Phone consultation...charges for

suzanne4, RN · Feb 24, 2006

They are billing for their time...................think of it, what if patients phoned all day to the office and continuously, they would not get their schedules that they have completed.

If they are starting to charge, then they have been getting an excessive amount of calls. And it is actually done all over the country.

Kim O'Therapy, BSN, RN · Feb 24, 2006

Wow Michelle! That's a new one. The facility I work at doesn't charge for phone calls. However, personally, when I call the pediatrician for common ailments, they WON'T deal with over the phone - they make me come in to the office. So, don't feel gipped - you end up paying one way or the other.

Home Health Columnist / Guide · Feb 24, 2006

Some insurance companies are now paying for this "telephonic advice" service.

Computer savy docs are accepting emails as supplement to office phone calls for established patients so expect to see reimbursement for this "Email consultation" service too.

What we are paying for is doctors time.

If nursing costs doesn't start to get split out + identified on hospital and physician bills (does tiwht NP's in collaberative practice) our true worth will never be known nor our cost saving expertise valued.

Jolie, BSN · Feb 24, 2006

They are billing for their time...................think of it, what if patients phoned all day to the office and continuously, they would not get their schedules that they have completed.
If they are starting to charge, then they have been getting an excessive amount of calls. And it is actually done all over the country.

I have no problem with a professional office charging for telephone consults, but they should certainly make the patient aware of this at the BEGINNING of the call!

CoffeeRTC, BSN, RN · Feb 24, 2006

I know, but what kills me is that it took 2 seconds, I heard her ask him in the back ground as I was talking to her.

I know....hey I saved $55 on a visit, of course I paid $10 for the scrip.

Kim O'Therapy, BSN, RN · Feb 24, 2006

Was the telephone consult charge significantly less than an office visit?

Altra, BSN, RN · Feb 24, 2006

In prescribing over the phone, they're using their expertise just as much as if you went in for an office visit. I don't really have a problem with it.

blynn · Feb 26, 2006

Hee hee.. my physician came out of the patient room after seeing a particularly trying patient that I had worked into the schedule, and he jokingly flipped me the bird cause I was teasing him about having to deal w/ her.. I just laughed and flipped him the bird back, I told him that for every time he has to deal w/ her in the office, I take about five phone calls from her, so no sympathy here.

Don't get me wrong, I know part of my job description is to handle phone calls, and I don't begrudge people for calling for advice (after all that's what we're here for!) but this particular patient is extremely... challenging.

I know that the physicians don't really understand just how much we deal with over the phone. They might see someone in the office a few times per year, but there are people that I will talk to maybe six times in a month, or three times in a day, etc. One particularly memorable individual called the office SEVEN TIMES in the span of about one hour and demanded to speak with the nurse every time. Sometimes you'll flip through a chart and there are pages and pages of handwritten notes documenting my phone calls w/ my patients, I'm fanatic about writing everything down.

We don't charge for phone calls, even if the doctors do the calling. I'm actually starting to wonder if we should, but I would be worried about my patients on a fixed income who might really need to talk with a nurse or doctor, but wouldn't call because they'd be afraid of getting charged. On the other hand, knowing that there may be a fee might help with people who abuse the system. (Like the seven times in one hour caller.)

mom23RN · Feb 26, 2006

I think this all began with those "users" who are CONSTANTLY calling their doctors for advice, meds, etc. If they are abusing the priveledge then I do understand it. Maybe a policy of more than 3 phone calls in a year you will be charged, but not for those of us who never call and once in a blue moon have to. I literally have called my doctor at home 3 times in 20 years (all three times since having kids). And I probably only call his office for something maybe twice a year.

I certainly am NOT paying for phone advice. He makes enough off the kids and I to forgive a 20 second phone call for a Tigan suppository/antibiotic/etc. The day he charges me for a phone call is the day that I find a new doctor.

Sadly it's the same old people ruining it for the rest of us. :crying2:

flashpoint · Feb 26, 2006

I make an average of ten calls an hour (in between getting patients in rooms, helping with procedures, cleaning rooms, charting, helping patients to the bathroom, etc). Some are short and sweet like telling the patient their lab was normal or their x-ray was negative and some are long and drawn out like explaining what a TSH is and how the thyroid works and what Synthroid does and what can / will happen if they don't take their Synthroid and why medicine is so expensive and why they need to repeat labs in six months and... We also get a huge amount of calls from people wanting our doctors to phone in prescrptions for them for either refills on chronic things or something to sure whatever bug happens to be going around. If we've seen a patient within the last year and they are having the same symptoms as everyone else in town, there is usually no problem calling in a prescription. It does get pretty frustrating when we spend fifteen minutes trying to get the patient to tell what is wrong, ask them if we can help them with anything else, talk to the doctor, get the prscription called in, call the patient back only to be asked, "Oh, by the way...can he call in something for _____ too?" So we go through the whole routine again and when we call the patient back, they have yet another problem. Those are the patients who are prompting doctors to charge for phone calls. We also have patients who call wanting a precription called in and call back five minutes later wanting to know if it has been done...and the patients who stop in the office and insist to talk to a nurse and then refuse to leave until their prescription has been called in. Those are the patients who make doctors want to charge for calling in a prescription or talking to a nurse.

I know that all of this is our job and that if we didn't offer these services no one would ever be able to get an appointment because the offices would be booked solid months in advance, but sometimes it gets ridiculous. I don't think anyone who has never worked in a clinic knows how busy it can be...I was pretty clueless until a few weeks ago!

I think a lot of the problem is lack of education...people either don't know or forget that antibiotics are not needed for every sneeze and sniffle. People don't understand that you don't need to check with a doctor before taking every OTC meds (people will call every 6 hours asking if it is OK to take Tylenol again). People don't know that if they are throwing up they should quit eating for a few hours or that a humidifier will help congestion or that you can put Neosporin and a Band-Aid on a skinned knee. If we could somehow educate our public better, I think our jobs would be much easier.

TazziRN, RN · Feb 26, 2006

I have never been billed for phoning in and asking for a script. With my last MD I would leave a message with the nurses and they would call me back if it was during the week....weekends I had to wait till Monday. With my current MD...I've had him paged to call me on weekends and he has called in scripts for me. He'll only do it if it's a known problem, never for something that hasn't been officially diagnosed.