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> Of all specialties, I'm the most sympathetic to billing issues because our billing is very predictable Most billing is predictable. Doctors in India, Mexico
by subhobroto 7y ago
> Of all specialties, I'm the most sympathetic to billing issues because our billing is very predictable
Most billing is predictable. Doctors in India, Mexico (two countries I have first hand experience in) quote down to the single digit, a price. Some surgeons guarantee it - as in 0% variance. You pay what you sign up for. I am talking triple bypass surgery. Sounds pretty complicated.
I don't have medical training but is triple bypass surgery way less complicated than an office visit for a flu symptom?
I don't believe doctors in India or Mexico receive special price estimation training that doctors in the U.S. is banned from attending. My body is still the same irregardless of whether I'm in India or Mexico or the U.S., so why all this baloney?
Now I don't fly down to India or Mexico to treat my flu symptoms but when I was in India, a physician visit was a flat USD $1, no matter what the issue was unless you needed hospitalization. I am talking walk in prices as in "go right now to see a doctor because I'm running a fever".
The $1 was the unsubsidized, full retail price paid by those who could afford to pay, like myself. There was no health insurance fad in India when I was there. There was 0 need and demand for it. The doctors would often take way less for the poor or completely waive it and these doctors would still be making bank.
Yet a visit here is an involved appointment process with multiple day waits and you still don't know what you owe as the copay is just the starting price.
It has become ridiculous.
> I personally think it should be illegal for non physicians to own physician groups like it is with legal practices
Hmm, I thought that applied and the board of directors all need to have a current medical license?
> I think this is a fair expectation; why not make it so insurance companies actually stop hiding this information?
First, I really appreciate the time and dedication you have shown here. YOU REALLY care about your profession and I love you for it.
Thank you.
It will be a pleasure to speak with you in person or over the phone or however we can connect. I am looking forward to it. I am my handle at gmail. Please, reach out.
I am sure, if everyone in your professional felt like you do, we would not be having this conversation right now.
Now, for some reason, it seems to me that you detest insurance companies. IF I might estimate why - perhaps they make processing claims very hard. Sometimes they don't pay you what you expected. We can have that conversation, but do understand that there are no lack of providers that outright defraud these insurance companies and while you might be extremely ethical, you are having to shoulder the burden of those who have betrayed the trust.
To address the topic at hand - no insurance company has ever refused to give me the information you claim that they hide - they just need the CPT CODES and they will gladly run the numbers for me. They will even give me a list and contracted rate for CPT codes.
The issue here is that I need a provider to tell me what those CPT CODES are.
Neither I NOR the insurance company are in the medical diagnosis business and only the medical diagnosis providers get to generate those CPT CODES.
I have a 250MB spreadsheet full of CPT codes and their negotiated rates for my plan, but I have no clue how D6010 ($2050) is different from D6190 ($125) or when they apply (these are not medical CPT codes because I have them at a secure location but you get the idea).
Just to be clear: The insurance company at no point in time tried to hide this information from me.
- ikiris 7y agoI can answer the coding question. They have automation that will select the highest level code for a procedure they think they can get away with without being sued. They brag about this. Like using emergency codes for specialty at a satellite facility they claim is physician owned but isn't soley so they can just bill insurance the higher rates.