Dr. Sievers' RHHC Medical Practice - Operations & Website

[wondering25]

As I said on a previous thread: I am an unverified former patient of TS. I started with her just after she moved from St Pete to Estero. 3 other friends, family members also went to her. She was my primary care physician for many years. I stayed with her because I loved her, but the overall tenor of the office dramatically changed over a couple of years. First the supplement business. Items were sold within her office. She had shelves of them. Everything became about buying supplements and from her. She got very feisty if you talked about buying from somewhere else. Suddenly lots of tests were being ordered. After a few years they dropped insurance billing, except BC, which I was using. Eventually they dropped BC. I never saw MS in the office although I spoke with him over the phone. The whole vibe became very "hinky" in the office. No one was available on nights, weekends. No DR covering for her when out of town. My pharmacy told me that they were having a lot of problems with the office getting back to them for prescription refills. We all left after becoming uncomfortable. Something was just "off". I left after the cash situation started and before LS started, if that timeframe helps. She was a wonderful DR, but it was all too weird for me and focused on $$ too much. IMO, if something was going on, she didn't know about it.
JMO

Being married to a professional, here is what he always says " I am working for them.. they are not working for me". The Dr/patient or lawyer/client relationship needs to be understood. YOU, AS THE PATIENT, are employing the doctor. If a Dr, for example is sweet and kind.. it may be their true self OR it may be bedside manner. Remember, it is all about business. I saw not one thing in any of the policies etc that made anything convenient for the patient. Dr. Sievers even charged for phone calls.. LAWYERS do that.. not doctors, typically.

If you build it, they will come.. and apparently people DID come. Why anyone would see a Dr and then not have this Dr follow you in the hospital is beyond me. This is NOT continuity of care... All of this just doesn't sit right with me. JMO

Anything i write is just my opinion

 

[CeaElle]

Sorry guys but I can't remember....who is SH?

Sandra H> was her nurse (but not looking at the post you are referring to)

 

[Southwflorida]

Sandra H> was her nurse (but not looking at the post you are referring to)

SH = awesome!

 

[villager]

Sandra was her nurse. Frank, the receptionist/front office guy, is Sandra's husband. It was pretty much a 3-person office for many years.

 

[villager]

Agree SH awesome.

 

[RANCH]

I think Medicare was billed by the office because the patient was told that the office would submit the paperwork after she paid. But TS did not actually accept Medicare anymore, so the claim was denied and the patient was out the money she had paid for two appointments. I think TS had to reimburse the patient.

IMO The fraud was taking the patient's money under false pretenses, knowing she would never be reimbursed by Medicare. Doctors have to be truthful about their relationship with Medicare. It's unlikely this patient would ever have come to her if she'd known that Medicare was off the table. It's not clear who eventually reimbursed her, but I assume TS did. It's quite possible that Medicare somehow pressured TS to reimburse the money the patient had paid or they would charge her with fraud. I can't imagine TS being happy with MS about this attempted fraud, if she ever found out. JMO



http://www.websleuths.com/forums/sh...June-2015-*ARRESTS*-8&p=12041918#post12041918

Why would Dr Sievers office bother to bill Medicare if they knew the claim would be denied?

Madtownbucky said that this happened around three years ago. AZlawyer found records showing Dr Sievers office received money from Medicare on multiple occasions two years ago in 2013.

Something isn't adding up here. JMO

 

[NSS]

Why would Dr Sievers office bother to bill Medicare if they knew the claim would be denied?

Madtownbucky said that this happened around three years ago. AZlawyer found records showing Dr Sievers office received money from Medicare on multiple occasions two years ago in 2013.

Something isn't adding up here. JMO

....and the previous poster (bucky) was inrritated that the office had taken her MC card, told her they would bill, published this on their website and then after she had paid a thousand dollars they (MS) denied it and got angry.

The problem in the boutique style practice is that waters get muddied and lines get blurred. The whole medicare/insurance versus cash only and selling of supplements and providing prostate and ob gyn exams but not hospital visits makes for a messy situation.

