=]

for some reason i wasn’t notified of your response.

I can provide data of my billing for non paid patients this last year and show it was lower than insured patients. I can also show that even with the discounts, the remainder remains unpaid of 80% of the amount for more than 120 days. This data is even worse for ER patients.

About appealing to your common sense. How about looking at numbers.

If I have a 100 patient practice and 90 are insured and 10 are self pay and they all get billed 100 for services.

The “bulk” of income comes from the 90 paying patients. or $9000.

I billed $1000 to the 10 patients but it’s hard for them to pay and only collect 20% in the first 120 days….or $200.
Why would I bother even with this amount when my collections are so low? Maybe there is a mass conspiracy where I charge MUCH more for non insured patients. So I charge $200, but again only collect 20% so I get $400. Woohoo.
That is such a small fraction of income with all the hassles and overhead to call and try to collect that why would I bother?

Also, if overcharging self pay patients was so lucrative, why wouldn’t practices not just say they wanted self pay patients only? Does that appeal to common sense better?

The point of asking for a discount from your law firms was just to try to personalize what happens to healthcare providers when people ask us for a discount.

For us, the contract was determined as well as the rate. People don’t seem to ask for a negotiation with their monthly insurance premium but feel it is ok to ask for it on the service side.

Also, when you state about if law firms operated like medical firms we would be disbarred is not accurate and again, shows how little people understand about health insurance.

If your law firm was like a medical practice, there would be a middleman the insurance company. The client would pay a monthly premium to see lawyers and you would contract to the insurance company a premium to see these clients. The problem is the law group down the street negotiated a higher premium, but another lower. But the other problem is there isn’t just one insurance company. You have contracts with BCBS, Aetna, Medicare, etc..Not only that there are BCBS HMO BCBS PPO, BCBS high deductible plan etc..

To add to that problem, is that even if you have your contract, the insurance company can state a certain thing you did was not covered.
So when a client comes in and says “what will my bill be”…its hard to determine.

There is no dishonestly or non forthwrightness about fees it really just depends on what gets covered, which insurance carrier, and it can be hard to determine.

I would LOVE to go back to the old days like it is now in your law field. That is a straight forward fee for service. That is I charge a patient directly. I can tell them my fee like you do and tell them what the cost will be upfront. But medicine is not like that. I hope your conversations with medical providers, insurance companies and your personal experience help you to see the difference.

actually medicaid is the least expensive medical insurance…in general.

Also, Medicare doesn’t negotiate a rate. They just unilaterally state that they will pay X rate for X procedure, test, visit etc… and that is set for the year. Physicians and hospitals do get a chance to argue the rate but the decision is pretty unilateral. The sequester where all of healthcare took a automatic 2% cut across the board.

This unilateral rate determination is why some physicians are no longer taking medicare patients and doing “concierge care” as they feel that the payment is less than the cost of doing business.

Also, when you mentioned who it would effect..you forgot one, that is the patients. There will probably be a limit on test that can be ordered, procedures done, cancer therapies that extend life a couple months, cataract surgeries, MRIs etc….basically any expense test/procedures.

To reduce costs either someone needs to get less service or the service they get has to be less expensive. Less expensive means less money for the people who provide it.

So to say that healthcare is totally tied into employment here in the United States is absolutely untrue.

If you do feel its a right and justice to have everyone covered. I am fine with that. That would fix the problem of the original poster “negotiating” fees out of hard working physicians and increasing cost as it would come out of all of our pockets in a non-negotiatable tax. I think she will find that what she saved and thought was “overcharged” will be cheap once we have universal coverage.

If you think about the US system, if we pay universal care by tax, its going to cost us a lot more money that is only going to go up. The population is aging with less people in the work force to contribute. When the baby boomers hit Medicare and senior health issues those cost will sky rocket. Someone will have to pay…..so no more negotiating for Sumitha

A colleague of mine suggested this to me, but I don’t like giving out my main email address to businesses.

Healthcare tied to employment = injustice.

Great point about lifestyle deflation and finding little ways to cut some spending and make your money back.

If I’m at loose ends and just want to go *out* and don’t care where I go, then I’ll look around for a free activity or other great discount. I actually like doing this, as I’ve discovered new museums and other cool attractions in my city because I was just looking for something cheap to do!

Also, which store(s) do you shop at? I have loyalty cards for Giant and Harris Teeter.

I can appreciate that the article is trying to show a different view of lifestyle inflation, but unless you specifically state beforehand that that’s what you are trying to do, to try and pull it off as proper usage causes confusion and defeats the purpose of language as an effective tool for comprehension.

Of course lifestyle inflation is going to refer to the cost of your lifestyle; the word “inflation” by definition will refer to the rise in cost of something, and many things we do in life have costs, but that doesn’t make everything lifestyle inflation. It is universally understood that lifestyle inflation refers to a rise in cost caused by a change of lifestyle (that’s typically prompted by an increase in income). Just because the rise in your rent and health insurance happens to coincide with your increased income does not mean the two are connected…they didn’t go up BECAUSE you’re making more money; “correlation does not imply causation”.

I think what we can all take away from the article is “If it’s not fun, it’s probably not lifestyle inflation!”

Recently my personal e-mail got hacked and even though I don’t have a Facebook account I keep getting notifications of invitations, new postings, etc. from Facebook. I’m afraid I’m going to have to abandon that account. Is there anyway, without having an account, to contact Facebook and get this stopped?

So my spam has folders like:
Bed Bath & Beyond
Enterprise
…

And when I want to buy something, it’s one of the first places I check for discount codes. Just hop to the appropriate folder and check out the most recent messages. Usually the discount codes they send out by email are much better than the discount codes they publish on their sites.

For times when I have to give out my email for coupons and special offers, I give out my normal Gmail account and set up a filter to automatically label the email as coupon and archive it so I don’t even have to look at it. A useful trick is adding a plus sign to your email address to help with sorting. For example, you might use yournormalemail+coupons (at) example.com to sort your coupon emails. Most mailers will ignore the plus sign and anything after it, but you can still use it for creating filters.

But I’m not sure that all these deals really save money, I’m of the mind set that deals and the associated marketing tend to increase spending (but you end up feeling like you got a deal). All those coupons and birthday deals still require you to spend money. I don’t do loyalty cards and the like either, I have a personal beef with the whole system.

Rather, I decided long ago that I’d rather make my decisions on activities, vacations, eating out, etc. and then see if I can get a deal. If I can great, if I can’t oh well, I’ve made my spending decision, I have the money for it and I go on my merry way. To me, my strategy, is more mindful. There is a spot I’ve been wanting to check out, so when I see a Groupon for it, I’ll buy it, but the decision to check out the spot came first.

Right now, since I’m in So. Fla. lots of my favorite spots are running specials so I find myself getting these emails regularly and its a conundrum for me. My favorite spa is running some great 50% off specials this summer, but I had already decided to hit the spa when we take an upcoming trip (as it something I like to do on trips). I may be able to save money at my local spa, but I likely will gain more pleasure from hitting the spa while on vacation (and yes paying full price).

But I do find myself spending more time than I should weeding out the important emails, and I don’t sign up for many other loyalty programs simply to keep the clutter down. With a spam account I could sign up for all of them and actually save money.