TWR Posted October 30, 2017 Share Posted October 30, 2017 My ex in NY told me her 96 y/o mom was in hospital and the following scenario took place. I am livid over this. Any ideas for recourse? I told them not to pay. The last sentence is true and we know it those of us that work in it. Her insurance ran out so she had to pay close to $2000.00 for a Dr Patel to come into her room 11 times to see how she was doing. Never once hands on, just came in to ask her a few questions. Eating?? Sleeping?? going to the bathroom?? any pain?? Yes, yes. yes,No!! I was there. $250.00 a visit for less than 5 minutes. The health system SUCKS!!! Link to comment Share on other sites More sharing options...
Maynard Posted October 31, 2017 Share Posted October 31, 2017 If Dr. Patel did in fact charge 250 bucks just for a five minute visit without doing any of the other things hospitalists do -- ordering/interpreting labs and imaging, consulting specialists, talking to nurses, writing notes, looking up literature -- then you would be right to be outraged. Link to comment Share on other sites More sharing options...
Guest ral Posted October 31, 2017 Share Posted October 31, 2017 I guess I look at it differently than some. What we know far exceeds what we do. Did the doctor review morning labs, rad reports, vital signs, consultant notes, before coming into the room? Did he put any thought into his orders, balancing the risk vs benefit of using an antibiotic that might result in the possibility of an extended stay due to c-diff colitis, or maybe serotonin syndrome because the ortho decided to prescribe tramadol for pain, and wasn't aware of the interaction with Zyvox? Is he a hospitalist, or did he come in to see his personal patients before heading to the office? Did he get woken up on the hour throughout the night, because the nurse was worried about Mrs. White's temp of 99.1, and did he want to do anything about Mr. Jones' rash on his left thumb? Did he just come from seeing Mr. Brown, who likely would have done just as well, or better being treated at home but, was admitted because he is over the age of 65, and admin has been on the ER staff's asses about finding a reason to admit anything that comes in, because revenues are down 1% from this same time last year? Did he pay malpractice premiums this year? Did he spend twelve years in school, missing family get togethers, birthdays, weddings, while amassing a butt load of financial debt? Does he risk taking the heat for many problems that were either created by those he serves, or pre-destined to occur regardless of his best efforts? Is he slowly becoming part of a corporate or government owned entity, that is forcing him to cram a day and half's work into ten hours? Does he typically get less respect for saving lives than the "sandwich artist" who prepared his six inch cold cut combo at the local Subway at lunch today? I don't know....can we really define "over paid" in this business? I have a brother in law (who is one of the coolest guys I know) who flies around the country selling software, or business forms, or who knows what, for a mere half million a year in base salary. His bonuses typically double that by my estimation. Doesn't get cussed out, spat at, coughed on, shit on, vomited on, or told that he is going to get sued every day by some toothless meth head. Link to comment Share on other sites More sharing options...
TWR Posted October 31, 2017 Author Share Posted October 31, 2017 She was hospitalized for a hip fracture that required a couple of pins. That was 2 months ago and home now and walking without a walker most of the time. Link to comment Share on other sites More sharing options...
thinkertdm Posted October 31, 2017 Share Posted October 31, 2017 1. Yes, health system sucks. We all agree. 2. I'm not sure how much your ex knows, but from an outsiders point of view, all we do is ask a few questions, but the patients don't pay much attention while someone else is footing the bill (eg insurance). However, as pointed out above, we bill for medical decision making, which is often not apparent to people watching- and to people who "know" what they have it can be frustrating, such as a 70 year old with 15 pound weight gain, dyspnea, orthopnea, rales, who comes to a walk in for a "cold". 3. Since we are being paid for the "medical decision making", each decision needs to be justified. No reason for it? Shouldn't order it. 4. Billing is based on contracts between the insurance companies and the hospital. Uninsured can still disagree over a bill, but would need to involve a discussion with the billing department and perhaps a lawyer. I don't know, I'm guessing on all of this. Link to comment Share on other sites More sharing options...
CAAdmission Posted October 31, 2017 Share Posted October 31, 2017 Pull her records. If he documented a physical exam and didn't do one, you might wish to point out his "oversight." Link to comment Share on other sites More sharing options...
Boatswain2PA Posted October 31, 2017 Share Posted October 31, 2017 Our health system is terrific. People come here from all over the world for the best medical care in the world. Our payment system sucks, mostly because everyone wants the best medical care in the world....at no cost to themselves. Lots wrong with the story. Why does a 96 year old "lose insurance"? If she lost private insurance, then she should have applied for medicare and it would have paid retroactively for 90 days. $2K for a 11 days of hospitalist coverage? I wouldn't complain about that, see Ral's comments above. Link to comment Share on other sites More sharing options...
Cideous Posted November 1, 2017 Share Posted November 1, 2017 On 10/31/2017 at 10:30 AM, Boatswain2PA said: Our health system is terrific. People come here from all over the world for the best medical care in the world. Our payment system sucks, mostly because everyone wants the best medical care in the world....at no cost to themselves. Lots wrong with the story. Why does a 96 year old "lose insurance"? If she lost private insurance, then she should have applied for medicare and it would have paid retroactively for 90 days. $2K for a 11 days of hospitalist coverage? I wouldn't complain about that, see Ral's comments above. Our Healthcare system is terrific? LOL ah no. Not even close.... -Our system sucks for anyone that doesn't have a Cadillac ins plan -Our system sucks unless you live in a medical region, there is NO parity for most of the country. -We are all ONE serious illness from medical bankruptcy thanks to our pay to play system. -The corporatization of our clinics, specialty groups and even hospitals now has made profit king. Not to mention the soulless price of drugs in this country. I see it every day and it severely degrades patient care and outcomes in the name of quarterly profit reports to investors. And btw, more US citizens now leave the US for health and dental care then come in. That is also a fact. Link to comment Share on other sites More sharing options...
