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  1. #76
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    Mar 2006
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    Shouldn't the state medical board hear about this type of shit, or are they just as guilty?
    Apparently, the state medical board of Tennessee will only ask for $500 if you get caught banging your patients.
    No longer stuck.

    Quote Originally Posted by stuckathuntermtn View Post
    Just an uneducated guess.

  2. #77
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    Quote Originally Posted by stuckathuntermtn View Post
    Shouldn't the state medical board hear about this type of shit, or are they just as guilty?
    Apparently, the state medical board of Tennessee will only ask for $500 if you get caught banging your patients.
    Yes, medical board made up of... yep you guessed it, other doctors.




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  3. #78
    Join Date
    Dec 2005
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    1,738
    Quote Originally Posted by Peruvian View Post
    Maybe one of our Canadian counterparts with that commie health insurance could explain what to do.
    Do you mean pay exorbitant personal tax rates on everything and then pay extra for insurance you may use on the things not covered? Or hope your company or your spouses actually has a medical plan?
    what's orange and looks good on hippies?

    fire

    rails are for trains
    If I had a dollar for every time capitalism was blamed for problems caused by the government I'd be a rich fat film maker in a baseball hat.

  4. #79
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    Mar 2006
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    14,783
    Quote Originally Posted by Cono Este View Post
    I love how everyone just jumps on the insurance company that wasnít even there.

    Sounds like the fool that checked him in took his insurance, and did not check if his facility accepted it.

    Thatís on the them.

    Typically you sign an agreement to pay regardless of insurance outcome

  5. #80
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    Sep 2008
    Location
    NorCal
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    428
    let us know when you get their letter stating your coverage is dropped.

  6. #81
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    Sep 2010
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    Tejas
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    Quote Originally Posted by 4matic View Post
    Typically you sign an agreement to pay regardless of insurance outcome
    Which is always hysterical given that they refuse to tell you what anything may cost up front. What other industry gets to operate that way?!

    I've told this story multiple times around here, but it annoyed me so bad when my wife and I went into Bozeman Deaconess for a standard ultrasound for her pregnancy. They asked us to sign the agreement saying we were responsible for payment no matter what, so I asked a fair enough question: "Could you please tell us what the cost of a routine ultrasound might be?" Girl said "No, we don't have that information. You'll find out when you get the bill." So, how does a hospital not know how much their own services cost?! It's beyond me.

    Oh yeah, and the one and only radiology department INSIDE the damn hospital is somehow NOT affiliated with said hospital, and magically "out-of-network"? Please someone explain to me how this is legal for an industry to operate this way?

  7. #82
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    Mar 2006
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    Missoula, MT
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    Commoditized farming and ranching kinda works that way. That's why farmers are so fucked.
    Gee, hope the wheat price is high enough this year (this thing be changing my emojis. Wanted guy shrugging, turned it to girl shrugging and girl symbol. I think that's a different month.)
    No longer stuck.

    Quote Originally Posted by stuckathuntermtn View Post
    Just an uneducated guess.

  8. #83
    Join Date
    Jan 2009
    Location
    Park City
    Posts
    2,958
    Iíll probably regret this.

    The u has many doctors who work at IHC as well. At the U facility your copay is $5. If you go to an in network doc but not at a u facility itís a $30 copay. Same doc out of network is a deductible then 65% of the allowable charge.

    If you have written proof of in network and they directed you to the other facility you will not be held accountable but you will need to prove it and deal with the bullshit.


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    I rip the groomed on tele gear

  9. #84
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    Oct 2003
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    slc
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    Quote Originally Posted by AustinFromSA View Post
    Which is always hysterical given that they refuse to tell you what anything may cost up front. What other industry gets to operate that way?!

    I've told this story multiple times around here, but it annoyed me so bad when my wife and I went into Bozeman Deaconess for a standard ultrasound for her pregnancy. They asked us to sign the agreement saying we were responsible for payment no matter what, so I asked a fair enough question: "Could you please tell us what the cost of a routine ultrasound might be?" Girl said "No, we don't have that information. You'll find out when you get the bill." So, how does a hospital not know how much their own services cost?! It's beyond me.

