Dr. Sievers' RHHC Medical Practice - Operations & Website

[FelicityLemon]

Medicals hire someone to take care of the billing precisely to distance themselves from the money aspect. Otherwise, they'd get drawn into the patient's personal money woes of "can we work something out? do I have to be charged for xyz"" - The doctor can legitimately say that they don't have any knowledge of charges and tell the patient must talk to the practice manager. This protects the doctor from having to be a bad guy. The doctor has to focus on health, not business operations other than general. Some doctors don't pay enough attention to their business only to discover they'd been robbed for years by a practice manager or bookkeeper.

I've looked back at my credit card charges for the past several years. There were always two accounts charged: Dr. Sievers (for the office visit), and RHHC (for supplements). Two transactions - Two accounts. In my case, the only thing that seems odd is a charge for one missed appointment this year that Mark insisted I pay for. I honestly don't believe Dr. Sievers would have charged me, and now I wonder if she even knew.

 

[KateB]

APPROXIMATELY $70,000 ..... But, THAT IS JUST FOR SERVICES....What are the totals for Medicare D scripps....seems to me I say over $300,000 in scripps being filled under that name....but I'll be darned if I can't find it now!

http://projects.propublica.org/checkup/providers/1669468013

 

[Lilibet]

Make her pay the full amount then charge it to medicare....baaaabaaam!

And that would explain why MS yelled at her for challenging the charges. I still think they would have made most of their claims on non-existing patients so they wouldn't be challenged as easily. Or maybe they learned from her not to use real patients from then on. JMO

 

[observation]

I really don't see a connection here to CWW if this is a Medicare-type scheme. Just my gut reaction to this angle.


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[Lilibet]

http://projects.propublica.org/checkup/providers/1669468013

According to this information, the price charged for the average prescription was more than twice the average.

$127 was the average price of a prescription from this provider, compared to $56 among peers.

http://projects.propublica.org/checkup/providers/1669468013

 

[IQuestion]

http://projects.propublica.org/checkup/providers/1669468013

Thank you KATEB! You are a brilliant resource... 2695 MEDICARE PART D FILLED in 2013, alone???? WOW...
TERESA SIEVERS M.D.

10201 ARCOS AVENUE SUITE 201
Estero | Florida | 33928

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At A Glance: This Prescriber in 2013
Internal Medicine

Self-Reported Primary Specialty

See Other Prescribers With This Specialty in This State »
2,695Medicare Part D Prescriptions Filled, Including Refills

Rank: 2884 out of 3722
$342K Total Retail Price of All Prescriptions

Rank: 1948 out of 3722
209 Patients Receiving at Least One Drug in Part D
92% Patients 65 Years and Older
5% Subsidized Claims for Low-Income Patients

 

[FelicityLemon]

Dr Sievers FEE SCHEDULE has a section about paying for missed appointments, which to me makes sense even IF it was MS who wrote the document.

http://www.drteresasievers.com/fees.pdf
NO SHOW FEES: (APPTS MUST BE CANCELLED AT LEAST 1 BUSINESS DAY PRIOR TO APPOINTMENT. PLEASE NOTE: IF YOUR APPOINTMENT IS MONDAY YOU MUST CANCEL BY THURSDAY BEFORE NOON.) THIS ALLOWS YOUR CANCELLED APPOINTMENT TO BE FILLED BY ANOTHER PATIENT WHO IS WAITING TO SEE DR. SIEVERS. WE UNDERSTAND EMERGENCIES HAPPEN AND ASK THAT YOU SPEAK WITH OFFICE MANAGER, MARK.
• NEW PT VISIT: $225.00/LOSS OF PRE-PAYMENT
• F/U APPTS: ARE BASED ON COST OF VISIT FOR THAT APPT. IE IF YOU HAD A 30 MIN APPT BOOKED, FEE WOULD BE $200.00. IF IT WAS A BASIC PHYSICAL, FEE WOULD BE $300.00

Yes, and it's not uncommon regarding medical practices. No Shows suck. LOL, years ago, hair salons began implementing a similar practice. I called to make an appointment and was asked for my CC number. I asked "why" since I would be paying cash. I was told it was to charge my card a $100 fee if I failed to keep the appointment.

