Trip to the doctor

[Daddie O]

Doctor: Symptoms

[alph]

i had a coworker that broke his ankle when he was in "probation" with the company we work for (meaning that he had to work 90 days before he could apply for company health insurance, and receive vacation time, etc. etc.) he went to the hospital to get his broken leg looked at and he informed them that it didn't happen on the job, and he didn't have insurance.  they patched him up with a flexible boot and sent him home, total cost; $500.  six months later, his wife does the same exact thing!!  broke her ankle nearly identically as he did!  but now he had insurance through the company, went to the SAME hospital and this time he filled out the same paperwork but he now has insurance. they sent her home, with the same boot!  took the same X-rays,  gave her the same pain pills, guess what the final bill was, $3000!!  why is it that with insurance the hospital is able to bill 6X the amount for the same procedure? 

oh, and you do realize that the government that gave us social security, Medicare, medicade, welfare, and all those other "social" programs, now wants to force every employer to pay for everyone else's medical bills.........  BRILIANT!!  there's a reason why uncle sam is dumb enough to buy an $800 hammer, or a $400 toilet seat!! 

[Doc809]

The video is as funny as $%%*().  Two things to consider.  One, I would rather have cash paying patients.  I get my money when they leave.  I don't have to prep the claim, pay a billing service, and wait 45 to 60 days to get a PORTION of my money.  So I cut the self pay patient a break on costs ( it is called a time of service discount).  Two, when I have to bill an insurance company I bill 6x  knowing that I am only going to receive 1/6 of that.  An exercise in futility?  No.  Because BCBS pays different than Aetna, which pays different than United, and so on.  I bill high because I don't know what the reimbursement is going to be.  I take what they pay (contractual agreement to participate in the network) and write off the rest.

Now before you go getting your panties in a wad and start a rant about how much money doctors make, let me assure you that my income is 50% of what it was 10 years ago.  Do you think my expenses are 50% of what they used to be.  If you do, get your head out of the sand.  I wonder how many on this board, my VRCC brothers and sisters, would still be in their profession if their income had steadily declined over the past 10 years?  Bet I know the answer to that one!  So before you lump us all into one pile, remember that there are still some in the healthcare profession that do what they do because their heart/motives are pure and they do it to be of help to others.

You guys ride safe.  Hope to share some wind with you at some time. Larry

[Toledo Mark]

I hear you Doc809,  I have four doctors, a nurse, and three pharmacists in my family.  I remember the talk about how their pay declined.

[POPS 57]

When the wife had dental the checkup and cleaning bill would be say $125.00. The insurance would pay $100.00 and that was O.K. Now we don't have dental and when the bill is $125.00 he wants the whole thing. I talked to him about this and the only thing he said was that's the way it is. So now I don't pay when I leave the office anymore. I let him bill me and wait.

[Doc809]

You can always negotiate fees.  However, you must do it PRIOR to the service being provided.  If your doctor won't negotiate for cash then go somewhere else!

[cookiedough]

When the wife had dental the checkup and cleaning bill would be say $125.00. The insurance would pay $100.00 and that was O.K. Now we don't have dental and when the bill is $125.00 he wants the whole thing. I talked to him about this and the only thing he said was that's the way it is. So now I don't pay when I leave the office anymore. I let him bill me and wait.

More and more dental offices are going this route pay upfront EVEN WITH insurance.  I left my dentist for that reason they demanded payment upfront once done w/o letting the billing go thru first.  Plus, they literally missed three 150 dollar payments for my kids braces and found it out by demanding them send me a detailed listing of all that was done and applied.  I went thru 2 years worth of payments and all they had to say was sorry.  Where did those 3 missing payments go to???  was charged on my credit card but not applied to my account and they had NO explanation, just sorry.  Also caught on those 2 years erronous/fraudulent billings to our insurance company.   I filed a grievance letter 2 whole pages long in specific detail, took me like 4 hours to type up, to delta dental (our insurance provider) since the dentist was suppose to be a premier provider fully expecting them to loose their premiere status.  All I got back was a B.S. letter from delta dental basically taking the dentist's side although I was wronged big time and I refused to pay for some false billings.

Morale:  I really do think the insurance carrier and the dental/drs. office (provider of care)  are in bed together and don't give a hoot about customer care and what is right and wrong.  Also went to better business bureau and filed a complaint on the dentist office for false billings and not applying 3 credit card payments to my account and no explanation for it.

