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DME Telemedicine Scams

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  • Avatar Kencufc 
    Participant
    Status: Physician
    Posts: 21
    Joined: 08/12/2017

    I recently started doing some moonlighting for a couple telemedicine companies.  The practice so far has been ordering DME (knee, ankle, lumbar braces etc).  My instincts kicked in after about 5 charts and I started to feel like these were scams.  The physician notes were entirely pre-populated.  In fact, there is only a small space to document any of my semi-required phone call to the patients.

    Has anyone else had experiences with these companies?  Specifically, RediDoc and Real Time Physicians.

    #134889 Reply
    The White Coat Investor The White Coat Investor 
    Keymaster
    Status: Physician
    Posts: 4191
    Joined: 05/13/2011

    That sure sounds like some scheme where you may be fraudulently billing insurers/medicare/medicaid. I would extricate myself as quickly as possible.

     

    But looking at those two sites, they don’t look scammy or fraudulent.  Maybe we should get more details. What are you doing exactly?

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #134894 Reply
    Avatar Kencufc 
    Participant
    Status: Physician
    Posts: 21
    Joined: 08/12/2017

    The company sends me a patient chart with a pre-populated note. The note states the patient is under my care for a specific problem. Some charts have patients requesting bilateral ankle, knee, and wrist braces. Some patients with whom I’ve spoken have some legitimate pain issues. Seems like others have been solicited for a free brace and just say “why not”.

    RediDoc in particular had a very quick Credentialing process and gave out very scant information on how to complete charts. I don’t mind writing for a single knee brace or some topical analgesic but six or seven braces for one person seems outrageous.

    My telemedicine moonlighting has not been very successful to this point due to low volumes. These DME charts are certainly easy but I don’t want to do anything to jeopardize my medical practice.

    #134914 Reply
    Liked by Zaphod
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 1807
    Joined: 01/03/2017

    Seems incredibly sketchy.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #134915 Reply
    The White Coat Investor The White Coat Investor 
    Keymaster
    Status: Physician
    Posts: 4191
    Joined: 05/13/2011

    7 for one person? Uhhhh….I can’t think of a reason that would be a legitimate medical practice.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #134916 Reply
    Avatar G 
    Participant
    Status: Physician, Small Business Owner
    Posts: 1390
    Joined: 01/08/2016

    7 for one person? Uhhhh….I can’t think of a reason that would be a legitimate medical practice.

    Click to expand…

     Head, shoulders, knees and toes–knees and toes.

    Avatar jacoavlu 
    Moderator
    Status: Physician, Small Business Owner
    Posts: 1701
    Joined: 03/01/2018

    1. This isn’t what you went to med school for.
    2. Medicare fraud is a pretty big deal.
    3. Trust your instinct.

    The Finance Buff's solo 401k contribution spreadsheet: https://goo.gl/6cZKVA

    Avatar RocDoc 
    Participant
    Status: Physician, Small Business Owner
    Posts: 95
    Joined: 06/20/2016

    This work sounds like health care fraud. Resign from these positions immediately. Call a health care attorney ASAP for advice. Do not deposit any pay checks these companies try to pay you.

    #134928 Reply
    Liked by PhotonsRGR8
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3111
    Joined: 01/21/2016

    You might be able to make some coin as a whistleblower.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    Side Hustle Scrubs Side Hustle Scrubs 
    Participant
    Status: Physician
    Posts: 366
    Joined: 04/12/2018

    I think there are enough alternative side hustles out there that pay similar money without risking your license or making you lose sleep at night.  That medical license is the golden goose – it must be protected at all costs.

    See hustle. Do hustle. Teach hustle.
    SideHustleScrubs.com

    #134946 Reply
    Avatar Kencufc 
    Participant
    Status: Physician
    Posts: 21
    Joined: 08/12/2017

    Yeah, I agree with everyone.  It just didn’t feel right.  In REAL practice, I don’t think I’ve ever prescribed more than one brace at a time, except maybe for someone with severe bilateral carpal tunnel syndrome.

    Hopefully any other well intended docs or providers will catch wind of this scheme and avoid it.

    I’ve only made 5 orders so I’m not too concerned.  It DOES concern me that this company has been around since 2011 and seems to be getting away with it since then.

    #134968 Reply
    Avatar Ellen 
    Participant
    Status: Attorney
    Posts: 5
    Joined: 07/10/2018

    Be sure and review your state’s laws regarding telehealth and follow all the requirements. The requirements can differ by state. You might want to explore the American Telemedicine Association website. http://www.americantelemed.org/home

    Here is a link to a post regarding telemedicine: https://www.linkedin.com/pulse/tricare-claims-processing-suspension-ellen-bonner/.

