riahi

11 ms·

61.
by riahi 7y ago
These factors would then push for the insurance carrier to lobby state legislatures to cripple the negotiating position of their contractors. Narrow networks are a big problem, having been denied access myself while trying to be in network.
62.
by riahi 7y ago
Their profits are capped at 20% by law. They can increase profits in one of two ways; either by increasing premiums or by increasing subscriber count. The upstarts can try to undercut the big guys, but they still are stuck at a 20% profit
63.
by riahi 7y ago
You can't compare the US standard of care with the rest of the world's standard of care. If you want equivalent costs to the rest of the world, expect the US expectation of care, turnaround time, and time-to-service to decrease d
64.
by riahi 7y ago
EMTALA is precisely the problem. We cannot ask for any money before seeing the patient; nor can we ask for a deposit. Further, we are medicolegally liable for all care we provide even if we don't get a dime. That was the original inte
65.
by riahi 7y ago
This is correct. Their profits are capped at 20%. If they make too much money, they have to refund premiums.
66.
by riahi 7y ago
I'd settle for 75th percentile to force insurance carriers to actually negotiate and not deliberately keep pruning their provider networks by offering terrible rates.
67.
by riahi 7y ago
> This is extremely disingenuous. The reason for the regulation was precisely because most physicians never bothered joining a provider network knowing that doing so would cap their income and the ability to hold the patient hostage. I&#
68.
by riahi 7y ago
It entirely depends on if they are independent and work for themselves, and therefore know their contracted rates with the insurance companies. If the physician in question is an employee or a member of a large health organization, it&#x27
69.
by riahi 7y ago
Right, I'll get on repealing Medicare, EMTALA, and now Balance Billing legislation before I can legally offer a sane bill. /s The proposed solution to balance billing is linking the "out of network rate" to the FAIR heal
70.
by riahi 7y ago
Physician here. The problem with this law is it takes the medical reimbursement contract system and then shoots the physicians in the back. When insurance companies are trying to get people to join their network, they offer competitive rate
71.
by riahi 7y ago
It's a similar telescoping training problem in Radiology. We can train someone to have basic proficiency in interpreting a specific imaging examination in a relatively short period of time, but building the knowledge base, following u
72.
by riahi 7y ago
This is the difference between coding the solution to a tough technical problem yourself versus watching someone else code it. There can only be so many assistants.
73.
by riahi 7y ago
This is called balance billing and many states have banned it.
74.
by riahi 7y ago
I don’t think it’s fair to say there is a lack of awareness that bacteriophages-as-concept exist. Most curricula in medical school will touch on these. However, what is more of a realistic lack of awareness is the ability to request bacteri
75.
by riahi 7y ago
There’s multiple variants of heterotaxy syndromes (left and right variants) as well as many on a wide spectrum. We see a couple a cases a year pass through the radiology department. The working understanding is that these are ultimately cil
76.
by riahi 8y ago
I interpreted many restaging PET/CTs today and am thankful I didn’t have to consider whether the nodules I saw were injected by malware. I’d be really curious to see what the final “product” of the altered CT looked like to see if the
77.
by riahi 8y ago
Adoption of Lung-Rads is essentially required to be designated as an ACR screening center. To be reimbursed for Lung Cancer Screening, you must provide registry data to CMS (the registry is run by the ACR). It's not codified into Fede
78.
by riahi 8y ago
Inpatient care for many major procedures are bundled under Medicare. This is actually the reimbursement for the entire hospitalization. Yes many places lose money in Medicare as it probably reimburses at around 80% of cost but it’s the only
79.
by riahi 8y ago
Final signed American radiology reports are not dictated in India, especially at academic medical centers. They've tried; it's blown up in their faces. https://www.nytimes.com/2003/11/16/business&#x2
80.
by riahi 8y ago
Sibling commenter is correct. The majority of ER visits are actually not emergencies; rather they are frequently used/abused as a convenience (open 24/7) or because payment is not required prior to care due to the unfunded mandat
81.
by riahi 8y ago
I looked into the data. This would probably be under DRG 252, 253, or 254 (DRG 252 OTHER VASCULAR PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY, 253 OTHER VASCULAR PROCEDURES WITH COMPLICATION OR COMORBIDITY, 254 OTHER VASCULAR PROCEDU
82.
by riahi 8y ago
Agree. I have seen estimates place purchasing power parity of USD in India as 0.3, implying that $100 spent in India purchases as much value as $300 in the USA. This would imply a $10,000 surgery in India is somewhere in the realm of $33,00
83.
by riahi 8y ago
And prisons don’t? I would argue the modern American prison system has stepped into the role of the old asylum system and done an arguably worse job.
84.
by riahi 8y ago
The rise in American incarceration coincides with the de-institutionalization of psychiatric patients and subsequent defunding of community mental health programs. Perhaps they are linked, and prisons have now taken on the previous role of
85.
by riahi 8y ago
We used to institutionalize people, then we defunded the entire psychiatric infrastructure.
86.
by riahi 8y ago
That study is entirely based off simulation with the ultimate data being derived from survivors from Hiroshima and Nagasaki bonbings. We do not categorically know if there is a linear, no threshhold relationship between diagnostic radiation
87.
by riahi 8y ago
Agreed. They do a lot more than just churn out refractions.
88.
by riahi 8y ago
Asbestos causes cancer because of repetitive trauma to the pleural space with subsequent chronic inflammation acquired by breathing.
89.
by riahi 8y ago
Your prescription cannot be the same for contacts as it includes additional parameters like curvature. The diopter may or may not be similar, true. The whole point of a separate contact lens exam is to assess lens fit and check for corneal
90.
by riahi 8y ago
The conversation goes more like this: DOCTOR: You have [medical condition]. We can manage it with [medication which is on the appropriate tiered formulary for the patient’s pharmacy benefits manager]. PATIENT: I would prefer to take this me

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