This just burns my butt,,,,,

Discussion in 'Fibromyalgia Main Forum' started by elliespad, May 31, 2006.

  1. elliespad

    elliespad Member

    When someone bashes a provider who doesn't accept insurance, saying they charge excessive amounts for treatment. Eg. FFC or some Naturopath. Their initial consultation is NO MORE than any specialist I have seen, Eg. Neurologists (5, who have never helped me) or Dermatologist (4, who have barely helped me), Urologists (who have barely helped me). And I don't have Dental expenses, but my husband does. Have you seen what THEY charge for a crown or root canal?

    The fact that you have to pay out of pocket doesn't mean they charge excessive amounts. It means you have to pay out of pocket. How many who moan about out of network doctors, pay for their Gyno visit, or Neurologist visit out of pocket? Same costs. I suspect most people you see walking around missing teeth is because THEY can't afford the outrageous price to repair a broken or diseased tooth. Nobody walks around saying $1000 is too much for a Dentist to charge.

    The problem is with YOUR and MY insurance company who won't adequately compensate them for the time involved in the evaluation and treatment.

    Treatments may be a combination of drugs and supplements. Supplements are not covered. Is that the providers fault? No, the fault lies with YOUR and MY insurance company, for being so stupid as to continue paying outrageous drug prices while denying coverage for proven natural remedies.

    So, don't hate the doctor, hate the insurance companies. Then, give some serious thought as to WHY insurance companies would continue to operate in this manner. I won't even go there.
    [This Message was Edited on 06/01/2006]
  2. justlooking

    justlooking New Member

    I once saw a news program (like 60 minutes, Dateline, 20/20) that did a story on 3 different people who had medical problems and all went to the same hospital for the same procedure, 1 was on an HMO, 1 on Medicare (retired), 1 had no insurance (illegal immigrant).
    The person who paid the most for the exact same care was the person on the HMO, the person who paid the least was the one who had no insurance.
    They found what happens is the hospitals increase the cost/fees of those who have insurance to cover the expenses of those who don't.
    Hospitals are not allowed to refuse service to a person who comes through their doors, but at the same time they don't eat the cost themselves instead they pass it on to the people with insurance and their insurance companies to pay for it.
    I guess thats why it cost $100 for a Tylenol in the ER!

    [This Message was Edited on 06/01/2006]
  3. TxSongBird

    TxSongBird New Member

    so I am use to paying out of my pocket for procedures. I am not insurable and we own our own business so we have to pay cash for our Dr. visit's, medications, eye glasses and dental work.

    TxSongBird
  4. elliespad

    elliespad Member

    Do you find Naturopath, Alternative Med Docs to be more expensive than initial consultation for Neurologist, Dermatologists, Allergists, etc?
  5. mykas_mommy

    mykas_mommy New Member

    I have worked in an Er, a doctors office and now for a medical billing company. In all three we have had uninsured patients. Of the patients we bill for where I work now, the centers offer private pays a discounted rate on the exams but they dont willingly offer it. Some one has to ask, as with any business they are not going to give a service away. As noted above people pay for insurance and use their insurance, the Dr or facility takes a write off amount with each service done. For example, a standard mri is $1300, blue cross blue sheilds has a contract with the center, their contracted rate may be $600. What that means is the center would write off $700 and either by deductables, coinsurance, copays and actual insurance payment the $600 is covered.

    The Er that I worked in we offered private pay patients a 30% discount if they pay in full with in 45 days. We also offered payment arrangements to pay out the amounts over time. As long as the agreement was kept, it would not go on your credit or incurr interest charges.

    Now the Dr office I worked at was a specialists office, an orthopeadic clinic. The doctors there had contractual obligation to see anyone seen and refered to them by the local Er's. But if a patient was a walk-in off the street with out insurance they had no obligation to see them if they could not pay. It sounds awful but their reasoning is that there are specialists that work for a college medical center close by that get grants to take care of the uninsureds bills.

    My best recommendation is to always ask if there is a cash discount for the visit/exam/service. If not then is there a payment arrangement that can be made to satisfy both parties. And if one doctor says no they are unable to help, seek out another in a differant office in a differant town. The two big cities in my state are an hour and a half away on one and two hours on the other. I know if I had to go to one of those cities for a better rate at a doctor's office I would go. There are always options, if one chooses to seek them out.
  6. TxSongBird

    TxSongBird New Member

    I paid $550.00 recently for a CT scan of my head at a private Imaging place. I paid $450.00 recently for a consultation and a tiny bit of blood work for the Hemotolgists at a Cancer Center. My massage therapist charges me $65.00 per hour.

    TxSongBird
  7. srobins

    srobins New Member

    that I have noticed. For so long, there were not places for us to go who suffer with these illnesses where there were treatments that actually work. Now that there are, people complain about the cost. I have spent a lot at the FFC, but I have noticed some results. For me just having a place to go where the doctor will actually listen is worth the extra cost to me.
  8. Cromwell

    Cromwell New Member

    You have a valid point. Our doctor, well DH went to see him re slowing of urine flow, so doc says while you are here we will do your physical, which took about 6 mins honestly, even though Dh said well I do not think I am due for one.

    We just got billed $150 for the physical which the office say Medicare will not cover as you are only allowed one physical in a lifetime! Can someone tell me if this is so? It seems odd. On top, was a bill for $80 for the Urine exam part of the visit. This is a small coumntry doctor. His top up would not cover the medicare refuse and only $25 of the urine flow exam, which took exactly 2 mins!!!!

