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How does eCardio get away with it?

Discussion in 'Cardionet' started by Anonymous, Dec 12, 2009 at 8:17 AM.

  1. Anonymous

    Anonymous Guest

    Although its not pervasive in my geography (yet), an account asked me "why can't we bill daily for your telemetry device?.....We are going to try eCardio and see if we can bill daily and get paid for it." Senseless. These are some fairly bright accounts that should know better. I would be interested in knowing what logic and CPT-4 codes eCardio is advising for Daily billing. Most of my accounts that are trying eCardio are not the most ethical BUT there are a few accounts I am concerned about, that are getting brainwashed by the billing info of eCardio. I would hate to see them go through a medicare fraud process. Running a practice is tough enough without 'that' keeping you up all night. Any info out there on HOW eCardio is getting away with this?
     
  2. Anonymous

    Anonymous Guest

    They get away with it by flying under the radar with many insurance companies. They do not have ANY contracts. They just try to say that they fit the 2 day code but to bill it for 30 days. Several won't pay including United, Aetna, Humana, Healthnet and a few Medicare providers.
     
  3. Anonymous

    Anonymous Guest

    who ever is writing these strings knows nothing about eCardio and the contracts they have. Yes..eCardio has many payor contracts. Don't listen to those who know nothing and have only critical things to say about things they know nothing about. If you want to know more about eCardio, please pick up the phone and call...ask for Robert Jordan. He will be happy to talk with you. Now, do you have the guts to call! or do you wish to keep spewing your vile crap over and over. BTW..eCardio is not getting away with anything. They are the most professional cardiac monitoring company in America.
     
  4. Anonymous

    Anonymous Guest

    How did it go with your own medicare provider? Many offices have been billed back due to your "contracts".

    The purpose of this article is to provide guidance on the appropriate use of CPT Codes 93224-93227, 93230-93233, and 93235–93237. NAS has recently noted that some providers have been advised to use CPT Code 93236 and CPT 93237 to bill on a daily basis for multiple days of monitoring and interpretation (e.g., 14 or 21 days). This is an incorrect usage of these codes or of other 24 hour cardiac event monitoring codes.
     
  5. Anonymous

    Anonymous Guest

    Really??? Is that why CIGNA dropped coverage? Stop spewing your lies and tell the truth. eCardio is NOT an ethical company. That is why they treat their reps like crap.
     
  6. Anonymous

    Anonymous Guest

    And another... how many do you want? Name ONE contract.

    TrailBlazer has become aware of problematic reporting of CPT codes 93235, 93236 and 93237. These codes are being used by providers in TrailBlazer’s jurisdiction to report long-term cardiac monitoring, sometimes in excess of 30 consecutive days. While these CPT codes are appropriate to use in billing for cardiac monitoring for up to 24 hours (patient is using a wearable device), they are not appropriate to use in billing for long-term monitoring. Additionally, CPT codes 93235, 93236 and 93237 are subject to the provisions of the “Holter Monitoring – 4C-48AB” Local Coverage Determination, which states the following:

    “Holter monitoring is generally not medically necessary more frequently than once every 180 days except to ascertain a response to a change in treatment based on a Holter monitor recording. Therefore, no more than three monitoring studies will be allowed without review of medical records that demonstrate medical necessity (i.e., redetermination, previously known as appeal).”
    Long-term cardiac monitoring should be reported using CPT codes 93228 and 93229, or 93268, 93270, 93271 and 93272 when a wearable monitoring device meeting the capabilities described by those codes is utilized. These codes are reported once per 30 days of monitoring. Long-term cardiac monitoring using a wearable monitoring device not meeting the capabilities described by CPT codes 93228, 93229, 93268, 93270, 93271 or 93272 must be billed using CPT code 93799.
    Even when coding advice is received from device manufacturers, providers of health care services are responsible for their correct use of CPT codes when billing services to Medicare. As evidenced by the recent settlement of a Boston-based neurologic testing device manufacturer with the Department of Justice and the Department of Health and Human Services Office of the Inspector General over alleged illegal kickbacks and sales and marketing improprieties, the federal government takes such activities seriously and will punish individuals and entities who engage in them.
    Physicians and other Medicare providers who have received inappropriate payments for long-term cardiac monitoring are encouraged to return those monies to Medicare. Instructions for making voluntary refunds to TrailBlazer are available on our Web site.
     
  7. Anonymous

    Anonymous Guest

    Please name one contract, not just "we fit the code". Remember, it is a 2 day code. What insurance company contracted saying you can bill more than 2 days? LW and CN had approvals from several and was specifically stated in medical policies.

    Name one with ecardio. Just one.
     
  8. Anonymous

    Anonymous Guest

    who is the Boston-based neurologic testing device manufacturer?
     
