Posted on 03/24/2010 5:42:07 PM PDT by Sir Gawain
March 23, 2010
My Dear Patient,
As you must know, Congress has just passed extensive legislation governing health care delivery and insurance systems. Whether you agree with what it does or not, we are all now subject to this law and its sweeping changes.
I have always conducted my medical practice with my patient’s best interests as my first priority. Although not legally obliged to do so, I have routinely provided you with a receipt that has all the codes necessary to bill your own health insurance company for any reimbursement to which you are entitled. Until now, that insurance company was a free enterprise despite the fact that it was heavily regulated by state and federal laws. Now the situation is quite different. Through the new law’s mandates, regulatory powers and reform, health insurance is and will be largely a government activity which will have an ever larger jurisdiction over how doctors practice, make clinical judgments and are paid.
(Excerpt) Read more at corner.nationalreview.com ...
But they haven't. Yes, they want to, but they can't. Because the American people have 250 million guns, and 2 billion rounds of ammunition.
*THAT* is what has protected our beloved 2nd Amendment, and that is what is going to protect all our other God-given rights, regardless of what the SCOTUS decides about ObamaCare.
In fact a friend from the UK just told my husband to relax about this new Obamacare. He said it just means that the people who can afford it will get the best doctors and those who are counting on the government for their healthcare will get the leftovers. It’s too bad the bleeding heart liberals don’t think their actions through all the way to a logical conclusion. This will just drive the best doctors into a private practice that middle income and the poor will not be able to afford. I’m not so cynical that I think it’s right to give the rich the best doctors and leave the rest for the poor. Obamacare will do just that.
“And if she sends you out for an MRI or Radiology or something, how will that work?”
Those are separate billing entities. The hospital or facility that the procedure was performed in will have their fees and quite often the specialist performing (or reading) the test will have a separate charge.
“I’m not sure I understand what she’s doing differently.”
She’s going to a “cash” based business. She won’t be providing the courtesy billing to insurances that many physicians do or the billing codes for you to submit on your own to the insurance company
Doctors would be more helpful altering their practice to either stop taking insured patents or reporting to patents to get back to their employer how much money they are spending on actual health-care, and thus how much money they could save by getting off the Government’s health insurance and going to direct pay.
Leaving the practice is not yet necessary.
You would be more helpful helping to change the practice to bypass the government.
This hints at the way forward.
Carry it to the next step to retainer medicine or concerge medicine (samething).
Sign a contract with your doctor direct. Negotiate monthly payments $250 for yourself to $1000 for a family of four. Ask the doctor to act as an agent for specialists by paying specialist retainers by adding an additional $100 to $150 per month. Or add a catastrophic policy at $75 to $150 per month (but this involves insurance which can entangle you with socialist government).
So for $350 to $400 per month for yourself you are completely covered by a doctor 24/7, a retainer or concierge doctor who will see you at any time or refer you to a specialist with virtually no waiting time.
If the monthly payment seems too much, ask your employer to pay you income instead of benefits. Put the extra income into a Health Savings Account and deduct from income at tax time. This is how it works now taxwise but that will likely change unless lawsuits or repeal are successful.
Remember it’s called retainer fee medicine or concierge medicine and its exists now. It’s not widely known (*see below) and it is NOT only for he rich. You can find a retainer doc for $2500 a year for yourself. That’s around the clock service and no waiting times, no seeing the doc for 5 minutes and pushed out the door; quality time, quality service.
*Retainer medicine is kept low profile because it is very competitive and much greater quality. Insurance companies do not want to see it become bigger because the insurance companies are heavily regulated by states and they feel it is unfair that retainer docs can avoid all that regulation. State insurance commissioners have gone after retainer docs accusing them of acting as insurance carriers rather than as contractors. The retainer docs have as a result kept a low profile. It’s a well-kept secret. The detractors of retainer medicine use scare tactics by saying “it’s expensive!”. It can be expensive, but so can anything else in the world of contracting. If you shop around you can find one at a reasonable price.
She will probably charge for an office visit... $50 or 60. She will also only use tests when absolutely necessary. Then we we see how much doctors practice defensive medicine. I had a doctor that made you sign a waiver understanding that she carried no medical malpractice insurance.
But won’t they require a “code” or something from the primary physician? Even if not, the patient would probably still have to have insurance to get the procedure done, unless they want to just get a big bill.
