Academy Exchange

 View Only
  • 1.  Anal PAP under Ryan White

    Posted 02-06-2025 09:14

    Hello,

    We are working on adding Anal PAP screenings to testing options for our PLWH. I have encountered an issue with coverage and was notified that this service is not covered under Ryan White. Many of our patients do not have other insurance. Any ideas on a work-around, or way to bill that would be covered? Thank you for your help. 



    ------------------------------
    Barbara Hart
    Lawrence KS
    ------------------------------


  • 2.  RE: Anal PAP under Ryan White

    Posted 02-06-2025 15:41
    Myself and a colleague did implemented an anal cancer screening program using Ryan White Funding almost 10 years ago at University of Maryland. We were trained by Joel Palefsky at UCSF and did some clinical observation sessions at Mount Sinai with Dr. Michael Gaisa and a private practice colorectal surgery at Greater Baltimore Medical Center, Dr. Francesco Grasso. 

    Feel free to read our implementation publication using the link below. 


    Getting good reimbursement from private insurance was a problem, not actively practicing but my colleagues still vent about this.

    When we did our project the Anchor study was still ongoing so we agreed data collection was important.

    We decided on what datapoints was important to us clinically and also to teach the field at onset. We used an access database that we created ourselves within the hospital's intranet with appropriate password protection. The datapoints were only identified by a generated unique identifiers. We had another file that provided a link between the unique identifiers and the collected data.

    Feel free to reach out if you have other questions.

    Leonard Sowah, MD, MPH, FACP
    Physician/Researcher 
    Baltimore,  Maryland, 21209







  • 3.  RE: Anal PAP under Ryan White

    Posted 02-07-2025 09:48
    Thank you, this is very helpful! 

    Sent from my iPhone





  • 4.  RE: Anal PAP under Ryan White

    Posted 05-14-2025 11:02

    Hello!

    We are working on implementing HRA practices in our clinic in San Antonio, Texas. Your published literature has been very helpful. Our clinic has purchased the equipment and is moving fast with implementation. 

    I was wondering if you'd know strategies to store pictures within EPIC EMR? I understand that "second opinion" can be purchased separately, our clinic is looking at ways that we could potentially store the pictures in a different way. 

    Thanks for your input!



    ------------------------------
    Ruth Serrano
    San Antonio TX
    ------------------------------



  • 5.  RE: Anal PAP under Ryan White

    Posted 05-14-2025 15:24

    Hi Ruth:

    If I were you, I would go ahead and buy Second Opinion.  You need a means of capturing photos while doing HRAs and treatments, and this is the best way to do that.  You can get trained by the Second Opinion folks to export the photos to either Epic or to a file or by someone in your IT department maybe.  You can also cut and paste photos from Second Opinion to your EMR.  Are you involved with IANS?  If not , I would recommend becoming a member.  Hope this helps, 

    James



    ------------------------------
    James Adams
    Rancho Mirage CA
    ------------------------------



  • 6.  RE: Anal PAP under Ryan White

    Posted 05-14-2025 15:55

    We discussed storage in EPIC but we developed this in the early days of our hospital's transition to EPIC and ended up storing the pictures in a password protected folder using powerpoint.  Other groups we had discussed this with in our development used applications that interface with EPIC that helps to generates notes with embedded pictures outside EPIC that are saved in EPIC as PDF files. You may want to discuss with any gastroenterologist in your group who may have similar applications. 

    Also as James mentioned joining IANS (International Anal Neoplasia Society) is useful because they send periodic updates on upcoming training and educational events.



    ------------------------------
    Leonard Sowah
    Baltimore MD
    ------------------------------