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We were in clinic in Vanderbilt and a patient came in with a worried look.  He had just gotten a colored piece of paper in the mail, asking him to do his renewal through the mail in exchange for a check.  Once he paid for the paperwork, he could stop at a hotel room and get a 'complimentary visit'  with a doctor and pick up his filled out paperwork for the state.  He thought it was shady- paying for the paperwork and getting a free visit with a doctor to make it 'legal'.

The law changed April 1st, with the goal of shutting down the signature mills and making medical marijuana certifications just like any other visit with the doctor.  But, as the old story goes, good doctors don't need to be forced to be good doctors with a change in the law, and those that found the loopholes before the law change would continue to find them afterward.  Pay for the paperwork, get a free visit with the doctor to make it legal.

At Denali Healthcare, our physicians and medical staff evaluate patients.  We make decisions and recommendation based on training and experience.  We stand behind our patients and can justify our decisions and recommendations in court if need be.  THAT is what we charge for.  The paperwork is 'complimentary'.

Are you paying for a doctor visit, or are you buying paperwork and the doctor is an afterthought to make it 'legal'?  What did the voters intend?  What does the law require?  What protects you in court?  We as a community have to decide what we are comfortable with- do we do things right or do we see what loopholes we can find?  It isn't hard to do things right.

This week we opened our 8th brick and mortar office.  Muskegon joins Mt. Pleasant, Cadillac, Saginaw, Kalamazoo, Traverse City, Greenville, and Marquette as full offices offering pain management and suboxone therapy in addition to medical marijuana certifications.  We also are running approximately 15 travel clinics offering certifications throughout N. Michigan and the UP.  There are two more and several additional physicians in the works, so stay tuned for more news this summer.
 
As we expand services, adding locations and staff, we have had to make some changes in our infrastructure.  We are adding a full call center out of Cadillac to provide central scheduling of appointments, coordinate my travel schedule, and make sure the phones are answered.  One other major change is that we are going to a full electronic medical record.  Other than the obvious advantage of being able to coordinate visits for a patient between several offices, we will be able to better track our patients for renewal reminders and research into the demographics of cannabis patients in Michigan.  All old records will be scanned into the new system and be available at any of our offices and even at the travel clinics.
 
Initially we did certifications, then expanded to pain and suboxone therapy.  Now we are setting our sights on our ultimate goal.  A series of reasonably priced primary care offices to better serve those without insurance and avoid costly and 'patchwork' primary care by ER.  We want a place for people to get routine care for minor issues without having to resort to hospital emergency rooms and urgent cares.  Folks have a right to have a doctor that is 'their' doctor, and we hope to be the one they turn to in the near future.  I think we are well on the way to realizing that goal.
 
Dr. Bob

It has been brought to my attention that many patients have received denials from another certification clinic, MMMCC, due to the physician continuing to sign certifications months after his license to practice medicine in Michigan expired.  This clinic is active in Gaylord and Grand Rapids and is based out of the Detroit area.  

Many of these patients are coming to me to have their certifications done again, correctly.  While I charge for certifications, I don't feel it is right to charge these patients again after they already paid the internet clinic for an invalid certification.  I've contacted that clinic and they refuse to cover the cost of the repeat certification.  Accordingly, I will see these pateints free of charge to correct their certifications in my Muskegon Office (for the GR patients) on May 11th, and in my Gaylord office on May 17th.  See my clinical calendar for locations, times, and contact numbers for these clinics.

Due to changes in the certification rules, this kind of activity will no longer protect patients in court.  Accordingly, I've decided to step forward for the community and take corrective action to protect the patients that got invalid certifications from this clinic.  We DO require medical records, so bring them with you when you come to our clinics, along with your old certification documents.  You will see me personally for your recertification, a valid one.  You must bring the certification paperwork from this clinic and Dr. Gonte (signed between 1-1-13 and now) to receive the free 're do' of the certification.

The new certification forms are out and can be downloaded from the state website here.  The state will continue to accept the old forms for the month of April, BUT they will only qualify you for a ONE YEAR card.  It has come to our attention that some patients are still being issued the old forms with their certification due to the failure of their doctors/clinics to update to the new forms.  Make sure your certification is with a clinic that follows the current guidelines (you meet with the doctor, you are required to have medical records, there is a follow up, and the new forms are used).

The price of the registration with the state is still $100 for the new two year certification, and samples of the documents needed for the $25 reduced fee can be found here.  Our prices for the certification visit, which include free follow up and free expert witness services from the doctor, have not changed.  

Stay tuned to the website for our new on line application process, which will streamline your forms and allow you to qualify for a reduced price for your certification.  You will still have to meet in person with the physician at one of our clinics, but the on line paperwork and prepayment will reduce errors and make filling out the state forms a breeze.  They will also create a secured, on line medical record for you to obtain copies of your certification documents, do on line follow ups, and replace your paper records in our office (in the unlikely event law enforcement ever tries to seize our records, once you renew on line your records are no longer there).

Remember to check your expiration dates and refer to our clinic schedule to renew your certifications.

Dr. Bob

Well the dreaded change in the law is here, no more no record mills, telemedicine, and the world is ending.  Or is it?

Yes there will be some changes, and my hand has been forced to some extent.  We shut down this first week to get the dust a chance to settle, I took a well earned vacation (but ended up having to replace the transmission in the Yukon down in Pensacola) and we are working on some exciting things.

First off the bat, I am going to pull back a little to my main offices to try and reduce the 6000 plus miles I drive every month.  Dr. Harwell is no longer in practice so I am taking over his offices in Muskegon, Grand Rapids, and Ann Arbor and his charts.  I didn't buy them or ask for them, but he wanted me to have them so his patients were well cared for.  That will give me about a dozen fixed base offices, and 15-20 travel clinics.  We are looking at adding additional physicians to cover the expanding practice.

Second, the new forms are a blessing really.  Yes they are longer and somewhat complexed, but they lend themselves very well to automation.  Yes, we are entering the 21st century.  ALL clinic actions, from the new and renewal applications, to release of information, to caregiver change forms will be available on line.  Not in the form from the state, but in a SIMPLE and EASY to read form which will be used to populate the state forms for you, and correctly every time.  No rejections because a birthdate was wrong or a box not checked.  Most denials are due to paperwork not being filled out correctly, these on line operation will eliminate that.  

Read more...

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