 

[wondering25]

Why would Dr Sievers office bother to bill Medicare if they knew the claim would be denied?

Madtownbucky said that this happened around three years ago. AZlawyer found records showing Dr Sievers office received money from Medicare on multiple occasions two years ago in 2013.

Something isn't adding up here. JMO

It depends on the claim.. for example.. a urine test etc would be paid and maybe she wouldnt bill in addition to that as medicare might pay 5 dollars and she might charge 7. She can bill for an office visit. she is not PARTICIPATING, however. Medicare eventually might pay for a visit for hypertension..but only 50. She would apply that to her 150 fee. Also, and i am not sure if this still applies.. MEDICARE does not pay for a yearly physical/well visit no matter who the MD is. If they code it differently, like you also have anemia.. then it can slide thru.. but Medicare never paid for a yearly physical.. which never made sense to me. It is like you go to a Dr.. and they dont accept blue cross. They will bill blue cross and get some money.. but their office charges exceed what blue cross is willing to pay their participating providers.. so you have 2 choices.. you can go to a Dr who will accept what blue cross pays as full payment (participating) or go to whomever you want and pay the difference.

Anything i write is just my opinion.

 

[CeaElle]

This might have already been discussed and if so, I missed it! Does anybody know who Frank is?


BBM: Frank was the receptionist previous to the current. He is also nurse Sandra's husband. He left to re-enter the real estate business.

 

[KateB]

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

It depends on the claim.. for example.. a urine test etc would be paid and maybe she wouldnt bill in addition to that as medicare might pay 5 dollars and she might charge 7. She can bill for an office visit. she is not PARTICIPATING, however. Medicare eventually might pay for a visit for hypertension..but only 50. She would apply that to her 150 fee. Also, and i am not sure if this still applies.. MEDICARE does not pay for a yearly physical/well visit no matter who the MD is. If they code it differently, like you also have anemia.. then it can slide thru.. but Medicare never paid for a yearly physical.. which never made sense to me. It is like you go to a Dr.. and they dont accept blue cross. They will bill blue cross and get some money.. but their office charges exceed what blue cross is willing to pay their participating providers.. so you have 2 choices.. you can go to a Dr who will accept what blue cross pays as full payment (participating) or go to whomever you want and pay the difference.

Anything i write is just my opinion.

BBM - bolded by me.
I don't know the answer to this, but it does appear that annual checkups are covered by some part of Medicare. (?)

 

[human]

I am sure that CWW was doing something illegal with her office, but I am too ignorant to figure out what it was or how it was done.

I know from friends that there have been numerous issues with bills where I lived.

Right now my hubby is supposed to be filling out some paperwork because he got a tetanus shot when we were in the US and Medicare and the supplement refused to pay because they said it could have been self administered. Seriously.

A friend has been fighting the same clinic but a different branch because a procedure she paid for had been coded wrong. She has been trying to get her money back for over a year. And this is from a huge medical conglomerate that is in several states.

When my daughter was born 41 years ago, I asked for an itemized bill as we had to pay some of it ourselves. We were charged for a circumcision.

i just don't see with the few things that she did where a bill a patient received would be very complicated whereas hospital bills are filled with procedures and charges that make no sense.

And when you are done getting some bills, more come from additional services you received. Confusing.

But her practice? Can't be that confusing

 

[wondering25]

BBM - bolded by me.
I don't know the answer to this, but it does appear that annual checkups are covered by some part of Medicare. (?)

[h=2]Preventive visit & yearly wellness exams[/h][h=3]How often is it covered?[/h]Medicare Part B (Medical Insurance) covers:

• A "Welcome to Medicare" preventive visit: You can get this introductory visit only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed. It also includes:
  • Height, weight, and blood pressure measurements
  • A calculation of your body mass index
  • A simple vision test
  • A review of your potential risk for depression and your level of safety
  • An offer to talk with you about creating advance directives.
  • A written plan letting you know which screenings, shots, and other preventive services you need.Get details about coverage for screenings, shots, and other preventive services.

