Filling Out Forms, Adding New Dx, And Other Medicare Advantage Issues

I know we all left the system for a ton of reasons. One was getting out of the data gathering, quality metric garbage. And it is an awesome feeling. I know we sometimes have to give a diagnosis code for a Medicare lab now and then but here is a weird question. Medicare Advantage is basically an HMO or capitated plan so the more they deny patients services the more money the insurance company makes. Also, the more diagnoses they give to the patient the more money they make. This has created a “Diagnosethon”. So here is my question. Have any of you received any letters from Medicare Advantage plans stating they found new diagnoses in your patients? Many of these companies use contractors to send nurses, PAs, NPs to the patients’ houses for a visit and all of a sudden you get a letter stating your patient now has diabetes, HTN, PVD, etc. You may have read articles in the NYT or Post about this. If this has happened to you would you please email me at support at dpcnews.com (use an @ instead of “at”. I don’t here as the email gets scraped off the web and I get bombarded with spam).






I worked briefly as a home visit NP for Medicare. I never added or changed diagnoses to a patient. I did get to see a lot of hazards in the home as well as sit down and discuss questions about medications, how to use medical equipment, and benefits of health screenings. I caught a lot of stuff that FFS patients couldn’t get addressed in the hamster wheel. So that’s why I went to DPC. Unfortunately everything in that system is ridiculous.