Thread Rating:

ams288
ams288 
Joined: Sep 26, 2012
  • Threads: 15
  • Posts: 4907
March 6th, 2018 at 12:39:06 PM permalink
Quote: RS

I understood the post on my first try. Give it another go, you'll get it.



Nope, still don't get it.

I'm guessing whatever translation tool he used screwed up the translation job from the original Russian....
Lock him up!
Steverinos
Steverinos
Joined: Jul 6, 2016
  • Threads: 5
  • Posts: 1218
March 6th, 2018 at 12:42:47 PM permalink
LOL, I don't know what a compilation of people stating their opinions has anything to do with truths and facts, but carry on.
billryan
billryan
Joined: Nov 2, 2009
  • Threads: 144
  • Posts: 7042
Thanks for this post from:
petroglyph
March 6th, 2018 at 2:22:15 PM permalink
“The creatures outside looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which”.
SOOPOO
SOOPOO 
Joined: Aug 8, 2010
  • Threads: 100
  • Posts: 5490
March 6th, 2018 at 2:24:50 PM permalink
Quote: terapined

The times are a changing
Liberal Trump and AZ against the free market. They want the govt to set ========= prices.
I have always supported a free market.



I erased the word 'steel'. Right now Medicare and Medicaid set the exact prices I can charge a patient. No negotiating. I guess you are not for a free market for me?
Steverinos
Steverinos
Joined: Jul 6, 2016
  • Threads: 5
  • Posts: 1218
March 6th, 2018 at 2:29:09 PM permalink
You have the option to take Medicare or Medicaid patients? Just curious.
SOOPOO
SOOPOO 
Joined: Aug 8, 2010
  • Threads: 100
  • Posts: 5490
March 6th, 2018 at 2:42:06 PM permalink
Quote: Steverinos

You have the option to take Medicare or Medicaid patients? Just curious.



No. There are doctors that do have that option and many do not accept Medicaid, and Medicare. . I would doubt there is a single anesthesiologist that can refuse a patient based on his insurance. If I am taking care of Warren Buffet and he has Medicare my rates are set by the government. The government pays me 80% of the very low set rate and I have to bill the patient for the other 20%. My point is for a patient with insurance I can negotiate with the insurance company. If we do not come to an agreement I can bill the patient. Not with the government.
billryan
billryan
Joined: Nov 2, 2009
  • Threads: 144
  • Posts: 7042
March 6th, 2018 at 2:53:42 PM permalink
Quote: SOOPOO

No. There are doctors that do have that option and many do not accept Medicaid, and Medicare. . I would doubt there is a single anesthesiologist that can refuse a patient based on his insurance. If I am taking care of Warren Buffet and he has Medicare my rates are set by the government. The government pays me 80% of the very low set rate and I have to bill the patient for the other 20%. My point is for a patient with insurance I can negotiate with the insurance company. If we do not come to an agreement I can bill the patient. Not with the government.



So I go into your operating room without knowing what I am going to be paying you? If the negotiations with my insurance break down, no big deal as you simply bill me? What, pray tell, is your incentive to negotiate a good price?
SOOPOO
SOOPOO 
Joined: Aug 8, 2010
  • Threads: 100
  • Posts: 5490
March 6th, 2018 at 3:05:00 PM permalink
Quote: billryan

So I go into your operating room without knowing what I am going to be paying you? If the negotiations with my insurance break down, no big deal as you simply bill me? What, pray tell, is your incentive to negotiate a good price?



Great question! The answer is that there is a coercive pressure on me to participate with insurance companies because surgeons hate hearing from patients that they got a bill from me, And there is a coercive pressure on the insurance company to have me participate because they do not want to hear from their customers that they thought my services were covered by them. These two forces have resulted in me participating with virtually every local insurance company throughout my career. I ask for $1000. The insurance company offers $500. Eventually we agree on $700...... or something like that.

You say "simply bill me" I can't even tell you how low my collection rate is for patients without insurance that I have to "simply bill".
Steverinos
Steverinos
Joined: Jul 6, 2016
  • Threads: 5
  • Posts: 1218
March 6th, 2018 at 3:18:28 PM permalink
Quote: SOOPOO

Great question! The answer is that there is a coercive pressure on me to participate with insurance companies because surgeons hate hearing from patients that they got a bill from me, And there is a coercive pressure on the insurance company to have me participate because they do not want to hear from their customers that they thought my services were covered by them. These two forces have resulted in me participating with virtually every local insurance company throughout my career. I ask for $1000. The insurance company offers $500. Eventually we agree on $700...... or something like that.

You say "simply bill me" I can't even tell you how low my collection rate is for patients without insurance that I have to "simply bill".



Sounds like an argument for single-payer, lol.
billryan
billryan
Joined: Nov 2, 2009
  • Threads: 144
  • Posts: 7042
March 6th, 2018 at 3:33:18 PM permalink
Quote: SOOPOO

Great question! The answer is that there is a coercive pressure on me to participate with insurance companies because surgeons hate hearing from patients that they got a bill from me, And there is a coercive pressure on the insurance company to have me participate because they do not want to hear from their customers that they thought my services were covered by them. These two forces have resulted in me participating with virtually every local insurance company throughout my career. I ask for $1000. The insurance company offers $500. Eventually we agree on $700...... or something like that.

You say "simply bill me" I can't even tell you how low my collection rate is for patients without insurance that I have to "simply bill".



Perhaps if you were willing to negotiate with patients the way you do with insurance companies, you'd get more money from them.
Several years ago, I had a colonoscopy. Routine procedure, requested by my Internist because I was 56 and never had one. Insurance is covering it, I know ahead of time the one Dr. is billing me $600,which insurance will only pay $500. So I'm expecting a bill for $100. I wake up and DR. says everything was good but I removed two polyps and am going to send them out for testing. He tells me it's routine and he has done more than 1,000 procedures and can tell a good one from a bad one, or words to that effect.
Months go by, no bills. Then ,over two days, I get a bill from the surgeon for $1400 for removing the polyps, another 1500 from the labs saying they are out of network with my insurance and $300 from the your counter-part. Insurance company won't pay for polyp removal because it wasn't pre-authorized. Dr. says it was my responsibility to request they send it to the right lab and your guy caves quickly and accepts $100 as full payment.
The Lab eventually stopped sending bills when I told them I didn't feel responsible( I had a copy of a form I filled out stating my insurance and which lab to use) and the DR.s office took almost two years and settled for $350. An awful lost of effort and lost will to collect $350. He certainly lost me as a future patient or reference

  • Jump to: