Posted on 10/22/2002 6:43:03 PM PDT by logic101.net
CUSTOMER ORIENTED MEDICAL CARE - IT CAN BE DONE 10/22/02
This will probably be shocking to most readers, but I have discovered that it is not necessary to wait in line for medical treatment. It is not necessary to be treated like a sheep waiting to be sheered. The first time I went to St Michael's clinic in Milwaukee was just to get a referral for a colonoscopy, for insurance reasons I needed an internist to suggest an internal medicine specialist for me. This was about 4 years ago. This initial visit was the only time I have ever sat in this waiting room, and then only to fill out the needed insurance information. As soon as I was done with the paperwork I was immediately ushered into an examination room. The doctor entered my room within 3 minutes.
I thought perhaps that this was because I was only there for a referral. After a number of questions as to my need for the colonoscopy, and other questions and tests regarding general health, I was sent to get a blood test, where I also was "rushed" though, the most time consuming part was the paperwork.
This month I have had to visit this same office twice; I never got to sit in their waiting room, and the doctor entered my examination room within two of minutes each time. This last time I was really impressed at this track record, and commented on it. The receptionist said that the doctor doesn't want people waiting for him - what a concept! Today I also needed to have blood drawn. How long was I in the lab for this? I was there for less than 10 minutes!
Later this same night, my wife decided that our daughter (5 ½ yrs old) needed to go to the Emergency Room due to a sliver under her nail that we couldn't get out ourselves. Their time in the hospital? Less than an hour! They were home within 1 ½ hours!
This got me to really thinking about this hospital and clinic. I asked my wife about her experiences there, and they were similar. She has never had to wait in the waiting room for more than 5 minutes.
These experiences show that it is not necessary to treat patients like sheep. It is too bad that more hospitals and clinics can't understand this.
MARK A SITY http://www.logic101.net/
You want to pay cash...be prepared to pay triple what the insurance would have paid.
If I don't want to pay overinflated prices the medical providers tell me to get my kids on the "Husky plan" (state of CT socialized medicine).
Will the doctor allow me to pay what the state would have paid on my behalf...NO - I must pay the list price.
Feedback.
In some instances you are correct. Insurance companies do negotiate with hospitals for the bills and do not pay what is shown on the initial billing.
But - there is always a but - hospitals and medical providers do bilk insurance companies. Due to family history, my daughter has to have mamograms every 2 or 3 years, although she is quite young. She was away at college for the first time and went to the doctor who recommended a mamogram. My daughter, thinking she was so grown was not going to tell us and called the radiologist to make the appointment. She told them she would be paying cash and how much would it be. She didn't realize she was still on our family plan.They told her $225. When the time got nearer, she got a little nervous, called us and we went with her. My husband told them to file on our insurance. About 2 weeks later, she got a bill from the radiologist for $10.00 and she thought that was great - but they had charged our insurance $450.!!! She called and told them if they didn't want her to notify the insurance company how much they were gouging them for, they would consider her bill paid in full.
The radiologist can bill $45,000 for all they care. The insurance will only pay the contracted amount for a given medical service/diagnostic code. Bilking can only take place when the report of which services were provided is falsified.
I did not make myself clear - the insurance company was billed AND PAID $450.00.
Now if you quote a price for cash and then BILL AND COLLECT twice as much from an insurance company, I don't know what to call it but bilking. What would you call it?
Driving up the cost of insurance and not necessarily that of medicine. The way I see it, there is greed enough to go around, but there are actually three prices for medical care. The cash price, and if negotiated, sometimes lower than the insurance price. The insurance price depending on who gets to gouge who, the doctor, the ins. co, the patient, is usually much higher than the cash price. Third is the real price. This is unknown because no one knows what it is.
Medicine ceased to be an "Art", as physicians claimed twenty years ago and became like modern day sports, a business. Once doctors learned to mark the proper boxes on the proper forms to cause a check to be generated to them, the patient was pretty much out of the loop. It doesn't matter if you get better, if you don't you're probably "non-compliant" and deserve your illness as much as the Dr. deserves to get paid. Even if he's wrong. Welcome to the "Big Leagues" and the age of the Medical-Industrial Complex".
Well, I do realize what you are saying.
I truly use doctors, very little. I haven't actually been ill, except for ear infection, in over 25 years, so haven't even satisfied my deductible for the 20 years we have had this insurance - neither my husband nor I. Not the case with daughter - she has used it, but so far the insurance company is ahead, but ours is quite reasonable considering. It is not an HMO, so I have never dealt with one of those.
I see the medical profession as the worse 'gougee', since that is the way it has been with us and others I have known.
