FFC Questions/ Insurance /Physician Costs Venting LONG

Discussion in 'Fibromyalgia Main Forum' started by kch64, Jan 4, 2006.

  1. kch64

    kch64 New Member

    I've been reading a lot of posts about these FFC treatment centers.

    Are they not covered under most health insurances? I've had some regular doctors in my area that are no longer going to participate with my insurance.

    Now, I would like to preface my comments with this. I've been to several docs this past year that don't accept my insurance, and if I was pressed to the wall, I would do it again if I thought they could help me. I've spent several thousands of dollars, with not much change in my health.

    However, my gynecologist, whom I've been a patient of for 20 years, has just sent a letter to Blue Cross carriers that she is no longer going to accept Blue Cross as a preferred provider. That is the only insurance she accepted anyway.

    I guess if I were a doctor, I may feel differently, however, I sometimes think that docs that don't take insurances are more in it for the money than to help their patients. She's always been a good doctor, and yes, it is a business, but if medical care is just becoming a business only, then we are all in jeopardy (that's not the first word I thought of).

    She said she can no longer accept the "deep discounts" that insurance requires her to take, and that the extra hours she has to work to make the money necessary to live, have cut into time she can spend with her daughter.

    I guess we patients are supposed to pat her on the back and feel sorry for her? Considering she probably makes at least six times more money than me a year and I make a relatively nice salary? Give me a break!

    Now I'm in the market for a new GYN doc. I could still stay with her and file claims and accept the more costly route, however, " I regret the fact that I can no longer abide a physician that doesn't really want me as a patient".

    It used to be that you couldn't get care if you didn't have insurance. Now, it seems that you can't get care unless you're willing to "suck up" the high costs that are being thrown into mix, even if you have insurance coverage.

    Guess I sound sour, and I am somewhat, but I needed to vent some frustration at the medical establishment. As many of us have, we have seen the exorbitant dollar amounts that medical docs, facilities, tests can cost. I believe its all to gouge the patient and the insurance industry.
    I don't have any sympathy for insurance companies either, however, WE are the ones getting squeezed and we are the ones who ultimately suffer, physically and financially, not the docs nor the insurance companies.

    So, with that being said. I have decided that I will not go to a physician that doesn't accept my insurance, unless its an alternative treatment (acupunture etc.)doc. My insurance doesn't cover those anyway.

    Thanks for letting me vent.

    Kendra


    [This Message was Edited on 01/05/2006]
  2. ldbgcoleman

    ldbgcoleman New Member

    Why are you blaming the Dr?? Sounds like your gripe is with the Insurasnce companies. MAny Drs are tired of Insurance companies dictating threatment plans. also Drs go through a very rigorus and expensive education to get the Dr and practice medicine. There are plenty of bad Drs out there it's true but practicing medicine is not what it used to be.

    I also ask what is wrong with making money? We live in a capitalistic society wth the greatest economy in the world and drs charge what the market will bear. Think about the costs for an obgyn. The malpractice insurance is unbeliveable. Many Drs are no longer going into obstetrics because of it. You have no idea of the P&L in a medical office nor how much your Dr take home.

    The FFC will not take insurance. They will give you the paperwork to file it yourself. You will have to contact your insurance to see what they cover. I also have BCBS of Ga and they cover most of the labwork and pay 60% of my office visits. I file and get reimbursed. I have a $25 copay on prescriptions and they pay the rest. What is covered depends on the plan you have chosen.

    I would not change my decision to go to the FFc of Atlanta. I am so much better and the treatment I have recieved there has been excellent.

    Good Luck in making your decisions on your healthcare. Lynn
  3. kch64

    kch64 New Member

    I never said there was anything wrong with making money. However, if most people have insurance and the docs decide the don't want to take it, then patients are stuck.

    I know all about how to file a claim with insurance. I also know that it is quite a bit more expensive than choosing a doctor that has agreed to be a preferred provide under the insurance.

    And how do you know that I'm not aware of the expenses it takes to run an office, or the amount that it costs to carry malpractice insurance?

    Apparently, she makes enough to consider losing many of her patients (stated in her letter) and take on more that are willing to suck-up the extra costs of having her as their physician.

    I'm not blaming her for anything, I'm stating my opinion. I have a choice and I'm going to "vote with my feet".

    K.[This Message was Edited on 01/05/2006]
  4. kch64

    kch64 New Member

    I said I was venting. I also prefaced my comments that I would go to docs that didn't accept insurance if I needed too.

    BUT....Why can't these physicians treat us in their offices doing the same exact protocol? Its all dollar driven.

    Why can't I get care for the amount I pay for a co-payment with insurance, but I can get care for deciding to accept to pay $300.00 an hour or more out of my pocket?

    If a doctor can run tests for lyme, viruses, T3/T4 thyroid etc. at a treatment center, then they can do it in their offices also.

    I'm not knocking anyone who goes to them. I would go if I needed too. If you read my post, I said that I had paid thousands of dollars already. BUT this is how I see it.

    Not mad, not grouchy, just stating my viewpoint. Yes, I read bunnyfluff's post before I started mine, and I agree with her.

    K.
    [This Message was Edited on 01/05/2006]
  5. elsa

    elsa New Member

    To bunnyfluff's post ... she was angry about apparent greed and money driven doctors.

    These doctors can no longer afford what the managed care organizations are forcing on them. We are quick to blast the doctors without perhaps looking at all sides of MCO's.

    If I was a doctor I would not sign a contract with them either. After ten years many are exhausted, frustrated, and going broke.

