Greetings From Florida!

This is part of a series looking at different practices of all sizes and locations, and how they are all dealing with issues during this pandemic. 

Dr. Carlos AlonsoBy Carlos M. Alonso, MD, RhMSUS

We have a 5-physician practice serving the South Florida community for 20 years. We have dealt with natural weather disasters, but none of these events compare to what we have been confronting since March. We run three locations, with a busy infusion suite in our main office.

Since the onset of the pandemic in the US, our main worry was having our patients visit the ER for disease flares. Our second concern was maintaining payroll since there was an 80% decrease in office visits. We decided not to close our office. Instead, the workweek was decreased to three days of full staffing with infusion services and two days of Telemedicine only visits. We hoped that the stimulus money would compensate for the decrease in work hours while we applied for a PPP loan. The process of loan approval was nerve-racking. The lack of updates from our bank made it impossible to create a plan for full office reopening. Finally, we were funded on April 20 and now are back to a five day per week schedule. We are moving as many visits as possible to Telemedicine in order to decrease exposure for our staff and patients. New patients still need to be seen in the office. Currently, about 80% of our visits are virtual. Our staff and patients get temperature checks, and every appointment gets screened for signs of infection. We continue offering hospital consult services.

One of the most frustrating endeavors has been figuring out how to bill for Televisits. Medicare Advantage has an enormous footprint in South Florida. We are providers for about 27 different insurance companies with different lines of service. Finding out the proper way to bill for each of these has been extremely time consuming and many times a hit and miss project. Guidelines might change from one week to the next. Even Medicare Advantage plans do not necessarily follow CMS guidelines.

Finally, being a father of 3 beautiful daughters, an 11-year-old teenager, and 6-year-old twins, let us not forget about the stress and pressure that virtual learning has put on families. Amid all these challenges, we hope that we can continue serving our community as we have for the last two decades and pray that our country will come out stronger and united from this unprecedented global event.

Carlos M. Alonso, MD, RhMSUS
Advanced Rheumatology of South Florida
Miami, FL

Stay safe, stay healthy, stay United. 

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