My daughter had an small auto accident (rear-ended a parked car while turing her radio!!) and they took her to the local ER. She spent approximately 20 to 30 minutes there. There was a 'Rent-A-Doc' there that smelled as if he hadn't bathed in weeks who was eating a cookie, walked up to her an dropped crumbs on her. At this point, I got between her and the DR. and kept him away. (Has no bearing on the story, just quality of care.) At any rate, when our insurance company paid the bill, they sent a copy of a letter they wrote the hospital stating that they had paid the charges that was 'usual and customary' for that area and that their charges were obscene. It left us owing over half the ER bill. It should have been only a small amount or none. The only instance the insurance gave in the letter was the charge of $135 for one of the neck braces that is just a piece of sponge with stockinette over it and 1 pc of velcro. The usual charge is $35.
We asked the hospital for a detailed billing. At first, was told they couldn't do that. (Now we could have gotten the info from the insurance company I am sure) Then told us they couldn't find the info and then turned us over to a collection agency. That is when we decided to quit playing and threatened a lawyer - they then decided that we could settle for about $125, on somewhere around $1800. My husband said, fine, send me a letter stating this and that it will pay it in full and we're through. Now who gouged who? Or attempted to gouge who?
I know a young woman who had surgery and kept up with exactly what they did to her (outside surgery, of course). When she got the bill, there was medication and procedures (test, etc), that she never had. She told the insurance company and they did not pay.
A man who worked for my husband (well my husband was his manager) was in the hospital, on his bill was 2 aspirins every 4 hours for 5 days at $10. a pop. He never took the aspirins, they were never offered. When he told the hospital, they said that since it was prescribed they had to charge even if they were not administered!! There were other things, but the aspirins is what I remember most.
People and the medical community abuse insurance and wonder why it is in such a mess. Insurance companies are not going to loose money - and they are going to charge as much as they can. In the end, the ones who just want decent insurance and decent medical care at a reasonable price are out in the cold.
No bearing on the story, but the parked car my daughter rear-ended just happened to have stereo equipment, expensive video equipment and some other electronic equipment in the trunk that was totally destroyed. (Can you imagaine?) Now there really was almost no visible damage to their car, I believe they said the frame was bent and they totalled the car. Yes,t here is enough greed to go around.
No that was not the case here. She told them she would be paying cash period. She actually thought since she was over 18 and away from home at college, she was no longer on our insurance. Now she should have known there was no way her father was going to allow her to be without insurance, but she was 19!!
No no plan was ever discussed. She simply asked how much it would cost as she was paying cash.
When they saw we had good insurance and they would, in fact, pay as much as $450. - that's what they charged.
In the end, we all pay for the greed of the doctors, hosptals, and policyholders who abuse the system.
What I mean is the hospital, for a cash paying customer, paying within 30 days, was unwilling to knock even the 10% off that they allowed the insurance company, just months ago when I still had insurance. It took fifteen minutes and the person I even knew, only got an answer from the top of NO.
I can't even get medical treatment without a unavoidable major rip off.
Getting back to your $450. This is the over-inflated amount that no insurance company will pay. This is so high because the hospital expects the UNINSURED to pay to make up for the lower fees from insurance. Boost the profits from the pockets of uninsured patients. I don't believe this amount has a ceiling. The legistature won't regulate it; their answer to citizens is sign up for the socialized medical plan that the government offers or else.
My daughter and I sat in a hospital clinic waiting room for almost 2 hours beyond her 12:30 appointment time today.
The signs on the wall said "patients will be taken in the order of their appointments, not in the order of their arriving at the office." The signs were in Spanish and in English.
The signs might just as well have been in Martian.
The receptionist informed my daughter that patients were taken in order of their time of arrival. There were loads of people ahead of us.
The final kicker was delivered as we left the parking lot. Two hours parking would have cost us $3.50. But, since we were there a little more than 2 hours, we had to pay the full day's rate $5.25.
My daughter hopes to change her primary care physician soon. She had to see him before she began student teaching and she needed to have a tb test.
The doctor noticed that if he gave her the tb test that day, the office would be closed on the day that the tb test would be "read." So the doctor told her to come in at the beginning of the next week to have the test administered.
She was shocked that she was charged for another office visit (another $75) the day she went back to have the test administered, even though she was there only a few minutes that second time. If the few minutesfor the tb test had been included in her first visit she would have saved $75.
Doesn't a lot of that depend on geographical area? I can believe it in the state I live in now, but it would seem from reports I've read, malpractice is the demon in some parts of Texas and elsewhere.
Re HMOs, have you seen the new show, MDs, on ABC? Really a hilarious, totally one-sided trashing of HMO management.
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