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PostPosted: Thu Apr 06, 2017 10:07 am 
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Hey all!!! I have posted this on here before and was so happy when several led me in a good direction. I found an absolutely amazing Dr however because he is is in GA , NC MEDICAID won't pay for meds.
So what I am looking for is a Dr that prescribes Suboxone, accepts Medicaid, and understands we are all at different levels of recovery meaning the amount of groups needed are different for all. I know addicts need support.. however every Dr that takes Medicaid in the area makes you come 2 times a week for group and every one to two weeks for meds. I have been on Suboxone for years and the ONLY time I have messed up was when Dr started having me come weekly for meds and weekly for group meeting. If a person is doing good then they are busy with work and accomplishing goals, and has no time to live at the Dr office. It's ridiculous. Yet the Drs that take cash only charge an outrageous fee. However they ask nothing of you other than one visit a month. This says to me that sadly many Drs aren't in it because they care , they simply want money. It's just sad when physicians get away with using a person's weakness to their advantage. I am looking for a Dr in NC that takes Medicaid and is able to individualize their patients, understanding some can strive without visiting weekly. Any help would be appreciated. I have looked under Suboxone Drs and found all the list. But it's a mile long. I spent hours contacting Drs with no lock. Frustrated beyond words.


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PostPosted: Thu Apr 06, 2017 8:22 pm 
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Sorry Mara, it's a tough world out there. I've done the all day phone calling too and it's tiresome, but necessary. All I can recommend is for you to keep calling until you hit pay dirt. Or end up finding a reasonable doctor with a not too high of charge.

Let's hope someone comes along and gives you some good info.

r

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PostPosted: Sat Apr 08, 2017 11:01 pm 
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I'm hoping for you too, Mara.

I just looked up the responsibilities for Medicaid providers of suboxone in NC. Here is a link to what I found:

https://ncdma.s3.amazonaws.com/s3fs-pub ... rogram.pdf

The pertinent information is on page 7-8. Medicaid providers in NC are required to make sure that their patients are in counseling at least once a month.

Across the border in GA, any provider of buprenorphine treatment needs to also provide counseling at their facility.

http://medmarktreatmentcenters.com/subo ... r-georgia/

My personal view is that our country, whether it is by national program or state by state needs to provide medical, and specifically buprenorphine coverage for the poor. That's what medicaid programs are for. My best friend here in Colorado is about to receive her BA in healthcare administration and she is a practice manager at a primary care clinic. She is well aware of the medicaid and medicare requirements in Colorado and she knows all of the issues regarding physicians who take on patients with various forms of payment.

I understand your frustration, Mara, and the reasons you question the ethics of various suboxone doctors. I think it's important to remember, however, the issues that are important to physicians who accept medicaid patients. One of the biggest issues is inadequate reimbursement by medicaid to primary care physicians. Some people suggest that doctors are being greedy if they complain about low medicaid reimbursement.

However, the average student debt load that a primary care physician has by the end of their schooling is $166K. Over 20 years of repayment, doctors will pay a total of $380K including interest. So the low payment reimbursement for medicaid patients usually require doctors to get a bit creative. My friend who manages a primary care practice has told me that we are trending toward practices where there are multiple doctors to share the overhead costs. Not only are multiple doctors getting together, but multiple specialties are sharing practices as well.

Another way of saying this is that the only way to break even and make any kind of profit is by making a facility with shared overhead and many kinds of services available at the same place. It is just about impossible for a single physician to have her own office and accept medicaid patients.

I am making an educated guess that the medicaid providers of addiction services in NC are providing counseling services and requiring a certain level of attendance because it improves their income. They are having to charge for the weekly/monthly appointments that medicaid will reimburse for. Plus they can charge medicaid for each counseling session or group therapy session because there would be no way to make a profit otherwise. The physicians who require cash payments do not take medicaid patients. They are making their profit by not having to hire and pay office staff who are knowledgable about insurance and medicaid reimbursement. And they are setting the fees so that they know they will make that profit. As long as they're not gouging patients (and there are those who do), there is nothing wrong with their practices.

These are two examples of models that provide enough funds to potentially see a profit. I think it is somewhat unfair to say one is motivated by altruism and the other by greed. It's not that simple.

I apologize for the big long post that is not exactly answering your question, Mara. Unfortunately, I think that when you have medicaid as your health coverage it limits your choices. You don't have the same options as a person who can either pay more or in cash.

I wish you luck in your search and hope that someone here will know of a facility that fits your specific needs.

Amy

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PostPosted: Sun Apr 09, 2017 11:19 pm 
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Amy, amazing effort you did for Mara. Thank you. Your effort is entirely what prompted me to recall a Dr that others here have mentioned that may take some limited medicaid patients.

Mara, there is an addictionologist Dr in Boone or Cornelius, NC, not sure which city. Jana Burson.MD (828) 265-7078 is one # for Boone but also check Cornelius. She could be at her patient cap. But check. Can you let us know? Do you get notice of our posts via email? Hope you are finding out this info. Best to you tonight!! P

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Stopping went well -- its the staying stopped -- where the real work begins.
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