Evergreen Newsletter

December 2021

Reflection of the Year

A Message from Jennifer Estrada

Clinical and Front Office Manager 
Evergreen Family Practice and Women's Health 

"For me looking back at 2021 evokes so many emotions, and the strength of those emotions are more intense and deeply felt than I have ever experienced before, for many reasons. 

 

Being in management allows me to see the challenges of keeping a "machine" like Evergreen running. I have witnessed moments where the decisions being made are enormous and effect the entire Evergreen staff, our patients and even our community. Some decisions are small in the realm of decision making, but they are large in number. During all these times I have had the privilege of watching our leadership discuss with genuine concern how each decision will affect our bottom line, our staff, our patients and our community. 

 

While they will never be able to make everyone happy all the time, I think they do a great job, and I am grateful to work for a company like Evergreen. It is no surprise to anyone that the last couple of years have been difficult for everyone. The work that was put into getting the staff increase was no small feat, and I am grateful. The increase has helped my staff feel a little lighter, a little more appreciated and the timing was amazing. The additional income happening before the Holiday's was a blessing. 

 

Personally, the loss of my sister was probably the hardest thing I have had to go through so far in my life. She was my younger sister, my best friend .... my person. There wasn't a part of my life that she wasn't in. She was just 10 years old when I started dating my husband, and in some ways, she was more like one of our kids. Every day I try to appreciate what we had and not be sad or angry about all the things we "could have had" and all the time we have lost. I think that my struggle will ease with time, and I will one day be able to think of her without the tears. Sorry for the emotional/personal downer, I just felt that I needed to give you a small idea of what losing her meant to me, so that you could understand just how strongly I feel about what my "work family" did for me during this time. 

My superiors where supportive and understanding. They have allowed me to have the time I have needed to process all the changes and recover. They allowed me to come back to work knowing that I needed the distraction and the day to day to keep me functioning and moving forward when I wasn't sure I could. They have overlooked mistakes, late deadlines and less than stellar work, all the while telling me that everything was fine and that I just need to give myself time. Thank you for that Dr. Mary, Dr. Tim, Kim, and Dr. John. 

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My fellow managers stepped in and helped my staff while I was out, they listened when I needed an ear, they hugged me when I needed it and kept at a distance when that was what I needed. I knew that at any moment I could call any of them and they would come through for me. I don't think there are many people out there that can say that. Amber, Quay, Beth, Ronda, and Bre, thank you. 


My Assistant Managers, and my Leads, kept the "machine" working. They did their job to the best of their abilities and they were amazing. They are my leaders, my experts, and my detail people. They set the tone for the rest of the staff; they all lead by example. We would not be successful without you. Thank you for having my back Jessica, Natasha, Shelly, Ellen and Angie. 

The other staff members showed up and worked hard, they knew things weren't typical for me and they not only supported me by kind words, hugs, and cards. They supported me by showing up for work, for doing the best that they could for our patients, and they let me have time. 


For me, 2021 had the potential to break me, and in many ways, I think it has, but I haven't shattered. My people have been the duct tape that has held me together. My career has given me purpose and I am thankful. " - Jennifer

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A word from Amber Reedy

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Without reflection, we go blindly on our way, creating more unintended consequences, and failing to achieve anything useful." - Amber


"I'd like to reflect on the number of patients we have served, both COVID and well patients. We have not changed hours or our days, even-though we have struggled with staffing shortages, just like any other business in town. We have worked extremely well together to continue to care for our patients. We have worked to keep the well patients well, and still care for the sick through our UC. In all departments, our team have come together to cover staff shortages and help each other out. This has aided in our team building and showed we are all truly a TEAM here at EFM. 


We have implemented new services in FP, including the Zio patch placement and the Retinal Cameras to provide these services for our patients conveniently while they are cared for at the time of their appointment with their PCP. Our administrative team has always supported the staff here at EFM. The wage increases, bonuses and appreciation is greatly appreciated. 


If you have not, please check out our previous EFM talks we have had, and the schedule of the upcoming ones. These are very educational and informational for our patients. 

Reflection by Leslie Olson, BSN, RN, NC 

 Office Manager 
 

"There once was a little nurse. Whose dream was to care for the caregivers. This led her to a management position in a company that felt more like family. From here, she felt like it was finally her time to put the puzzle pieces of quality whole-person care together in such a beautiful and caring way that everyone felt seen and appreciated and supported. She is grateful for the open doors this year has brought her. She sees where we are and where we need to be - and is giddy to help bring that dream to fruition in 2022." - Leslie

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Billing Department Reflections 

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"The positivity that every person that works here brings to each other is that they build each other up and are willing to help whenever they can. UNITED is the word that comes to mind. Dr. Tim has shown me that he truly cares about us as his employees." - Karen P. 