    So that is over $200 we have to find. My feeling is if the doc knew Medicare would not pay for well check and he knows we are very low income (under $20,000 for family of three) as he used to do the PAP for us, then why did he do that?

    So I agree-I had the best naturopathic doc in Newport Or, who even visted me in hospital for free.

    Love Anne C
  9. victoria

    victoria New Member

    the problems started with the insurance companies a long time ago. My DH was a psychologist... when he originally started in practice, they were told they should take charity patients and /or at least charge less to those in need without much money.

    The insurance companies put a stop to that by saying they were being discriminated against, that if a provider charged anyone less or provided services free, that it meant that was their actual charge. . . made it illegal to have sliding fees!

    So now it has to be done pretty much on the sly unfortunately... when doctors have found I'm paying out of pocket, for instance, I've noticed that charges are often less than they were... how they code it makes the difference!

    and I've found they are often much more generous with samples of meds as well. . . have often received a full month' worth in fact!

    So I agree, blame the insurance companies for making it illegal in many/most all cases for providers to have compassion...

    all the best,
    Victoria


    [This Message was Edited on 06/01/2006]
  10. TxSongBird

    TxSongBird New Member

    is wonderful as he charges me $45.00 for an office visit where some Dr.'s would charge $100.00. He takes his time and never rushes me out. He does give us samples of med's that he has, that we are on, but he doesn't always have the specific medications. He knows we have no health insurance and is very understanding of this. When I needed a nebulizer for my asthma, he wrote me a prescription for one at a refurbished medical supply store that cost me $50.00 instead of the $200.00. He has helped us out in many times of need.

    TxSongBird
  11. mimilove

    mimilove New Member

    Gosh don't I know it........somebody wrote about Dateline, 20/20 doing a show to show the differences in healthcare in America.

    It was one of the best shows that Tom Brokaw did before he left, (can't remember who posted on it). It ended up being the "illegal alien" here illegally without a visa or anything, jumped over a fence or whatever have you, "faired better" than even the person paying the "highest" for insurance.

    When Tom Brokaw asked her if she felt bad, she said "NO, America lets me get away with it, why should I". Turned out she was pregnat and in dire need of some different kind of care and needed to be helicoptered I think and they paid everything for her. And the lady who paid all her insurance "out of pocket" not through her work needed some "prosthesis" to actually improve the quality of her life, they would not cover her.

    Now, I can go on and on about what burns me about "illegal stuff" and what I have had to endure, and the ones who just gets away with stuff because they know how to bend and break every rule/law there is. And I am found guilty for being so freaking honest!

    Cromwell, like you say, you go try and ask an HMO for a physical or anything for that matter though, they will to make sure to let you know "you don't need that, it's going to come back negative. But when "you are paying for it, or medicare or whoever" yes you need this, that and then some.

    On 4/19 I went to the ENT, the one who just checked my ear like 5 other physicians had done and told me "no, you don't have and ear infection" and was about to send me home, if I had not told her "is that all, you the specialist, you are going to do for me?" To then find out, I am going deaf in my left ear. Well, right after that, I should say before that, I started having bad chest pains, tremors, sweating hot/cold, so after I was done, I called the appointment desk and because I was after chest pains they decided to send me to ER.

    Unbeknownst to be, the ENT office was right across the street from a big hospital (literraly), I could have just crossed the street. They asked if I could see it, oh yes now I do, but don't walk we are going to send the ambulance. 3 firetrucks, 2 ambulances show up. Well the one ambulance who picked me up those 2 EMT's were so rude. Not to say that they might be very good at what they do and not to take lightly the fact that they might one day save my life; but that day to me it was "bad".

    They picked me up and right away started being sarcastic, "oh, you can walk right back and pick up your car!" one of them said. They just made the turn and ooops we were there. Nothing was unwrapped, no pulse taken no life saving nothing. As a matter of fact, after I called and reported the whole thing to the hospital and the ambulance company, they were supposed to make 2 stops inside the ER which they did not, they made 1 stop wich was right before the EXIT to make me get off their little bed and put me in a wheel chair. They then wheeled me through the EXIT doors, I asked "where R u taking me, they said "you will see in a minute" and laughed.

    Well I have a bill that just came for $863.10. And, that is after reporting them to their supervisors who huffed on the phone with me, like she had heard the whole thing before, they sent me a survey to complete.....I told them those 2 sucked. I am going to make a call right now and asked why I was sent this bill.

    My complaint is not about the amount I have to pay $50, it's about how bad things are. I called my insurance company and asked them not to pay, it seemed like I was talking out of my... the person seemed new or couldn't care less. It's no wonder it's this way. By the way I did end up walking to my car, I never got any service because there were so many people waiting in wheelchairs some much, much older than me, they looked in a lot worse situations than me.
    A huge sign on the door "If you are having chest pains of any kind........DO NOT WAIT/LET ONE OF US KNOW IMMEDIATELY!!! What a joke!!

    Mimi................sorry for being so long :(
  12. victoria

    victoria New Member

    like someone else mentioned, many treatments are not available thru these sliding income or public health clinics, such as for mycoplasma or chronic lyme - most cannot even get proper testing, let alone treatment.

    That is where the uninsured poor get really left behind...

    From what little I have seen in just trying to help my son, it can be very hard to navigate the system, they do not make it easy at all no matter how sick one is.

    V






    [This Message was Edited on 06/01/2006]
  13. mrdad

    mrdad New Member

    Elliespad,
    Do you know what burns my butt??

    A flame about 3feet high!!

    Sorry, couldn't pass it by!!
    MRDAD
    [This Message was Edited on 06/01/2006]