Ya wanna talk Healthcare issues?

[PCIntern]

My practice is in every sense, a small business, replete with the problems which are pandemic these days. The difference between my business and a REAL one is that I ethically cannot and will not 'sell' procedures which are unnecessary or which would place an undue burden upon the patient for no reason other than to inflate my income. But, here's a new, and potentially devastating problem with which I have to deal. I basically work for 5 major insurance companies who each send me a bulk-check each week for the treatment rendered 1-2 weeks before. These five checks account for 80% of my practice gross income.

Starting in November, the companies began delaying checks for 3-5 days which means that I never know if the money is going to be ther for payroll, laboratory expenses, telephone, etc. I don't have two weeks expenses in the bank and all the credit lines disappeared back in the panic months of the recession or whatever that was prior to the bailouts of the 'too big to fail' folks.

I am operating under such uncertainty and fear that I just don't know how much longer I can pull the rabbit out of the hat, which I have done for 31 years. This is a subtle destruction of the small practitioner whilst the companies glean huge profits. and there is no appeal play: under the laws of the state, they can wait up to 30 days before paying. Everything is set for them, and the legislature thinks it was doing us a big favor by limiting it to a month...and here's the best part: if they're late...they have to pay INTEREST! I get checks for eight cents, twelve cents...great, just great.

But no one gives a flying (fill in the blank).

[midnight]

1. This is another revealing side of the two standards of business......

The insurance co. pay no interest for late payment....

[eridani]

2. Too bad we aren't a civilized country

You never hear about such BS from ANY other developed country.

[PCIntern]

5. the kicker here is that the insurance companies have the

right to review all treatment, and get this: if you give a patient a break, say some poor schmuck comes in with a wicked abscess and you take out the tooth for, say 40 bucks instead of 130, which might be your fee, and the ins. co.'s get wind of this, they'll make you pay back the difference for each case you did with the same code. Don't want to pay? No problem, they'll withhold your payments until it's even, and threaten you with disaster all the while.

[SheilaT]

3. Many years ago someone told me

that the Federal Govt was notorious about being late in paying, although you could know that they would eventually pay.

Is there any realistic way you can start to build up a two week expenses fund in the bank?

No, I suppose not.

[PCIntern]

4. At these fees...?

I'm working for half my list price which is considered low by regional standards...I'm probably working for about 38% of true 'list'...I defy ANY business to do that for any length of time...

[Mimosa]

6. K&R

My best buddy is an MD and I've heard what goes on. Too many people think you all make more money than you do. And they have no idea how many hours you put in.