EPC, DVA Home Visits

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Here's probably an old bug bear but here goes

How come we only get the same amount for DVA and EPC home visits. The cost of these is obviously in excess to the cost of seeing a client in the clinic.

The other question is

Do GP's gain more payment for seeing a patient at home or are they in the same predicament as us.

Ive tried researching the medicare and dva site but cannot find the answers.

I guess the only way to gain more is to charge a higher amount and receipt them so they then have to go to medicare and claim their $50.05 back. This in itself would prove that they really arent home visit clients??

Let me have your thought folks

many thanks

 

Having an out of pocket amount or higher fee is the only way to go. In the time it takes to drive to the clients house, treat and return you could usually treat at least 3 general care patients.

Most of my clients are understanding when the higher "home visit" price is quoted.

My other pet hate is when GP's issue EPC referrals for orthotics!

 

DVA you are entitled to charge for mileage and consumeables. Any one doing home visits should be charging accordingly.

Any tradie charges more than we do just to turn up! Not to do anything!
Any one bulk billing for home visits has no idea what there overheads are and need to assess this as a part of the practice managment.

Regards

 

HI Heather

Ive never claimed for mileage and neither has any of my previous employers. In what circs would you claim..also the consumables i presume this means anything other than standard equipment??

 

On the DVA payment form there is a section title kilometres travelled. You just put in the number of kilometers you travelled and claim that. You can charge for dressings, padding, etc.

 

Tough Spiders,

You should be getting at least 2 or 3 signatures on DVA slips to cover various item codes.
- One for your consult (F004/F012)
- One for consumables DURING consult (F986) ie: charging a sterilisation fee or sterile wound dressings;
- One for consumables AFTER consult (F987) ie: anything the patient takes home with them, but is not apparently supposed to be used for something they could easily get from a pharmacy.

Cheers,
Nat

 

Someone please tell me youre joking!!!!

Ive worked for two employers since coming from the UK and neither have claimed for anything like this for treatments. All have been just the usual F012 or F033. Ive been claiming for otoforms etc but not for dressings or padding etc.

How does claiming for mileage stand with the taxman???

Thanks so much for your help folks

Does anyone know if the DVA issue guidance notes for claiming. Ive read the fee schedule but it is not clear about thing such as claiming for sterilisation or mileage

 

sterilisation fee?..........this cannot be true

 

I've only just started charging the F986 code for consumables during consult.
At the recent Private Practice conference here in Vic, a few other pods mentioned they've been charging it for years, based on a sterilisation fee and dressings etc...
A set of sterilised instruments that can only be used once before re-sterilising, can be classified as consumables.
I think the thing here is not to take it for granted and overcharge for anything. I now use the F986 code to cover the costs of consult consumables, not to make a huge profit. Put a fair, reasonable price on things like mileage and consumables and not try to rort the system.

 

hmmmm interesting.......considering how hard it is to justify medical grade footwear for clients I am amazed they havnt cracked down on it

 

DVA only pay for travel over 10km.

Also, under the new Health Professionals and Support Services award employers have to pay their staff $0.74/km for travel. This can be quite a hefty impost and needs to be factored in your fee.

 

Brevis,
I'm surprised they haven't too, but since they give a pricing allocation for consumables up to a certain amount without obtaining consent, I assume they're ok with it. I think the thing with footwear is that too many vets were thinking they could all get a free pair of shoes every yr and it got too costly. It all comes down to DVA's budget doesn't it? If pods get too greedy and overcharge for the consumables, I think they may crack down soon enough.
As for my fee schedules, I have 2 clinics with totally different demographics - at one I bulk bill and the other I charge $60 for an F012. I bulk bill all the DVA though.

 

I don't charge for mileage as I only do home visits in the immediate neighbourhood, but I do have a pt that gets DVA to pay for his taxis down to my clinic. They cover transport for the patient to and from their appointment if they need it. We have to fax a request through to DVA the day before with the patient's appt time for them to organise the taxi.