    Keep in mind that the doctors who are walking away from MCO's would not be able to do so with out patient support. Both groups have had their fill of MCO directives and are looking to work together for a better solution.

    Take care,

    Elsa

    PS .... I don't have anything to gain by taking this stance ... matter of fact, might lose $$ as we are in the insurance/healthcare/administration industry.
  6. kch64

    kch64 New Member

    Do you accept this? How can it be justified if a doc chooses to be a preferred provider, but he's "directing" his patients to the FFC because he can make more money?

    Its a question of ethics. O.K....If a doctor chooses not to participate, like I said my gyn is doing, then that their decision, and I am the one who has to choose how I will react.

    BUT, I I'm going a doc, that IS a preferred provider, but is telling me that they can't provide my treatment under one roof, but they can under a more expensive roof, and oh, by the way, its coming out of the patients pocket, and the doctor doesn't care?

    Its not right and its not ethical.
    [This Message was Edited on 01/05/2006]
  7. elliespad

    elliespad Member

    But, for the sake of arguement, you said "if medical care is just becoming a business only, then we are all in jeopardy (that's not the first word I thought of)."

    If the playing field were equal, meaning all medicine was administered as "pay for services" with no insurance companies turning "good doctors" into puppets, then we may actually get superior care and treatment because then, only the docs giving quality care would get repeated business and personal referrals.

    And this doesn't mean I want this to happen as we would all go broke trying to get care. I have decent insurance that doesn't restrict who I see and I need no referrals. My insurance allows me to see any of the above puppets I wish. If I wish to see a doctor not just thinking, but practicing, out of the box, then I do so at my expense. And my insurance will even reimburse me at 80%. Not too shabby.


  8. kch64

    kch64 New Member

    (If the playing field were equal, meaning all medicine was administered as "pay for services" with no insurance companies turning "good doctors" into puppets, then we may actually get superior care and treatment because then, only the docs giving quality care would get repeated business and personal referrals.)

    After this you said you didn't necessarily agree with this because you had good insurance and we would all go broke trying to pay medical costs.

    I agree, but I don't think a contract doctor (which he is), that shuffles his patients to another place, when he could cover some of the testing and services more cost effectively for the patient, is considerate of the patient. If I was his patient, I think I would ask for an explanation, maybe he could give better reasons as to why he can't do this.

    So, in a perfect world, we would all get the greatest care, for a reasonable cost, and be just peachy (smile)...Alas, this isn't a perfect world and I'm thankful we can speak openly about it, as I'm sure you are too.

    Thanks for reading my venting (smile).

    K.

    [This Message was Edited on 01/05/2006]
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  9. elliespad

    elliespad Member

    My guess is, if a doctor continues to practice under two separate roofs he WILL have some SERIOUS splainin to do. The local board of health and mainstream docs will be on him like a wounded animal. I bet he goes full-time with the FFC as he is not likely to be welcomed by his old herd for long. They will go in for the kill.

    And what I meant to convey is that I don't necessarily WANT to have all health care go to "pay for service". Those without $$$ would have trouble treating a case of strept, let alone a chronic illness and those of us with 10 chronic illnesses. The poor and the elderly would go without. And most people sick enough, long enough, become cash poor. The way our insurance driven "health care" works, is to actually promote "sick care". But that's a whole nother topic ;0).
  10. kch64

    kch64 New Member

    Even with insurance, it's hard for many people to make it.

    That goes back to my original post. Just do the right thing.

    When people have to choose between health care and groceries, electric etc, then that's where we are now.

    There has to be a more equitable-for-everyone healthcare solution. I'm pooped now. I've been on my soapbox all day, now I need a nap (hahahaha)

    "splainin" You been watching I Love Lucy too? I read your bio. I'm going to look up that website. Pesticides can be fierce. Are you getting any better?


    Thanks "Ricky" elliespad.

    Kendra
    [This Message was Edited on 01/05/2006]
  11. kch64

    kch64 New Member


    I'm sorry to hear that Elliespad. Just keep trying to get the toxins out of your body, maybe then you can recover.

    You're in my thoughts and prayers.

    Have a good weekend.

    Kendra
  12. Mikie

    Mikie Moderator

    My prayers are with you. I hope you regain some energy. I know the weakness these illnesses can cause. God bless you.

    Love, Mikie
  13. Mikie

    Mikie Moderator

    Docs spend years and years in college, medical school, interning, and possibly more time training in a specialty. Years ago, the average doc left school with $100,000 in student loans. It has to be much more than that today.

    Most docs today do not make the huge money that they used to. A few specialists are still well paid, but considering the education and skills needed for their services, and considering the deep discounts contracted with managed-care insurance plans, they are not out of line.

    Docs are like everyone else. They want and need time off to keep going and to spend with their families. If contracting with insurance companies means they now have to see an additional 30-40 percent of patient load, how in the world can they continue to work like that. It's an impossible position. More and more docs are saying, "Enough!" Who can blame them.

    I do not believe we can compare our salaries with those of docs unless we have also gone to medical school and try to treat patients in a practice. Socialism is the alternative and that does not work.

    We are in a health crisis in this country but before any of us jumps to accept a different paradigm, we need to look at all the pros and cons. Every kind of health care system has its problems.

    I know patients are getting just as fed up as the docs and it's OK to vent but I think blaming the docs for the present crisis is too simplistic. This is a complex problem.

    I hope you can find docs in your plan who can provide good care for you.

    Love, Mikie
  14. laura81655

    laura81655 New Member

    Just wanted to let you know that I had the boodwork done through the FFC lab and the lab billed my Ins. which is an HMO. I really didn't think they would pay for the tests but they did!