 

[FelicityLemon]

I haven't had time today to catch up with you guys, but have confirmed the following if it helps:

1. Teresa Sievers is still, today, listed as a Medicare provider.

2. For Calendar Year 2013 (the last data set available), TS was paid by Medicare approximately the following (you guys will have to do the math!):

For 81002 Urinalysis 11 claims x $3.46
For 82270 Stool analysis 52 claims x $4.42
For 93000 Routine EKG 33 claims x $14.60
For 96372 Injection 539 claims x $19.47
For 99203 New patient 30 minutes 17 claims x $69.97
For 99211 Established patient 5 minutes 41 claims x $15.60
For 99212 Established patient 10 minutes 15 claims x $26.90
For 99213 Established patient 15 minutes 119 claims x $49.32
For 99214 Established patient 25 minutes 278 claims x $74.10
For 99215 Established patient 40 minutes 182 claims x $107.01
For G0101 Cervical or vaginal cancer screening 24 claims x $33.70
For G0102 Prostate cancer screening 17 claims x $11.88
For G0439 Annual wellness visit 67 claims x $112.80

I can see why some doctors won't accept medicare - those are pretty low reimbursements.

 

[KateB]

According to this information, the price charged for the average prescription was more than twice the average.

$127 was the average price of a prescription from this provider, compared to $56 among peers.

http://projects.propublica.org/checkup/providers/1669468013

It might be inline with other practices that were into the wellness therapy which I'm theorizing there aren't generics for those type of drugs. Maybe. I haven't had time to do any proper research on the individual drugs listed.

 

[Nana46]

Just my two cents....I worked for a surgeon for 21 years....true it was not a big city...but.....we would not have had much of a practice if we tried to charge for no shows.....would never have worked.....and we had a huge medical practice as well such as just general medical stuff. Word would spread and folks would not like the idea of being charged for no show.

towards the end, the doctor I worked for got into herbs and over the counter stuff big time.....this was in the late 90's but I cannot imagine what a high dollar cost for such things could be......what could she possibly have been prescribing? I guess I am outta the loop on this stuff. I suppose things have progressed in the area since back in the day it was fish oil, melatonin, calcium, garlic, etc.

 

[concernedmother]

I hear you, but I'm not talking about duplicate claims. I'm talking about totally bogus claims for services never rendered as described in the article from NPR I linked. I'll have to go googling some more, but I think the patients didn't exist. They used Medicare numbers no longer in use. But by the time Medicare caught up with this, the fraudsters had moved on to another location.

I'm not saying this was happening in TS's practice. But it could have been without her knowing it. She was the doctor. Doctors aren't involved in billing, although there are dishonest ones who were just arrested according to the link. MS and CWW could have done this easily. Not all the people arrested are geniuses. They just knew how to work the system and took the risk.
JMO

A man from my area got sent to prison for medicaid fraud. He ran a medical transport service. He was billing medicaid for trips that he never transported anyone.

 

[Bobbywoo]

Yes, and it's not uncommon regarding medical practices. No Shows suck. LOL, years ago, hair salons began implementing a similar practice. I called to make an appointment and was asked for my CC number. I asked "why" since I would be paying cash. I was told it was to charge my card a $100 fee if I failed to keep the appointment.

All of my docs have been long term....10 plus years, maybe that's why I got one missed appointment freebie? But since MS gave CWW so many 2nd, 3rd, 4th chances as a friend despite his illegal, irresponsible behavior, I find it contradictory that he wouldn't give TS's parients at least one do over. I remember in the ebella article one of her favorite comments was about not burning bridges you may need later. I had considered that that way of thinking by her is what allowed CWW another chance in her eyes. Sooooo....sucking up the $ lost over one missed appointment could create a loyal patient that is willing to pay the large fee for many years in the future. I think MS's tough guy tactics were done wirhout TS's knowledge. Which leads me to wonder in what other situations he may have used the tough guy tactics that we don't know about.

