimes I am writing in a sleep-deprived state and things are not as clear as they should be.
As someone else commented, why don't I just call and see if we can talk or email prior to the potential new guy meeting one or both of my parents. I am just trying to see how I like the guy before I go to the hassle of attempting to take mom. She is enough work just getting to the hair or DDS appts.
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I think you might be able to spin it to your mother that having separate primary physicians is the *really* ethical and responsible thing to do.

Point out to your mother that she owes it to your father to ensure that she is taking proper care of herself, like a grown-up, and that she should no more be piggy-backing on his medical appointments than she would live on his leftovers at dinner.

Forgive my ignorance: if Medicare didn't cover this introductory appointment, how much would it cost?

I wouldn't pretend anything, though. First impressions last, and doctors do not like surprises when it comes to what appointments are meant to be for. You'd be getting off on totally the wrong foot.
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gdaughter Mar 1, 2019
I can't believe how I seem to have misled people into thinking I would do anything fraudulent or misrepresent myself or the circumstances! No way! And hell, I don't even have the energy for that looking after these two! There is no reasoning with my mother. She has dementia. She is amazingly functional but her ability to comprehend the concept you are describing was gone at least 2 years ago. How much would it be? LOL. It's Cleveland Clinic. They can decide how much and not tell you but when I see the Medicare statements ...well, let's see, I'd guess close to $200 for the facility fee, and then $300 if it is a "short" visit. Which it never is because dad is deaf and communication is slowed using an i-phone. Good question though! And again, not pretending anything. My thought, IF necessary, was to just go as myself as the patient and make the visit an introductory one and let him know I just wanted to see how he was with people, ME for starters.
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Get a grip Cali. NO FRAUD, you misunderstood, I would be up front about the whole thing and I would be the patient, just a patient who wanted to discuss caregiving issues related to my elder parents and would make that known IN ADVANCE. If they so know we'll figure something else out. My mother is a pain in the ass who is uncooperative about going out or anywhere unless SHE spontaneously wants to go because she has dementia. She is capable of dressing and going out...but if she doesn't want to or is told there is an appt and she doesn't want to go there is no way to force her. As I said, by framing it around Dad having an appt and she needs to come, which appeals to her meddling and controlling behavior, then she'll come along, insisting she does NOT have an appt but typically allowing her BP and heart rate to be checked.
MY QUESTION was only to ask if it was possible for a family member to consult on a patient's behalf not to commit fraud.
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worriedinCali Mar 1, 2019
No need for me to get a grip thanks. Maybe you need a reality check?

It is fraud. But we can agree to disagree on that. You are the one who made the comment about impersonating your mother so Medicare would pay! That is fraud. Just ask the teacher arrested for doing something similar with her student ;)
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It sounds like this is fraud. It sounds like ongoing fraud.

you shouldn’t lie and say you are the patient. That’s illegal and it’s fraud and you will get yourself and the doctor in to the trouble. Why can’t you bring your mother to the doctor?
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gdaughter Mar 1, 2019
NOTHING HAS HAPPENED, YOU MISUNDERSTOOD. AND as far as being the patient, I COULD pick this guy to be MY damn primary MD if I wanted to. I wouldn't want to get anyone in trouble, especially myself or a good MD. No one would put up with it, and the system knows identifying info in the computer system anyhow. IT would be impossible to do it. And as stated before, my mother HAS DEMENTIA. She can be functional, but she can also be miserable and stubborn, and to take her under the guise of going elsewhere is more than exhausting. So if she doesn't want to go, she won't. As said before, nearly impossible some days to get her to get her hair done (only way it gets washed) or to the DDS. She still slides into her controlling self, so if Dad has an appt, she goes willingly to keep an eye on him/supervise...and then the current MD and staff are on to the whole thing, and they usually can check her vitals and sometimes get her to agree to some lab work. It's a challenge only someone dealing with a similar kind of dementia can understand. That is why this is a hard situation because the guy I heard good things about is at a further distance than the current guy who is very close...right now I am losing my own sick time to be at appointments with them...which is essential from an advocacy perspective and understanding since my dad is deaf and communication is a challenge...plus the Cleveland Clinic system is set up to exploit every last issue a patient presents or mentions. (EX: dad goes in 2-3 weeks after Thanksgiving...at THanksgiving he cut himself with a clean knife. The wound is healed. He mentions how it still hurts a little to MD. Gets listed as "Laceration, right thumb, first encounter". And then the computer prompts the MD to ask about Tetanu$$$. So I will follow through with the original, simplest way to go, although I WOULD like to know the official standing by Medicare because I think there is something honest and legitimate about a caregiver/family member providing info, especially in the case of dementia. If and when I find anything out I will report back.
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