3 ms·

Insurance companies give me 90 days to submit a claim, then they do not have to pay it. I guess their rationale is that if I did not bother to submit an invoice

by bawana 9y ago

Insurance companies give me 90 days to submit a claim, then they do not have to pay it. I guess their rationale is that if I did not bother to submit an invoice, then why should they pay? And by the way, a lot of them will not accept paper claims any more. They want all the claims done electronically through their ancient systems. And by the way, this push for electronic medical records(EMR) was a way for them to further decrease their overhead (thank you insurance lobbies). EMR that is CCHIT certified (= Certification Commission for Health Information Technology, pronounounced 's-h-i-t', for real) can interface with payment clearing houses directly (I as a physician have to pay to use a clearing house, btw). Then the claims are scrubbed by their scripts and rejected for various reasons, (for example, no referral from PCP, invalid gender for treatment code,etc). No humans involved. This allows them to lay off vast swaths of auditors. And effectively outsources their work onto the physician's office. And increases their earnings per share. Now you know why the only new physicians you will meet are not homegrown anymore. It costs 400k to go to medical school. Then you have 3-7 years of postgraduate training at 35k a year. Then your debt has ballooned to 800k with deferred interest payments. BTW, new physicians get paid 90-100k.

pc86 9y ago
The new physicians making $90k a year after residency are not the ones with $400,000 in student loans, and $800k in total student interest load is... atypical, to say the least. $300-400k total load post-residency is much more - I refuse to say "reasonable," but much more realistic. And the folks who have $400k total load are on a fast track to make $250-300k/yr just a few years after residency. A huge part of why doctors are paid as well as they are is because of the risk and the massive opportunity cost of getting an MD and going into practice. Yes, it takes planning and dedication to set yourself up on solid financial footing post-medical school, and it's entirely conceivable to be in your early thirties before you're debt free. But it's pretty damn hard to be struggling financially as a physician in any field.
- bawana 9y ago
  there is no 'reason' as to why physicians are paid what they are paid. It's simply supply and demand. A typical physician has to care for 5000 patients a year (that is the size of a full panel, btw) and gets 150k a year. Do the math - 20 patients a day, 5 days a week for 50 weeks a year is 5000 new visits. BTW, phone calls are not billable hourz. Oh, and I forgot 'emergencies' like aunt jemima who has severe burning when she pees, etc and needs to be seen ASAP or else she's going to the ER. Now add in the follow ups and emergencies and you're up to 35 patients a day. If you work for 8 hours (no lunch or breaks) that's 4 patients an hour. But wait, you have to enter patient info into an emr while you're supposed to be talking to the patient. Maybe you need to sip some water and go to the bathroom too. So that's 10 min a patient. for 150k a year. Instead, most MDs are looking to become 'boutique' docs. Each patient pays $2k a year for as much primary care as he/she wants. The boutique doc limits his panel to 500 patients. He makes 6x the money for 1/10 the work. now the doctor can spend an hour with each patient and treat him like a human being instead of a slab of meat. And cut the expensive insurance middleman out of the picture. So right, who needs the stress and bs that comes with a corporate existence. Why should the people who do the work (programmers and coders in your case perhaps) support the wasted busy work of people who are corporate drones and never actually interface with customers/patients/clients/aka the people who pay the money.

by bawana 9y ago

pc86 9y ago

The new physicians making $90k a year after residency are not the ones with $400,000 in student loans, and $800k in total student interest load is... atypical, to say the least. $300-400k total load post-residency is much more - I refuse to say "reasonable," but much more realistic. And the folks who have $400k total load are on a fast track to make $250-300k/yr just a few years after residency. A huge part of why doctors are paid as well as they are is because of the risk and the massive opportunity cost of getting an MD and going into practice. Yes, it takes planning and dedication to set yourself up on solid financial footing post-medical school, and it's entirely conceivable to be in your early thirties before you're debt free. But it's pretty damn hard to be struggling financially as a physician in any field.

bawana 9y ago
there is no 'reason' as to why physicians are paid what they are paid. It's simply supply and demand. A typical physician has to care for 5000 patients a year (that is the size of a full panel, btw) and gets 150k a year. Do the math - 20 patients a day, 5 days a week for 50 weeks a year is 5000 new visits. BTW, phone calls are not billable hourz. Oh, and I forgot 'emergencies' like aunt jemima who has severe burning when she pees, etc and needs to be seen ASAP or else she's going to the ER. Now add in the follow ups and emergencies and you're up to 35 patients a day. If you work for 8 hours (no lunch or breaks) that's 4 patients an hour. But wait, you have to enter patient info into an emr while you're supposed to be talking to the patient. Maybe you need to sip some water and go to the bathroom too. So that's 10 min a patient. for 150k a year. Instead, most MDs are looking to become 'boutique' docs. Each patient pays $2k a year for as much primary care as he/she wants. The boutique doc limits his panel to 500 patients. He makes 6x the money for 1/10 the work. now the doctor can spend an hour with each patient and treat him like a human being instead of a slab of meat. And cut the expensive insurance middleman out of the picture. So right, who needs the stress and bs that comes with a corporate existence. Why should the people who do the work (programmers and coders in your case perhaps) support the wasted busy work of people who are corporate drones and never actually interface with customers/patients/clients/aka the people who pay the money.