Still fighting 2 office visits billed out for $177 level 3 care for same identical problem when the first office vist (all about 3 days apart) was billed out for level 2 care for 110 bucks.  Dr. reviewed care level and felt 2nd and 3rd office visit was justified even when I asked why level 3 vs. level 2 for same problem going in for and demand reasoning in detail as to why.  They supposedly reviewed level of service and all the fricking letter said in return was they reviewed care level and found it appropriate with NO reasoning in detail as I requested.  Now, I am sent to collection agency all for about less than about 30 bucks more out of my pocket should not have to pay.  I figure dean care has sent me already 20 bucks in postage demanding for payment the past year or more.   I probably should pay it eventually since now to collection agency since will ruin my perfect credit rating but it is STILL VERY WRONG!!!!!!!!!!!!!!!

I'm all for paying my fair share ACCORDING to correct billing procedure codes and billings being done properly, but when I know I am right and they are wrong, it makes me HATE having insurance since the provider and the insurance carrier don't give a crap period and have no sense of right and wrong.  

I could go on and on about 4 other improper health care codings, but I think you get my point.  Health insurance is SO wrong and F'ed up.    

[BF]

i had a coworker that broke his ankle when he was in "probation" with the company we work for (meaning that he had to work 90 days before he could apply for company health insurance, and receive vacation time, etc. etc.) he went to the hospital to get his broken leg looked at and he informed them that it didn't happen on the job, and he didn't have insurance.  they patched him up with a flexible boot and sent him home, total cost; $500.  six months later, his wife does the same exact thing!!  broke her ankle nearly identically as he did!  but now he had insurance through the company, went to the SAME hospital and this time he filled out the same paperwork but he now has insurance. they sent her home, with the same boot!  took the same X-rays,  gave her the same pain pills, guess what the final bill was, $3000!!  why is it that with insurance the hospital is able to bill 6X the amount for the same procedure? 

oh, and you do realize that the government that gave us social security, Medicare, medicade, welfare, and all those other "social" programs, now wants to force every employer to pay for everyone else's medical bills.........  BRILIANT!!  there's a reason why uncle sam is dumb enough to buy an $800 hammer, or a $400 toilet seat!! 

You already pay for everyone else's medical bills.  The cost is built into that $3,000.00 bill. You pay for the crack addicts, the illegal aliens, and everyone else on the government dole by getting charged for, and you and your insurance company paying for that $3,000.00 bill.  "Insurance" just passes the cost onto you.  We all pay whether you like it or not. 

[cookiedough]

I may be in the minority here, maybe not, but I believe our premiums and billing rates should be somewhat dependent on how much you use the insurance.  I know I will get slack for it, but paying around 150 bucks for family coverage the past 15 years or more and using it almost exclusively for routine physicals minus a 5,000 minor 20 minute surgery and the birth of our 2 kids way back when,  it disturbs me how much we have paid in FOR BASICALLY NOTHING. 

Near 2 grand per year times past say 20 years of coverages totaling around 40 grand could even have bought me 2 HD's, well almost -              It is that one major injury though that insurance pays off, but other than that which hasn't happened yet for our family,  I feel for what WE get it is crazy high in price. 

I told the wife if we didn't have kids,  we would opt of of having insurance all together.  Even with kids, we really don't use it hardly at all.  The few times we have had to use it, they screw up the billing or inflate the billing to unjustified rates or INCORRECT procedure code or level of care just to make more money is all it is about as far as I am concerned.

That said, we have 2 ladies at work who seem to take off 1 week every month literally no joke for health issues for seems like forever and those are the ones on why our insurance premiums are way too high.  Some of their issues they cannot help and feel bad for their poor situation, but they are way overweight  and don't eat very well and overall they don't help their own miserable health issues at all.

[G-Man]

The video is as funny as $%%*().  Two things to consider.  One, I would rather have cash paying patients.  I get my money when they leave.  I don't have to prep the claim, pay a billing service, and wait 45 to 60 days to get a PORTION of my money.  So I cut the self pay patient a break on costs ( it is called a time of service discount).  Two, when I have to bill an insurance company I bill 6x  knowing that I am only going to receive 1/6 of that.  An exercise in futility?  No.  Because BCBS pays different than Aetna, which pays different than United, and so on.  I bill high because I don't know what the reimbursement is going to be.  I take what they pay (contractual agreement to participate in the network) and write off the rest.

