Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

EPC s again im afraid

Discussion in 'Australia' started by toughspiders, Dec 14, 2011.

  1. toughspiders

    toughspiders Active Member


    Members do not see these Ads. Sign Up.
    or should i say CDMs and TCa'S

    I was wondering..... The medicare plan obliges us to write a letter to the GP on the first and last treatment.

    My question is this.

    Do you write the last letter when the plan expires? Or do you write the last letter on the final treatment of that calendar year??


    Also do any of you promote the system and tell patients to discuss this with their GP's.
    There was an article in the Observer recently about GP's feeling pressurised into completing the plan and specifically names Dentists and Allied Health Professionals as culprits. Where do we stand on this matter. Do we mention Care plans to patients we feel have a need or do we just stay stum???

    Many thanks for your thoughts?
     
  2. Kara47

    Kara47 Active Member

    I understand it to be the first and last treatment of that particular referral, so if you are carrying it over from one year to the next it is the 1st & 5th appointment.
    Am currently tearing my hair out over the number of patients who think all their treatments should be "free", and want to argue with you about how many they think they are entitled to. It doesn't help when the referring GP doesn't understand the system either. I've had one this year who initially gave 3 referrals, then 2 more, (which meant I have to write 4 letters instead of 2), because he thought the referral ran from the financial year.:bash:
    I've also found that the records I've kept of px appointments often differ to what Medicare has, whether the px has gone to other Allied Health or not is a mystery.
    It would be much easier if you could check via website rather than the tedious process of ringing up ( they limit you to 6 px checks in one call)
    Not happy when the px is supposed to only have seen you 3 times from 5 visits & it comes back they have used them all, then you have the joy of trying to extract money out of them.
    Bring on the Xmas break!!:drinks
    Cheers,
    Kara
     
  3. toughspiders

    toughspiders Active Member

    it's a bloomin nightmare.

    Ok, i get someone who is referred lets says Oct 11... let says they have been given 5 services ( another issue for debate!!!)

    I write a letter on the 1st treatment OCT 11, they have another treatment in Dec11 so thats 2 treatments.

    My understanding is then that they get 5 per calendar year so its back to 5 again in Jan 12 !!!! So do you write the letter when you've done five treatments in total?? or when the plan expires and requires renewing?.. or you could argue the last treatment may arise then at the end of the 2012 if you space the new five out to 10 weeks apart.

    Hope that's clear... :)

    I also don't know if i should be telling patients about the Plans, some GPs really dont like you advising clients of such things!!!!!! others are quite happy to speak to their patients about it. I think our professional body should give us more guidelines on such matters
     
  4. pdoan01

    pdoan01 Active Member

    Lets discuss, I believe that we should more than just 5 government fundedd appts and we have to share these with the rest of allied health in whom we share little in common with, more appts for patients to visit pods i say, especially all those diabetics at least 7-10 minimum
     
  5. Kara47

    Kara47 Active Member

    Toughspiders,
    Using your example, You would write a letter for the Oct visit (Appt1), Appt 2 is in Dec, they then have 3 appts left on that referral to be used in 2012. You write your letter when the 3rd appt in 2012 ( the 5th from that referral) is used. They then can go back & get a new referral for 2 more visits in 2012 if need be. ( Yes it's a nightmare, I agree)
    Or you could ask all px to get a new referral at the start of the year, but I find most GPs get snowed under, you wait for weeks for the referral to arrive & in the meantime the px expects" free" treatment (Aaargh!!)
    In relation to the number of visits...
    NSW Pod Association recently had a petition for Pods to supply to their clients to request that more funding is supplied for Diabetes, quoting the number of amputations/ deaths per annum.
    I heard a rumour 2 years ago that it was going up to 10 visits a year, but that hasn't happened yet.

    I mention the program to some px who have chronic conditions and need regular care , especially those who can't afford to come regularly. We have a sign in the clinic stating that current referrals are required for EPC & DVA px, so a few enquire that way. Some local GPs do a lot, others a few, and some don't do any EPCs at all. Ethically you can't put pressure on the GP to write one, but honestly, how many GPs would look at their px feet in a normal consultation?
    Cheers,
    Kara.
     
  6. jos

    jos Active Member

    Had a patient that was referred for 2 visits earlier in the year (2 letters written) then another 2 (and another 2 letters written), so total of 4 letters written for 4 visits-WHAT A PAIN !!
    She is non diabetic, with no remarkable Hx, so I just changed dates on the letters and sent them, but what a waste of time and postage !!
     
  7. PostMortem

    PostMortem Active Member

    Hi, the CDM is in place to improve co-ordination of care for px with chronic disease, like DM, RhA, etc. the GP gets paid very well for completing the TCA and CDM plan, with most GP's getting their practice nurse to do all the work. A lot of the GP's around here have dedicated PN's for CDM Ax.

    If GP's are not completing the CDM/TCA there could be a very good argument to say they are being negligent as it is highly likely these Px are not receiving the level of multi-disciplinary care that is required to manage their condition. So, on the basis of that argument, do we have a duty of care to advise Px that they are elligble for this service. Done properly it can keep all health practitioners informed of where the Px is up to and reduce the duplication of Ax that can occur otherwise.

    Yes, I totally agree that the way Medicare manages the service is :craig::bang: but it does allow Px to access services that they may not otherwise be able to get.

    I use Argus, which is a nation-wide secure email service to sent report to GP and get referrals from them. Saves a hell of a lot of paper and you are gaurenteed that the GP has to see the report before it goes into the Px record and they will get the report within a few minutes. Have used it many time to facilitate rapid referral on to other specialist or hospital.

    Good to have a rant, but try looking at the ++ it provides and where the Px would be without it. Go to your local Division of GPs, promote it through that and yourself too :).

    Alastair
     
Loading...

Share This Page