    Oh yeah, and the one and only radiology department INSIDE the damn hospital is somehow NOT affiliated with said hospital, and magically "out-of-network"? Please someone explain to me how this is legal for an industry to operate this way?
    There's a word you're not fond of that can fix this kind of bullshit, it starts with an "R"....

  10. #85
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    Dec 2005
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    STL
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    Quote Originally Posted by 4matic View Post
    Typically you sign an agreement to pay regardless of insurance outcome
    Again, another example of bullshit provider practices. You pay no matter what, even if you get bullshit information.

    Always get a firm quote before you do anything. Being a health agent, providers staff hates me. I ask a million questions. And since I mostly pay out of pocket with my shitty Obamacare, I do the same with doctors. Last week this little ENT bitch was complaining that I was keeping him. No fuck you, Iím paying $250 on the way out to get my drivers license back, because your greedy staff thinks they can hold on to other peoples property.

    At least Iím not black. Would probably want cash upfront.


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  11. #86
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    Jan 2008
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    truckee
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    Quote Originally Posted by Cono Este View Post
    Doctors have no interest in how you pay, they just want to practice medicine. Ha, that’s a joke. They’ll send the bill collectors right after you.



    Sent from my iPhone using TGR Forums
    The dinosaurs yes. In California young doctors are beating down the doors trying to get into Kaiser Permanente so they can work for a salary and not deal with the business end of things. I think our acceptance rate is something like 1 doc in 10.

    Quote Originally Posted by Cono Este View Post
    Yes, medical board made up of... yep you guessed it, other doctors.




    Sent from my iPhone using TGR Forums
    I don't know about Utah but in CA the medical board has 6 docs out of 12

    Quote Originally Posted by AustinFromSA View Post
    Which is always hysterical given that they refuse to tell you what anything may cost up front. What other industry gets to operate that way?!

    I've told this story multiple times around here, but it annoyed me so bad when my wife and I went into Bozeman Deaconess for a standard ultrasound for her pregnancy. They asked us to sign the agreement saying we were responsible for payment no matter what, so I asked a fair enough question: "Could you please tell us what the cost of a routine ultrasound might be?" Girl said "No, we don't have that information. You'll find out when you get the bill." So, how does a hospital not know how much their own services cost?! It's beyond me.

    Oh yeah, and the one and only radiology department INSIDE the damn hospital is somehow NOT affiliated with said hospital, and magically "out-of-network"? Please someone explain to me how this is legal for an industry to operate this way?
    The reason the receptionist can't tell you what it will cost you is because everyone is paying something different--the negotiated rate is different, the copay is different, they don't know if you've reached your deductible, and they don't know how the visit will be coded. If you go into the hospital for an operation--inpatient or outpatient, they usually send you to the business office ahead of time to figure out the cost, but that takes a fair amount of figuring.
    They will usually have to check with your insurance company, and even then you will only get a base figure for an uncomplicated procedure. If you have to stay extra, if there are complications, it's more. Generally speaking, only Medicare pays a fixed rate for a hospitalization--based on the diagnosis and other patient factors.

    As far as non-network providers in a network hospital--in California the insurance company pays them the same rate as they pay network providers and the patient can only be billed the copay for a network provider. That should be the law everywhere. Congress has been looking at this at the federal level for a while--nothing signed yet. I don't think there's a final bill passed by both houses. I don't know the details.

  12. #87
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    I feel like all the extra staff needed to navigate this bullshit is one of the things driving health care costs.
    No longer stuck.

    Quote Originally Posted by stuckathuntermtn View Post
    Just an uneducated guess.

  13. #88
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    Sep 2010
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    Shuswap Highlands
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    Quote Originally Posted by stuckathuntermtn View Post
    I feel like all the extra staff needed to navigate this bullshit is one of the things driving health care costs.
    Ya think? Wage loading the bottom end of the business is how most companies are able to pay for their top staff, let alone padding of the profit margins of much larger institutions.