She’s precisely the doctor whom I would see if I could afford a doctor at all.
I can’t, & would probably be among the first adults to qualify for the gov’t run monstrosity, but I intend to avoid the government’s involvement in my health care for as long as possible. If i miss out on necessary medication that I’m running out of, oh well.
Notice that she intends to stay in business for the patients who stick with her, and of course she remains vulnerable to malpractice lawsuits.
When you run out of your prescriptions and need a refill find a walk in clinic and visit the doctor there. For $40.00 you can have script refill and ask him renewals as many as possible.
And she’ll save a boat load of money (if not already) by not having to employee 3-4 people (depending on the size of her practice) billing and rebilling and rebilling and rebilling the insurance companies (medicare is the absolute worst)and then sending her patients a bill and hoping that that the payment is received in posted in time to pay her employees.
As some of the pp have said, it won’t be those with money who can’t access healthcare. It will becoming increasingly difficult for those dependent on the government to access same the level of care. Currently, hospitals and physicians are able to offset some of their costs of the indigient and government dependents because patients who pay their bills and insurance providers. I suspect that before too long, in-patient care facilities will be following suit of the cash based physicians.
Tell your friend this is not so much about quality of care, that’s not the issue. Money will always find quality.
Tell them this is not about healthcare, this is about control, changing the nature and character of the relationship of the People to its government.
America was really set up different for the purpose of keeping the government at bay because history shows that persons in government ALWAYS seek more and more control, more and more taxes, more and more roles to butt in. It never stops, it is like greed to a banker; it’s hardwired into the human character.
The UK and its commonwealth are not known for medical excellence. America is known for medical excellence. There is a reason for this. It has to do with the fundamental notion of a market. In the UK, the market is the government. In the USA, the market is free persons or free entities driven to find new products and services to market.
In the UK you can find medical excellence in a black market or in a special secretive word-of-mouth clinic. But I can guarantee you that 9 times out of 10, the techniques and technology used in those higher end clinics were developed in American markets.
I’m not sure where you live, but many of the larger not-for profit Catholic facilities and associated physician practices provide services through what is considered “scholarship” or “assistance” that has nothing to do with the government (at this point in time:)). The programs are funded through large donors through the hospitals’ foundations.
Doesn’t gov’t control who can prescribe? And then, goodbye natural home remedies. All I take is aspirin - so I’ll just chew on some willow bark.
No...the billing codes and (diagnosis codes) are different. When the facility and the other physicians bill the insurances, they (or their staff) make their own diagnosis and for that diagnosis there is a correlating billing code that is sent to the insurance companies or the government. Nothing, in terms of money or payment, goes back to the primary (or referring) physician. The tricky part for these patients may be if their insurance company requires a referral from their primary care doctor to see a specialist. Most of my experience shows that as long as the primary care physician writes a “prescription”, that the referral is acknowledged and accepted. Maybe someone here with more experience could add something more:)
There was a discussion on a thread a while back and it was mentioned how health care costs started escalating when government introduced medicare/medicaid. Prior to that there was no need for health insurance because doctors were paid by their patients at time of service. Doctors also have been known to bartered services with patients.
Looks like KittyKat7 has been playing with too much catnip. If the doctor is not required to provide treatment codes, then they don’t have to provide them since they won’t be getting anything from the insurance companies.
OBAMA owns the insurance companies, GM, the Banks, and other little things in life. You are so screwed you don’t even know it.
My greater concern is this: If I can find a physician who opts out of the system,, as this woman does, I will. But I want to keep the government's prying eyes off of my medical records. I suppose I can get that reassurance from such a doctor, especially if I do not carry insurance (I plan not to comply), but that won't be the case for an MRI, Radiology, etc., where records will be kept and sent to the government.
bump
I believe it. Any time the government gets involved the costs to providers goes up. A lot of our healthcare has been socialized (meaning government involvement) for a long time...from health department inspections to JCAHO accreditations to billing and coding regulations to licensure requirements to medicaid to medicare and the list goes on. The amount of staff required by an average sized hospital just to ensure compliance to all of the government regulations would probably surprise a lot of people.
Next time (hopefully not soon) you have to go to a hospital, ask someone if they have someone specifically designated just for compliance to HIPAA.
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