How Long Will Your Doctor Continue Accepting Private Insurance?

[marmar]

via AlterNet:



How Long Will Your Doctor Continue Accepting Private Insurance?

By Maggie Mahar, Health Beat. Posted July 18, 2008.

Doctors are getting fed up with private insurers. Here's a look at what out-of-pocket costs could look like for patients.



This article originally appeared on Health Beat.

More and more doctors are fed up with private insurers. It's not just a question of how stingy they are, but how difficult it is to get reimbursed. Paperwork, phone calls, insurers who play games by deliberately making reimbursement forms difficult to interpret ...

Some physicians have just said "no" to insurers.

What does this mean for patients? Business models vary. Some doctors charge by the minute. I recently read about a physician who punches a time clock when the appointment begins. She has calculated that her time is worth $2 per minute. Fifty-nine minutes = $118. Will you be paying cash, or by charge today? Somehow, I think the meter would make me nervous. I suspect I might begin talking very quickly. But this is only one model.

Rather than charging by the minute, some doctors make fee-for-service charges. In those cases, many physicians mark up their fees well beyond what an insurer would pay. But, they point out, they also spend more time with their patients. No one feels rushed.

A story in a New Jersey newspaper describes how physicians in Northern Jersey have begun following in the footsteps of "elite Manhattan doctors and are withdrawing from all insurance plans." The article compares fees with and without insurance. On the right, the fees that insurers typically pay for these services; on the left, the fees that Jersey doctors who don't take insurance charge:


* Mastectomy: $5,000 / $900

* Ruptured abdominal aneurysm: $8,000 / $1,800

* Routine screening mammogram: $350 / $100

* Initial neurological consultation: $400 / $100 .......(more)

The complete piece is at: http://www.alternet.org/healthwellness/91876/

[comtec]

1. I can't belive the prices on the right

even assuming the ones on the left are inflated a bit... 100 for a mammogram? that doesn't even cover the cost of USING the equipment!!!

[Vinca]

2. My doctor closed his practice last December and went to work in the ER.

He was battling lymphoma and found the combination of being screwed as a provider and being screwed as a policy holder was too much to keep him solvent. It was very sad - he was beloved by many, many patients.

[Thothmes]

3. What does Medicare pay for these procedures?

Many physicians in my geographical area will not accept any new Medicare patients because of the low reimbursement rates.

[ayeshahaqqiqa]

4. I work for a doctor

And I can assure you that it is taking longer and longer to jump through all the hoops insurance companies put up. They will deny claims on the flimsiest of excuses, and often dictate, by what they will or will not pay, what kind of treatment a patient will get. It is a disgrace! Doctors should be allowed to practice medicine, not the insurance companies.

I work for a non-profit. Doc doesn't even get a salary for the work she does in the clinic. We have a program where we run fund raisers to gain funds to use for laboratory assistance grants. That means if someone comes to us who is ill and needs lab work they cannot afford (and it is surprising how many insurance companies aren't paying for certain labs), the Board of Directors can vote to have the non-profit pay for it. And at the clinic we take payments for office visits, too. We tend not to take insurance because it is too much of a hassle.

[bemildred]

5. They ought to ALL refuse to deal with Insurance Companies.

This is war.

[madrchsod]

6. my doctor and the hospital i had my surgery at

are both fed up with private insurance. they screw them just as badly as they screw us.

[ourbluenation]

7. profits out of healthcare now. n/t