Grrrr... Can someone explain a doctor's bill to me using small words?

[A930Rocket]

Every physical I've had, the doc said bring my meds so they can renew them.

[livi]

I use a secure message/e-mail system were my patients can contact me anytime they want for questions, prescriptions, booking schedule etc. I am usually able to get back to them within a few hours. No charge of course.
The MILF benefits are tremendous..

[RWebb]

have you contacted the medical practice yet, and if so, what did they say?

BTW - IIRC, a yearly physical is now covered with no deductible for everyone

[mudman]

Originally Posted by RWebb

...BTW - IIRC, a yearly physical is now covered with no deductible for everyone

Everyone? Really? Me too?

What about those of us without health insurance? I guess I don't count.

This social paradigm really has blinded those on either side to each others reality, and I don't mean any of this in a political way. All this mumbo jumbo billing code crap doesn't apply to me and I don't understand it and shouldn't have to be a part of it. For that reason I've found MDs who understand my predicament and happily deal with my requests for up front pricing and cash discounts.

If you expect a proposal from a repair shop or contractor then why not an MD?

[craigster59]

Send the bill to Justin Bieber, end of story....

[RWebb]

Don't worry, mudman, if the S.Ct. doesn't kill off the entire thing, you will soon have health care. You will have to pay for it tho.

[mudman]

Oh I have health care now. Health insurance is what I'll be forced into.

[mudman]

And I pay for it now too. What you mean is that I'll be chipping in on some fat dudes bypass in the future.

[RWebb]

my plan is to employ people by paying them to chase the fat dudes with sticks - solves all the problems at once

[Moses]

Originally Posted by Normy

-I can explain to you the solution to your problem: It is called "socialized medicine", and if you've ever lived under its umbrella, [I lived in Brussels for a year] you know that what consists of "health insurance" in this country is a joke....

N!

How many encounters did you have with socialized healthcare during your year in Belgium? One? Two? Did you need a total joint replacement or an expensive bone marrow transplant? Heart valve replacement? Dialysis?

I worked in a London hospital for a year. Thousands of patient encounters. It's brilliant if you get the flu or break your leg. If you develop a problem that's complex or costly...not so much.

[bpu699]

Yep, that's how billing is done now. A physical only includes preventative issues and screening. If you mention symptoms, such as a cold, pain, asthma flare ups, it gets billed separately.

Docs use to absorb this as good will, but now with ever decreasing reimbursement, we can't do it anymore. Patients never want to come in as copays are usually very high and deductibles too. When they do, they want to address everything in one visit. It just can't be done. Everyone wants everything done over the phone...can't be done. Your care takes just as long as it did 5 years ago, even though insurance went to crap in the meantime. I am not trying to be insensitive, just pointing out the math.

It's now the same as other businesses. If you hire a landscaper to cut your grass on an annual contract, you can't just expect to have other things done for free. When you take your car for a tuneup, you can't just add a free brake job. Etc.

This is actually perfectly correct. If it wasn't your insurance would never pay for it. Historically most docs have under billed. Now they are billing what insurance allows.

Medicare is also very directional in this. They now cover free annual wellness visits. Very misleading. They don't pay to examine you, address any issues, or treat any symptoms. The moment you get examined, or the doc treats your rash, the cost is on you.

[bpu699]

Refills are usually not a problem under a physical. But if your wife complained of asthma symptoms that is a separate level 3 visit...

God, I hope someone fixes the system. Patients dislike it and so do the docs...and its poised to get worse.

Right now there is a dramatic shortage of primary care docs...good luck getting a doc in the future.

Ps. Level 1 is a nurse visit
Level 2 is a nurse visit where the nurse talks to the doc
Level 3 is 1 symptom basically. Pretty much the least a doc can bill
Level 4 is reviewing 3 old issues or 1 old and 1 new
Level 5 is generally out of reach...

The billing is extremely technical, it's not just a number the doc pulls out of the air...

Not sure why you bill was 350$ or so. A level 3 visit is about 100$ or so... You insurance isn't covering something else.

[bpu699]

Originally Posted by RWebb

have you contacted the medical practice yet, and if so, what did they say?

BTW - IIRC, a yearly physical is now covered with no deductible for everyone

Really? . I didn't get that memo...

