the Doctor

On my latest call with my shrink, as always, I'm 'in the room' first, awaiting his log-on. I've been brought up with the 'if you show up on time, you're late' mentality.  (This does not apply to open houses or parties per se). 

The doc gets on the call, and is chuckling. 

On personal Zoom with my friends I have typed my name in as 'Blobby'.  I forgot to change it back. There was little explaining to do - and I never brought up (nor have I ever) the blog. 

Dith told me I should. I said it could save some therapy time. She countered that it might add to it. Which is totally fair. 

Therapy went fine. At the end of the call, when we normally make our follow-up(s), he mentions there is a change to his schedule. The pause before that had me wondering if he was leaving the practice, but alas he is not. However, starting in 2026 he is no longer doing tele-health. 

On some level I knew this was probably coming. Dr. Spo had mentioned it in his blog for his patients. 

CMS* - for some unknown reason - is no longer reimbursing providers for tele-health visits. It's insane - and that's coming from a mentally challenged patient. 

A year or so before Covid, CMS had plans to greatly increase tele-health visits over the next five years. That was their goal. Adherence rates to these appointments are much higher, as patients clearly don't have to travel to see their provider. 

Space is facilities are classified as DO (Doctor's Office) or OH (Hospital Office). Oddly, the office in the latter does not have to be in / at a hospital. It is how the building / facility is affiliated. Depending on the designation, DO or OH can (or can't) charge for certain things. Lots and lots of details behind each. BUT, OH charges an 'administrative fee' which is usually picked up by insurance. When there is not a physical visit, you can't charge that fee. 

While Medicare and Medicaid pay or don't get charged these (respectively), it's no loss to them. It's no loss to the insurance company either. It is a loss to the practice. Those administrative fees do pay overhead - staff, brick and mortar, utilities. 

Covid really jumpstarted the increase in tele-health, so I'm not quite getting the 180. But it is. No doubt some BLOTUS related bullshit. Dr. Fucking Oz or something. 

So, come January, I will be actually meeting my therapist. In person. He's local-ish. It's gonna be a 30-40 minute drive each way. I suppose I could go with another doc, but ugh - I don't wanna start over. I'm 2.5 years into this. 

We will see how it goes. As it is January, I'm expecting it to be -9F or 15" of snow. Or both. 

*Center for Medicare and Medicaid Services (yes, it should be CMMS, but it's not)

Song by: Loudon Wainwright III