Docs Are Demanding More From Patients

Fret not! This will all be taken care of when our government takes over the entire health care system. BHO et al will run it with military like precision and cost effectiveness of a bailed out Wall St. bank.

Anyone actually happy with the current healthcare “system” today in the U.S., either has unlimited resources with money to burn, or has never needed medical attention.
Where does it say in the Constitution that BIG INSURANCE has some god given right to exploit us for the maximum profit possible.
Government is the only entity powerful enough to break the strangle hold insurance companies have on all of us.
Talk about “Government Rationing” makes me laugh…as if every private insurance company today isn’t absolutely committed to standing between the patient and the care they need.
WAKE UP AMERICA!!!

As a patient myself and also directly working in the medical billing side at the same time, i can honestly say that both are the victims of this “mafia” network called the US insurance companies.

The truth is that the insurance plans and administration rules are so complex, perhaps intentionally so, that most brainiacs will have trouble figuring these out, much less the average Joe on the street… (err…the procedure is covered with a 20% copay, but only up to an annual benefit maximum of $ XXX, and covered only if you do it at location A, B, C, but not covered if done at location D, and only if you use all in-network providers, but also subject to deductible, which patient has only met part of, but will not be covered if it is a pre-existing condition, and will not be covered at all if precertification procedure is not met, etc, etc………..)

On top of that, they throw in the all mighty self-protective disclaimer – whatever insurance rep quotes you on the phone or on the website is not a guarantee of accuracy nor of actual payment. WTH?? If the insurance people don’t stand by what they say, who the heck else is the patient or the doc supposed to turn to for accurate information? You don’t think patients have to accurately know how much they’ll be out before they opt for a kind of treatment? And don’t you think docs need to know if they’ll get paid before they do a procedure?

In all normal everyday biz transactions, we are able to see the price tag at the store before buying something. For non-tangible products like services, we get a reasonble quote for services in writing, make a deposit, before we enter into a deal with them and before they start work.

On the flip side, docs should have a reasonable guarantee that they’ll get paid BEFORE they dole out their services ( I’m talking about non-emergency situations). But the truth is that everyday, the docs do their work without knowing if they will get paid, and have to wait till they send a bill to the insurance company and wait, wait, wait to see if the check comes through. And often, it will get held for this, that technicality.

Have you been able to walk out of a salon after a haircut and tell them you’ll pay them later? It is like Wimpy saying “I’ll gladly pay you Tuesday for a hamburger today.” Would you be willing to work on those terms, ever?

I have accumulated a 3 inch stack of papers in just 5 months for the MD office I do accounting work for – ALL DENIED CLAIMS. Work/surgery has already been done and cannot be recovered. Unlike the auto biz, it’s not like you can re-possess the device our doc has implanted in the patient.

And you wonder why, we too, switched to an office policy of taking “Deposits” up front. Rather than “trust” the insurance mafia (proven to not be worth the trust), we would rather take matters in our hand. The difference from this story is that, if we are overpaid, we do issue a refund check as soon as we can. People should be forewarned however, that negotiating back and forth with the insurance, IPA, etc. can take up to 3, 6, even 9 months before the case is completely closed.

There should be national health care. Health care can’t get any worse. Even the “best” doctors and hospitals in the most affluent cities are an absolute disaster. There is no such thing as quality medical care anymore because the medical profession is not accountable or transparent. Those who cling to the status quo are just creatures of habit who subscribe to the devil you know is better than the devil you don’t know philosophy. Meanwhile, Medi-care functions rather well and that’s nationalized health care.