camoman1234 Posted November 1, 2017 Share Posted November 1, 2017 On 10/31/2017 at 10:30 AM, Boatswain2PA said: Our health system is terrific. People come here from all over the world for the best medical care in the world. Our payment system sucks, mostly because everyone wants the best medical care in the world....at no cost to themselves. Lots wrong with the story. Why does a 96 year old "lose insurance"? If she lost private insurance, then she should have applied for medicare and it would have paid retroactively for 90 days. $2K for a 11 days of hospitalist coverage? I wouldn't complain about that, see Ral's comments above. Lots of "older" people in my area cannot get medicare cause they never "worked" (i.e. family farm). I can give you a list of people that are "old" or "medicare age" that do not qualify for medicare...There is a entire list of what qualifies which everyone can look up but seriously I have a lot of farmers that do not qualify for it or they have to pay the $411 premium per month while they make $600-800/month... Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted November 1, 2017 Share Posted November 1, 2017 I thought everyone qualified for Medicare at age 65 and that everyone on it has a premium contribution.Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
HmTwoPA Posted November 1, 2017 Share Posted November 1, 2017 1 hour ago, Cideous said: Our Healthcare system is terrific? LOL ah no. Not even close.... -Our system sucks for anyone that doesn't have a Cadillac ins plan -Our system sucks unless you live in a medical region, there is NO parity for most of the country. -We are all ONE serious illness from medical bankruptcy thanks to our pay to play system. -The corporatization of our clinics, specialty groups and even hospitals now has made profit king. Not to mention the soulless price of drugs in this country. I see it every day and it severely degrades patient care and outcomes in the name of quarterly profit reports to investors. And btw, more US citizens now leave the US for health and dental care then come in. That is also a fact. I think what he was trying to say is we have the best medical advancements and up to date practices in the world. People do come here for a lot of procedures that are cutting edge. America kind of bankrolls medical developments for the rest of the world. Other governments like Canada limit the price of drugs and in turn drug companies limit the amount of drugs available in Canada. This thread isn't really the place for a discussion about this though, as there are other countless threads on this forum that dives into it. Link to comment Share on other sites More sharing options...
d2305 Posted November 1, 2017 Share Posted November 1, 2017 I've had several patients that were over 65 and no medicare. Link to comment Share on other sites More sharing options...
TWR Posted November 2, 2017 Author Share Posted November 2, 2017 Get me out of this mess, Not everyone does qualify. Learn something new every day don't we? Link to comment Share on other sites More sharing options...
LKPAC Posted November 2, 2017 Share Posted November 2, 2017 22 hours ago, Cideous said: Our Healthcare system is terrific? LOL ah no. Not even close.... -Our system sucks for anyone that doesn't have a Cadillac ins plan -Our system sucks unless you live in a medical region, there is NO parity for most of the country. -We are all ONE serious illness from medical bankruptcy thanks to our pay to play system. -The corporatization of our clinics, specialty groups and even hospitals now has made profit king. Not to mention the soulless price of drugs in this country. I see it every day and it severely degrades patient care and outcomes in the name of quarterly profit reports to investors. And btw, more US citizens now leave the US for health and dental care then come in. That is also a fact. Most of what you describe is not a problem with the health care system, but rather a problem with the way health care is paid for. IMO, too many people want Cadillacs, they just want someone else to pay for them! Link to comment Share on other sites More sharing options...
sas5814 Posted November 2, 2017 Share Posted November 2, 2017 23 hours ago, GetMeOuttaThisMess said: I thought everyone qualified for Medicare at age 65 and that everyone on it has a premium contribution. Sent from my iPad using Tapatalk You have to pay into Medicare to get it when the time comes. There was an exemption to contributing to Social Security and Medicare (I don't know if it still exists) we used to call "teachers and preachers" and certain professions were not required to contribute. I have had a few nursing home patients over the years who were usung that exemption and had neither when it came retirement time. Link to comment Share on other sites More sharing options...
camoman1234 Posted November 2, 2017 Share Posted November 2, 2017 23 hours ago, GetMeOuttaThisMess said: I thought everyone qualified for Medicare at age 65 and that everyone on it has a premium contribution. Sent from my iPad using Tapatalk Nope it has to be paid into and in a farming community it is quite common for older people to not have medicare. I probably have more 30-40 year old's on medicaid and medicare than > 65+. Some of it is for MR disability, but lots of people in rural communities know how to get onto these programs including getting energy assistance, food stamps, etc... I see it almost everyday in my practice and it is mind blowing... Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 2, 2017 Moderator Share Posted November 2, 2017 refuse to pay it contest the debt when it goes to collections as being invalid offer them $250 to settle the whole thing NEVER sign anything that transfers the liability to another family member let them come after the estate after the fact Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted November 2, 2017 Share Posted November 2, 2017 Straight from the Medicare horse's mouth (again, this is Part A only, or hospitalization): Who can get Medicare? Medicare Part A (hospital insurance) People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A. You’re eligible for “Part A” at no cost at age 65 if: You receive or are eligible to receive Social Security bene ts; or You receive or are eligible to receive railroad retirement bene ts; or Your spouse (living or deceased, including divorced spouses) receives or is eligible to receive Social Security or railroad retirement bene ts; or You or your spouse worked long enough in a government job through which you paid Medicare taxes; or You are the dependent parent of a fully insured deceased child. If you don’t meet these requirements, you may be able to get Medicare Part A by paying a monthly premium. Usually, you can purchase this coverage only during designated enrollment periods. Part B (for those who may not know) is what the majority of providers are concerned about which is office/clinic based care. There is a premium charge for this and this is typically what the supplemental coverages from private insurers cover. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.