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AOII Angel 12-29-2009 09:06 AM

Quote:

Originally Posted by AXiDTrish (Post 1878962)
I must say, I LOVE this thread. Kevin, AOII Angel, KSig....your discussion has been very interesting!!

Not that I want to bring this up and interrupt, but...



Doctor's absolutely have the right the collect money that is owed to them and should! It's when balance billing takes place or collector's balance bill on a doctor's behalf that is the problem. Ex: A doctor bills $100 for a procedure and their negotiated rate based on their contract is to receive payment of $75 whether from an insurance company or through a members/patients copay, coinsurance, deductible or a combo of all three. The doctor, by signing a contract (and they don't have to) has agreed to write off the other $25. Balance billing is when they bill the member for the additional $25 making them in breach (sp?) of their contract. Many times that ends up in a collections agency's queue. I'm working a scenario right now where the doctor closed their practice and sold all their accounts to a collector. The collector going after a member for a claim from three years ago that they paid correctly according to their benefits! The collector doesn't care that the member has paid everything they are supposed to and the provider is in breach of contract. All they care is that they get a cut of any money they collect at the expense of a member/patient. It's infuriating and unfair. Balance billing is very, very common. Sometimes it's due to a simple A/R mistake, sometimes inexperienced billers, sometimes intentional.

I agree...That is wrong.

AOII Angel 12-29-2009 09:15 AM

Quote:

Originally Posted by KSig RC (Post 1878937)
And, to bring this back to the health care bill . . . Congress apparently does not address this issue, or the others we've discussed, in the slightest. Medical malpractice is barely touched at all, from what I've read. So, apparently, we're going to "reform" health care and get it to everyone, for cheaper, with better service, without addressing any of these fundamental issues. Pardon me if I'm skeptical.

I'm skeptical, too. I wish there was a way to reform the system that could bring in common sense allowing for experts to evaluate a case fairly, tease out the uninvolved parties without any of the "Good Ole Boy" network getting in the way. There are so many physicians who are scared of their own shadows because of thoughts of suits. I'm a lot more practical, but then again, I've never been afraid of making a decision. In some areas, radiologists won't read mammograms because everyone thinks you get sued all the time. I've been reading them for three years (and knock on wood, haven't been sued yet) but it's only a matter of time before it happens. It's a part of practicing. I think that we just don't trust that when the case goes to court that it can be evaluated scientifically instead of emotionally.


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