[RWebb]

doesn't that take effect Jan. 1 under the ACA?

[A930Rocket]

I've got a buddy who's a Doc and he's started a company called JamboDoc. It allows patients to interact with the Doc over the Internet for these very same issues, questions, etc.

I use a secure message/e-mail system were my patients can contact me anytime they want for questions, prescriptions, booking schedule etc. I am usually able to get back to them within a few hours. No charge of course.

The MILF benefits are tremendous..

[dennis in se pa]

What insurance pays should be good enough.

I agree with an above post - the the billing end of medicine is a joke.

I think they send out bills to past patients that they know are bogus just hoping some fool pays them. I have gotten a few of these from hospitals that I have not been to in years. I throw them away. Funny how they don't show up on my credit report either.

[bpu699]

Originally Posted by RWebb

doesn't that take effect Jan. 1 under the ACA?

Not sure how that would work...there is zero capacity in the system to absorb any patients. And, if its anything like medicare's "wellness visit," its simply a teaser.

Folks, it looks like we are in an era where insurance covers less and less. It is currently the expectation that folks pay much of their own bills. This is not the doctors fault, so I truly hope folks don't place blame where it doesn't belong. The system is broke. It offered too much to too many (medicare specifically). Doc's lose money, or at best break even, on medicare. These costs are shifted elsewhere.

Today, many folks (myself included) have $5000 deductibles and pay half their premiums (another $5000). Copays often are $50-200.

If your insurance sounds better than this, be thankful, as this is the "new normal."

I often wince when patients tell me they got a bill and had to pay $100 of it themselves. They are infuriated. They don't understand that there are folks paying $5000+, routinely. The days of $300 dedcutibles are gone...unless you work for the government...

[Tobra]

But, doctors are rich and play golf all day every Wednesday and go home at noon on Fridays

not so much

[bpu699]

[QUOTE=dennis in se pa;6334246]What insurance pays should be good enough.

QUOTE]


Sure, as long as patients don't ask for anything beyond that...

Kind of like having your boss pay you for "40 hours," should be good enough, even if he wants you to work 80 hours....right?

You can't hire a painter to paint your house, and the add "why don't you paint the garage, and the shed, and my furniture while you are in there." That would be an extra charge.

You can't hire an electrician to put in a fixture, and then ask for a couple outlets to be rewired for free "while youre there."

The world doesn't work that way. You have the right to be upset. But, not at the doctor. You can be upset at your coverage, the government, the economic climate, etc. Your choice.

There simply isn't enough resources to go around. There aren't enough doctors to go around. You can't expect to schedule a physical (which insurance covers), and then expect that to also cover other issues. Some insurance companies consider that fraud.

[Tobra]

Let me just turn this around, so y'all might appreciate the perspective of the other end of the stethoscope, so to speak

I see a lady in a wound care clinic with HMO insurance. Her regular foot doctor takes a look at her, says to himself, "I am not dealing with this," and turfs her to wound clinic. I see her a week after he does, in the same month. I treat her, order some radiographs. Next day she calls me at my office, complaining about foot pain. I don't have any records at all for her at my office, her meds, allergies, history, nothing. I suggest she should call her primary care doc about this, as I don't have enough data about her to make a reasonable decision on what to do. Instead, she goes to the ER later that day, gets some studies done to check for blood clots, gets a pain shot and goes home. She calls my office again the following day, asking about the x-rays she had done few days ago, someone called her and mentions bone infection. I read the report, it is talking about changes in the bone where there is no ulcer or other way she could have gotten a bone infection. I look into getting more studies, and in talking to the radiology dept, we come to the conclusion that figuring out where she needs to go for these tests so they are covered by her insurance is not a straightforward proposition. I call her primary care docs office, they are out to lunch, so I leave a message.

All told, I have spent more than an hour dealing with this woman. I am absolutely certain I won't even get "a point" which is how they do the reimbursement, because her regular guy saw her, and two specialists of the same flavor are not credited for the same month. A point is like $1 a month for the next three months, so that is 3 bucks, plus whatever copay she has. In the case of a person seen at the hospital, they don't have a copay.

Bottom line is it is free.

I still treat freebies the same way as paying customers, because I am stupid like that.