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<p>How did we get to this place??? Doctors are working non-stop and still many avoid certain areas (e.g. peds and family practice) because otherwise they won’t make enough to repay student loans. But fees are sky high! Many can’t afford to go to a doctor at all. Where is the money going? This all needs to be fixed.</p>
<p>The thing is I thought I understood our coverage very well. We have an HSA with a high deductible for everything but preventative care. We do question how much things cost and if certain tests are really necessary etc. More than once the doctor has wanted to send on of us for an expensive test. When we said we would have to pay for it and asked if it was really needed he has decided we didn’t need the test afterall.</p>
<p>If a person is in a nursing home, its probably JACO approved and has to follow rules. They can’t take a person who has not been pronounced and roll him to the curb in a desk chair with a toe tag on. A person has to be pronounced and a death certificate has to be completed. Its the law. You cant plant him out back in the garden by the pool your mom hangs out at.</p>
<p>If you had him at home and you called 911 they’d have sent the EMT’s who would take him to the hospital and the fees would have been incurred. Were you planning to throw him in the trunk and take him to the funeral home? Sorry to be so blunt, but if you’d prefer to pay the fees for the services that were required and utilized before he was pronounced out of your pocket instead of bilking insurance, that would be quite fine by me. But wait-- cant ask a person who is medicare eligible to pay out of pocket. And since he was the patient, dead or alive, no can do.</p>
<p>As for annual physicals, it stinks that the insurance company is vague about what they will or will not cover. They will often say they cover a routine physical, but sometimes if the Dr puts a diagnosis down it wont get paid as a routine physical. So they say they cover a physical but ther are probably little asterisks. Ther may be a cap. There may be labs that arent covered. You think you might need an EKG? If it isnt “needed” it may not be covered. etc.</p>
<p>I have not seen what looked like over charges from my doctors. Frankly, I have often felt that they were way underpaid for certain services. For example, going back 14 years ago, so this is nothing new, a specialist was paid next to NOTHING to do a 15 minute, same day in hospital procedure on one of my children. I noticed that he made far more money in his office than he did for some inpatient procedures! FWIW, his medical staff also had to spend half an hour to get a medical test precertified for this same child and nobody paid the office for the time that was used. This doctor was not even doing that medical test, so he was not going to earn a dime to get it done! I felt terrible about both situations.</p>
<p>“A person has to be pronounced and a death certificate has to be completed. Its the law.”</p>
<p>A person has to be pronounced. They don’t have be carried in an emergency ambulance (owned by the same entity) 200 yards away to an ER (owned by the same entity), then have attempts to resuscitate a body dead for three hours, and then have three separate parties build for all three procedures. Meanwhile, my mother had been called three hours earlier.</p>
<p>In fact, if they were so concerned about reviving the dead, a doc could have walked 200 yards and called in a couple of witchdoctors and shamans or other “alternative practitioners”, and they all could have got a piece of the action.</p>
<p>Does the facility have a staff doctor they would call who can come to the facility and bill for their time to medicare? Many assisted living and nursing homes do not have this in place. Maybe your wife could pull in a favor and get one of her medical associates to work for free, leave their office and their patients, make a housecall, pronounce a patient they have never seen before, fill out all the necessary paperwork (cause of death, etc), etc etc. Good luck with that. Doesnt matter if the facility was 2 feet or 2 miles away. I have visions of you plopping dad in a supermarket buggy and rolling him across the street. These sound like legisltive changes you want to make. I am behind you 100% . Was he in a facility that requires someone to have staff priviledges? Probably not. In many instances trying to bill for a nursing home visit is a red flag to Medicare. Most avoid it like the plague.</p>
<p>I must add, and I realize that this is a serious subject so I’m sorry if I offend…but you guys and your sarcastic wit are really cracking me up today.</p>
