Insurance Stuff again (OT)

I'm taking part of the "I can relate" thread and starting it over here,
mostly to reply to something Sherry posted. Hope you don't mind!

Sherry wrote:
On Aug 30, 7:21?am, "jmcquown" wrote:

My doctor is now waffling about whether or not I need surgery. I
think he's figured out I don't have health insurance.


was causing him a lot of discomfort. But the surgeon then wanted to do
a colonoscopy! WHY?
On a patient who was already quickly deteriorating from kidney
failure. BECAUSE HE HAD
MEDICARE, AND A SUPPLEMENT THAT PAID 100%. I swear there are docs that
MILK
medicare and do procedures on people that are just not necessary.

Oh, tell me about it! For a while Mom was refusing to take her prescription
meds. She takes a ton of them every day, some of them several times a day.
I looked all of them up and it appeared to me there was some duplication.
(And yes, they were all prescribed by the same guy.) I'm no doctor. Maybe
there is a good reason for her to be taking (just throwing this out as an
example) two different medicines for high blood pressure. But I also think
the sheer number of pills she has to take every day is overwhelming, which
is why she balks at taking them.

So I called her doctor. I explained the situation to his nurse. I told
her Mom feels okay, she's not having any symptoms or anything. I was told
she'd have to come in and bring all her prescriptions with her and they'd
see if things could be changed. Why do they have to see her?!

I'll tell you what I think. They charge $175 for an office visit. There's
a big sign at reception: "Uninsured patients must pay $175 office visit fee
at the time of service." But see, she has Medicare. And TriCare for Life
pays what Medicare doesn't cover. So if she walks in the door, boom! They
get to bill $175.

When I was here in the spring she had a problem. A short term prescription
got it cleared up. Still, they wanted her to come back every 2 weeks! I
ask you again, WHY? Two guesses and the first one doesn't count

BTW, since I told Mom I was going to take her to the doctor she promised to
(and has been good about) take her pills again. LOL

How do YOU feel? Do you have a lot of discomfort? If so, I don't think
your doc should approach it
like it's an elective surgery or something, asking you what *you*
want! I would guess that if you
were covered by a good insurance policy, you'd already be scheduled.

Yeah, that's what I figure too. I feel okay. I'm back on an antibiotic,
though, because this past Monday I thought I was maybe feeling twinges of
the same discomfort that started this whole thing back in June. The doctor
had told me to call immediately if I even *thought* it was coming back.

I'm sorry for the rant. I realize this is none of my bizwax but it
really hits a nerve. You deserve the
same care as anyone else, and your ability to pay should NOT factor
into your diagnosis or care plan.
Sherry


Rant away! I'm right there with you on this. As for my medical bills, I'll
what I can, when I can. The bitch of it is I can't even *think* about
getting even a part time job, because taking care of Mom is a full time gig,
you know?

Jill

[medical annoyances]

When I had the weekend stay in the hospital, I dreaded the bill.

When the bill came in, it stated "paid by insurance" for the entire
amount. I heaved a sigh of relief.

Well, except for a portion of the radiology. And a portion of the fees for
two doctors I saw for ten minutes. And a portion of the fee for
consultation with an opthamologist who I never saw at all...

This "nickel and dime" billing afterwards is one of the things that really
gets on my nerves.


Hugs and Purrs,
Mark
--
Proof of Sanity Forged Upon Request

Mark Edwards wrote:
[medical annoyances]

When the bill came in, it stated "paid by insurance" for the entire
amount. I heaved a sigh of relief.

Well, except for a portion of the radiology. And a portion of the
fees for two doctors I saw for ten minutes. And a portion of the fee
for consultation with an opthamologist who I never saw at all...

Contest that!!!

This "nickel and dime" billing afterwards is one of the things that
really gets on my nerves.


Hugs and Purrs,
Mark


Here's the deal. I was approved by the hospital for 100% financial aid.
For services provided BY the hospital. Which includes practically nothing.
The room charges and nursing staff and nurses aides are included. That's
about it.

Pretty much everything else is handled by (and billed by) outside providers.
Oh, there are doctors they call "hospitalers". They don't have private
practices. They're also all residents or interns under supervision.
Everything else, the radiologist, all the labs for blood work, etc. isn't
part of the hospital charges. So while it's great the hospital isn't going
to charge me as thought I were staying in a hotel with room service (heh)
the majority of the bills are from all these outside providers. One doctor
who was on call that weekend spent maybe 2 minutes with me and sent me a
bill for $900. It's ridiculous. He didn't DO anything.

Jill

"jmcquown" wrote in message
. ..

Rant away! I'm right there with you on this. As for my medical bills,
I'll what I can, when I can. The bitch of it is I can't even *think*
about getting even a part time job, because taking care of Mom is a full
time gig, you know?



