Posted on 03/19/2014 7:49:27 AM PDT by Oldeconomybuyer
Doctors groups fear their members wont get paid because of an unusual 90-day grace period for government-subsidized health plans and are urging physicians to check patients' insurance status before every visit.
This puts the physician and their patients in a very difficult situation, said Dr. Ardis Dee Hoven, president of the American Medical Association (AMA), which advised physicians Wednesday about how to minimize their risk.
If a patient is being treated for a serious illness, that requires ongoing care, she said. The physician is having to assume the financial risk for this. Thats the bottom line.
If an enrollee in a subsidized plan falls behind on their premium payments, the Affordable Care Act requires insurers to cover their medical bills for 30 days.
But for the next 60 days, insurers may pend, or hold off paying the claims -- and ultimately, deny them if the patient doesn't catch up on his premiums. That means doctors dont get paid for their services. If the insurer ends up canceling the policy after 90 days, doctors can bill patients directly but may face difficulty collecting.
"The doctors get left holding the bag on pending claims," said Robert Laszewski, a former insurance executive and consultant.
(Excerpt) Read more at kaiserhealthnews.org ...
Yesterday during the lunch hour, my wife, an FP office RN, until she and her doctor retired last year, saw a friend, the receptionist/office manager for a busy FP, out shopping.
In the past, this hard working/dedicated lady would be in her office helping patients with appts and paper work while grabbing a bite of her sandwich.
Now, they are closing the office doors from noon to two pm to avoid putting up with what you noted below.
This dedicated woman for over two decades has lost her dedication. She, now takes off a day a week as she was supposed to, and didn’t. She goes home at a little after 5 pm versus after the last patient.
This is where the whole jalopy is going to start coming apart at the seams. When Doctors AND Insurers realize that at the end of the day, they AIN’T gonna get paid, and start walking away.
“Hmmm. Is this the same AMA that worked so hard for the passage of this legislation? The group that blindsided its politically clueless membership, selling them and their services like that of slaves to the crude giant of Bureaucracy?”
Out here in N Californicator land, the graduates of UC Med School/Berkley/Gay Frisco are left progressives, and they control many of the private practice HMO’s.
The UC Med School doctors pushed Obozo Scare, and some doctors in Gay Frisco helped Pelosi in writing the bill.
These left wing doctors and their wives are real PIA progressives to deal with on any level.
Like NY City rat voters, these left wing doctors are getting what they voted for, not what they thought they were getting.
this must be Dr. Obvious
I’m guessing that forcing docs into HMOs, which may have enough cash flow to absorb this but also where docs can be better controlled, is the reason why this is in there.
AMA certainly knew about it, probably helped design it, and is just playing dumb to avoid mass resignations ...
At least there’s a simple way to deal with this.
No proof of payment of premiums? No cash on the barrelhead? Sorry, we find that our patient list is full at the moment.
You are probably correct on both of your premises.
“Im guessing that forcing docs into HMOs, which may have enough cash flow to absorb this but also where docs can be better controlled, is the reason why this is in there.
AMA certainly knew about it, probably helped design it, and is just playing dumb to avoid mass resignations ...”
I can see doctors paying the patients' back premiums just so that insurance company pays them.
Hey, doctors are rich, everybody knows that. They can afford it.
Maybe it is the area.
A small percentage of Doctors are members of AMA. Unfortunately the doctors that were against it were not organized so they didn’t pour millions into lobbying like the AMA did.
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