December 13, 2024- As temperatures drop, this typically signals an annual increase in cardiac illnesses and the rise of an increasing variety of respiratory diseases. Most of us have already been providing our customers with flu and COVID vaccines and helping them prepare for the rise in annual school physical exams. It is also likely that your customers have asked you about your respiratory testing portfolio this year and your recommendations to help them prepare for respiratory testing for their patients. Make sure to have comprehensive discussions with your trusted respiratory testing manufacturers to understand available platforms, tests, current reimbursement and testing trends.
This year, I am seeing more interest in RSV testing for older adults than in previous years. This trend mirrors an increased level of RSV vaccination utilization for older adults. As the pharmaceutical companies that offer RSV vaccines create awareness of the incidence of RSV in older adults and the seriousness of RSV in this patient group, they create opportunities for us to expand our discussion of respiratory testing. If you need a refresher on overall respiratory testing options, please refer back to my August 2024 Repertoire column which describes typical respiratory tests, their CPT codes, reimbursement, waived status and available lateral flow and molecular testing platforms.
Hopefully we have the foresight to plan for these annual experiences, but if we have not so far, it is not too late to prepare to be an active and well-informed consultant for the balance of the fall prevention season. What do I mean by this? In this column I plan to help you think about late fall and early winter the way your customers do. We need to go beyond talking about the patient conditions and concerns they will face. Not all their patient visits will involve specific clinical conditions. Some will involve questions about which vaccines are appropriate for them. Others will involve questions about health insurance, including which plans the practice will cover in the coming year.
This year there are changes in Medicare Advantage program coverage by many commercial insurance companies that your customers’ patients may ask about. Many Medicare Advantage (Part C) plans will increase in cost and some will offer reduced benefits or increases in deductibles. As we approach the end of the calendar year, a number of patients will schedule appointments and request tests to make sure they take advantage of all their current year benefits, before annual deductibles go into effect in January.
Read more in the latest issue of Repertoire Magazine HERE.