When I am consulted for an issue with a “bad physician,” my first question to the person in charge is: “Are you prepared to fire this doc?” Firing used to take many forms, mostly working through the difficult process of medical staff bylaws and rules, appeals and making the case usually to the medical executive…
Read more
About: Gus Geraci, MD
Recent Posts by Gus Geraci, MD
5 Reasons Why Health IT Is Worth the Risk
Security breaches are reported every day. The safety of health information, and the clear fact that there are government-sponsored hackers out there, make us all the more concerned about the safety and security of our health information, now often stored in some protected cloud, or on a server somewhere, and soon available (theoretically to only…
Read more
RAC Audits: Follow the Rules and We’ll Deny You Anyway
No one questions the right of any payor to audit its payments to detect fraud, patterns of abuse or patterns of error. Around $5.4 billion were returned to the Medicare coffers as a result of audits by the contractors to Medicare for these audits. But let’s dig a little deeper into this. What if I…
Read more
‘Those Guidelines Don’t Apply to Me’
I was taking a peer review call from a pediatrician. For those of you who don’t know, a request for “peer review” means a physician-to-physician conversation about something that was denied by an insurance company. In this case, I had denied payment to a hospital (as a medical director for an insurer) for a readmission…
Read more
Recent Comments by Gus Geraci, MD
No comments by Gus Geraci, MD yet.