This visit is covered one time. You don’t need to have this visit to be covered for yearly "Wellness" visits.

• Yearly "Wellness" visits: If you've had Part B for longer than 12 months, you can get this visit to develop or update a personalized prevention help plan to prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It also includes:
  • A review of your medical and family history
  • Developing or updating a list of current providers and prescriptions
  • Height, weight, blood pressure, and other routine measurements
  • Detection of any cognitive impairment
  • Personalized health advice
  • A list of risk factors and treatment options for you
  • A screening schedule (like a checklist) for appropriate preventive services. Get details about coverage for screenings, shots, and other preventive services.

This visit is covered once every 12 months (11 full months must have passed since the last visit).
[h=3]Who's eligible?[/h]All people with Part B are covered.

[h=3]Your costs in Original Medicare[/h]You pay nothing for the “Welcome to Medicare” preventive visit or the yearly “Wellness” visit if your doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply.
However, if your doctor or other health care provider performs additional tests or services during the same visit that aren’t covered under these preventive benefits, you may have to pay coinsurance, and the Part B deductible may apply.
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

[h=3]Related resources[/h]

• Information about your “Welcome to Medicare” preventive visit
• What you need to know when you're new to Medicare
• Medicare & You: women's health (video)
• [video=youtube;opQFBVd7oHI]http://www.youtube.com/watch?v=opQFBVd7oHI&feature=plcp[/video]

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[human]

BBM - bolded by me.
I don't know the answer to this, but it does appear that annual checkups are covered by some part of Medicare. (?)

I believe they are for the first time when you get on Medicare. Not sure about after that. My supplement pays, I think.

Insurance and costs are so confusing. The Medicare and supplement books you get are enormous. I don't know how anyone can figure it out.

I got cataract surgery and I read that Medicare pays for basic lenses and frames after surgery. My eyeglass place does not do Medicare but they offer a nice discount.

I called my supplement provider and asked how much is covered. I asked what is the amount for basic lens and frame. They would not give me an answer. I went with my eyeglass place . It was simply too confusing.

 

[Helper9693]

1-Frank was there during the 2 years I saw Dr Sievers. Great guy! He actually gave me my RECORDS when I needed them for a new specialist. He hit the print button and handed them to me a few minutes later....Just so I wouldn't get to my new appt without them because (he said) sometimes it can take awhile for them to be sent.
2- Sandra (SH) is not a nurse...it would be more appropriate to call her the "nurse" I was surprised to find that out here on WS.
3-I can't tell you how many times Dr Sievers suggested cheaper ways to get certain supplements (at Whole Foods), cheaper food alternatives etc Buying the supplements in the office was quick, no shipping and she had the Gluten Free products I needed....also some sublingual choices that are hard to get I felt no pressure to buy anything.
4-I never saw Mark in the office either..not once in 2 years.
5-That whole section that we are all finding so offensive on the patient info...was not on the website when I began with her. I doubt she saw and approved it...if so...it tells me whole lot about what she was dealing with in an office manager/husband.
6- Dr Sievers was reading test results one night and called me to check on me from her personal cell phone..it was 9:15pm...How many Doctors do that these days...just saying.


These are just some thoughts on posts #632, #651, #652....

 

[wondering25]

I believe they are for the first time when you get on Medicare. Not sure about after that. My supplement pays, I think.

Insurance and costs are so confusing. The Medicare and supplement books you get are enormous. I don't know how anyone can figure it out.

I got cataract surgery and I read that Medicare pays for basic lenses and frames after surgery. My eyeglass place does not do Medicare but they offer a nice discount.

I called my supplement provider and asked how much is covered. I asked what is the amount for basic lens and frame. They would not give me an answer. I went with my eyeglass place . It was simply too confusing.

