Posted on 07/23/2006 2:42:46 AM PDT by Hostage
Nearly five years ago, my husband and I left a university clinic practice to explore ways to spend more time with our patients. Denied the right to provide services to my patients because the patients' insurer did not deem it necessary, we felt we were losing personal control of the practice of medicine.
Much of my practice was women's care, and the idea of providing comprehensive women's care in 12-minute visits was absurd. Furthermore, to maintain an "efficient" patient flow, my schedule was typically filled weeks in advance with physicals and Pap smears, so that acute care was frequently shunted to one of my colleagues; any possibility of continutity of care was totally lost. Believe me, when a patient is acutely ill, frightened, or in pain, there is nothing "kind" about forcing her to see a total stranger for her care.
We moved to a completely new area and started a retainer-fee practice from scratch. Unlike many retainer practices which cover "extra" sevices while charging insurance and/or Medicare for the usual covered services, our fees cover the entire cost of the medical care.
We are not on contract with Medicare, Medicaid, or any insurance company, although many of our patients still retain traditional insurance coverage for secondary services, hospitalization, medication, etc. However, they pay us out of pocket for the personalized care we provide them.
Ironically, our monthly care fees are considerable lower than the "access fees" that insurance e-based retainer practices charge for the "extra" services.
The bottom line is that we are very affordable.
Two years ago, our state insurance commissioner decided that he did not approve of the concept of "concierge" medicine and announced that he would shut us down. We pointed out that, far from serving only the wealthy, we in fact provide care for many groups of people who could not otherwise afford care of any kind, or might otherwise abuse emergency rooms for outpatient care. Even our maximum monthly charge (which is for housebound adults who require in-home care) is only $100 a month, regardless of utilization.
So, yes -- retainer-based medical care can be kind. But perhaps you can see why we take exception to the term "concierge".
And the basis of the denial? It sound absurd to deny the claim.
We've written them and asked for a detailed explanation for the claim denial. In the statement they sent us no reason was stated. To date we have not heard back from them and I agree, it is absurd.
I wish you and the family best of luck on the claim. Maybe you can find attorney on contingency and make them pay.
ping
The thing I find amazing is that Doc Nancy and her husband were "not on contract with Medicare, Medicaid, or any insurance company," yet the totalitarian "state insurance commissioner decided that he did not approve of the concept of "concierge" medicine and announced that he would shut us down."
Freedom threatens to all tyrants throughout history. It is not about money. Doc Nancy gives the best medical bargain in Washington State. It is all about control and power that so threatens the bureucratic totalitarians.
United sucks. When I was "covered" by UHC, I spent more time explaining basics to those mental midgets than I spent sick.
I'm in Omaha. Where did you grow up?
Dodge County (north of Fremont about 21 miles).
Aha!
She got treated for every illness for very little actual money (*lots* of labor!) and he actually got *more* out of the deal than if he'd been paid in cash. (Organic veggies are very pricy.)
The staff loved her. She'd bake for them. And I'm talking about a *lot* of food. Each member of the staff would get their own pie and loaf of bread. It didn't stop after the visit, either. She'd continue to bring in baskets of fresh eggs, milk, baked goods and preserves. During the fall they'd hit the mother lode. When she'd get hit with a winter bug, she was taken care of. When she had an accident, the shots were on the house. He even greased the skids for her to see a specialist with the same arrangement.
I miss the good ol' days where two consenting adults could come to a mutually satisfying arrangement without it being anyone's business but their own.
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