doctors and billing

[He Man]

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.

[derby]

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...

[Mother]

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

[ungeheuer]

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. 

[mitt]

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?   

[Grappa]

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.   

[mitt]

^ great example!

mitt

[ungeheuer]

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

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

[Triple J]

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.   

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.

[Langanobob]

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

[JEFF_H]

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