Cost of dealing with insurance bureaucracy

[midnight]

is hurting doctors and endangering patients.

Even one open slot is lost revenue, so patients who have something which could possibly be handled over the phone or through e-mail are forced to come in for a visit.

Schedules become packed and inflexible, leading to physicians who are harried and insufficiently empathetic and patients who are frustrated from hours wasted waiting for a five-minute appointment. The resulting chaos, due directly to the payment system, is unhealthy for everyone.http://reclaimdemocracy.org/articles/2008/family_doctors_dying.php

[wolfgangmo]

1. I own a primary care clinic

It got so bad that a few years back we got off the insurance treadmill and no longer bill insurance. Today we are a cash only practice and the reason why is that we could not survive financially. We were literally going broke. And the patients were the ones to suffer.

If things continue as they have been since Reagan, then there will be no primary care doctors left in America. Good luck getting care. The system is in freefall and is breaking faster than

[Donnachaidh]

2. so, do you insist on cash up front from your patients now?

And do you charge the same for office visits that other doctors who deal with insurance charge?

[wolfgangmo]

3. Yes and no

We take things on a case by case basis, but generally we need cash on the barrelhead so to speak. We do not bill insurance but do provide superbills that have all insurance codes on them for patients to submit.

And we charge less than insurance doctors do. We are able to do this because we no longer need hire 3 billers for every doctor . Our staff is now almost entirely medical rather than almost entirely insurance specialists.

We now provide better care. Our patients actually pay less for more time and better care.

Having said all of that we hope for the day of universal single payer insurance and would jump back into insurance as long as the game is no longer rigged.

[DemReadingDU]

4. I am hearing and reading more doctors do the cash thing

Insurance (and medicare) has become a nightmare to deal with, not only for the doctors, but patients too. This country needs a better system.

[exboyfil]

5. How much for a short visit like an ear infection?

I have a $5000 deductible on my insurance so I would be inclined, especially in the second half of the year, to pay cash and not mess with my insurance. It costs me $100 to spend less than five minutes with a doctor to be told that I have an ear infection and here is the medicine which I require (I already know what the prescription will be).

If I could pay $40 then I would pay cash and not worry about my insurance carrier.

[Demeter]

6. ?Did Your Practice Become Profitable?

Are your rates the same, or do they reflect the savings of not having to deal with insurance?

Do you accept government programs, like Medicare and Medicaid?

[exboyfil]

7. I keep arguing with my coworkers about the merits of

a Universal Single Payer system. The same ones who continually complain about our insurance carrier are the same ones most adamantly opposed to a single payer system. They worry about folks who don't contribute getting health benefits, but I try to explain to them that, since hospitals cannot deny care, we are already in that position anyway. I am paying $4000+ for my child's orthodontia but Medicaid recipients get the same service nearly for free. I pay a $4500(orthodontia not included in deductible) deductible while Medicaid gets every dollar paid for.

My employer pays $10,000/year+ for my insurance (at least that is what he tells me).

For this payment we get continually hassled about the insurance company payments, get taken advantage of in every way conceivable, not given any support in controlling our health care costs (even though we are told to take ownership of those costs) etc.

I would like a simple fee structure upfront for a doctor's visit for all doctors in this area, and I cannot get this information from them.

Honestly I cannot see how a single payer system would be much worse than what I have now, and I am in the enviable position of actually having pretty good health insurance (at least for catastrophic events).

The thing that keeps me up at night is the possibility of getting into a preexisting condition situation or the solvency of my health insurance carrier. That alone is reason enough to go to a single payer system with universal coverage.

[ccinamon]

8. I finally convinced my brother with this argument....

If someone who has no insurance has an ear infection, do you want your taxes/doctors payments/insurance payments to help pay for the ambulance ride/emergency room visit and possibly an overnight stay in the hospital for an ear infection (the cost being thousands of dollars), or would you rather your taxes/doctors payments/insurance payments help pay for the ear infection and drugs at a few hundred dollars....either way we all pay, it is just a matter of How Much we are paying. By helping everyone who needs it early in the process of their illness/injury, we will be saving money instead of the injured waiting until they need a trip to the emergency room where the cost is much greater.

I used an ear infection, because it is easy to treat when caught early, but can become a very bad situation if left untreated, and almost everyone has had at least one ear infection and it can remind the listener of how painful an illness/injury can be.

Of course I prefaced the above with, stop and listen to what I am saying...he was a big republican until I started telling him about what they were doing, then he switched to being a "libertarian" - and when I started going after their beliefs, he said he didn't want to discuss politics any more.

[DemReadingDU]

9. Don't the military already have universal health care?

Where I live, the military (active and retired) go to the military doctors and military hospitals. So our tax dollars already support the military, hence don't our tax dollars also support the military health care?