Generally a supplement does not pay what medicare turns down.. Offices employ several medical billing coders, often because the whole reimbursement system is a real challenge. Without prolonging this.. here is an example. family member got chemo.. each chemo was billed to medicare for 33,000 a treatment.. yes, that is correct. They are medicare participating.. medicare paid 2500 and the supplement kicked in 127. Because the MD accepts medicare assignment there was no additional fee. Almost every MD in this area accepts Medicare..but..recently, one of the major pulmonary groups in the area disbanded. they were not going to be governed by the insurance industry and could not function (they felt) within the narrow guidelines for payment. A major hospital in my state has started "buying" the practices in the area. Technically, the MDs are now working for the hospital although they have private "offices". The hospital does the billing but also does a lot of the hiring and the office personnel for example are now employed by the hospital and not the individual md. For the Mds this eliminates some cost..HOWEVER, technically, they can be fired by the hospital. This hospital participates in every insurance.. so you will never be turned down and the 1 zillion mds who have been bought by this hospital are guaranteed payment for their services. Confusing? you betcha.. BUT 98% of the formerly private practices in this state are really governed by this major hospital . They are now all connected by one electronic medical system and it makes for smooth continuity of care. This will be happening all over soon.. it is the wave of the future.. MDs like TS wont sign on because she wants her boutique service, and there is no oversight..and for that you have to play by a different set of rules. JMO

 

[Nana46]

Generally a supplement does not pay what medicare turns down.. Offices employ several medical billing coders, often because the whole reimbursement system is a real challenge. Without prolonging this.. here is an example. family member got chemo.. each chemo was billed to medicare for 33,000 a treatment.. yes, that is correct. They are medicare participating.. medicare paid 2500 and the supplement kicked in 127. Because the MD accepts medicare assignment there was no additional fee. Almost every MD in this area accepts Medicare..but..recently, one of the major pulmonary groups in the area disbanded. they were not going to be governed by the insurance industry and could not function (they felt) within the narrow guidelines for payment. A major hospital in my state has started "buying" the practices in the area. Technically, the MDs are now working for the hospital although they have private "offices". The hospital does the billing but also does a lot of the hiring and the office personnel for example are now employed by the hospital and not the individual md. For the Mds this eliminates some cost..HOWEVER, technically, they can be fired by the hospital. This hospital participates in every insurance.. so you will never be turned down and the 1 zillion mds who have been bought by this hospital are guaranteed payment for their services. Confusing? you betcha.. BUT 98% of the formerly private practices in this state are really governed by this major hospital . They are now all connected by one electronic medical system and it makes for smooth continuity of care. This will be happening all over soon.. it is the wave of the future.. MDs like TS wont sign on because she wants her boutique service, and there is no oversight..and for that you have to play by a different set of rules. JMO

Exactly...this very thing has happened in my area as well....doctors found it was too big of a hump to try to run an office and overhead with what they were paid from insurance/medicare etc.....this had begun when I was still working in medicine in the 90's and area doctors were so frustrated with being told if and when a surgery etc. could be performed according to their guidelines...for instance, patient comes in with extreme rlq (right lower quadrant) pain and all signs including bloodwork reveal possible appendicitis..but....insurance etc. would require more tests thus delaying surgery and infuriating doctors....I have seen it so many times....doctors go to school for years and then insurance companies try to tell them how to practice....I know there is an upside to this as well....this was just an example IMO. Lots of doctors in my area are now employed by the hospital since overhead has gotten so huge.

 

[human]