The doctors here gripe their heads off about Tricare insurance. Some won't
take any Tricare standard (Mandy and me) or Tricare Extra, but man they want
those Tricare Prime and Tricare for Life (Rob) patients. They can really
pad the bills for them. However, most Tricare Prime get seen at the
military clinics. The rest of us aren't good enough for them.

Pam S. who spends a lot of her time disgusted by the greed of the medical
profession

Mark Edwards wrote:

When the bill came in, it stated "paid by insurance" for the entire
amount. I heaved a sigh of relief.

Well, except for a portion of the radiology. And a portion of the fees
for two doctors I saw for ten minutes. And a portion of the fee for
consultation with an opthamologist who I never saw at all...

This "nickel and dime" billing afterwards is one of the things that
really gets on my nerves.

I know what you mean! About 10 years ago, I had a bad reaction to
antibiotics and ended up in the ER for several hours. I was never
admitted, and in all, I was there for less than 24 hours, but managed
to rack up quite a bill, insurance notwithstanding. I was aghast at
how many *different* bills I kept getting, one for this specialist,
another for that department, more for medicines, etc, etc. When did
they stop just billing once for everything, centrally?

At one point while I was there, someone showed up at my bedside saying
that she'd heard I had asthma and would I like to try a new gadget for
my inhaler? I didn't have any other pressing engagements, so I said sure,
and pretty soon I had a bunch of new equipment to take home. I wasn't
thinking very clearly at the time (and I hadn't been in the hospital for
years and had never experienced this before, or I would've known better),
but OF COURSE, I was charged a hefty sum for this consultation and the
gadgets. It really aggravated me because I wasn't even there for asthma!
It was like, since they had me, why not read my charts and see what else
they could sell me?

I got bills associated with that visit for months and months.

--
Joyce ^..^

(To email me, remove the X's from my user name.)

"jmcquown" wrote in message
. ..
I'm taking part of the "I can relate" thread and starting it over
here, mostly to reply to something Sherry posted. Hope you don't
mind!

Sherry wrote:
On Aug 30, 7:21?am, "jmcquown" wrote:

My doctor is now waffling about whether or not I need surgery. I
think he's figured out I don't have health insurance.


was causing him a lot of discomfort. But the surgeon then wanted to
do
a colonoscopy! WHY?
On a patient who was already quickly deteriorating from kidney
failure. BECAUSE HE HAD
MEDICARE, AND A SUPPLEMENT THAT PAID 100%. I swear there are docs
that
MILK
medicare and do procedures on people that are just not necessary.

Oh, tell me about it! For a while Mom was refusing to take her
prescription meds. She takes a ton of them every day, some of them
several times a day. I looked all of them up and it appeared to me
there was some duplication. (And yes, they were all prescribed by
the same guy.) I'm no doctor. Maybe there is a good reason for her
to be taking (just throwing this out as an example) two different
medicines for high blood pressure. But I also think the sheer
number of pills she has to take every day is overwhelming, which is
why she balks at taking them.

So I called her doctor. I explained the situation to his nurse. I
told her Mom feels okay, she's not having any symptoms or anything.
I was told she'd have to come in and bring all her prescriptions
with her and they'd see if things could be changed. Why do they
have to see her?!

I'll tell you what I think. They charge $175 for an office visit.
There's a big sign at reception: "Uninsured patients must pay $175
office visit fee at the time of service." But see, she has
Medicare. And TriCare for Life pays what Medicare doesn't cover.
So if she walks in the door, boom! They get to bill $175.


If it makes you feel any better, it isn't like they get paid $175
every time they see her.

I don't have one of my Medicare payment things handy but I think they
actually get more like $40 between Medicare and TriCare.

Jo

Jofirey wrote:
"jmcquown" wrote in message
. ..
I'm taking part of the "I can relate" thread and starting it over
here, mostly to reply to something Sherry posted. Hope you don't
mind!

Sherry wrote:
On Aug 30, 7:21?am, "jmcquown" wrote:

My doctor is now waffling about whether or not I need surgery. I
think he's figured out I don't have health insurance.


was causing him a lot of discomfort. But the surgeon then wanted to
do
a colonoscopy! WHY?
On a patient who was already quickly deteriorating from kidney
failure. BECAUSE HE HAD
MEDICARE, AND A SUPPLEMENT THAT PAID 100%. I swear there are docs
that
MILK
medicare and do procedures on people that are just not necessary.

Oh, tell me about it! For a while Mom was refusing to take her
prescription meds. She takes a ton of them every day, some of them
several times a day. I looked all of them up and it appeared to me
there was some duplication. (And yes, they were all prescribed by
the same guy.) I'm no doctor. Maybe there is a good reason for her
to be taking (just throwing this out as an example) two different
medicines for high blood pressure. But I also think the sheer
number of pills she has to take every day is overwhelming, which is
why she balks at taking them.

