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Three Minutes and a Few Ounces of Pee...

Discussion in 'The Okie Corral' started by RayB, Apr 2, 2010.

  1. RayB

    RayB Retired Member

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    Last month I went to see a well known pain specialist. I had seen this doctor a few years back, and he indeed helped me. He knows his stuff.

    My initial visit to his office involved my completion of elaborate paperwork, prior to the meeting.

    When I arrived, a urine sample was politely demanded.

    My meeting with the doc involved my standing up, touching my toes, and leaning back. I answered a few questions and offered a few comments.

    He recommended a new MRI image and a new EMG test (both of which I set up for the following week) and issued a prescription. So far, so good.

    This initial meeting with the doctor lasted not three minutes. Fair enough, if that's all he needed. Like I said, he's good. :whistling:

    I notice that he billed my insurance company $900.00 :wow:

    Nine hundred dollars for three minutes and a few ounces of pee? :faint:

    Now, I'm dubious at best about ObamaCare... :upeyes:

    But this is nuts! :freak:

    --Ray
     
  2. Eyescream

    Eyescream hates you

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    The insurance company didn't pay $900, or if they did, he initially billed them well over that and they negotiated it down.
     

  3. Rabbi

    Rabbi The Bombdiggity Lifetime Member

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    Yep, this is a case, like so many things in life, (it happens to all of us) that you are making assumptions about something you dont understand.

    I have found that one of the keys to being happy, right behind having reasonable expectations is to simply not form opinions(when that is possible) about things you dont understand.

    If you couldnt make money doing something, chances are you dont understand it and that is a good rule of thumb, it also keeps you from warping your children and teaching them to look for correct information and not just be another generation of misunderstanding.
     
  4. BAILIFF

    BAILIFF Piece Officer

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    I'm over here now.
  5. rjrivero

    rjrivero

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    The doctor can bill the insurance company anything he would like, but likely, will only get paid pennies on the dollar. Most of the costs for your doctor signing up with an insurance company as a "preferred provider" implies he takes a standard billing schedule for services.

    For private insurance, it's barely 30 cents on the dollar. For medicaid or medicare it's only 12-15 cents on the dollar.

    There is a schedule for new patient visits vs. follow up visits and follow up visits are often worse than this.
     
  6. glock19_fan

    glock19_fan ... --- ...

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    Pretty harsh, but correct responses to the OP.

    The $900 will be negotiated down. It covers the doctor's staff, office, utilities, mal-practice insurance, work involved in sending the claim to the insurance, etc etc.

    My dentist now has hired 2 full time staffers just to deal with dental insurance. The whole thing is a nightmare, no one wins except the insurance companies.

    I am pretty fed up with insurance. They will arbitrarily deny legit claims, and make you pay out of pocket. You call and call and spend hours on the phone with the doctors, the labs, the insurance company, and get no where. You get to the point where you're so fed up that you just give up and pay out of pocket.

    This whole situation stinks.
     
    Last edited: Apr 2, 2010
  7. U-phorik407

    U-phorik407 'Night Michelle

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    My Wife used to be a medical biller, she could tell u some stories that would make your head spin, Doctors would charge say 900 bucks for a procedure. They would pay out maybe 100, and the Dr. would have to essentially eat the 800 dollar loss as part of being part of the insurance providers network of supported drs. so to speak. I used to go to a podiatrist who would perform very minor outpatient surgical procedures monthly, and I would be in there maybe 20 minutes total, and he would ring up 8-900dollar bills to my insurance company for what he would document as 'surgery' I never minded because my insurance was paying it, I would pay the 40 dollar specialist co-pay and be on my way.
     
  8. hockeyrcks9901

    hockeyrcks9901

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    My wife works in medical billing and the doctor will not get that much money from the insurance company. He'll be lucky to get $200.
     
  9. RayB

    RayB Retired Member

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    No offense taken to the replies. I know this bunch. :cool:

    Still, I'm not quite so dumb... :freak:

    I have a medical-surgical history.

    I have on three occasions, written to the Office of the Commissioner of Insurance in my state, and in each case, won the decision against an insurance company.

    My wife, Judy, works for the largest medical lab in the country. As a perquisite of her job, I can get any lab test performed gratis. This doctor's office refused to use her lab, who would have sent a uniformed, on-call driver to pick up the sample.

