BHO Providers
This PCSM Dr is not only the head of the PCSM group, but he also works as an official physician with the Miami Dolphins.
Who is Dr. Michael Swartzon?
These two types of insurances are easy to spot because they are funded by the government. Some require referrals and some are non-par (non-participating) with our clinic.
What are Medicare and Medicaid?
A patient calls to see Dr. Uribe for pain in the Right Shoulder. They have seen Dr. Uribe 20 years ago in back before he was a part of Baptist Health. But this is their first time seeing her for this issue in Baptist. They would be labeled as this.
What is New Patient?
In the state of Florida, patients in a car accident cannot use the auto/health insurance of the who was the cause of the accident. That's because Florida is this type of state when it comes to these situations.
What is a No-Fault State?
Dr. Zviajc is the medical director for the Miami-Dade County Public School Athletic League. If a patient from any of the listed MDC public schools is injured during school or extra curricular activities and have an incident report, they can bring that report known as this.
What is the HSR form (Health Special Risk)?
The Surgeons from this team are the go-to providers for ACL Tears in the knees, rotator cuff tears in the shoulders and the occasional dislocated kneecap/shoulder. Most of the doctors from this team can also perform Total Shoulder Replacements.
Who are the Sports Medicine Team?
This is a website that displays updated statuses of each insurance our doctor's are in network with or non-participated with. Insurances not mentioned here may appear in the handbook under the non-par list.
What is the Universal Grid?
A patient calls and they want to see Dr. Davis for the RT-Knee. According to the patient's chart, they last saw Dr. Davis for the RT-Shoulder 14 months ago. They would be labeled as?
What is Established New Injury?
If a patient was referred to our Orthopedic department by a Baptist Urgent Care, OCED, or the ERs, then they would fall under this category. We can transfer these calls to their number 786-573-6078.
What is Outpatient Care Coordination (fka Care Retention)?
These kinds of injuries or pains are considered as such when a patient sustains an injury with a distinct break or pop within a recent timeframe (no more than a month).
What is an acute case?
!DAILY DOUBLE!
Foot and Ankle recently swapped PAs around with the exit of Dr. San Giovanni. That means that the team is back to having 1 float (Ean Philips). The new list looks like this.
Who are Dr. Chapman with Adrianna Raudes, Dr. Gil with Lazaro Rodriguez, and Dr. Wingo with Mike Santoro?
In Soarian, there is a Self-Pay option available to patients who go to a Baptist ED or OCED and are referred to our Orthopedic group when they are TRUE self-pay or non-par with us. We can allocate it the BHMG 1x ED F/Up and it costs between this amount of money.
What is $124-$185 ?
A patient calls and would like to schedule an appointment with Dr. Chapman for their LT-Ankle. They have seen Dr. Chapman for this issue before but that was 5 years ago. That means that they should be labeled as this.
What is a New Established Patient?
These calls arise when a nurse/medical provider from the Baptist ER call with questions for the On-Call orthopedic doctor. Sometimes the On-Call provider is Dr. Jordan, Dr. Chapman, Dr. Bravo, and Dr. Lerebours among others. These calls are very important to communicate with the medical team by transferring to that provider's front desk or messaging your Team Leads.
What are ER Consults?
!Daily Double!
Even though Sports Medicine can see knees, they do not typically treat patient's for arthritic issues in the knee that require a Total Knee Replacement. This team is better suited to offer those TKA consultations
What is Total Joints?
A patient calls to schedule an appointment to go over the results of a DEXA Scan (Bone Density) with one of our providers. The patient mentions that they were recently diagnosed with Osteopenia. They can see these two providers from the Bone Health Clinic.
Who is April Tschumy and Yasmine Canela, ARNPs?
If a patient has a surgery with us and no longer has insurance afterwards, this policy guarantees that the patient is covered for the next 90 days post surgery.
What is the Global Period?
A patient called to schedule an appt with Dr. Lawrie for their LT-Knee. In checking the pt's chart, you noticed that they were also seen with Dr. Fongue for a Fx they had in their RT-Humerus (arm) 9 months ago. What would be the appointment label if they are scheduled with Dr. Lawrie
What is Established New Injury?
Dr. Roger Saldana is a go-to resource and referral for younger patients that are referred to us. He works at Nichlaus Hospital treating these kind of patients.
What are pediatric patients?
A patient with a fracture in the spine can be seen by BHOC. This is the doctor or team of doctors the patient can see to treat this issue.
Who is Dr. Mena/Juan Alfonso, ARNP?
We have 2 doctors that work with the Miami Cancer Institute. One works with our Total Joints team and the other works with the Hand and Wrist team.
Who are Dr. Giovanni Paraliticci and Dr. Matthew Treiser?
There are certain Medicare plans that we are mostly not-in-network. But there are few exceptions we take with these plans such as Aetna, Cigna, and even United.
What are Medicare Advantage Plans?
!Daily Double!
A patient calls to see Dr. Davis for their RT-Elbow. Previously, they had seen Dr. Mena for their cervical spine 1 year ago. If the patient is scheduled now with Dr. Davis, what would their label be for the appt?
What New Patient?
Knowing when to transfer as call to this department involves two factors. One of these factors is the patient having an address outside the domestic US (not including Puerto Rico). The other is that they have a non-domestic health insurance policy (like VUMA or BUPI).
What is the International Department?
In car accident cases these are the 7 things we require to take note of if the patient plans on using their auto-insurance for health benefits.
What are:
1. Date and time of accident
2. Name of Auto insurance
3. Policy #
4. Claim #
5. Adjuster name and phone #
6. Health insurance
7. Attorney name and phone # (if any)