So I called her doctor. I explained the situation to his nurse. I
told her Mom feels okay, she's not having any symptoms or anything.
I was told she'd have to come in and bring all her prescriptions
with her and they'd see if things could be changed. Why do they
have to see her?!

I'll tell you what I think. They charge $175 for an office visit.
There's a big sign at reception: "Uninsured patients must pay $175
office visit fee at the time of service." But see, she has
Medicare. And TriCare for Life pays what Medicare doesn't cover.
So if she walks in the door, boom! They get to bill $175.


If it makes you feel any better, it isn't like they get paid $175
every time they see her.

I don't have one of my Medicare payment things handy but I think they
actually get more like $40 between Medicare and TriCare.

Jo

No, it doesn't really make me feel any better LOL I know all about "fee
schedules". I worked for an HMO and a PPO in a previous lifetime They
still get paid something, and that was my point. But you knew that. Her
doctor didn't need to see her to review her list of medications. They're in
her file. She isn't having any problems, I told them that. Trust me, if
she was having problems I'd be the first one to drag her to the doctor.

Jill

"jmcquown" wrote in
:

I'm taking part of the "I can relate" thread and starting it over
here, mostly to reply to something Sherry posted. Hope you don't
mind!

Sherry wrote:
On Aug 30, 7:21?am, "jmcquown" wrote:

My doctor is now waffling about whether or not I need surgery. I
think he's figured out I don't have health insurance.


was causing him a lot of discomfort. But the surgeon then wanted to
do a colonoscopy! WHY?
On a patient who was already quickly deteriorating from kidney
failure. BECAUSE HE HAD
MEDICARE, AND A SUPPLEMENT THAT PAID 100%. I swear there are docs
that MILK
medicare and do procedures on people that are just not necessary.

Oh, tell me about it! For a while Mom was refusing to take her
prescription meds. She takes a ton of them every day, some of them
several times a day. I looked all of them up and it appeared to me
there was some duplication. (And yes, they were all prescribed by the
same guy.) I'm no doctor. Maybe there is a good reason for her to be
taking (just throwing this out as an example) two different medicines
for high blood pressure. But I also think the sheer number of pills
she has to take every day is overwhelming, which is why she balks at
taking them.

So I called her doctor. I explained the situation to his nurse. I
told her Mom feels okay, she's not having any symptoms or anything. I
was told she'd have to come in and bring all her prescriptions with
her and they'd see if things could be changed. Why do they have to
see her?!

I'll tell you what I think. They charge $175 for an office visit.
There's a big sign at reception: "Uninsured patients must pay $175
office visit fee at the time of service." But see, she has Medicare.
And TriCare for Life pays what Medicare doesn't cover. So if she
walks in the door, boom! They get to bill $175.

When I was here in the spring she had a problem. A short term
prescription got it cleared up. Still, they wanted her to come back
every 2 weeks! I ask you again, WHY? Two guesses and the first one
doesn't count

BTW, since I told Mom I was going to take her to the doctor she
promised to (and has been good about) take her pills again. LOL

How do YOU feel? Do you have a lot of discomfort? If so, I don't
think your doc should approach it
like it's an elective surgery or something, asking you what *you*
want! I would guess that if you
were covered by a good insurance policy, you'd already be scheduled.

Yeah, that's what I figure too. I feel okay. I'm back on an
antibiotic, though, because this past Monday I thought I was maybe
feeling twinges of the same discomfort that started this whole thing
back in June. The doctor had told me to call immediately if I even
*thought* it was coming back.

I'm sorry for the rant. I realize this is none of my bizwax but it
really hits a nerve. You deserve the
same care as anyone else, and your ability to pay should NOT factor
into your diagnosis or care plan.
Sherry


Rant away! I'm right there with you on this. As for my medical
bills, I'll what I can, when I can. The bitch of it is I can't even
*think* about getting even a part time job, because taking care of Mom
is a full time gig, you know?

Jill






You really should stop asking questions you already know the answer to.

Mark Edwards wrote in
m:


[medical annoyances]

When I had the weekend stay in the hospital, I dreaded the bill.

When the bill came in, it stated "paid by insurance" for the entire
amount. I heaved a sigh of relief.

Well, except for a portion of the radiology. And a portion of the fees
for two doctors I saw for ten minutes. And a portion of the fee for
consultation with an opthamologist who I never saw at all...

This "nickel and dime" billing afterwards is one of the things that
really gets on my nerves.


Hugs and Purrs,
Mark


And each bill comes separate and spread out over months and none of them
can be paid online and and ..... AND all of this when you, likely, feel
like crap to start with. But I am repeating myself now.

"Jofirey" wrote in news:gkDvk.20079$cW3.15088
@nlpi064.nbdc.sbc.com:



If it makes you feel any better, it isn't like they get paid $175
every time they see her.

I don't have one of my Medicare payment things handy but I think they
actually get more like $40 between Medicare and TriCare.

Jo




That's a lot more than I make for 5-10 minutes of my time.