Surgeon Charge for Medical Leave Paperwork????

[Kim B]

Melissa, I'll be sure to ask about aneurysms following RP. Sorry you had one develop after your surgery and hope doesn't go beyond the current 4.8 cm. I'm anxiously awaiting a CT scan of the aorta to see if I have or appear predisposed to aneurysms. Yesterday the surgeon's office called to say my HMO approved the CT but not the 64-slice scan of my arteries. It was my regular contact there who is very nice and helpful, and I didn't even ask her about medical leave paperwork issue since I'm resigned to paying cash if that's what they want. I'll deal with the paperwork when I go to have the CT scan done. I hope that gets scheduled soon.

By the way, I agree with Jkm7 that often insurance companies in the US are not bad at all. I personally have never experienced anything that would qualify as a horror story, only a few annoyances. I'm grateful to have the coverage I have as it allows me to have my surgery done by one of the top surgeons in the world.

 

[Lisa in Katy]

Braveheart, as long as you don't mind going to a doctor who is breaking the law, that is fine. Personally, I'd rather go to doctors who have integrity and skills.

Forbes recently listed the top 10 careers in the US. 9 of the top 10 and 15 of the top 20 were various medical specialties. They average annually about $100,000 more than their counterparts in Canada. That's one of the "benefits" of socialized medicine that saves the taxpayers money - salaried physicians.

 

[catwoman]

Kim:

One idea as to why a doctor's office would handle a fee for paperwork as you describe:

There's probably no place for paperwork fees on the standard form doctors use to submit charges to an insurance company. Insurance companies no doubt would refuse to cover such a fee, so a doctor would take payment separately/independently of the form.

However, that doesn't explain the request for cash/money order...

If you get the chance to ask Dr. Ryan, I'd be interested in his explanation. He may not even be aware of it. Very frequently, doctors leave all financial matters to their office managers.

 

[Kim B]

Marsha, I plan to ask my main contact there about the cash requirement. Later I'll ask Dr. Ryan about it if that is even really the policy. Although for a few minutes I questioned whether I chose the right surgeon, I very quickly got over that and have 100% confidence that Dr. Ryan is the best choice for me. I can't imagine he would do anything to jeopardize his reputation as a world class surgeon. I was just reacting to my surprise at the charge itself (but now know that is typical with all practices), and even more so to the way the person on the phone explained it as didn't sit well with me.

I'll provide an update when I get more info. I don't want anything I have said so far to be construed as a negative against Dr. Ryan. I believe his integrity to be on par with his skills. If I find out otherwise, I'll share it here, but I'm pretty sure I won't have anything scandalous to report.

 

[Lisa in Katy]

Kim, just to be clear, my response about integrity and skills was to Braveheart. I KNOW that it is illegal to charge Medicare patients $500 for a general checkup, assuming the provider is a participating provider with Medicare, which is an assumption I made based on the implied number of Medicare patients that this doctor is seeing. This practice could probably land this doctor in prison.

Although I THINK the cash payment for records could be a way of getting around insurance, I'm not sure without seeing his contract with your insurance company, and even then, it could be that the doctor is not really aware of the policy. $25 is a much smaller amount than $500.

For those of you wondering, there are codes to use to bill for records completion - 99080 is for completion of paperwork, other than standard reporting forms, suchs as FMLA paperwork. There are also codes for disability paperwork. Believe me, they've thought of everything.

For those of you feeling sorry for physicians, remember that many insurance companies give at least 5% overall annual increases, even this year when the economy is terrible and I got 0. I don't have a reimbursement schedule in front of me, but I believe that Medicare pays $50 or more for an office visit, plus add ons for various things that they might do during the visit. Assuming a doctor sees 4 patients an hour, which is probably low, $200 an hour is an hourly rate I could live with. Yes, I believe that doctors are wonderful and that the services I get from mine are worth every penny, but I'll never convince myself that they are underpaid. Last year my annual cardiology visit included an echo, lasted about 15-20 minutes face to face, and was reimbursed at over $300.

 

[Kim B]

Lisa,
Yes, I understood what you were saying and knew you weren't referring to Dr. Ryan. I just wanted to make sure no one thought I was making any unfounded accusations toward him. Oh, and I don't feel sorry at all for the physicians and what they're paid. The good ones deserve to be highly compensated and I agree they are not underpaid.