Ducati Monster Forum

I can never understand how the billing department for general practitioner office do it.  The doctor I normally see charges a certain amount and this one time I see someone else in the office as he was not available and they bill me different and more.
I call them and question it.  The lady at the billing gets agitated as to why I question it.  She tells me
1- the doc saw your for four things
2- the doc does not know your chart

My reply
I have been seen years before for the same things at the same time and did not charge me more.  Are you telling me that because she does not know my chart, you are charging me more.  Of course, she said no.

Jeesh, I am talking to her stern and she says why are you rude.  I tell her, this is how I talk and basically I was not gonna have her push me over.  She goes on to say, come to the office and talk to the doctor.  I am like I can't even get in for an appointment to do physical and you are saying he can see me.  No, do your job and have the doctors review this and get back to me.   

I wonder if I will hear back.  I better write a letter complaining and have it on record I guess.

It is so hard to find a good doctor.  I hate that they don't even look at your when examine, they got their laptop and just busy typing everything you say.  No eye contact whatsoever.  Just great.


What you guys/gals experience ?

practically the same.  it's a numbers game lately.

You pretty well summed up my experience also.  IZ_ math for billing, general lack of caring, etc.  I think 50% of the cost of health care is shuffling papers / negotiating costs / arguing with patients over billing, etc. that has no value add.

I think for our second son, who was born in Dec 2008, it wasn't until Sept 2009 before the last bill was paid to the hospital due to above reasons.


mitt

I work in the medical setting and can tell you all about billing. I no longer work directly for  rehab companies because of it.  The name of the game is productivity.

Yep.

It seems all they're after is your money. I won't go unless something is seriously wrong, or if it's the annual checkup.

 [thumbsup]


I approve this statement.   (unfortunately  :-\ )

I haven't been to a doctor in over 7 years..  wife works in medical billing,  has been laid off for quite some time now..  ill ask her about it...

I go at least once a year for my physical. If I go at any other point it's probably I'm on my death bed.

Don't get me started.   [bang]

Still fighting with Orthopedics office for a visit in May.  They submitted it to my old insurance company even though I had updated my insurance info with them at the time of appointment.

My 8 weeks of PT for my shoulder following aforementioned Ortho appt was like tossing $20 out my car window going down the road.  I rarely ever saw the PT, just the PTA.  I don't need to pay someone $40 a pop to watch me do my exercises. 

I believe this is why all the insurance companies are trying to shift everyone to an HSA coverage... they turn you into your own billing department, which allows them to reduce their costs by reducing their billing staff.

In the one year I was covered in a HSA, I caught four instances of double-billing.

I need to start with HSA.  I will soon, now that we are done having kids, and can hopefully manage our costs better. 

Another example of where we are today as a medical profession - at a well being check for my son, I caught the nurse plotting jaundice lever vs weight progress wrong on log paper.  He was normal, but she was plotting it high, which would have made us start daily treatments for him  [bang]   [bang]   [bang]  The only thing that prevented that was me watching her like a hawk.

If you can't do your job right, you should be fired.

mitt

Other than getting girl parts checked out regularly, I haven't had a physical in decades. 

Coincidentally found a doc this past week to schedule the long-overdue check-up but only because of some achy joint pain that has developed (this GP is also a sports medicine specialist).

I'm beginning to fear insurance issues as much as finding out that I'm just getting old.   :P

It probably depends on the carrier, but all of the billing has been done by the doc's office and processed by the ins co.  It is just the payment is made by me at the office and is on me to double check that what was paid matches what was filed.

The main reason for the HSA push is that it puts more of the usage cost on the user at the benefit of lower premiums with the thought that the user will be more mindful of what they're spending when the cost is coming out of their pocket instead of billed behind the scene never to be directly viewed by the user.

After I broke my neck in May 2007 I fought over medical bills for over a year and a half. I got hurt in Oklahoma, was taken by med evac helo to an Arkansas hospital then taken by ground ambulance back home to a Dallas hospital. So I had three states worth of medical providers billing me for shit. I swear there were 250 different outfits reviewing my x-rays and MRIs in all three states! It was crazy.

More than half of them had all my personal info, medical insurance and social security number wrong. That just added to the fun. [bang] It was made even more entertaining when a lot of them somehow sent bills to my ex-wife's house (WTF?) and she just tossed them in the trash. Soooo, I start getting calls from collection agencies about past due med bills that I never got. Let me guess, the bill was sent to XYZ address? [roll] I told them the wrong address/ex-wife story, we'd get a good laugh out of it and the problem would get straightened out. I never thought it would ever come to an end. :P

I have had a really good personal doctor for twenty years. I was one of his very first patients when he opened his private practice. We are like old friends. He had a very honest talk with me last year about the way the medical profession is going and you could see and hear the sorrow in his tale.

He said the relationship that he and I have as patient and doctor is coming to an end. The changes in insurance, Medicare, the potential new health care plan, etc are going to force doctors to turn their practices into a high speed low drag patient mill. He said to make ends meet he will probably start seeing twice as many patients a day and that means spending less and less time with each one. Opening up the avenue for misdiagnosis and maybe not ordering the right tests. He sounded depressed even telling me about it.