  9. Anonymous

    Anonymous Guest

    As a competitor in this space I have to say that they are "getting away with it" because they can. They realize that their device offers no advantage over a traditional auto trigger other than it will call in the transmission. It is just a Braemar 900 series monitor. They know and have known all these years ( dating back to LL's involvement with Health Monitoring Services ) that the hot button is money. Accounts, even the best of them, will pay attention to a rep who drives home the daily billing feature and what it means to the account in terms of revenue. Most often this info comes from a device rep working on an indy basis who has amassed some level of trust and standing with the groups, they ( the groups ) assume blindly that this info is factual and run with it. You must drive home with all the documentation (trail blazer and the cardiology coders pink sheets ) and common sense ( that is: they really make more for this eVolution than for putting in a dual chamber of doing a cath? ) Logic and documentation do win out in the end you must be persistent in your conslutation. My fear is they eventually turn ligit and use that with the captial they have raised and their relationship with manufacturing to build on the solid things they do, then they will be a real threat.

    We all know what they are doing is wrong they know too. You will hang your hat on the only rack available. If their device "fits" the code then we would all go out buy the same device or the Vitaphone device and be "selling" the same way.
     
  10. Anonymous

    Anonymous Guest

    Neurometrix?
     
  11. Anonymous

    Anonymous Guest

    Ok, I am looking at the infamous matrix, published by eCardio that says for Extended Monitoring eCardio bills......93236 (which is a HOLTER CODE!)....Bill for each day patient is monitored"

    Physician bills... (NO HOOK UP code, we knew that (but).....93237 "Professional Interpretation: Bill for each day patient is monitored"...say what??????

    I can't believe they leave this stuff behind. So why isn't eCardio in Medicare Fraud jail along with all the cardiology practices they've sucked into their lying web??
     
  12. Anonymous

    Anonymous Guest

    Good attorneys? Who can figure that out. Maybe CMS has bigger fish to fry. It's pathetic how they conduct their business. I find that most accounts eventually figure out what they are doing is wrong and come back to reality. The principals in this company had the same M-O when they had Health Monitoring Services. They eventually had to pack up and move to TX. It will come to an end.
     
  13. Anonymous

    Anonymous Guest

    Agreed. eCardio is one of the cleanest and most ethical companies I've ever worked for. Hands-down. And, for the record, I really enjoy working for them.
     
  14. Anonymous

    Anonymous Guest

    You have to be kidding!!! Your management has been run out the state of FL for suspect billing practices when they were Health Monitoring Services and your management was involved in a company called Cardiostaff where the same thing happened now eCardio. A tiger never changes his stripes and the m.o. has always been to hook physicians with the lure of making more money off an interp than they do for some invasive procedures. Tell you what, you have Mr. Jordan post to this site and list the providers who pay daily for an interp. I would love to know which ones do, now that would be gutsy. I saw an eob where eCardio billed $220 per day for the service (technical) and the patients was charged their 20% co-pay for each day for 21 days. That equalled $924 the patient was responsible for and was listed on the eob. On top of that the doctor billed almost $40 per day for the interp and was reimbursed $28 per day and that totaled $588. It's companies like this which have dilouted the healthcare system with crap!!! No way an event monitor, or whatever you claim that monitor to be, should cost this much. No way a physician should get $588 for doing interps when 95% of the strips were NSR. No way you can justify this and that is why Trailblazer stepped in. You love the company because with unethical billing practices like this they are able to pay about $100 per enrollment. Your accounts are very pleased when they learn this. Enjoy while you can because it will not last.
     
  15. Anonymous

    Anonymous Guest

    I find it so amusing that eCardio is telling customers to bill old holter codes for multiple days. i.e. CPT Code 93237. but interesting that Medicare is telling people that are using the "eVolution" device to bill #93799 with a 26 modifier, which pays less than a event and can only be billed once per 30 days.
     
  16. Anonymous

    Anonymous Guest

    Really Phil, if you would take this time to make calls on the accounts, you wouldn't have to reply to the thread.............get to work, or hire another consultant to do your job.

     
  17. Anonymous

    Anonymous Guest

    Well if it is funny, then laugh your way to the bank Mr. Jay...South FL wanna be weight-lifter!!!!!!!'You are not fooling those who know you and know you are on the boards trashing others..............go to the gym and blow off that steam!
     
  18. Anonymous

    Anonymous Guest


    You are correct. I know for a fact that eCardio enrollments are down as customers are becoming aware of the unethical billing practices. The accounts do not want to take the risk of paying back any money. Sure there will always be the practice that will do anything for a buck, but most will come around and use a company they feel is ethical.
     
  19. Anonymous

    Anonymous Guest

    CardioNet numbers are down as well...................let's see, blame it on reimbursement. Oh, I forgot Randy, it isn't because of your poor customer service.....it's the AE's fault according to your most recent comments to investors.
     
  20. Anonymous

    Anonymous Guest

    Cardionets numbers are down for two simple reasons;
    1. more competition
    2. reimbursement issues

    you may say that poor customer service is a reason, but that is not a market driven.
     

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