 

[Russian Blue]

I hear you, but I'm not talking about duplicate claims. I'm talking about totally bogus claims for services never rendered as described in the article from NPR I linked. I'll have to go googling some more, but I think the patients didn't exist. They used Medicare numbers no longer in use. But by the time Medicare caught up with this, the fraudsters had moved on to another location.

I'm not saying this was happening in TS's practice. But it could have been without her knowing it. She was the doctor. Doctors aren't involved in billing, although there are dishonest ones who were just arrested according to the link. MS and CWW could have done this easily. Not all the people arrested are geniuses. They just knew how to work the system and took the risk.
JMO

I hear you, but, in general while doctors might not be involved in the direct billing, they do drive billing costs by their orders, services rendered, tests ordered etc-- what is billed. Not saying that TS did this but the next step down could be where erroneous billing was occurring.

 

[ohreally]

What I don't get is most of the money is in prescriptions. Wouldn't those prescriptions have to be filled in order to be paid by Medicare. My doctor's office has free samples they give sometimes, but they don't stock medicine. Wouldn't a pharmacy have to be involved?

 

[FelicityLemon]

I find it difficult (impossible) to believe that TS was given an allowance and didn't have access to bank accounts, or have her own charge card or checking account.

"Controlling" is a deliberate and emotionally loaded word that is possibly being misused instead of "handling" the finances. There is a huge difference and we don't know what their arrangement was.

This isn't an unusual arrangement in marriages, and it's especially business as usual in medical or even legal (example) practices. I think more so with a trusted spouse partnership - they're on the same side working toward the same goal I presume, but we don't know. I assume that they discussed the practice overall and business of course, but the daily running of the office end of it is a job by itself and the doctor/lawyer does their thing, the practice manager does theirs. There is nothing odd about that. If it wasn't her husband, it would be someone else.

My DH handles the finances, in no freaking way does he control them. Many husbands who are the sole earners and have their wives handle the finances. Some of those wives control them, lol, but there is a difference.

What little we know about TS leads me to think she wasn't subservient or controlled in any way.

 

[Russian Blue]

Just my two cents....I worked for a surgeon for 21 years....true it was not a big city...but.....we would not have had much of a practice if we tried to charge for no shows.....would never have worked.....and we had a huge medical practice as well such as just general medical stuff. Word would spread and folks would not like the idea of being charged for no show.

towards the end, the doctor I worked for got into herbs and over the counter stuff big time.....this was in the late 90's but I cannot imagine what a high dollar cost for such things could be......what could she possibly have been prescribing? I guess I am outta the loop on this stuff. I suppose things have progressed in the area since back in the day it was fish oil, melatonin, calcium, garlic, etc.

She was in to multiple areas of integrative medicine. So when we talk about her being a "wholistic natural" doctor she is still incorporating western methods along with natural. This is where integrative comes in. One area was the joint supplements. While not break the bank expensive some of these formulations are not cheap either. Then if you watch the youtube presentations she gave on BHRT, which is Bio Identical Hormone Replacement Therapy for women. That is not cheap. It is an emerging area as a replacement to regular estrogen replacement therapy. The compounding pharmacies for these designed specifically for you as an individual are making a mint and growing rapidly. The idea is that BHRT is not as dangerous as traditional HRT and more "natural". TS was a proponent of this. I believe you can go directly to the video in our video links section.

 

[ohreally]

FWIW. Our doctor does have a no show fee of twenty-five dollars. In over fifteen years I have only missed one appointment. I was charged the fee. Called up billing and asked them to look into my records ans see this was the first and only tome I had missed an appointment. They took it off my billing and apologized to me for billing me since it was the only time it has happened.