  14. #89
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    Mar 2006
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    Missoula, MT
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    And the $250,000 in student loans. Or however much.
    No longer stuck.

    Quote Originally Posted by stuckathuntermtn View Post
    Just an uneducated guess.

  15. #90
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    Jan 2008
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    truckee
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    The cost of processing bills is huge--at both ends: the provider and the insurer. There is enormous cost savings if everyone is on a prepaid plan like Kaiser with no fee for service. Any copays are collected upfront. Deductibles are still a problem with some individual plans--Kaiser didn't used to have these, and they require Kaiser to generate a bill. I don't have a problem with visit copays, but deductibles, besides increasing administrative costs discourage people from seeking care which defeats the purpose of a prepaid plan which incentivizes people to get preventative care and stay healthy.

  16. #91
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    Sep 2004
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    champlain valley
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    4,892
    Quote Originally Posted by old goat View Post
    The way the EMR works a lot of stuff gets autopopulated, some of which is inaccurate, and most docs don't check everything their name is under.
    from the systems I know, the above would have to be incorporated in the build. ultimately that is on the hospital doing the install.

    a doctor faking entries in an emr is hard to believe. I guess it happens, it's something I take at face value that it doesn't happen

  17. #92
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    Jan 2008
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    truckee
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    Quote Originally Posted by DBdude View Post
    from the systems I know, the above would have to be incorporated in the build. ultimately that is on the hospital doing the install.

    a doctor faking entries in an emr is hard to believe. I guess it happens, it's something I take at face value that it doesn't happen
    Our hospital uses epic. Most hospital docs use daily visit note templates which are autopopulated all the previous diagnoses, problems, and imaging. These notes have huge amounts of data which repeats every day and due to their length are very difficult for the responsible doc to review. Admitting diagnoses which are subsequently ruled out continue to be propagated in the daily notes and often in the discharge summary and diagnoses--because no one bothered to delete them. Easy for a biller to base a code on such inaccurate information. (Another thing that happens is that the note is autopopulated with the daily labs but the doc who "wrote" the note doesn't look at it and fails to notice a dangerous lab value--I saw this happen with a potentially lethal potassium value. Docs are trained to complete the EMR but not to use it effectively as a clinical and communication tool. It's been coopted by the business office and lawyers for their purposes.)

    As far as entering false data--a doc can obviously do this deliberately and with the intent to defraud or they have a template for a normal history and physical which includes negative findings for all 12 organ systems. They use their template, change the findings for the musculoskeletal system to describe the sprained ankle, but don't bother to delete all the negative findings from systems they didn't examine.

    I used to get calls from coders asking me if I could add such and such to my discharge summary so they could charge a higher diagnosis. Sometimes the request was appropriate, sometimes not. Of course these folks have no medical training and they're under a lot of pressure not to miss an opportunity to upcode.

    I appreciate your faith in the integrity of the docs you worked with and it may very well be deserved but I have encountered enough shady practice to view the integrity of fee-for-service docs with a degree of skepticism.

  18. #93
    Join Date
    Nov 2005
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    Land of Brine Shrimp and Magic Underwear
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    5,882
    Dude, get Gephardt, seriously!

    https://kutv.com/news/get-gephardt/n...ll-or-email-us

    I work at the U and itís said a lot that they have a very low threshold for settling things out of court. Hope you fuck them good.
    There's nothing better than sliding down snow... flying through the air.

  19. #94
    Join Date
    Aug 2007
    Posts
    5,328
    I got a concussion and memory loss on top of Guardsman pass once, and the ambulance was going to a non-network hospital. I said it's out of network, medic said no, it's in your network, don't worry. I fuzzily said OK. Bu it was out of network and the ride to the non-network hospital in Murray was very long and very expensive because of how long it was. I called up the manager of the ambulance service and complained, he was nice and gave me a 'poor man's discount' but said technically they have to go to the closest hospital, not the in-network one the patient prefers. Fuuuuck, really?

    Hope this story helps someone else in the same situation...

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