Now before you go getting your panties in a wad and start a rant about how much money doctors make, let me assure you that my income is 50% of what it was 10 years ago.  Do you think my expenses are 50% of what they used to be.  If you do, get your head out of the sand.  I wonder how many on this board, my VRCC brothers and sisters, would still be in their profession if their income had steadily declined over the past 10 years?  Bet I know the answer to that one!  So before you lump us all into one pile, remember that there are still some in the healthcare profession that do what they do because their heart/motives are pure and they do it to be of help to others.

You guys ride safe.  Hope to share some wind with you at some time. Larry

            

[G-Man]

Morale:  I really do think the insurance carrier and the dental/drs. office (provider of care)  are in bed together and don't give a hoot about customer care and what is right and wrong.

Yup, you caught us.  Us docs are only in it for the money.  And we have to hire billers and/or billing services just to get paid poorly from the insurance companies who do everything in their power to make it more difficult to get paid from them.

Don't forget the drug companies as well,...those evil fiends who want to keep you sick.

Boy, with all the evil in the healthcare industry, it's amazing to me how life expectantcy has increased by more than 10 years, just in our lifetime alone.  Shame on us for giving you anther 10 years to bitch about us.  You should all find another way of keeping yourselves healthy because we really couldn't care less.

[Longlivedixie]

Buuuuwwwwaaaaaa!!!! Too funny!!

Listen folks, I do not wanna take any money out of an Americans pocket........but IF ya have to pay for any medical care/dental care over $5000 out of your pocket.......consider going to Thailand as a 'medical tourist'. Medical care there averages about 3/4 less than here......and the care/facilities/doctors there are TOP NOTCH! I have used them several times, and my positive impression of them is off the scale! They treat cash paying Westerners like KINGS!

And IF ya use insurance, many insurance companies do not require you pay the normal 20% deductible......since the end-cost to them is so much in their favor. Some insurance companies require that you pay the bill yourself though, and then reimburse you. Naturally, check with them.

Lot'sa info on the net regarding doing this.

[G-Man]

........  it disturbs me how much we have paid in FOR BASICALLY NOTHING. 

Near 2 grand per year times past say 20 years of coverages totaling around 40 grand could even have bought me 2 HD's, .........

That's because you didn't buy health care.  Nobody buys healthcare.  You bought insurance.  What about your homeowners or life insurance.  You are protecting yourelf IN CASE SOMETHING HAPPENS.  

We don't even call it health insurance anylonger, we call it healthcare.  And everyone should be entitled to everything within healthcare, which has morphed into this all inclusive thing that everyone wants, but noone wants to pay for.  

[BF]

Buuuuwwwwaaaaaa!!!! Too funny!!

Listen folks, I do not wanna take any money out of an Americans pocket........but IF ya have to pay for any medical care/dental care over $5000 out of your pocket.......consider going to Thailand as a 'medical tourist'. Medical care there averages about 3/4 less than here......and the care/facilities/doctors there are TOP NOTCH! I have used them several times, and my positive impression of them is off the scale! They treat cash paying Westerners like KINGS!

And IF ya use insurance, many insurance companies do not require you pay the normal 20% deductible......since the end-cost to them is so much in their favor. Some insurance companies require that you pay the bill yourself though, and then reimburse you. Naturally, check with them.

Lot'sa info on the net regarding doing this.

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

[G-Man]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

[cookiedough]

........  it disturbs me how much we have paid in FOR BASICALLY NOTHING. 

You are protecting yourelf IN CASE SOMETHING HAPPENS.  

We don't even call it health insurance anylonger, we call it healthcare.  And everyone should be entitled to everything within healthcare, which has morphed into this all inclusive thing that everyone wants, but noone wants to pay for.  

Personally, for the past 20 years age 20 thru 40, I neither wanted healtcare/insurance as well to pay for it, but that is just me.  Maybe age 40-60 though will be different since as we age more medical issues may arise.

I can tell you one thing,  the coverages have decreased in the past 3-4 years while the premiums have gone up too much.  Not just me, but seems like almost everywhere and everyone I know, wonder why all of a sudden?  Is Obummercare to blame or what????????????

[BF]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

I was being sarcastic, but as I understand their system, it's universal for Thai nationals.  It's a pay for system for anyone else. 

However, from what I've read before, the Thailand system of universal healthcare is second to none in the world is should be an example of the right way to do it.  It can be done and be done right AND cost efficient. 

[MP]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

I was being sarcastic, but as I understand their system, it's universal for Thai nationals.  It's a pay for system for anyone else. 

However, from what I've read before, the Thailand system of universal healthcare is second to none in the world is should be an example of the right way to do it.  It can be done and be done right AND cost efficient. 

That may well be true.