Generally a supplement does not pay what medicare turns down.. Offices employ several medical billing coders, often because the whole reimbursement system is a real challenge. Without prolonging this.. here is an example. family member got chemo.. each chemo was billed to medicare for 33,000 a treatment.. yes, that is correct. They are medicare participating.. medicare paid 2500 and the supplement kicked in 127. Because the MD accepts medicare assignment there was no additional fee. Almost every MD in this area accepts Medicare..but..recently, one of the major pulmonary groups in the area disbanded. they were not going to be governed by the insurance industry and could not function (they felt) within the narrow guidelines for payment. A major hospital in my state has started "buying" the practices in the area. Technically, the MDs are now working for the hospital although they have private "offices". The hospital does the billing but also does a lot of the hiring and the office personnel for example are now employed by the hospital and not the individual md. For the Mds this eliminates some cost..HOWEVER, technically, they can be fired by the hospital. This hospital participates in every insurance.. so you will never be turned down and the 1 zillion mds who have been bought by this hospital are guaranteed payment for their services. Confusing? you betcha.. BUT 98% of the formerly private practices in this state are really governed by this major hospital . They are now all connected by one electronic medical system and it makes for smooth continuity of care. This will be happening all over soon.. it is the wave of the future.. MDs like TS wont sign on because she wants her boutique service, and there is no oversight..and for that you have to play by a different set of rules. JMO

Exactly how it is with my doc. My clinic originally was two docs. They got bigger. Still independent. Then my doc retired and the clinic was bought by the conglomerate.

There used to be one doc where I lived that did not take insurance and did alternatives. But she has been gone for years.

I had NO IDEA until I read about MS sister that a person can call themselves a doc but in fact are not.

We had a fake doc once in the city, Fake credentials but eventually busted.

Now I see that some alternative practioners can get a piece of paper in a very easy way and put out a shingle. I wonder if Florida is more lax or is this the way it is everywhere?

 

[FelicityLemon]

In all do respect, I find it unlikely TS was totally oblivious to their billing process. From my understanding, she initially accepted insurance and then slowly migrated to accepting private patients only. However, she still "grandfathered" in her insured patients, which I find to be honerable.

I agree Knowing what little we know, I certainly don't believe she was deliberately oblivious to anything. My point is that service providers can be insulated or protected from having to be the perceived "bad" guy or only concerned about money. They can have the backup to be able to say something like "I'm sorry I don't handle that part of it, don't know anything about the billing. You need to talk to my husband or the the manager.". The doctor and the practice mgr can discuss it later and decide to under bill or reimburse, but it really is unfair to ask the doctor anything other than can we discuss a payment plan or something like that. In actuality, that conversation should never happen at a practice like this where it's cash at time of service rendered, prices are pretty much spelled out clearly as far as general charges, I imagine the patient signs something like I do at the doctors. Similar to a contract, if not an actual contract. Doctors have bills to pay. If patients don't pay, the doctor can't serve.

As far as donating services for indigent people, that's a completely different thing going into it up front not expecting payment and I suspect that it's more like regular doctor visit rather than a treatment course of supplements, massage, acupuncture unless those docs volunteering their services, too. I don't know anything other than to treat without payment in this case was her choice upfront. I imagine she expected her patients to pay so she could continue to donate her services.

 

[Maxine2U]

I am sure that CWW was doing something illegal with her office, but I am too ignorant to figure out what it was or how it was done.

I know from friends that there have been numerous issues with bills where I lived.

Right now my hubby is supposed to be filling out some paperwork because he got a tetanus shot when we were in the US and Medicare and the supplement refused to pay because they said it could have been self administered. Seriously.

A friend has been fighting the same clinic but a different branch because a procedure she paid for had been coded wrong. She has been trying to get her money back for over a year. And this is from a huge medical conglomerate that is in several states.

When my daughter was born 41 years ago, I asked for an itemized bill as we had to pay some of it ourselves. We were charged for a circumcision.

i just don't see with the few things that she did where a bill a patient received would be very complicated whereas hospital bills are filled with procedures and charges that make no sense.

And when you are done getting some bills, more come from additional services you received. Confusing.

But her practice? Can't be that confusing

BBM

Human, you mean your DH doesn't normally give himself tetanus shots? :facepalm::maddening:

 

[Wyle_E_Coyote]

With the exception of the first visit, I never paid more than $150.

RSBM

Wow, this is a big difference than what many of us had thought regarding her hourly rates, and would lead to a very different financial picture given her 24 hour per week work schedule.

Perhaps financial difficulties contributed to a motive for her murder?

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