 

We do the same Nat. I believe that the taxis are only for Vets over the age of 80.

We dont actually take on new home visits any more. If they cant manage the taxi we will pass them on to another podiatrist in the area who will see them. With our overheads it is just not economical to see them. For long term patients, we will make exceptions though.

 

Thanks Mark,
Didn't know that about the 80yrs of age. I only have one vet that needs a taxi to bring him, as he has no family to help out.
I do have one vet that rides herself down the footpath a few kms on her 4WD scooter!
I think the ApodA or ApodC may need to get on to DVA to help distribute better info out to pods as to what is or isn't allowed; we need a better clarification of the rules so we can charge accordingly.

 

I wanted to ask Nat Smith what was the actual fee that was charged for the consumables used in a Podiatry DVA home VIsit and to also sat that in Tasmania we are not able to bill for the first 10 kilometres we only get paid for kilometres in excess of 10, is this the same in other states?

 

Max,
The code F986 is for consumables during consult either in clinic rooms or home visits.
I've only recently started charging it myself upon advice from other pods and better practice management, in order to cover costs.
I only charge depending upon what I actually use; whether it is just a sterile instrument pack or includes wound dressings.
DVA allow up to $48.95. I think that would be a tad excessive to charge that much, however Allevyn et al. ain't cheap. Usually I just charge for a sterile pack of instruments.
There is big debate on what it costs to sterilize a pack of instruments, the consensus appears to be between $10 - $15 depending on who you ask. If I'm just charging for the instruments I charge $8. I believe this to be a fair price, if not below what the actual cost is supposed to be.
As I mentioned before, I think the key to charging for consumables is to cover your costs with ethical charges - not to make profit. I'm not charging willy nilly and rorting the system, the code is in the fee schedule because it is allowed. I think if pods abuse it then DVA will clamp down.


Nat

 

I suspect that if/when your clinic gets audited that you are going to have a fair bill to repay as I cannot see how instruments being sterised is classed as a consumable unless you are using disposable instruments.

 

We have been claiming consumables for a long time from DVA but we never include sterlisation. I also think there will be no leg to stand on from DVA when they pay more then what most people usually charge. The biggest issue has got to be for people to stop bulk billing not adding sterilisation onto DVA forms. We can only say we need more money from medicare if we stop accepting it as enough. We worked out the extra number of patients we would have to see to break even by bulk billing and it was enormous. I honestly cannot understand why people are devaluing podiatry by accepting $50 for an appointment, let alone an appointment plus report.

 

Interesting... I am not sure about claiming the intruments, but do you have to document the items you are claiming for in the progress notes? ie. F986 sterilisation, betadene, cream, scalpel blades etc?

 

All new to me! F986 can be a friend to us all as sterilisation is indeed a costly process! (think of our time in cleaning, documentation and packing etc.!)

 

Tim,
Considering I don't hide in anonymity on here, I suspect if an audit's coming my way I'll see soon enough. I have no problem with that. I try to run my practice as ethically as I can, to be accountable and transparent in my dealings. If I'm doing something wrong I'll stop. In fact, I'm going to speak to the powers that be and get some clarification....

As for your comment about instruments not being consumable unless they're disposable, I would have to disagree.
Our profession requires us to use a sterile set of instruments for each patient.
If they're disposable, we throw them away. If not, they are washed, dried, re-bagged & re-sterilized. The effect is the same, all instruments are SINGLE USE, therefore a consumable. What is the difference bw charging for a disposable set of instruments or charging for a sterilizing fee? I imagine the cost of disposables would actually far outweigh an agreed upon sterilizing fee.

Nat

 

Hi All

Wel i rang the DVA and asked them for clarification. They advised me that we cannot claim for necessities involved in the sterilisation process, ie bags, water etc. They advised me that this is included in the treatment cost.

 

You are also supposed to be the closest practitioner, so you generally can't claim mileage in a metropolitan area.

Your contract with DVA also forbids you charging patients any extra for what is normally covered by DVA, so you have to "bulk bill"!

Cheers,

Brad