 

[FightTheOstrich]

According to this information, the price charged for the average prescription was more than twice the average.

$127 was the average price of a prescription from this provider, compared to $56 among peers.

http://projects.propublica.org/checkup/providers/1669468013

A couple of thoughts on this...

Teresa may have been writing whatever was in her sample closet or pushing certain drugs because she was a speaker for a pharmaceutical company. Heck, maybe she pushed certain drugs because MS liked getting a free lunch when he worked. It would not shock me to learn that he required pharma reps to order lunch for "the office" from the chef the family supposedly used.

Even if a patient paid cash at Teresa's office, insurance would still cover prescription costs.

TS pushed bio-identical compounded products. It's important to note that there are also prescription bio-identical hormone products (actually the compounding pharmacies use the same pharmaceutical estradiol etc... that the pharma companies use) and most of the good transdermal estrogen products are more expensive. That would easily set her apart from her peers prescribing generic oral estradiol.

 

[Nana46]

She was in to multiple areas of integrative medicine. So when we talk about her being a "wholistic natural" doctor she is still incorporating western methods along with natural. This is where integrative comes in. One area was the joint supplements. While not break the bank expensive some of these formulations are not cheap either. Then if you watch the youtube presentations she gave on BHRT, which is Bio Identical Hormone Replacement Therapy for women. That is not cheap. It is an emerging area as a replacement to regular estrogen replacement therapy. The compounding pharmacies for these designed specifically for you as an individual are making a mint and growing rapidly. The idea is that BHRT is not as dangerous as traditional HRT and more "natural". TS was a proponent of this. I believe you can go directly to the video in our video links section.

I am familiar with the compounding pharmacies as I worked for one after the doctor's office closed....huge money in compounded rx's.

 

[FelicityLemon]

All of my docs have been long term....10 plus years, maybe that's why I got one missed appointment freebie? But since MS gave CWW so many 2nd, 3rd, 4th chances as a friend despite his illegal, irresponsible behavior, I find it contradictory that he wouldn't give TS's parients at least one do over. I remember in the ebella article one of her favorite comments was about not burning bridges you may need later. I had considered that that way of thinking by her is what allowed CWW another chance in her eyes. Sooooo....sucking up the $ lost over one missed appointment could create a loyal patient that is willing to pay the large fee for many years in the future. I think MS's tough guy tactics were done wirhout TS's knowledge. Which leads me to wonder in what other situations he may have used the tough guy tactics that we don't know about.

I'm with you with having long term doctors. I have been charged, but it was with a new practice manager whose job it is to make sure patients pay. No problem, I knew the rules, I had signed the paper years ago. Big whoop. It hurt my wallet, but it made me much more conscientious about keeping appointments. I talked to the doctor about it and he laughed and said he has nothing to do with it and he was right. The role of the office manager is to insulate the service provider from having to be a hard-*advertiser censored* mercenary about it.

They're in business, their time is money. TS' practice even more so since she didn't run a cattle call practice like so many doctors and someone else could have been seen by her in that slot. I don't know what the relationship was between the patient who was charged, TS or MS or anyone else in the office. Maybe it was a question of personalities not meshing. Maybe the patient had done it one too many times. I don't know, but I just don't see anything underhanded about charging for missed appointments. No offense to the patient who was charged who posted that, I don't know them either. Nothing personal to them, it's just my personal view. It sucks, but it's understandable.

I will say, if a doctor overbooked or missed an appointment with me without 24 hour notice, I'd have no problem telling them I will invoice them for my time. I actually told the doctor that did it to me that I had a problem with no cancellation notice to me. I/we patients have to take time off work, the cost of driving, taxi or bus to the dr. office, and having to do it all over again for another appointment. I said it was unfair because they were already there, and if a patient didn't show, it was a little easier for them since patients come to them. I was compensated by an equitable discount on a following appointment. Of course, my charges were much lower than his, but it was completely fair and right to my wallet.