I bet half of every doctors office staff are there just for billing purposes and dealing with insurance carriers. And I too seem to get different stories about my bills vs insurance every time. I think they want to confuse you so you will stop asking. It's apparently working. [bang] [roll]

Too easy  :-X

they are 90% crooks. when i was picking my doctor, the one that i first saw was EXTREMELY nice to me. she spent extra time talking to me and voicing my concerns.

then after i got locked in with her, i went to see her about a muscular injury and she was the most rude person in the world and said she cant do anything to help me and that theres no poitn in talking about it.


then theres the dentist wisdom teeth issue i have. they keep applying to my insurance to get 18k gold crown for my teeth when i dont need it. i get notices all the time saying thye keep submiting the request, but it keeps getting rejected even though i never requested it. they just want the money. its all crooked.

i've got about $360 in FSA money i have to spend by the end of the year.

went to the doctor today for a list of concerns i've been slowly adding to over the year resulting in an order for a few x-rays, and a few labs.

first of all, the girl collecting my copay charged me $15... i had to point out that my insurance card said $25. i'd normally let that slide, but i hate having to stay on top of the billing department emails asking for their other $10.

the last time i had these labs done (a few years ago) i got surprised with a $250 bill about 3 months later. got bounced back and forth between my insurance provider, the doctors office, and the lab (which is under the same umbrella as the doctor but has a different billing office).

nobody could explain to me why the labs weren't covered. i finally paid it so just to make the collection attempts stop.

back to today... i call the billing office and explain that i'd like to know what my final out of pocket expense is going to be  for the labs so i can either set aside my FSA money or, if the labs are covered, be free to spend my FSA money on glasses/lenses/feel good pills/etc...

nobody could tell me! "we won't know until the doctor's office submits the bill to the billing office and we see how the orders were coded..."

uggh...

I'm no doctor obviously

but

I do know a bit about how Pt's feel about the eyes in the laptop thing

10 years ago it was a simple SOAP chart with your standard demos

Name, DOB, weight, address, phone number, meds and allergies and an hour at the hospital to finish the SOAP

now

it is an electronic PCR with a 144-point matrix and 10 minute hospital times

translates to Pt care whilst head is shoved up computer's ass

Billing?  My Doctor is free.  They over-service and rob the government instead.  Unless its a near-death event I try to keep away from 'em. 

Who is the government then and where does it get its money?   ;D

I used to go for a yearly dermatologist check-up (living in the sun) and I was constantly amazed at the amount of staff in his office.  Walking from the waiting room to the doctor room I would typically pass about 6 employees sitting at desks.  Not to mention the 2 receptionists at the front.  Think of how much it must cost to lease a building big enough for your office plus six other desks, paying salary and benefits for six full-time employees.  Add to that the armies of other staff members on the insurance company side of it.  That adds a lot of cost.  I would think that a cash only system would simplify the matter greatly, and bring costs down enormously.  Can you think of any other good or service you buy where you don't know how much it costs, and won't get the final bill for close to a year?  Just have insurance for the major catastrophic stuff. 

Example:

Had LASIK surgery a few years back.  Done by very reputable doctor.  Very expensive, state of the art equipment.  Big potential for make the beast with two backs-ups.  Doctor needed two assistants during procedure.  Some sedatives were given, some antibiotics.  Pre-consultations and post-op follow ups.  Actual procedure took about 20 minutes.  In and out of the building in less than 3 hours.  Not covered by insurance.  About $4500 out the door.  Knew the total costs up front.

Had surgery to rotator cuff about a year ago.  Done by very reputable doctor.  Not as expensive equipment used, or stuff that's been around for a while.  Scalpel.  Arthroscopic camera and tools.  Granted, I was under general anesthesia, which requires another doctor and monitoring equipment, operating room, plus added potential for death.  Pre-consultation visit and post op visits were not included in the surgical bill.  They were billed to insurance for about $300 bucks a pop, plus $20 co-pays.  Actual surgical procedure took about 20 minutes.  In and out of the building in less than 3 hours.  Covered by insurance.  Had no idea what the costs would be for months afterwards.  Bill to insurance company...  $50,000.  Got to see an itemized version of bill.  Had a cheap cotton and velcro sling on my arm when I awoke.  Probably made overseas in a sweatshop.  They billed the insurance $150 just for that.  Would any rational consumer ever pay for that?  Would you not throw a shit-fit at the doctors office for that if you were responsible for the bill?  Would they even try to pull that BS if the patient was the payer?

One procedure has market forces that affect cost-controls and innovation.  The other is a giant free-for-all-shit-show where office people throw around BS numbers at each other and try to game the system on both sides.   :-\

^ great example!

mitt

From each according to ability, to each according to need Comrade  ;)

Good example, but don't forget: One procedure took place at a location where everyone pays...the other at a location where a number significantly less than everyone pays...hence the ridiculous mark-up to people who are able to pay.

Had to take my dog to the vet last week and the experience  there was very similar to what's been discussed in this thread.  Twice I was asked to sign one of those digital signature boards, while the stuff I was agreeing to was displayed on a computer screen that was facing away from me.  They told me that they had about 35 employees.  The place was very clearly  a money mill.

And it wasn't all that long ago that doctors actually made house calls...

Bob

The missus is an RN in the OR so i only go to the docs she knows that are good.
that really helps
Like everything, people vary in their technical and personal skills.
insurance/billing on the other hand always sucks.

i went to the ortho-hand doc this morning.
i have a broke pinky that is FUBAR in medical terminology  :P