However, that is certainly NOT what we have gotten into with ObummerCare!

MP

[BF]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

I was being sarcastic, but as I understand their system, it's universal for Thai nationals.  It's a pay for system for anyone else. 

However, from what I've read before, the Thailand system of universal healthcare is second to none in the world is should be an example of the right way to do it.  It can be done and be done right AND cost efficient. 

That may well be true.

However, that is certainly NOT what we have gotten into with ObummerCare!

MP

No argument about that from me.   

[G-Man]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

I was being sarcastic, but as I understand their system, it's universal for Thai nationals.  It's a pay for system for anyone else. 

However, from what I've read before, the Thailand system of universal healthcare is second to none in the world is should be an example of the right way to do it.  It can be done and be done right AND cost efficient. 

But, how big is Thailand?  I'm guessing, but I think it's population is less than New Jersey.  On a tiny scale, That model CAN WORK very well.  The money and costs can be monitored to the penny.  Fraud would be at the very minimum.  There are also less hands in the pot that need to be paid.  On a scale like ours, the only way to stay in control of cost and money it to not provide (pay for) services. 

[Longlivedixie]

Buuuuwwwwaaaaaa!!!! Too funny!!

Listen folks, I do not wanna take any money out of an Americans pocket........but IF ya have to pay for any medical care/dental care over $5000 out of your pocket.......consider going to Thailand as a 'medical tourist'. Medical care there averages about 3/4 less than here......and the care/facilities/doctors there are TOP NOTCH! I have used them several times, and my positive impression of them is off the scale! They treat cash paying Westerners like KINGS!

And IF ya use insurance, many insurance companies do not require you pay the normal 20% deductible......since the end-cost to them is so much in their favor. Some insurance companies require that you pay the bill yourself though, and then reimburse you. Naturally, check with them.

Lot'sa info on the net regarding doing this.

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Yes.......for Thai national po' folk, they have national health care........and hospitals set up that only do that business. It may not the super-duper best care and facilities, but MUCH better than nothing, which was what they used to have.

Of course, I was speaking about the cash up front care. That is an entirely different network of hospitals/doctors/dentist. That is what the rich Thai, and the medical tourist use.

Now, my doctor once sent me to a national health care hospital to get a particular test run, using a machine even he did not have..........and though the facility was plain & utilitarian, it had some EXCELLENT staff, and ran a bang-up test on me. I had to pay up front, and then turn it in to my insurance for reimbursement. It was like stupid cheap. Surreal cheap. Like, this cannot be right cheap. They (3 staff members) spent an hour on me using a star-wars type machine, and charged me about $75!!! HUH??!! DO WHAT??!!

[Longlivedixie]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

From what I sen, the average citizen was treated fine. Unfortunately, while I was there, my Thai GF's brother was in a national health care hospital for blood disease. The hospital was someheat industrial looking, and he was in a ward of about a 12 fellas.........but from what I seen, his care was excellent. But, try as they may, he passed.

And if ya EVER have to be involved in a Buddhist burial (cremation) ceremony that last a week (his did anyway), like my poor soul.........RUN BACKWARDS!!!!! Talk about WTF going on!!!!!

[Longlivedixie]

But but but.......Thailand has universal healthcare.  And everyone knows how evil and horrible universal healthcare is.   

I gotta find that sarcasm font.   

Actually, the way the poster describes it, it wouldn't be "universal" for outsiders, actuall a fee for service,....capitalism.  He also said that outsiders paying cash are treated like royalty.  Not sure how the average citizen is treated, or how long they have to wait for a procedure, or if they are granted the procedure at all.  All parts of the practise and dispensing of government run medicine as we've seen examples of time and time again.  Sorry if I messed up your sarcasm.

I was being sarcastic, but as I understand their system, it's universal for Thai nationals.  It's a pay for system for anyone else. 

However, from what I've read before, the Thailand system of universal healthcare is second to none in the world is should be an example of the right way to do it.  It can be done and be done right AND cost efficient. 

But, how big is Thailand?  I'm guessing, but I think it's population is less than New Jersey.  On a tiny scale, That model CAN WORK very well.  The money and costs can be monitored to the penny.  Fraud would be at the very minimum.  There are also less hands in the pot that need to be paid.  On a scale like ours, the only way to stay in control of cost and money it to not provide (pay for) services. 

Rather large.......about the size of Texas and South Carolina combined......with about 65 million people. But, the culture, people, government, and society are not NEAR so anal and lawyered up about everything as ours, so things are run much differently. Not saying superior in all respects, but different.