Karen, Billing

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"Even though this year has felt like a rollercoaster ride in a carnival of craziness, I am blessed and honored to work for a company that values and respects its employees and their values. Evergreen has given me a greater sense of appreciation than I have ever had before. Thank you for making me feel important." - Kristina C.

Kristina, Billing

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"Evergreen truly cares about the patients. They continue to bring more services to the community within the facility and the outreach to senior homes and schools. I was amazed at the ability the company had to rally with Covid-19 and support the needs of the community. It is great to work for a company where
patient care is number one overall and it starts at the top. I have hired several new people in my department and the current employees who work at Evergreen
are just a great group of people who truly embrace new hires and fold them into the family. They reflect kindness and they are a happy group. They make coming to work enjoyable." - Teresa H.

Teresa, Billing

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"We've had a lot of exciting surprises this year! We worked for years, and now are approved for our first home! I learned that how to tie flies this year, I spent a lot of time creating my own fly fishing flies. I spent a lot of time thinking about the unhoused community. For a better part of the year I spent time asking the unhoused community what resources they needed most to get to their appointments. The response was transportation. Unfortunately, there are not a lot of transportation services for our unhoused community but this has been a passion project of mine now to collaborate with the county and try to help. Everyone deserves kindness. You never know the battles a person is going through day in and day out. Kindness doesn't cost money, but it is worth so much. Ask that coworker how their day is and truly mean it. Take that shut-in neighbor a homemade meal. " - Jessica B.

Jessica, Billing

Now Hiring At Evergreen!

Interested in a career in Healthcare? Evergreen Family Medicine is recruiting qualified healthcare workers with a passion for providing the best possible care to our patients and community. Visit efm.bamboohr/jobs to see current openings and apply.

Billing Questions

Will my office visit be billed as a physical or a problem-focused exam?

Who decides? Why should I care?

 

     Those are some great questions.  I wish the answers were clearer than they are. Let me start with the last question first.

You care because the way the visit is billed greatly impacts what you owe personally as opposed to what insurance will pay.

Most commercial insurance will pay 100% for an annual preventative exam. You pay very high premiums and have a high deductible, so it seems right to receive that benefit. This would be a good time to encourage you to read your policy or call your insurance to be certain of that coverage.

     Medicare, on the other hand, never pays for a "physical". If your visit is billed as a routine physical, they will pay zero. You pay 100 % of that bill. However, selected Medicare Advantage plans will pay for an annual physical. And every Medicare policy - whether regular Medicare or Medicare Advantage - will pay for an "Annual Wellness Visit" at 100%.

     Are you confused yet? Maybe it will help to explain what these terms mean in regards to what is actually intended during the office visit. Because I now answer the second question of who decides how the visit is billed.

     Criteria considered in assigning the proper billing code are two:  1. What was the main purpose for the visit?  and 2. What was accomplished at the visit?  And the responsibility for assigning that code lies with the Provider who performed the visit. As Providers, we have both ethical and legal mandates to do this correctly.

     A problem focused exam is what it sounds like. The patient presents with a specific concern(s) or problem, such as chest, abdominal, joint or other pain process, a bad cough or shortness of breath, unintended weight loss, etc - and the provider's focus is on that issue. It also occurs when the patient presents for a follow up of an established problem such as high blood pressure or diabetes.

     A "physical" or "annual health exam" is a more general focus on both established medical and preventative issues. The providers take a broader focus of overall health maintenance. This also occurs when a patient is establishing care with a provider. It is a scheduled visit once yearly.

     An "Annual Wellness Visit" is limited to Medicare patients and is restricted entirely to preventative medicine including vaccinations, covered diagnostic exams, assessment of safety and function, assurance of medication list accuracy, end of life decision making, etc.

 These visits are extremely helpful, they are paid at 100%, and Evergreen encourages every Medicare patient to take advantage of this benefit.

     The truth is that sometimes these visits fall in-between problem focused and annual exam criteria and could be properly billed either way.  When that occurs, we will do our best to work with our patients and their insurance policy to allow coverage. We will not misrepresent the office encounter, but we do want to reduce the cost barrier to medical care wherever possible.

     We appreciate your patience and understanding of the complexity and murkiness that sometimes accompanies these decisions. Our first priority is to take care of you and your family whatever your need.  Please let us know if you believe we have not billed your insurance in a correct fashion. We may or may not be able to correct that, but we can always explain our reasoning.

 

      Sincerely,

      Your friends at Evergreen Family Medicine.

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