<p>There’s plenty of money to be made treating the dead. After all, they don’t complain, and they usually don’t contest the billing, and so if you bill three different entities for the same service to the dead, usually the dead person won’t notice. Come to think of it - why would you choose to treat the living, if you could make more money on the formerly living ones?</p>
<p>That’s one of the problems with ObamaCare. It didn’t include special provisions for guaranteeing health care for the dead, or treating death as a pre-existing condition.</p>
<p>Hey missiepie-- you are on to something. Perform the exam in silence. Insurance companies do have a procedure code (no guarantee, and unlikely they will pay it though) for using “physical devices, language interpreter, or other mechanisms of non-verbal communication,” to perform the procedure. </p>
<p>Did you know several insurers require Drs. to provide interpreters/ sign language etc for patients who are hearing impaired or unable to communicate, at the Drs expense? I guess in mini’s circumstance it would not have been required since I doubt they are expected to pay for a seance or use of a ouija board…</p>
<p>Now, now, that would be discriminating against someone with a pre-existing condition. Just because their dead doesn’t meant they shouldn’t be treated equally.</p>
<p>Dont make this a political discussion, mini. </p>
<p>If they called your mom 3 hrs before, how long did it take her to get up form the pool and get to the facility? BTW, dead people dont pay their bills too often. Several states are now enacting legislation requiring surviving children to be responsible for end of life bills of their parent. </p>
<p>And I heard from a friend who was in medical billing in the past that there are now changes being made that if a doctor is in a practice that is owned by a medical facility (increasingly common) and a patient gets admitted to a facility the day they see the dr in the drs office, the drs visit wont get paid, or at a very reduced rate of the already very reduced rate.</p>
<p>People who aren’t breathing are a protected class under the Americans with Disabilities Act. (They should also be guaranteed equal pay for equal work - you should see some of those at my workplace.)</p>
<p>Medicare and the insurance company both paid for the emergency services for my dead stepfather. His estate would likely have paid, too, but the “health care for the dead” facility made the mistake of sending the bill to my mother.</p>
<p>Wonder if the legislation will include responsibility for post-end-of-life services.</p>
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The bill is sent to the address on file. Maybe its the billing service who should hold the seance or hire Carnac the Magnificent to hold the envelope up to his turbin and surmize what the new billing address for the “estate” should be. Really now. This is ridiculous.</p>
<p>Well, they did manage to collect from two out of three, so they’re doin’ the happy dance! ;)</p>
<p>And if the “facility” were to have called “their ambulance” (whatever that means) would you or your mom or “the estate” really have paid the bill? Promise? Really? These services quite often go unpaid. Why was it their responsibility to transport him? Why didnt you just call a cab and have him picked up and transported to his personal doc to have him pronounced?</p>
<p>They’ll be lucky if the “two out of three” barely covered their costs. I’ll bet it was not the “happy dance” they were doing.</p>
<p>DW had a minor surgical procedure scheduled. Her primary care physician told her he planned to attend the operation because he’d never seen the procedure and wanted to see how it was done. So he did - then sent a bill. We suggested to him that he withdraw the bill before we informed the insurance company what was going on, a suggestion he took. DW also changed doctors.</p>
<p>I am glad we are providing some levity, busdriver. When it comes to the craziness of insurances and sometimes the attitude of individuals, if I didnt laugh, I’d cry.</p>
<p>As for witnessing an uncommon medical procedure, if I had the opportunity to witness a craniorectal inversion, I’d clear my calendar to watch it. ;)</p>
<p>Okay, it ks time for a Seinfeld reference. BRB.</p>
<p><a href=“http://lifeofadoctorswife.■■■■■■■■■■■■■/2009/07/20/jerry-seinfeld-on-waiting-at-the-doctors-office/[/url]”>http://lifeofadoctorswife.■■■■■■■■■■■■■/2009/07/20/jerry-seinfeld-on-waiting-at-the-doctors-office/</a></p>
<p>I KNOW I’ve linked this one before. I LOVE this one.</p>
<p>What did you edit out earlier, shrinkrap? Inquiring minds want to know.</p>