     

     

     

     

    #135391 Reply
    Avatar ebotrd 
    Participant
    Status: Physician
    Posts: 14
    Joined: 10/25/2018

    I was looking for telemed offerings as a moonlighting option.  RediDoc is advertised a lot.  I noted the onboarding process was oddly easy/rapid, although they did ask for all the usual licensure, NPI, etc.  They emailed me one “example patient” and you just see a lot of insurance info and basic PMH, etc and are asked to sign off for a back brace.  No interaction with the patient was necessary as far I as I could tell.

    #160066 Reply
    Avatar ebotrd 
    Participant
    Status: Physician
    Posts: 14
    Joined: 10/25/2018

    I decided to google around for reviews on RediDoc and found this forum.  Searched a bit more and found this article where RediDoc is mentioned in a concerning light.  https://www.dispatch.com/news/20180618/scammers-trick-seniors-with-free-medical-devices-then-bill-medicare    Did any of you find out any more about it?

    #160071 Reply
    Avatar ebotrd 
    Participant
    Status: Physician
    Posts: 14
    Joined: 10/25/2018

    They sent me a “real” patient.  They have a PDF note all ready for you to sign off – SOAP all gathered by “intake rep”.  I could see gathering the subjective history for you, but the “Objective” they list there isn’t really observing anything except that the patient can walk. They say the pain is a 9 and worse by movement.

    Here’s a fully redacted example:

    Chief Complaint
    [Patient] has inquired about utilizing orthotic bracing for his current conditions; his chief complaint at the time of this assessment is: Back pain.
    Subjective Notes – Information reported by intake rep and patient test
    [Patient] described his pain as shooting pain  sharp pain, constant, ache. [Patient]’s back pain has been constant for over 5 years He has a fear of falling..[Patient]’s chief complaint is
    back pain, which is associated with a level of 9 on a scale of 1-10. The patient stated that movements aggravates the condition, temporarily resulting in higher pain levels. [Patient] has indicated that his pain restricts his ambulatory functions.
    Objective notes from treating physician
    My assessment of the condition of [Patient] today, a XX year-old was in regard to his complaint of back pain. [Patient] is ambulatory. This is a level 9 pain, but is made even
    worse when aggravated by movements. Based on my assessment, I consider this to be caused by instability and general weakness (ambulatory), due to a pre-existing condition
    resulting in the current level of pain and discomfort for an extended time.
    Assessment Notes – The diagnosis includes:
    M54.5 Low Back Pain,M62.81 Muscle weakness (generalized)
    Plan Notes – Doctor’s order from treating physician
    The benefits of the L0650, which is an alternative, non-invasive method to potentially relieve his back pain, has been explained to [Patient], who is interested in this treatment.
    Based on my assessment, I have determined it is medically necessary and appropriate to prescribe treatment today. For his complaint of back pain, I am prescribing this
    device: L0650. The first date He is authorized to start using the brace is the exam date, as signed, and should continue to use for 99 months/Lifetime. [Patient] or an assisting
    caregiver will be able to apply this brace with minimal self-adjustment as the L0650 does not require custom fitting.
    I feel the L0650 back brace will benefit [Patient] by helping address all of the following:
    Reduce Pain,Reduce pain by restricting mobility to the trunk,Support spinal muscles and/or deformed spine
    The patient will have the potential to benefit functionally from the AFO.
    The goals of this treatment plan hope to achieve the following:
    [Patient]has been provided with our telephone number to schedule a follow up brace evaluation, or if needed for questions. It is recommended that [Patient] consults with a pain
    management physician to discuss and control his pain management regimen. This brace evaluation is an additional pain management aid and not a substitution for [Patient]’s
    current treatment.

    They also send you an audio file of the interview to listen – sounds like a phone call, not in person.  Patient actually sounds slightly annoyed by all the questions/confirmation of information discussed (as one might with a telemarketer).  Patient only has to say yes/no – patient is not saying anything describing the pain or how it affects their function in the audio.  It doesn’t mention the info above that it’s been ongoing x 5 years or that “he has a fear of falling”.  Perhaps that part wasn’t recorded on the audio – only the summary(?)  Otherwise it does at least verify that the patient would like the orthotic and thinks it will help them.

    I could see patients rushed through their medical appointments and their aches and pains perhaps often not addressed by their PCP.  Then these RediDoc guys call them and ask if anything hurts.  Probably 80% of elderly Americans will say something hurts, right?  OK, do you think a brace/support might make that feel better?  It’s free.  I suspect most patients will say OK, why not.  Maybe some are helped by this.  I’m not sure what to think.  The Columbus Dispatch article mentions that these orthotics are very expensive for Medicare, but I’m not sure why they must be so expensive – Medicare should probably look into why their suppliers are overcharging for such items.  I wouldn’t be comfortable ordering 8 orthotics on the same patient, but one (maybe 2) seems reasonable and I don’t see any way this could harm the patient.

    Thoughts?

    #160083 Reply

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