    I'm also well aware that the negotiated amount the insurance company pays, is very different from what this doctor charges. I have yet to receive the insurance statement on this charge...

    In short, I've seen my share of medical billings and statements, and this charge is off the wall! :shocked:

    The freaking MRI was only $600.00! :dunno:

    Anyway, let's see if he tries to bill me the difference... :eyebrow:

    Last week, a professor of neurosurgery at our medical college spent a half hour with me, reviewing my MRI and EMG, and elaborately discussing my case and what options are open to me. Let's see how he bills for that half hour...

    Both doctors are listed as "in network" with my insurance.

    I just thought I'd bounce this off you! :whistling:

    --Ray
     
  10. Rabbi

    Rabbi The Bombdiggity Lifetime Member

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    There are very few things in life as expensive as a Neurosurgeon.
     
  11. RayB

    RayB Retired Member

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    :agree:

    This is the third one I've worked with! ;)

    He's cool too, quite a character, complete with beard and yarmulke. I liked him--looks a little like your avatar! :supergrin:

    But somehow, I doubt he'll exceed $300.00 a minute! :upeyes:

    --Ray
     
  12. Ol Timer

    Ol Timer ↓ hog hunter ↓ Millennium Member

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    I worked as a trainer for the logistics department of Quest Diagnostics. The doctor can choose whichever lab they desire. We lost an account because the driver reported compliance infractions at an office, storing samples in the same fridge as foodstuffs. No big deal as the account would have been terminated on our end when the doc refused to come into compliance. Doctors walk on water.

    I'm sure your wife can tell you how outrageously overpriced lab work can be.
     
    Last edited: Apr 2, 2010
  13. glockfan5

    glockfan5

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    I've always wondered if a doctor bills out an insanely high rate,knowing the insurance company will only pay $X, and then writes off the difference.
     
  14. bearshoegun

    bearshoegun

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    Heres a concept, what if the Doctors actually charge the real cost of the visit instead of inflating the cost to cover 3 ex-wives and the vacation home in the bahamas!
     
  15. RayB

    RayB Retired Member

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    1) I hear that. I've met some real jerks in my time.

    2) No doubt.

    Since Doc One is a pain specialist, I'm sure he sees drug-seeking behavior all the time. What's more, I know the feds ride the pain doc's butts on these matters.

    The urine test was for toxicology, and I'm clean, but the insurance company expects us to use our lab, so we'll see how that goes...

    --Ray
     
  16. RayB

    RayB Retired Member

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    :supergrin: !!!

    Ex-wives! Easily as expensive as neurosurgeons! :faint:

    --Ray
     
  17. Eyescream

    Eyescream hates you

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    God. I'd love to pay $600 for an MRI. The one my wife got about a month ago cost me $1500 (negotiated down) out of pocket. The one we had to use was out of network and the insurance company wouldn't accept the claim.
     
  18. Doc Holliday

    Doc Holliday CLM

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    If you really want to complain about something, complain that you pay too much for a house that was made with $20-$30K worth of materials and cheap labor.

    For 30 long years.

    American Dream? American Nightmare.
     
  19. Eyescream

    Eyescream hates you

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    And half the time they throw it up so fast that it might as well be held together with chewing gum.
     
  20. RayB

    RayB Retired Member

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    1) Smart Choice MRI offers any MRI for $600.00, and they have both open and enclosed MRI machines available.

    Two years ago, I had an EBT Heart Scan done for $200.00, which included an analysis and report by a cardiologist, to me and my doctor. Since insurance would not cover this, I just popped for it. By the bye, I was essentially plaque-free. The odds of my having a heart attack in the next five years are ostensibly zero.

    Anyway, that's what competition will do, if government gets the hell out of the way, and lets competition and market forces do their thing!

    2) See, it's crap like that, where the Left make their point on this whole healthcare business!

    I'm by no means a Michael Moor fan, but his movies usually do contain some well-made points.

    In Sicko, a man's daughter is denied two cochlear implants by his insurance company because she can get by with hearing in just one ear... But the CEO of that company makes a gazillion dollars a year... When asked if he (the CEO) would like to star in a Michael Moor film, approval was given for two cochlear implants... That, frankly, stinks! :steamed:

    Of course, the bulk of Sicko was the usual Liberal BS...

    --Ray