Search found 11 matches

by BrianPierce
Thu Mar 16, 2017 6:44 am
Forum: Clinical Use of Buprenorphine
Topic: Random Drug Screen Generator
Replies: 3
Views:

I generally test my addiction patients at each visit but for my chronic scheduled med patients, we keep it simple and simply select a random integer within a small range and test anyone who 'rolls' the number. We have dice at the front desk but it's easier just to use one of the many online random n...
by BrianPierce
Fri Oct 14, 2016 11:26 am
Forum: Clinical Use of Buprenorphine
Topic: naloxone and naloxone metabolite on uds
Replies: 2
Views:

I had the same issue here last month. I corresponded with an addiction specialist who explained that it is possible (but clearly not common) to absorb some naloxone and get a positive for naloxone metabolites via appropriate dosing and routes with buprenorphine/naloxone. However, remember that norox...
by BrianPierce
Mon Sep 21, 2015 9:25 am
Forum: Clinical Use of Buprenorphine
Topic: Patient cap being lifted?
Replies: 80
Views:

@kcairns- "methadone maintenance is much less expensive than bup" ? Here in Maine we currently have several legislative proposals concerning addiction treatment and costs are a big part of the debate so this would be useful information. However, I've also recently spent a lot of time estimating labo...
by BrianPierce
Mon Sep 21, 2015 9:25 am
Forum: Clinical Use of Buprenorphine
Topic: Patient cap being lifted?
Replies: 80
Views:

As a direct primary care physician, it's frustrating to see third party payment listed as a requirement of a qualified practice setting. Given the harm that third party payment has done to primary care and psychiatry, the burden should be on insurance oriented practices to show that they are qualifi...
by BrianPierce
Fri Sep 18, 2015 10:21 am
Forum: Clinical Use of Buprenorphine
Topic: Any Direct Primary Care (membership) practices?
Replies: 3
Views:

I know what I think is reasonable for my income per hour and per year and what I would need to pay young physicians considering direct primary care, what I need is a better estimate of the time demands of typical growing and stable buprenorphine practices. I'll be meeting a few folks in my area but ...
by BrianPierce
Fri Sep 18, 2015 10:21 am
Forum: Clinical Use of Buprenorphine
Topic: Any Direct Primary Care (membership) practices?
Replies: 3
Views:

Our buprenorphine fees, like the rest of the practice, will be sustainable. I intend to attract other physicians to this practice and this business model and that requires an appropriate income and a sane work life. Direct Primary Care practices like us publish our fees openly. Transparent pricing h...
by BrianPierce
Mon May 19, 2014 7:23 pm
Forum: Clinical Use of Buprenorphine
Topic: Medicaid patients in programs not enrolled with Me
Replies: 10
Views:

Barbara,

You "opt out" of Medicare, not Medicaid. The rules for the two programs are very different.

BP

Rockport, Maine
by BrianPierce
Mon Sep 23, 2013 9:52 am
Forum: Clinical Use of Buprenorphine
Topic: Billing for NP counseling and physician visit ?
Replies: 2
Views:

Thanks, I'll be curious to see how that is settled. In the meantime, we're probably going to set up the buprenorphine clinic under a separate tax ID and not accept third party payers. If Medicare has the same restrictions we may exclude its patients as I haven't opted out of Medicare. In the long te...
by BrianPierce
Wed Jan 30, 2013 5:19 am
Forum: Clinical Use of Buprenorphine
Topic: Announcement for "Newbies" here
Replies: 3
Views: 223

A search function would be very helpful here.

I tried using Google Site Search via Chrome but that doesn't work here apparently.

Brian Pierce
by BrianPierce
Wed Jan 05, 2005 12:54 pm
Forum: Clinical Use of Buprenorphine
Topic: Initial labs tests
Replies: 12
Views: 675

I have run into the same question and found this old 2005 thread. I know the MAT guidelines recommend various labs when starting a new patient on treatment but what data are there for this? Are there data that an exam and history suffices to exclude signficant liver or other disease? I don't want to...

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